Search results for: activated partial thromboplastin time

Authors: Jacqueline Eleonora Ek, Michael Spiteri, Chris Giordimaina, Pierre Agius

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Background: Malta is known for being a key player as a frontline country with regard to irregular immigration from Africa to Europe. Every year the island experiences an influx of migrants as boat movement across the Mediterranean continues to be a humanitarian challenge. Irregular immigration and applying for asylum is both a lengthy and mentally demanding process. Those doing so are often faced with multiple challenges, which can adversely affect their mental health. Between January and August 2020, Malta disembarked 2 162 people rescued at sea, 463 of them between July & August. Given the small size of the Maltese islands, this regulation places a disproportionately large burden on the country, creating a backlog in the processing of asylum applications resulting in increased time periods of detention. These delays reverberate throughout multiple management pathways resulting in prolonged periods of detention and challenging access to health services. Objectives: To better understand the spatial dimensions of this humanitarian crisis, this study aims to assess disparities in the acute medical management of migrants presenting to the emergency department (ED) with acute mental health presentations as compared to that of local and non-local residents. Method: In this retrospective study, 17795 consecutive ED attendances were reviewed to look for acute mental health presentations. These were further evaluated to assess discrepancies in transportation routes to hospital, nature of presenting complaint, effects of language barriers, use of CT brain, treatment given at ED, availability of psychiatric reviews, and final admission/discharge plans. Results: Of the ED attendances, 92.3% were local residents, and 7.7% were non-locals. Of the non-locals, 13.8% were migrants, and 86.2% were other-non-locals. Acute mental health presentations were seen in 1% of local residents; this increased to 20.6% in migrants. 56.4% of migrants attended with deliberate self-harm; this was lower in local residents, 28.9%. Contrastingly, in local residents, the most common presenting complaint was suicidal thought/ low mood 37.3%, the incidence was similar in migrants at 33.3%. The main differences included 12.8% of migrants presenting with refused oral intake while only 0.6% of local residents presented with the same complaints. 7.7% of migrants presented with a reduced level of consciousness, no local residents presented with this same issue. Physicians documented a language barrier in 74.4% of migrants. 25.6% were noted to be completely uncommunicative. Further investigations included the use of a CT scan in 12% of local residents and in 35.9% of migrants. The most common treatment administered to migrants was supportive fluids 15.4%, the most common in local residents was benzodiazepines 15.1%. Voluntary psychiatric admissions were seen in 33.3% of migrants and 24.7% of locals. Involuntary admissions were seen in 23% of migrants and 13.3% of locals. Conclusion: Results showed multiple disparities in health management. A meeting was held between entities responsible for migrant health in Malta, including the emergency department, primary health care, migrant detention services, and Malta Red Cross. Currently, national quality-improvement initiatives are underway to form new pathways to improve patient-centered care. These include an interpreter unit, centralized handover sheets, and a dedicated migrant health service.

Keywords: emergency department, communication, health, migration

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Authors: Andrew Laming, John Hattie, Mark Wilson

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Nine Queensland Independent high schools provided deidentified student-matched ATAR and NAPLAN data for all 1217 ATAR graduates since 2020 who also sat NAPLAN at the school. Graduating cohorts from the nine schools contained a mean 100 ATAR graduates with previous NAPLAN data from their school. Excluded were vocational students (mean=27) and any ATAR graduates without NAPLAN data (mean=20). Based on Index of Community Socio-Educational Access (ICSEA) prediction, all schools had larger that predicted proportions of their students graduating with ATARs. There were an additional 173 students not releasing their ATARs to their school (14%), requiring this data to be inferred by schools. Gain was established by first converting each student’s strongest NAPLAN domain to a statewide percentile, then subtracting this result from final ATAR. The resulting ‘percentile shift’ was corrected for plausible ATAR participation at each NAPLAN level. Strongest NAPLAN domain had the highest correlation with ATAR (R2=0.58). RESULTS School mean NAPLAN scores fitted ICSEA closely (R2=0.97). Schools achieved a mean cohort gain of two ATAR rankings, but only 66% of students gained. This ranged from 46% of top-NAPLAN decile students gaining, rising to 75% achieving gains outside the top decile. The 54% of top-decile students whose ATAR fell short of prediction lost a mean 4.0 percentiles (or 6.2 percentiles prior to correction for regression to the mean). 71% of students in smaller schools gained, compared to 63% in larger schools. NAPLAN variability in each of the 13 ICSEA1100 cohorts was 17%, with both intra-school and inter-school variation of these values extremely low (0.3% to 1.8%). Mean ATAR change between years in each school was just 1.1 ATAR ranks. This suggests consecutive school cohorts and ICSEA-similar schools share very similar distributions and outcomes over time. Quantile analysis of the NAPLAN/ATAR revealed heteroscedasticity, but splines offered little additional benefit over simple linear regression. The NAPLAN/ATAR R2 was 0.33. DISCUSSION Standardised data like NAPLAN and ATAR offer educators a simple no-cost progression metric to analyse performance in conjunction with their internal test results. Change is expressed in percentiles, or ATAR shift per student, which is layperson intuitive. Findings may also reduce ATAR/vocational stream mismatch, reveal proportions of cohorts meeting or falling short of expectation and demonstrate by how much. Finally, ‘crashed’ ATARs well below expectation are revealed, which schools can reasonably work to minimise. The percentile shift method is neither value-add nor a growth percentile. In the absence of exit NAPLAN testing, this metric is unable to discriminate academic gain from legitimate ATAR-maximizing strategies. But by controlling for ICSEA, ATAR proportion variation and student mobility, it uncovers progression to ATAR metrics which are not currently publicly available. However achieved, ATAR maximisation is a sought-after private good. So long as standardised nationwide data is available, this analysis offers useful analytics for educators and reasonable predictivity when counselling subsequent cohorts about their ATAR prospects.  

Keywords: NAPLAN, ATAR, analytics, measurement, gain, performance, data, percentile, value-added, high school, numeracy, reading comprehension, variability, regression to the mean

Procedia PDF Downloads 67

Authors: Sara Mosteller, Larissa K. Samuelson, Sobanawartiny Wijeakumar, John P. Spencer

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This study was designed to examine how humans are able to teach and learn semantic information as well as cooperate in order to jointly achieve sophisticated goals. Specifically, we are measuring individual differences in how these abilities develop from foundational building blocks in early childhood. The current study adopts a paradigm for novel noun learning developed by Samuelson, Smith, Perry, and Spencer (2011) to a hyperscanning paradigm [Cui, Bryant and Reiss, 2012]. This project measures coordinated brain activity between a parent and child using simultaneous functional near infrared spectroscopy (fNIRS) in pairs of 2.5, 3.5 and 4.5-year-old children and their parents. We are also separately testing pairs of adult friends. Children and parents, or adult friends, are seated across from one another at a table. The parent (in the developmental study) then teaches their child the names of novel toys. An experimenter then tests the child by presenting the objects in pairs and asking the child to retrieve one object by name. Children are asked to choose from both pairs of familiar objects and pairs of novel objects. In order to explore individual differences in cooperation with the same participants, each dyad plays a cooperative game of Jenga, in which their joint score is based on how many blocks they can remove from the tower as a team. A preliminary analysis of the noun-learning task showed that, when presented with 6 word-object mappings, children learned an average of 3 new words (50%) and that the number of objects learned by each child ranged from 2-4. Adults initially learned all of the new words but were variable in their later retention of the mappings, which ranged from 50-100%. We are currently examining differences in cooperative behavior during the Jenga playing game, including time spent discussing each move before it is made. Ongoing analyses are examining the social dynamics that might underlie the differences between words that were successfully learned and unlearned words for each dyad, as well as the developmental differences observed in the study. Additionally, the Jenga game is being used to better understand individual and developmental differences in social coordination during a cooperative task. At a behavioral level, the analysis maps periods of joint visual attention between participants during the word learning and the Jenga game, using head-mounted eye trackers to assess each participant’s first-person viewpoint during the session. We are also analyzing the coherence in brain activity between participants during novel word-learning and Jenga playing. The first hypothesis is that visual joint attention during the session will be positively correlated with both the number of words learned and with the number of blocks moved during Jenga before the tower falls. The next hypothesis is that successful communication of new words and success in the game will each be positively correlated with synchronized brain activity between the parent and child/the adult friends in cortical regions underlying social cognition, semantic processing, and visual processing. This study probes both the neural and behavioral mechanisms of learning and cooperation in a naturalistic, interactive and developmental context.

Keywords: communication, cooperation, development, interaction, neuroscience

Procedia PDF Downloads 251

Authors: Ashok Kumar Lonavath, V. Sathish Kumar

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Urban sprawl is the uncontrolled and uncoordinated outgrowth of towns and cities. The process of urban sprawl can be described by change in pattern over time, like proportional increase in built-up surface to population leading to rapid urban spatial expansion. Significant economic and livelihood opportunities in the urban areas results in lack of basic amenities due to the unplanned growth The patterns, processes, dynamic causes and consequences of sprawl can be explored and designed with the help of spatial planning support system. In India context the urban area is defined as the population more than 5000, density more than 400 persons per sq. km and 75% of the population is involved in non-agricultural occupations. India’s urban population is increasing at the rate of 2.35% pa. The class I town’s population of India according to 2011 census is 18.8% that accounts for 60.4% of total unban population. Similarly in Erstwhile Andhra Pradesh it is 22.9% which accounts for 68.8% of total urban population. Suryapet town has historical recognition as ‘Gate Way of Telangana’ in the Indian State of Andhra Pradesh. The Municipality was constituted in 1952 as Grade-III, later upgraded into Grade-II in 1984 and to Grade-I in 1998. The area is 35 Sq.kms. Three major tanks located in three different directions and Musi River is flowing from a distance of 8 kms. The average ground water table is about 50m below ground. It is a fast growing town with a population of 1, 06,805 and 25,448 households. Density is 3051pp sq km, It is a Class I city as per population census. It secured the ISO 14001-2004 certificate for establishing and maintaining an environment-friendly system for solid waste disposal. It is the first municipality in the country to receive such a certificate. It won HUDCO award under environment management, award of appreciation and cash from Ministry of Housing and Poverty Elevation from Government of India and undivided Andhra Pradesh under UN Human Settlement Programme, Greentech Excellance award, Supreme Courts appreciation for solid waste management. Foreign delegates from different countries and also from various other states of India visited Suryapet municipality for study tour and training programs as part of their official visit Suryapet is located at 17°5’ North Latitude and 79°37’ East Longitude. The average elevation is 266m, annual mean temperature is 36°C and average rainfall is 821.0 mm. The people of this town are engaged in Commercial and agriculture activities hence the town has become a centre for marketing and stocking agricultural produce. It is also educational centre in this region. The present paper on urban sprawl is a theoretical framework to analyze the interaction of planning and governance on the extent of outgrowth and level of services. The GIS techniques, SOI Toposheet, satellite imageries and image analysis techniques are extensively used to explore the sprawl and measure the urban land-use. This paper concludes outlining the challenges in addressing urban sprawl while ensuring adequate level of services that planning and governance have to ensure towards achieving sustainable urbanization.

Keywords: remote sensing, GIS, urban sprawl, urbanization

Procedia PDF Downloads 228

Authors: Alena Nesterenko, Svetlana Petrikova

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Research evaluation is one of the most important elements of self-regulation and development of researchers as it is impartial and independent process of assessment. The method of expert evaluations as a scientific instrument solving complicated non-formalized problems is firstly a scientifically sound way to conduct the assessment which maximum effectiveness of work at every step and secondly the usage of quantitative methods for evaluation, assessment of expert opinion and collective processing of the results. These two features distinguish the method of expert evaluations from long-known expertise widespread in many areas of knowledge. Different typical problems require different types of expert evaluations methods. Several issues which arise with these methods are experts’ selection, management of assessment procedure, proceeding of the results and remuneration for the experts. To address these issues an on-line system was created with the primary purpose of development of a versatile application for many workgroups with matching approaches to scientific work management. Online documentation assessment and statistics system allows: - To realize within one platform independent activities of different workgroups (e.g. expert officers, managers). - To establish different workspaces for corresponding workgroups where custom users database can be created according to particular needs. - To form for each workgroup required output documents. - To configure information gathering for each workgroup (forms of assessment, tests, inventories). - To create and operate personal databases of remote users. - To set up automatic notification through e-mail. The next stage is development of quantitative and qualitative criteria to form a database of experts. The inventory was made so that the experts may not only submit their personal data, place of work and scientific degree but also keywords according to their expertise, academic interests, ORCID, Researcher ID, SPIN-code RSCI, Scopus AuthorID, knowledge of languages, primary scientific publications. For each project, competition assessments are processed in accordance to ordering party demands in forms of apprised inventories, commentaries (50-250 characters) and overall review (1500 characters) in which expert states the absence of conflict of interest. Evaluation is conducted as follows: as applications are added to database expert officer selects experts, generally, two persons per application. Experts are selected according to the keywords; this method proved to be good unlike the OECD classifier. The last stage: the choice of the experts is approved by the supervisor, the e-mails are sent to the experts with invitation to assess the project. An expert supervisor is controlling experts writing reports for all formalities to be in place (time-frame, propriety, correspondence). If the difference in assessment exceeds four points, the third evaluation is appointed. As the expert finishes work on his expert opinion, system shows contract marked ‘new’, managers commence with the contract and the expert gets e-mail that the contract is formed and ready to be signed. All formalities are concluded and the expert gets remuneration for his work. The specificity of interaction of the examination officer with other experts will be presented in the report.

Keywords: expertise, management of research evaluation, method of expert evaluations, research evaluation

Procedia PDF Downloads 204

Authors: P. J. Sweeney, T. Ahtoniemi, J. Puoliväli, T. Laitinen, K. Lehtimäki, A. Nurmi, D. Wells

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Duchenne muscular dystrophy (DMD) is caused by an X linked mutation in the dystrophin gene; lack of dystrophin causes a progressive muscle necrosis which leads to a progressive decrease in mobility in those suffering from the disease. The MDX mouse, a mutant mouse model which displays a frank dystrophinopathy, is currently widely employed in pre clinical efficacy models for treatments and therapies aimed at DMD. In general the end-points examined within this model have been based on invasive histopathology of muscles and serum biochemical measures like measurement of serum creatine kinase (sCK). It is established that a “critical period” between 4 and 6 weeks exists in the MDX mouse when there is extensive muscle damage that is largely sub clinical but evident with sCK measurements and histopathological staining. However, a full characterization of the MDX model remains largely incomplete especially with respect to the ability to aggravate of the muscle damage beyond the critical period. The purpose of this study was to attempt to aggravate the muscle damage in the MDX mouse and to create a wider, more readily translatable and discernible, therapeutic window for the testing of potential therapies for DMD. The study consisted of subjecting 15 male mutant MDX mice and 15 male wild-type mice to an intense chronic exercise regime that consisted of bi-weekly (two times per week) treadmill sessions over a 12 month period. Each session was 30 minutes in duration and the treadmill speed was gradually built up to 14m/min for the entire session. Baseline plasma creatine kinase (pCK), treadmill training performance and locomotor activity were measured after the “critical period” at around 10 weeks of age and again at 14 weeks of age, 6 months, 9 months and 12 months of age. In addition, kinematic gait analysis was employed using a novel analysis algorithm in order to compare changes in gait and fine motor skills in diseased exercised MDX mice compared to exercised wild type mice and non exercised MDX mice. In addition, a morphological and metabolic profile (including lipid profile), from the muscles most severely affected, the gastrocnemius muscle and the tibialis anterior muscle, was also measured at the same time intervals. Results indicate that by aggravating or exacerbating the underlying muscle damage in the MDX mouse by exercise a more pronounced and severe phenotype in comes to light and this can be picked up earlier by kinematic gait analysis. A reduction in mobility as measured by open field is not apparent at younger ages nor during the critical period, but changes in gait are apparent in the mutant MDX mice. These gait changes coincide with pronounced morphological and metabolic changes by non-invasive anatomical MRI and proton spectroscopy (1H-MRS) we have reported elsewhere. Evidence of a progressive asymmetric pathology in imaging parameters as well as in the kinematic gait analysis was found. Taken together, the data show that chronic exercise regime exacerbates the muscle damage beyond the critical period and the ability to measure through non-invasive means are important factors to consider when performing preclinical efficacy studies in the MDX mouse.

Keywords: Gait, muscular dystrophy, Kinematic analysis, neuromuscular disease

Procedia PDF Downloads 275

Authors: Anubhav Kumar Dwivedi, Arshad Khan, S. N. Tripathi, Manish Joshi, Gaurav Mishra, Dinesh Nath, Naveen Tiwari, B. K. Sapra

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In a nuclear reactor accident scenario, a large number of fission products may release to the piping system of the primary heat transport. The released fission products, mostly in the form of the aerosol, get deposited on the inner surface of the piping system mainly due to gravitational settling and thermophoretic deposition. The removal processes in the complex piping system are controlled to a large extent by the thermal-hydraulic conditions like temperature, pressure, and flow rates. These parameters generally vary with time and therefore must be carefully monitored to predict the aerosol behavior in the piping system. The removal process of aerosol depends on the size of particles that determines how many particles get deposit or travel across the bends and reach to the other end of the piping system. The released aerosol gets deposited onto the inner surface of the piping system by various mechanisms like gravitational settling, Brownian diffusion, thermophoretic deposition, and by other deposition mechanisms. To quantify the correct estimate of deposition, the identification and understanding of the aforementioned deposition mechanisms are of great importance. These mechanisms are significantly affected by different flow and thermodynamic conditions. Thermophoresis also plays a significant role in particle deposition. In the present study, a series of experiments were performed in the piping system of the National Aerosol Test Facility (NATF), BARC using metal aerosols (zinc) in dry environments to study the spatial distribution of particles mass and number concentration, and their depletion due to various removal mechanisms in the piping system. The experiments were performed at two different carrier gas flow rates. The commercial CFD software FLUENT is used to determine the distribution of temperature, velocity, pressure, and turbulence quantities in the piping system. In addition to the in-built models for turbulence, heat transfer and flow in the commercial CFD code (FLUENT), a new sub-model PBM (population balance model) is used to describe the coagulation process and to compute the number concentration along with the size distribution at different sections of the piping. In the sub-model coagulation kernels are incorporated through user-defined function (UDF). The experimental results are compared with the CFD modeled results. It is found that most of the Zn particles (more than 35 %) deposit near the inlet of the plenum chamber and a low deposition is obtained in piping sections. The MMAD decreases along the length of the test assembly, which shows that large particles get deposited or removed in the course of flow, and only fine particles travel to the end of the piping system. The effect of a bend is also observed, and it is found that the relative loss in mass concentration at bends is more in case of a high flow rate. The simulation results show that the thermophoresis and depositional effects are more dominating for the small and larger sizes as compared to the intermediate particles size. Both SEM and XRD analysis of the collected samples show the samples are highly agglomerated non-spherical and composed mainly of ZnO. The coupled model framed in this work could be used as an important tool for predicting size distribution and concentration of some other aerosol released during a reactor accident scenario.

Keywords: aerosol, CFD, deposition, coagulation

Procedia PDF Downloads 142

Authors: Michael Josef Schwerer, Oliver Peschel

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Background: The sense and purpose of forensic postmortem examinations are undoubtedly the same in Institutes of Legal Medicine all over the world. Cause and manner of death must be determined, persons responsible for unnatural death must be brought to justice, and accidents demand changes in the respective scenarios to avoid future mishaps. The latter particularly concerns aircraft accidents, not only regarding consequences from criminal or civil law but also in pursuance of the International Civil Aviation Authority’s regulations, which demand lessons from mishap investigations to improve flight safety. Irrespective of the distinct circumstances of a given casualty or the respective questions in subsequent death investigations, a forensic autopsy is the basis for all further casework, the clue to otherwise hidden solutions, and the crucial limitation for final success when not all possible findings have been properly collected. This also implies that the targeted work of police forces and expert witnesses strongly depends on the quality of forensic pathology practice. Deadly events in foreign countries, which lead to investigations not only abroad but also in Germany, can be challenging in this context. Frequently, second-look autopsies after the repatriation of the deceased to Germany are requested by the legal authorities to ensure proper and profound documentation of all relevant findings. Aims and Methods: To validate forensic postmortem practice abroad, a retrospective study using the findings in the corresponding second-look autopsies in the Institute of Legal Medicine Munich over the last 20 years was carried out. New findings unreported in the previous autopsy were recorded and judged for their relevance to solving the respective case. Further, the condition of the corpse at the time of the second autopsy was rated to discuss artifacts mimicking evidence or the possibility of lost findings resulting from, e.g., decomposition. Recommendations for future handling of death cases abroad and efficient autopsy practice were pursued. Results and Discussion: Our re-evaluation confirmed a high quality of autopsy practice abroad in the vast majority of cases. However, in some casework, incomplete documentation of pathology findings was revealed along with either insufficient or misconducted dissection of organs. Further, some of the bodies showed missing parts of some organs, most probably resulting from sampling for histology studies during the first postmortem. For the aeromedical evaluation of a decedent’s health status prior to an aviation mishap, particularly lost or obscured findings in the heart, lungs, and brain impeded expert testimony. Moreover, incomplete fixation of the body or body parts for repatriation was seen in several cases. This particularly involved previously dissected organs deposited back into the body cavities at the end of the first autopsy. Conclusions and Recommendations: Detailed preparation in the first forensic autopsy avoids the necessity of a second-look postmortem in the majority of cases. To limit decomposition changes during repatriation from abroad, special care must be taken to include pre-dissected organs in the chemical fixation process, particularly when they are separated from the blood vessels and just deposited back into the body cavities.

Keywords: autopsy practice, second-look autopsy, retrospective study, quality standards, decomposition changes, repatriation

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Authors: D. Heinemann, S. Schramm, S. Knabner, D. Baumgarten

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Purpose: Applying solder paste to printed circuit boards (PCB) with stencils has been the method of choice over the past years. A new method uses a jet printer to deposit tiny droplets of solder paste through an ejector mechanism onto the board. This allows for more flexible PCB layouts with smaller components. Due to the viscosity of the solder paste, air blisters can be trapped in the cartridge. This can lead to missing solder joints or deviations in the applied solder volume. Therefore, a built-in and real-time inspection of the printing process is needed to minimize uncertainties and increase the efficiency of the process by immediate correction. The objective of the current study is the design of an optimal imaging system and the development of an automatic algorithm for the detection of applied solder joints from optical from the captured images. Methods: In a first approach, a camera module connected to a microcomputer and LED strips are employed to capture images of the printed circuit board under four different illuminations (white, red, green and blue). Subsequently, an improved system including a ring light, an objective lens, and a monochromatic camera was set up to acquire higher quality images. The obtained images can be divided into three main components: the PCB itself (i.e., the background), the reflections induced by unsoldered positions or screw holes and the solder joints. Non-uniform illumination is corrected by estimating the background using a morphological opening and subtraction from the input image. Image sharpening is applied in order to prevent error pixels in the subsequent segmentation. The intensity thresholds which divide the main components are obtained from the multimodal histogram using three probability density functions. Determining the intersections delivers proper thresholds for the segmentation. Remaining edge gradients produces small error areas which are removed by another morphological opening. For quantitative analysis of the segmentation results, the dice coefficient is used. Results: The obtained PCB images show a significant gradient in all RGB channels, resulting from ambient light. Using different lightings and color channels 12 images of a single PCB are available. A visual inspection and the investigation of 27 specific points show the best differentiation between those points using a red lighting and a green color channel. Estimating two thresholds from analyzing the multimodal histogram of the corrected images and using them for segmentation precisely extracts the solder joints. The comparison of the results to manually segmented images yield high sensitivity and specificity values. Analyzing the overall result delivers a Dice coefficient of 0.89 which varies for single object segmentations between 0.96 for a good segmented solder joints and 0.25 for single negative outliers. Conclusion: Our results demonstrate that the presented optical imaging system and the developed algorithm can robustly detect solder joints on printed circuit boards. Future work will comprise a modified lighting system which allows for more precise segmentation results using structure analysis.

Keywords: printed circuit board jet-printing, inspection, segmentation, solder paste detection

Procedia PDF Downloads 334

Authors: Joanna Marie A. Paulino-Morente, Vaneza Valentina L. Penolio, Grace Sabado

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Ovarian cancer is extremely hard to diagnose in its early stages, and those afflicted at the time of diagnosis are typically asymptomatic and in the late stages of the disease, with metastasis to other organs. Ovarian cancers often occur sporadically, with only 5% associated with hereditary mutations. Mutations in the BRCA1 and BRCA2 tumor suppressor genes have been found to be responsible for the majority of hereditary ovarian cancers. One type of ovarian tumor is Malignant Mixed Mullerian Tumor (MMMT), which is a very rare and aggressive type, accounting for only 1% of all ovarian cancers. Reported is a case of a 43-year-old G3P3 (3003), who came into our institution due to a 2-month history of difficulty of breathing. Family history reveals that her eldest and younger sisters both died of ovarian malignancy, with her younger sister having a histopathology report of endometrioid ovarian carcinoma, left ovary stage IIIb. She still has 2 asymptomatic sisters. Physical examination pointed to pleural effusion of right lung, and presence of bilateral ovarian new growth, which had a Sassone score of 13. Admitting Diagnosis was G3P3 (3003), Ovarian New Growth, bilateral, Malignant; Pleural effusion secondary to malignancy. BRCA was requested to establish a hereditary mutation; however, the patient had no funds. Once the patient was stabilized, TAHBSO with surgical staging was performed. Intraoperatively, the pelvic cavity was occupied by firm, irregularly shaped ovaries, with a colorectal metastasis. Microscopic sections from both ovaries and the colorectal metastasis had pleomorphic tumor cells lined by cuboidal to columnar epithelium exhibiting glandular complexity, displaying nuclear atypia and increased nuclear-cytoplasmic ratio, which are infiltrating the stroma, consistent with the features of Malignant Mixed Mullerian Tumor, since MMMT is composed histologically of malignant epithelial and sarcomatous elements. In conclusion, discussed is the clinic-pathological feature of a patient with primary ovarian Malignant Mixed Mullerian Tumor, a rare malignancy comprising only 1% of all ovarian neoplasms. Also, by understanding the hereditary ovarian cancer syndromes and its relation to this patient, it cannot be overemphasized that a comprehensive family history is really fundamental for early diagnosis. The familial association of the disease, given that the patient has two sisters who were diagnosed with an advanced stage of ovarian cancer and succumbed to the disease at a much earlier age than what is reported in the general population, points to a possible hereditary syndrome which occurs in only 5% of ovarian neoplasms. In a low-resource setting, being in a third world country, the following will be recommended for monitoring and/or screening women who are at high risk for developing ovarian cancer, such as the remaining sisters of the patient: 1) Physical examination focusing on the breast, abdomen, and rectal area every 6 months. 2) Transvaginal sonography every 6 months. 3) Mammography annually. 4) CA125 for postmenopausal women. 5) Genetic testing for BRCA1 and BRCA2 will be reserved for those who are financially capable.

Keywords: BRCA, hereditary breast-ovarian cancer syndrome, malignant mixed mullerian tumor, ovarian cancer

Procedia PDF Downloads 286

Authors: Zofija Tupikovskaja-Omovie, David Tyler, Sam Dhanapala, Steve Hayes

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The UK is leading in online retail and mobile adoption. However, there is a dearth of information relating to mobile apparel retail, and developing an understanding about consumer browsing and purchase behavior in m-retail channel would provide apparel marketers, mobile website and app developers with the necessary understanding of consumers’ needs. Despite the rapid growth of mobile retail businesses, no published study has examined shopping behaviour on fashion mobile websites and apps. A mixed method approach helped to understand why fashion consumers prefer websites on mobile devices, when mobile apps are also available. The following research methods were employed: survey, eye-tracking experiments, observation, and interview with retrospective think aloud. The mobile gaze tracking device by SensoMotoric Instruments was used to understand frustrations in navigation and other issues facing consumers in mobile channel. This method helped to validate and compliment other traditional user-testing approaches in order to optimize user experience and enhance the development of mobile retail channel. The study involved eight participants - females aged 18 to 35 years old, who are existing mobile shoppers. The participants used the Topshop mobile app and website on a smart phone to complete a task according to a specified scenario leading to a purchase. The comparative study was based on: duration and time spent at different stages of the shopping journey, number of steps involved and product pages visited, search approaches used, layout and visual clues, as well as consumer perceptions and expectations. The results from the data analysis show significant differences in consumer behaviour when using a mobile app or website on a smart phone. Moreover, two types of problems were identified, namely technical issues and human errors. Having a mobile app does not guarantee success in satisfying mobile fashion consumers. The differences in the layout and visual clues seem to influence the overall shopping experience on a smart phone. The layout of search results on the website was different from the mobile app. Therefore, participants, in most cases, behaved differently on different platforms. The number of product pages visited on the mobile app was triple the number visited on the website due to a limited visibility of products in the search results. Although, the data on traffic trends held by retailers to date, including retail sector breakdowns for visits and views, data on device splits and duration, might seem a valuable source of information, it cannot explain why consumers visit many product pages, stay longer on the website or mobile app, or abandon the basket. A comprehensive list of pros and cons was developed by highlighting issues for website and mobile app, and recommendations provided. The findings suggest that fashion retailers need to be aware of actual consumers’ behaviour on the mobile channel and their expectations in order to offer a seamless shopping experience. Added to which is the challenge of retaining existing and acquiring new customers. There seem to be differences in the way fashion consumers search and shop on mobile, which need to be explored in further studies.

Keywords: consumer behavior, eye-tracking technology, fashion retail, mobile app, m-retail, smart phones, topshop, user experience, website

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Authors: Negar Vkilbashi, Hassan Kabiri

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Modern diplomacy, in its general form, refers to the people and not the governments, and diplomacy tactics are more addressed to the people than to the governments. Media diplomacy and cyber diplomacy are also one of the sub-branches of public diplomacy and, in fact, the role of media in the process of influencing public opinion and directing foreign policy. Mass media, including written, radio and television, theater, satellite, internet, and news agencies, transmit information and demands. What the Qatari government tried to implement in the countries of the region during the Arab Spring and after was through its important media, Al Jazeera. The embargo on Qatar began in 2017, when Saudi Arabia, the United Arab Emirates, Bahrain, and Egypt imposed a land, sea, and air blockade against the country. The media tool constitutes the cornerstone of soft power in the field of foreign policy, which Qatari leaders have consistently resorted to over the past two decades. Undoubtedly, the role it played in covering the events of the Arab Spring has created geopolitical tensions. The United Arab Emirates and other neighboring countries sometimes criticize Al Jazeera for providing a platform for the Muslim Brotherhood, Hamas, and other Islamists to promote their ideology. In 2011, at the same time as the Arab Spring, Al Jazeera reached the peak of its popularity. Al Jazeera's live coverage of protests in Tunisia, Egypt, Yemen, Libya, and Syria helped create a unified narrative of the Arab Spring, with audiences tuning in every Friday to watch simultaneous protests across the Middle East. Al Jazeera operates in three groups: First, it is a powerful base in the hands of the government so that it can direct and influence Arab public opinion. Therefore, this network has been able to benefit from the unlimited financial support of the Qatar government to promote its desired policies and culture. Second, it has provided an attractive platform for politicians and scientific and intellectual elites, thus attracting their support and defense from the government and its rulers. Third, during the last years of Prince Hamad's reign, the Al Jazeera network formed a deterrent weapon to counter the media and political struggle campaigns. The importance of the research is that this network covers a wide range of people in the Middle East and, therefore, has a high influence on the decision-making of countries. On the other hand, Al Jazeera is influential as a tool of public diplomacy and soft power in Qatar's foreign policy, and by studying it, the results of its effectiveness in the past years can be examined. Using a qualitative method, this research analyzes the impact of the media on the implementation of Qatar's foreign policy on the public opinion of the people of the Middle East. Data collection has been done by the secondary method, that is, reading related books, magazine articles, newspaper reports and articles, and analytical reports of think tanks. The most important findings of the research are that Al Jazeera plays an important role in Qatar's foreign policy in Qatar's public diplomacy. So that, in 2011, 2017 and 2023, it played an important role in Qatar's foreign policy in various crises. Also, the people of Arab countries use Al-Jazeera as their first reference.

Keywords: Al Jazeera, Qatar, media, diplomacy

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Authors: Marie-Helena Docherty, Sion Edryd Williams

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The prevalence of diabetes mellitus is increasing worldwide. In Sub-Saharan Africa, type 2 diabetes represents over 90% of all types of diabetes with the number of diabetic patients expected to rise. This represents a huge economic burden in an area already contending with high rates of other significant diseases, including the highest worldwide prevalence of HIV. Diabetic complications considerably impact on morbidity and mortality. The epidemiological data for the region quotes high rates of retinopathy (7-63%), neuropathy (27-66%) and microalbuminuria (10-83%). It is therefore imperative that diabetic screening programmes are established. It is recognised that in many parts of the developing world the implementation and management of such programmes is limited by a lack of available resources. The International Diabetes Federation produced guidelines in 2012 taking these limitations into account suggesting that all diabetic patients should have access to basic screening. These guidelines are consistent with the national diabetic guidelines produced by the Lesotho Medical Council. However, diabetic care in Lesotho is delivered at the local level, with variable levels of quality. A cross sectional study was performed in the outpatient department of Maluti Hospital in Mapoteng, Lesotho, a busy rural hospital in the Berea district. Demographic data on gender, age and modality of treatment were collected over a six-week time period. Information regarding 3 basic screening parameters was obtained. These parameters included eye screening (defined as a documented ophthalmology review within the last 12 months), foot screening (defined as a documented foot health assessment by any health care professional within the last 12 months) and secondary prevention (defined as a documented blood pressure and lipid profile reading within the last 12 months). These parameters were selected on the basis of the absolute minimum level of resources in Maluti Hospital. Renal screening was excluded, as the hospital does not have access to reliable renal profile checks or urinalysis. There is however a fully functioning on-site ophthalmology department run by a senior ophthalmologist with the ability to provide retinal photography, retinal surgery and photocoagulation therapy. Data was collected on 183 type 2 diabetics. 112 patients were male and 71 were female. The average age was 43 years. 4 patients were diet controlled, 140 patients were on oral hypoglycaemic agents (metformin and/or glibenclamide), and 39 patients were on a combination of insulin and oral hypoglycaemics. In the preceding 12 months, 5 patients had undergone eye screening (3%), 24 patients had undergone foot screening (13%), and 31 patients had lipid profile testing (17%). All patients had a documented blood pressure reading (100%). Our results show that screening is poorly performed in the basic indicators suggested by the IDF and the Lesotho Medical Council. On the basis of these results, a screening programme was developed using the mnemonic SaFE; secondary prevention, foot and eye care. This is simple, memorable and transferable between healthcare professionals. In the future, the expectation would be to expand upon this current programme to include renal screening, and to further develop screening pertaining to secondary prevention.

Keywords: Africa, complications, rural, screening

Procedia PDF Downloads 285

Authors: Tibor Ajtai, Noémi Utry, Máté Pintér, Gábor Szabó, Zoltán Bozóki

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Beyond its climate and health related issues ambient light absorbing carbonaceous particulate matter (LAC) has also become a great scientific interest in terms of its regulations recently. It has been experimentally demonstrated in recent studies, that LAC is dominantly composed of traffic and wood burning aerosol particularly under wintertime urban conditions, when the photochemical and biological activities are negligible. Several methods have been introduced to quantitatively apportion aerosol fractions emitted by wood burning and traffic but most of them require costly and time consuming off-line chemical analysis. As opposed to chemical features, the microphysical properties of airborne particles such as optical absorption and size distribution can be easily measured on-line, with high accuracy and sensitivity, especially under highly polluted urban conditions. Recently a new method has been proposed for the apportionment of wood burning and traffic aerosols based on the spectral dependence of their absorption quantified by the Aerosol Angström Exponent (AAE). In this approach the absorption coefficient is deduced from transmission measurement on a filter accumulated aerosol sample and the conversion factor between the measured optical absorption and the corresponding mass concentration (the specific absorption cross section) are determined by on-site chemical analysis. The recently developed multi-wavelength photoacoustic instruments provide novel, in-situ approach towards the reliable and quantitative characterization of carbonaceous particulate matter. Therefore, it also opens up novel possibilities on the source apportionment through the measurement of light absorption. In this study, we demonstrate an in-situ spectral characterization method of the ambient carbon fraction based on light absorption and size distribution measurements using our state-of-the-art multi-wavelength photoacoustic instrument (4λ-PAS) and Single Mobility Particle Sizer (SMPS) The carbonaceous particulate selective source apportionment study was performed for ambient particulate matter in the city center of Szeged, Hungary where the dominance of traffic and wood burning aerosol has been experimentally demonstrated earlier. The proposed model is based on the parallel, in-situ measurement of optical absorption and size distribution. AAEff and AAEwb were deduced from the measured data using the defined correlation between the AOC(1064nm)/AOC(266nm) and N100/N20 ratios. σff(λ) and σwb(λ) were determined with the help of the independently measured temporal mass concentrations in the PM1 mode. Furthermore, the proposed optical source apportionment is based on the assumption that the light absorbing fraction of PM is exclusively related to traffic and wood burning. This assumption is indirectly confirmed here by the fact that the measured size distribution is composed of two unimodal size distributions identified to correspond to traffic and wood burning aerosols. The method offers the possibility of replacing laborious chemical analysis with simple in-situ measurement of aerosol size distribution data. The results by the proposed novel optical absorption based source apportionment method prove its applicability whenever measurements are performed at an urban site where traffic and wood burning are the dominant carbonaceous sources of emission.

Keywords: absorption, size distribution, source apportionment, wood burning, traffic aerosol

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Authors: Maria Zulema Morquecho Vega, Fabiola CarolinaMiranda Castro, Rafael Verdugo Miranda, Ignacio Yocupicio Villegas, Ana lidia Barron Raygoza, Martin enrique MArquez Cordova, Jose Alberto Duarte Moller

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Background: Anemopsis californica, also called (tame grass) belongs to the Saururaceae family small, green plant. The blade is long and wide. Gives a white flower. The plant population is only found in humid, swampy habitats, it grows where there is water, along the banks of streams and water holes. In the winter, it dries up. The leaves, rhizomes, or roots of this plant have been used to treat a range of diseases. Some of its healing properties are used to treat wounds, cold and flu symptoms, spasmodic cough, infection, pain and inflammation, burns, swollen feet, as well as lung ailments, asthma, circulatory problems (varicose veins), rheumatoid arthritis, purifies blood, helps in urinary and digestive tract diseases, sores and healing, for headache, sore throat, diarrhea, kidney pain. The tea made from the leaves and roots is used to treat uterine cancer, womb cancer, relieves menstrual pain and stops excessive bleeding after childbirth. It is also used as a gynecological treatment for infections, hemorrhoids, candidiasis and vaginitis. Objective: To study the cytotoxicity of gels prepared with silver nanoparticles in AC extract combined with chitosan, collagen and hyaluronic acid as an alternative therapy for skin conditions. Methods: The Ag NPs were synthesized according to the following method. A 0.3 mg/mL solution is prepared in 10 ml of deionized water, adjust to pH 12 with NaOH, stirring is maintained constant magnetic and a temperature of 80 °C. Subsequently, 100 ul of a 0.1 M AgNO3 solution and kept stirring constantly for 15 min. Once the reaction is complete, measurements are performed by UV-Vis. A gel was prepared in a 5% solution of acetic acid with the respective nanoparticles and AC extract of silver in the extract of AC. Chitosan is added until the process begins to occur gel. At that time, collagen will be added in a ratio of 3 to 5 drops, and later, hyaluronic acid in 2% of the total compound formed. Finally, after resting for 24 hours, the cytotoxic effect of the gels was studied. in the presence of highly positive bacteria Staphylococcus aureus and highly negative for Escherichia coli. Cultures will be incubated for 24 hours in the presence of the compound and compared with the reference. Results: Silver nanoparticles obtained had a spherical shape and sizes among 20 and 30 nm. UV-Vis spectra confirm the presence of silver nanoparticles showing a surface plasmon around 420 nm. Finally, the test in presence of bacteria yield a good antibacterial property of this nanocompound and tests in people were successful. Conclusion: Gel prepared by biogenic synthesis shown beneficious effects in severe acne, acne vulgaris and wound healing with diabetic patients.

Keywords: anemopsis californica, nanomedicina, biotechnology, biomedicine

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Authors: Suikinai Nobre Santos, Ranko Gacesa, Paul F. Long, Itamar Soares de Melo

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Extremophilic microorganism are adapted to biotopes combining several stress factors (temperature, pressure, radiation, salinity and pH), which indicate the richness valuable resource for the exploitation of novel biotechnological processes and constitute unique models for investigations their biomolecules (1, 2). The above information encourages us investigate bioprospecting synthesized compounds by a noval actinomycete, designated thermotolerant Streptomyces caatingaensis CMAA 1322, isolated from sample soil tropical dry forest (Caatinga) in the Brazilian semiarid region (3-17°S and 35-45°W). This set of constrating physical and climatic factores provide the unique conditions and a diversity of well adapted species, interesting site for biotechnological purposes. Preliminary studies have shown the great potential in the production of cytotoxic, pesticidal and antimicrobial molecules (3). Thus, to extend knowledge of the genes clusters responsible for producing biosynthetic pathways of natural products in strain CMAA1322, whole-genome shotgun (WGS) DNA sequencing was performed using paired-end long sequencing with PacBio RS (Pacific Biosciences). Genomic DNA was extracted from a pure culture grown overnight on LB medium using the PureLink genomic DNA kit (Life Technologies). An approximately 3- to 20-kb-insert PacBio library was constructed and sequenced on an 8 single-molecule real-time (SMRT) cell, yielding 116,269 reads (average length, 7,446 bp), which were allocated into 18 contigs, with 142.11x coverage and N50 value of 20.548 bp (BioProject number PRJNA288757). The assembled data were analyzed by Rapid Annotations using Subsystems Technology (RAST) (4) the genome size was found to be 7.055.077 bp, comprising 6167 open reading frames (ORFs) and 413 subsystems. The G+C content was estimated to be 72 mol%. The closest-neighbors tool, available in RAST through functional comparison of the genome, revealed that strain CMAA1322 is more closely related to Streptomyces hygroscopicus ATCC 53653 (similarity score value, 537), S. violaceusniger Tu 4113 (score value, 483), S. avermitilis MA-4680 (score value, 475), S. albus J1074 (score value, 447). The Streptomyces sp. CMAA1322 genome contains 98 tRNA genes and 135 genes copies related to stress response, mainly osmotic stress (14), heat shock (16), oxidative stress (49). Functional annotation by antiSMASH version 3.0 (5) identified 41 clusters for secondary metabolites (including two clusters for lanthipeptides, ten clusters for nonribosomal peptide synthetases [NRPS], three clusters for siderophores, fourteen for polyketide synthetase [PKS], six clusters encoding a terpene, two clusters encoding a bacteriocin, and one cluster encoding a phenazine). Our work provide in comparative analyse of genome and extract produced (data no published) by lineage CMAA1322, revealing the potential of microorganisms accessed from extreme environments as Caatinga” to produce a wide range of biotechnological relevant compounds.

Keywords: caatinga, streptomyces, environmental stresses, biosynthetic pathways

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Authors: Rebekah Granger Ellis, Richard B. Speaker, Pat Austin

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This study used two psychological scales to examine the level of social and emotional intelligence and moral judgment of over 500 gifted and talented high school students in various academic and creative arts programs in a large metropolitan area in the southeastern United States. For decades, numerous models and programs purporting to encourage socio-affective characteristics of adolescent development have been explored in curriculum theory and design. Socio-affective merges social, emotional, and moral domains. It encompasses interpersonal relations and social behaviors; development and regulation of emotions; personal and gender identity construction; empathy development; moral development, thinking, and judgment. Examining development in these socio-affective domains can provide insight into why some gifted and talented adolescents are not successful in adulthood despite advanced IQ scores. Particularly whether nonintellectual characteristics of gifted and talented individuals, such as emotional, social and moral capabilities, are as advanced as their intellectual abilities and how these are related to each other. Unique characteristics distinguish gifted and talented individuals; these may appear as strengths, but there is the potential for problems to accompany them. Although many thrive in their school environments, some gifted students struggle rather than flourish. In the socio-affective domain, these adolescents face special intrapersonal, interpersonal, and environmental problems. Gifted individuals’ cognitive, psychological, and emotional development occurs asynchronously, in multidimensional layers at different rates and unevenly across ability levels. Therefore, it is important to examine the long-term effects of participation in various gifted and talented programs on the socio-affective development of gifted and talented adolescents. This quasi-experimental longitudinal study examined students in several gifted and talented education programs (creative arts school, urban charter schools, and suburban public schools) for (1) socio-affective development level and (2) whether a particular gifted and talented program encourages developmental growth. The following research questions guided the study: (1) How do academically and artistically talented gifted 10th and 11th grade students perform on psychometric scales of social and emotional intelligence and moral judgment? Do they differ from their age or grade normative sample? Are their gender differences among gifted students? (2) Does school environment impact 10th and 11th grade gifted and talented students’ socio-affective development? Do gifted adolescents who participate in a particular school gifted program differ in their developmental profiles of social and emotional intelligence and moral judgment? Students’ performances on psychometric instruments were compared over time and by type of program. Participants took pre-, mid-, and post-tests over the course of an academic school year with Defining Issues Test (DIT-2) assessing moral judgment and BarOn EQ-I: YV assessing social and emotional intelligence. Based on these assessments, quantitative differences in growth on psychological scales (individual and school) were examined. Change scores between schools were also compared. If a school showed change, artifacts (culture, curricula, instructional methodology) provided insight as to environmental qualities that produced this difference.

Keywords: gifted and talented education, moral development, socio-affective development, socio-affective education

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Authors: Waleed Al-Nuaimy, Luke Anastassiou, Manjinder Kainth

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As the process of teaching has evolved with the advent of new technologies over the ages, so has the process of learning. Educators have perpetually found themselves on the lookout for new technology-enhanced methods of teaching in order to increase learning efficiency and decrease ever expanding workloads. Shortly after the invention of the internet, web-based learning started to pick up in the late 1990s and educators quickly found that the process of providing learning material and marking assignments could change thanks to the connectivity offered by the internet. With the creation of early web-based virtual learning environments (VLEs) such as SPIDER and Blackboard, it soon became apparent that VLEs resulted in higher reported computer self-efficacy among students, but at the cost of students being less satisfied with the learning process . It may be argued that the impersonal nature of VLEs, and their limited functionality may have been the leading factors contributing to this reported dissatisfaction. To this day, often faced with the prospects of assigning colossal engineering cohorts their homework and assessments, educators may frequently choose optimally curated assessment formats, such as multiple-choice quizzes and numerical answer input boxes, so that automated grading software embedded in the VLEs can save time and mark student submissions instantaneously. A crucial skill that is meant to be learnt during most science and engineering undergraduate degrees is gaining the confidence in using, solving and deriving mathematical equations. Equations underpin a significant portion of the topics taught in many STEM subjects, and it is in homework assignments and assessments that this understanding is tested. It is not hard to see that this can become challenging if the majority of assignment formats students are engaging with are multiple-choice questions, and educators end up with a reduced perspective of their students’ ability to manipulate equations. Artificial intelligence (AI) has in recent times been shown to be an important consideration for many technologies. In our paper, we explore the use of new AI based software designed to work in conjunction with current VLEs. Using our experience with the software, we discuss its potential to solve a selection of problems ranging from impersonality to the reduction of educator workloads by speeding up the marking process. We examine the software’s potential to increase learning efficiency through its features which claim to allow more customized and higher-quality feedback. We investigate the usability of features allowing students to input equation derivations in a range of different forms, and discuss relevant observations associated with these input methods. Furthermore, we make ethical considerations and discuss potential drawbacks to the software, including the extent to which optical character recognition (OCR) could play a part in the perpetuation of errors and create disagreements between student intent and their submitted assignment answers. It is the intention of the authors that this study will be useful as an example of the implementation of AI in a practical assessment scenario insofar as serving as a springboard for further considerations and studies that utilise AI in the setting and marking of science and engineering assignments.

Keywords: engineering education, assessment, artificial intelligence, optical character recognition (OCR)

Procedia PDF Downloads 121

Authors: Pedro Felgueiras, Ana Miguel, Nélson Almeida, Raquel Silva

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Objective: Through the study of a clinical case of delusional somatic disorder secondary to phantogeusia, we aim to highlight the importance of considering psychosomatic conditions in differential diagnosis, as well as to emphasize the complexity of its comprehension, treatment, and respective impact on patients’ functioning. Methods: Bearing this in mind, we conducted a critical analysis of a case series based on patient observations, clinical data, and complementary diagnostic methods, as well as a non-systematic review of the literature on the subject. Results: A 61-year-old female patient with no history of psychiatric conditions. Family psychiatric history of mood disorder (depression), with psychotic features found in her mother. Medical history of many comorbidities affecting different organ systems (endocrine, gastrointestinal, genitourinary, ophthalmological). Documented neuroticism traits of personality. The patient’s family described a persistent concern about several physical symptoms across her life, with a continuous effort to obtain explanations about any sensation out of her normal perception. Since being subjected to endoscopy in 2018, she started complaints of persistent phantogeusia (acid taste) and developed excessive thoughts, feelings, and behaviors associated with this somatic symptom. The patient was evaluated by several medical specialties, and an extensive panel of medical exams was carried out, excluding any disease. Besides all the investigation and with no evidence of disease signs, acute anxiety, time, and energy dispended to this symptom culminated in severe psychosocial impairment. The patient was admitted to a psychiatric ward for investigation and treatment of this clinical picture, leading to the diagnosis of the delusional somatic disorder. In order to exclude the acute organic etiology of this psychotic disorder, an analytic panel was carried out with no abnormal results. In the context of a psychotic clinical picture, a CT scan was performed, which revealed a right cortical vascular lesion. Neuropsychological evaluation was made, with the description of cognitive functioning being globally normative. During treatment with an antipsychotic (pimozide), a complete remission of the somatic delusion was associated with the disappearance of gustative perception disturbance. In follow-up, a relapse of gustative sensation was documented, and her thoughts and speech were dominated by concerns about multiple somatic symptoms. Conclusion: In terms of abnormal bodily sensations, the oral cavity is one of the frequent sites of delusional disorder. Patients with these gustatory perception distortions complain about unusual sensations without corresponding abnormal findings in the oral area. Its pathophysiology has not been fully elucidated yet. In terms of its comprehensive psychopathology, this case was hypothesized as a paranoid development of a delusional somatic disorder triggered by a post-invasive procedure phantogeusia (which is described as a possible side effect of an endoscopy) in a patient with an anankastic personality. This case presents interesting psychopathology, reinforcing the complexity of psychosomatic disorders in terms of their etiopathogenesis, clinical treatment, and long-term prognosis.

Keywords: psychosomatics, delusional somatic disorder, phantogeusia, paranoid development

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Authors: Natalie Riley, Anita Quigley, Robert M. I. Kapsa, George W. Greene

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As the fields of medicine and bionics grow rapidly in technological advancement, the future and success of it depends on the ability to effectively interface between the artificial and the biological worlds. The biggest obstacle when it comes to implantable, electronic medical devices, is maintaining a ‘clean’, low noise electrical connection that allows for efficient sharing of electrical information between the artificial and biological systems. Implant fouling occurs with the adhesion and accumulation of proteins and various cell types as a result of the immune response to protect itself from the foreign object, essentially forming an electrical insulation barrier that often leads to implant failure over time. Lubricin (LUB) functions as a major boundary lubricant in articular joints, a unique glycoprotein with impressive anti-adhesive properties that self-assembles to virtually any substrate to form a highly ordered, ‘telechelic’ polymer brush. LUB does not passivate electroactive surfaces which makes it ideal, along with its innate biocompatibility, as a coating for implantable bionic electrodes. It is the aim of the study to investigate LUB’s anti-fouling properties and its potential as a safe, bioinspired material for coating applications to enhance the performance and longevity of implantable medical devices as well as reducing the frequency of implant replacement surgeries. Native, bovine-derived LUB (N-LUB) and recombinant LUB (R-LUB) were applied to gold-coated mylar surfaces. Fibroblast, chondrocyte and neural cell types were cultured and grown on the coatings under both passive and electrically stimulated conditions to test the stability and anti-adhesive property of the LUB coating in the presence of an electric field. Lactate dehydrogenase (LDH) assays were conducted as a directly proportional cell population count on each surface along with immunofluorescent microscopy to visualize cells. One-way analysis of variance (ANOVA) with post-hoc Tukey’s test was used to test for statistical significance. Under both passive and electrically stimulated conditions, LUB significantly reduced cell attachment compared to bare gold. Comparing the two coating types, R-LUB reduced cell attachment significantly compared to its native counterpart. Immunofluorescent micrographs visually confirmed LUB’s antiadhesive property, R-LUB consistently demonstrating significantly less attached cells for both fibroblasts and chondrocytes. Preliminary results investigating neural cells have so far demonstrated that R-LUB has little effect on reducing neural cell attachment; the study is ongoing. Recombinant LUB coatings demonstrated impressive anti-adhesive properties, reducing cell attachment in fibroblasts and chondrocytes. These findings and the availability of recombinant LUB brings into question the results of previous experiments conducted using native-derived LUB, its potential not adequately represented nor realized due to unknown factors and impurities that warrant further study. R-LUB is stable and maintains its anti-fouling property under electrical stimulation, making it suitable for electroactive surfaces.

Keywords: anti-fouling, bioinspired, cell attachment, lubricin

Procedia PDF Downloads 123

Authors: Sophie Del Fa, Loup Ducol

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This presentation will focus on the discursive practices of Les Soulèvements de la Terre (hereafter SdlT), a French environmentalist group mobilized against agribusiness. More specifically, we will use, as a case study, the violently repressed demonstration that took place in Sainte-Soline on March 25, 2023 (see after for details). The SdlT embodies the renewal of anti-capitalist and environmentalist struggles that began with Occupy Wall Street in 2009 and in France with the Nuit debout in 2016 and the yellow vests movement from 2019 to 2020. These struggles have three things in common: they are self-organized without official leaders, they rely mainly on occupations to reappropriate public places (squares, roundabouts, natural territories) and they are anti-capitalist. The SdlT was created in 2021 by activists coming from the Zone-to-Defend of Notre-Dame-des-Landes, a victorious 10 yearlong occupation movement against an airport near Nantes, France (from 2009 to 2018). The SdlT is not labeled as a formal association, nor as a constituted group, but as an anti-capitalist network of local struggles at the crossroads of ecology and social issues. Indeed, although they target agro-industry, land grabbing, soil artificialization and ecology without transition, the SdlT considers ecological and social questions as interdependent. Moreover, they have an encompassing vision of ecology that they consider as a concern for the living as a whole by erasing the division between Nature and Culture. Their radicality is structured around three main elements: federative and decentralized dimensions, the rhetoric of living alliances and militant creatives strategies. The objective of this reflexion is to understand how these three dimensions are articulated through the SdlT’s discursive practices. To explore these elements, we take as a case study one specific event: the demonstration against the ‘basins’ held in Sainte-Soline on March 25, 2023, on the construction site of new water storage infrastructure for agricultural irrigation in western France. This event represents a turning point for the SdlT. Indeed, the protest was violently repressed: 5000 grenades were fired by the police, hundreds of people were injured, and one person was still in a coma at the time of writing these lines. Moreover, following Saint-Soline’s events, the Minister of Interior Affairs, Gérald Darmin, threatened to dissolve the SdlT, thus adding fuel to the fire in an already tense social climate (with the ongoing strikes against the pensions reform). We anchor our reflexion on three types of data: 1) our own experiences (inspired by ethnography) of the Sainte-Soline demonstration; 2) the collection of more than 500 000 Tweets with the #SainteSoline hashtag and 3) a press review of texts and articles published after Sainte-Soline’s demonstration. The exploration of these data from a turning point in the history of the SdlT will allow us to analyze how the three dimensions highlighted earlier (federative and decentralized dimensions, rhetoric of living alliances and creatives militant strategies) are materialized through the discursive practices surrounding the Sainte-Soline event. This will allow us to shed light on how a new contemporary movement implements contemporary environmental struggles.

Keywords: discursive practices, Sainte-Soline, Ecology, radical ecology

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Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

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Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

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Authors: Wei Ji

Abstract:

This study was conducted in the Kansas City metropolitan area of the United States, which has experienced significant urban sprawling in recent decades. The remote sensing of land cover changes in this area spanned over four decades from 1972 through 2010. The project was implemented in two stages: the first stage focused on detection of long-term trends of urban land cover change, while the second one examined how to detect the coupled effects of human impact and climate change on urban landscapes. For the first-stage study, six Landsat images were used with a time interval of about five years for the period from 1972 through 2001. Four major land cover types, built-up land, forestland, non-forest vegetation land, and surface water, were mapped using supervised image classification techniques. The study found that over the three decades the built-up lands in the study area were more than doubled, which was mainly at the expense of non-forest vegetation lands. Surprisingly and interestingly, the area also saw a significant gain in surface water coverage. This observation raised questions: How have human activities and precipitation variation jointly impacted surface water cover during recent decades? How can we detect such coupled impacts through remote sensing analysis? These questions led to the second stage of the study, in which we designed and developed approaches to detecting fine-scale surface waters and analyzing coupled effects of human impact and precipitation variation on the waters. To effectively detect urban landscape changes that might be jointly shaped by precipitation variation, our study proposed “urban wetscapes” (loosely-defined urban wetlands) as a new indicator for remote sensing detection. The study examined whether urban wetscape dynamics was a sensitive indicator of the coupled effects of the two driving forces. To better detect this indicator, a rule-based classification algorithm was developed to identify fine-scale, hidden wetlands that could not be appropriately detected based on their spectral differentiability by a traditional image classification. Three SPOT images for years 1992, 2008, and 2010, respectively were classified with this technique to generate the four types of land cover as described above. The spatial analyses of remotely-sensed wetscape changes were implemented at the scales of metropolitan, watershed, and sub-watershed, as well as based on the size of surface water bodies in order to accurately reveal urban wetscape change trends in relation to the driving forces. The study identified that urban wetscape dynamics varied in trend and magnitude from the metropolitan, watersheds, to sub-watersheds in response to human impacts at different scales. The study also found that increased precipitation in the region in the past decades swelled larger wetlands in particular while generally smaller wetlands decreased mainly due to human development activities. These results confirm that wetscape dynamics can effectively reveal the coupled effects of human impact and climate change on urban landscapes. As such, remote sensing of this indicator provides new insights into the relationships between urban land cover changes and driving forces.

Keywords: urban land cover, human impact, climate change, rule-based classification, across-scale analysis

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Authors: Giuseppina Anna Giorgio, Angela Lorusso, Maria Ragosta, Vito Telesca

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Climate change is a major public health threat due to the effects of extreme weather events on human health and on quality of life in general. In this context, mean temperatures are increasing, in particular, extreme temperatures, with heat waves becoming more frequent, more intense, and longer lasting. In many cities, extreme heat waves have drastically increased, giving rise to so-called Urban Heat Island (UHI) phenomenon. In an urban centre, maximum temperatures may be up to 10° C warmer, due to different local atmospheric conditions. UHI occurs in the metropolitan areas as function of the population size and density of a city. It consists of a significant difference in temperature compared to the rural/suburban areas. Increasing industrialization and urbanization have increased this phenomenon and it has recently also been detected in small cities. Weather conditions and land use are one of the key parameters in the formation of UHI. In particular surface urban heat island is directly related to temperatures, to land surface types and surface modifications. The present study concern a UHI analysis of Matera city (Italy) based on the analysis of temperature, change in land use and land cover, using Corine Land Cover maps and satellite Landsat images. Matera, located in Southern Italy, has a typical Mediterranean climate with mild winters and hot and humid summers. Moreover, Matera has been awarded the international title of the 2019 European Capital of Culture. Matera represents a significant example of vernacular architecture. The structure of the city is articulated by a vertical succession of dug layers sometimes excavated or partly excavated and partly built, according to the original shape and height of the calcarenitic slope. In this study, two meteorological stations were selected: MTA (MaTera Alsia, in industrial zone) and MTCP (MaTera Civil Protection, suburban area located in a green zone). In order to evaluate the increase in temperatures (in terms of UHI occurrences) over time, and evaluating the effect of land use on weather conditions, the climate variability of temperatures for both stations was explored. Results show that UHI phenomena is growing in Matera city, with an increase of maximum temperature values at a local scale. Subsequently, spatial analysis was conducted by Landsat satellite images. Four years was selected in the summer period (27/08/2000, 27/07/2006, 11/07/2012, 02/08/2017). In Particular, Landsat 7 ETM+ for 2000, 2006 and 2012 years; Landsat 8 OLI/TIRS for 2017. In order to estimate the LST, Mono Window Algorithm was applied. Therefore, the increase of LST values spatial scale trend has been verified, in according to results obtained at local scale. Finally, the analysis of land use maps over the years by the LST and/or the maximum temperatures measured, show that the development of industrialized area produces a corresponding increase in temperatures and consequently a growth in UHI.

Keywords: climate variability, land surface temperature, LANDSAT images, urban heat island

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Authors: Linda Fellag, Arlene Caney

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E-learning has earned an essential place in academia because it promotes learner autonomy, student engagement, and technological aptitude, and allows for flexible learning. However, despite advantages, educators have been slower to embrace e-learning for ESL and other non-traditional students for fear that such students will not succeed without the direct faculty contact and academic support of face-to-face classrooms. This study aims to determine if a non-traditional student-friendly online course can produce student retention and performance rates that compare favorably with those of students in standard online sections of the same course aimed at traditional college-level students. One Music faculty member is currently collaborating with an English instructor to redesign an online college-level Music Appreciation course for non-traditional college students. At Community College of Philadelphia, Introduction to Music Appreciation was recently designated as one of the few college-level courses that advanced ESL, and developmental English students can take while completing their language studies. Beginning in Fall 2017, the course will be critical for international students who must maintain full-time student status under visa requirements. In its current online format, however, Music Appreciation is designed for traditional college students, and faculty who teach these sections have been reluctant to revise the course to address the needs of non-traditional students. Interestingly, presenters maintain that the online platform is the ideal place to develop language and college readiness skills in at-risk students while maintaining the course's curricular integrity. The two faculty presenters describe how curriculum rather than technology drives the redesign of the digitized music course, and self-study materials, guided assignments, and periodic assessments promote independent learning and comprehension of material. The 'scaffolded' modules allow ESL and developmental English students to build on prior knowledge, preview key vocabulary, discuss content, and complete graded tasks that demonstrate comprehension. Activities and assignments, in turn, enhance college success by allowing students to practice academic reading strategies, writing, speaking, and student-faculty and peer-peer communication and collaboration. The course components facilitate a comparison of student performance and retention in sections of the redesigned and existing online sections of Music Appreciation as well as in previous sections with at-risk students. Indirect, qualitative measures include student attitudinal surveys and evaluations. Direct, quantitative measures include withdrawal rates, tests of disciplinary knowledge, and final grades. The study will compare the outcomes of three cohorts in the two versions of the online course: ESL students, at-risk developmental students, and college-level students. These data will also be compared with retention and student outcomes data of the three cohorts in f2f Music Appreciation, which permitted non-traditional student enrollment from 1998-2005. During this eight-year period, the presenter addressed the problems of at-risk students by adding language and college success support, which resulted in strong retention and outcomes. The presenters contend that the redesigned course will produce favorable outcomes among all three cohorts because it contains components which proved successful with at-risk learners in f2f sections of the course. Results of their study will be published in 2019 after the redesigned online course has met for two semesters.

Keywords: college readiness, e-learning, music appreciation, online courses

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Authors: Arfanara Najnin, Michael W. Roach, Jr., Dr. Jianhong Cecilia Xia

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The SkyCar Rapid Transit System (SRT) is an innovative intelligent transport system for the sustainable urban transport system. This system will increase the urban area network connectivity and decrease urban area traffic congestion. The SRT system is designed as a suspended Personal Rapid Transit (PRT) system that travels under a guideway 5m above the ground. A driver-less passenger is via pod-cars that hang from slender beams supported by columns that replace existing lamp posts. The beams are setup in a series of interconnecting loops providing non-stop travel from beginning to end to assure journey time. The SRT forward movement is effected by magnetic motors built into the guideway. Passenger stops are at either at line level 5m above the ground or ground level via a spur guideway that curves off the main thoroughfare. The main objective of this paper is to propose an integrated Automated Transit Network (ATN) technology for the future intelligent transport system in the urban built environment. To fulfil the objective a 4D simulated model in the urban built environment has been proposed by using the concept of SRT-ATN system. The methodology for the design, construction and testing parameters of a Technology Demonstrator (TD) for proof of concept and a Simulator (S) has been demonstrated. The completed TD and S will provide an excellent proving ground for the next development stage, the SRT Prototype (PT) and Pilot System (PS). This paper covered by a 4D simulated model in the virtual built environment is to effectively show how the SRT-ATN system works. OpenSim software has been used to develop the model in a virtual environment, and the scenario has been simulated to understand and visualize the proposed SkyCar Rapid Transit Network model. The SkyCar system will be fabricated in a modular form which is easily transported. The system would be installed in increasingly congested city centers throughout the world, as well as in airports, tourist resorts, race tracks and other special purpose for the urban community. This paper shares the lessons learnt from the proposed innovation and provides recommendations on how to improve the future transport system in urban built environment. Safety and security of passengers are prime factors to be considered for this transit system. Design requirements to meet the safety needs to be part of the research and development phase of the project. Operational safety aspects would also be developed during this period. The vehicles, the track and beam systems and stations are the main components that need to be examined in detail for safety and security of patrons. Measures will also be required to protect columns adjoining intersections from errant vehicles in vehicular traffic collisions. The SkyCar Rapid Transit takes advantage of all current disruptive technologies; batteries, sensors and 4G/5G communication and solar energy technologies which will continue to reduce the costs and make the systems more profitable. SkyCar's energy consumption is extremely low compared to other transport systems.

Keywords: SkyCar, rapid transit, Intelligent Transport System (ITS), Automated Transit Network (ATN), urban built environment, 4D Visualization, smart city

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Authors: Nurkhairul Bariyah Baharun, Afzan Adam, Reena Rahayu Md Zin

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Tumor microenvironment (TME) in breast cancer is mainly composed of cancer cells, immune cells, and stromal cells. The interaction between cancer cells and their microenvironment plays an important role in tumor development, progression, and treatment response. The TME in breast cancer includes tumor-infiltrating lymphocytes (TILs) that are implicated in killing tumor cells. TILs can be found in tumor stroma (sTILs) and within the tumor (iTILs). TILs in triple negative breast cancer (TNBC) have been demonstrated to have prognostic and potentially predictive value. The international Immune-Oncology Biomarker Working Group (TIL-WG) had developed a guideline focus on the assessment of sTILs using hematoxylin and eosin (H&E)-stained slides. According to the guideline, the pathologists use “eye balling” method on the H&E stained- slide for sTILs assessment. This method has low precision, poor interobserver reproducibility, and is time-consuming for a comprehensive evaluation, besides only counted sTILs in their assessment. The TIL-WG has therefore recommended that any algorithm for computational assessment of TILs utilizing the guidelines provided to overcome the limitations of manual assessment, thus providing highly accurate and reliable TILs detection and classification for reproducible and quantitative measurement. This study is carried out to develop a TNBC digital whole slide image (WSI) dataset from H&E-stained slides and IHC (CD4+ and CD8+) stained slides. TNBC cases were retrieved from the database of the Department of Pathology, Hospital Canselor Tuanku Muhriz (HCTM). TNBC cases diagnosed between the year 2010 and 2021 with no history of other cancer and available block tissue were included in the study (n=58). Tissue blocks were sectioned approximately 4 µm for H&E and IHC stain. The H&E staining was performed according to a well-established protocol. Indirect IHC stain was also performed on the tissue sections using protocol from Diagnostic BioSystems PolyVue™ Plus Kit, USA. The slides were stained with rabbit monoclonal, CD8 antibody (SP16) and Rabbit monoclonal, CD4 antibody (EP204). The selected and quality-checked slides were then scanned using a high-resolution whole slide scanner (Pannoramic DESK II DW- slide scanner) to digitalize the tissue image with a pixel resolution of 20x magnification. A manual TILs (sTILs and iTILs) assessment was then carried out by the appointed pathologist (2 pathologists) for manual TILs scoring from the digital WSIs following the guideline developed by TIL-WG 2014, and the result displayed as the percentage of sTILs and iTILs per mm² stromal and tumour area on the tissue. Following this, we aimed to develop an automated digital image scoring framework that incorporates key elements of manual guidelines (including both sTILs and iTILs) using manually annotated data for robust and objective quantification of TILs in TNBC. From the study, we have developed a digital dataset of TNBC H&E and IHC (CD4+ and CD8+) stained slides. We hope that an automated based scoring method can provide quantitative and interpretable TILs scoring, which correlates with the manual pathologist-derived sTILs and iTILs scoring and thus has potential prognostic implications.

Keywords: automated quantification, digital pathology, triple negative breast cancer, tumour infiltrating lymphocytes

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Authors: Azza Zagouani

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Introduction: In the work of William Faulkner, characters often evade the boundaries and categories of patriarchal standards of order. Female characters like Lena Grove and Joanna Burden cross thresholds in attempts to gain liberation, while others fail to do so. They stand as non-conformists and refuse established patterns of feminine behavior, such as marriage and motherhood after. They refute submissiveness, domesticity and abstinence to reshape their own identities. The presence of independent and creative women represents new, unconventional images of female subjectivity. This paper will examine the structures of submission and oppression faced by Lena and Joanna, and will show how, in the end, they reshape themselves and their identities, and disrupt or even destroy patriarchal structures. Objectives: Participants will understand through the examples of Lena Grove and Joanna Burden that female subjectivities are constructions, and are constantly subject to change. Approaches: Two approaches will be used in the analysis of the subjectivity formation of Lena Grove and Joanna Burden. Following the arguments propounded by Judith Butler, We explore the ways in which Lena Grove maneuvers around the restrictions and the limitations imposed on her without any physical or psychological violence. She does this by properly performing the roles prescribed to her gendered body. Her repetitious performances of these roles are both the ones that are constructed to confine women and the vehicle for her travel. Her performance parodies the prescriptive roles and thereby reveals that they are cultural constructions. Second, We will explore the argument propounded by Kristeva that subjectivity is always in a state of development because we are always changing in context with changing circumstances. For example, in Light in August, Lena Grove changes the way she defines herself in light of the events of the novel. Also, Kristeva talks about stages of development: the semiotic stage and the symbolic stage. In Light in August, Joanna shows different levels of subjectivity as time passes. Early in the novel, Joanna is very connected to her upbringing. This suggests Kristeva’s concept of the semiotic, in which the daughter identifies closely to her parents. Kristeva relates the semiotic to a strong daughter/mother connection, but in the novel it is strong daughter/father/grandfather identification instead. Then as Joanna becomes sexually involved with Joe, she breaks off, and seems to go into an identity crisis. To me, this represents Kristeva’s move from the semiotic to the symbolic. When Joanna returns to a religious fanaticism, she is returning to a semiotic state. Detailed outline: At the outset of this paper, We will investigate the subjugation of women: social constraints, and the formation of the feminine identity in Light in August. Then, through the examples of Lena Grove’s attempt to cross the boundaries of community moralities and Joanna Burden’s refusal to submit to the standards of submissiveness, domesticity, and obstinance, We will reveal the tension between progressive conceptions of individual freedom and social constraints that limit this freedom. In the second part of the paper, We will underscore the rhetoric of femininity in Light in August: subjugation through naming. The implications of both female’s names offer a powerful contrast between the two different forms of subjectivity. Conclusion: Through Faulkner’s novel, We demonstrate that female subjectivity is an open-ended issue. The spiral shaping of its form maintains its characteristics as a process changing according to different circumstances.

Keywords: female subjectivity, Faulkner’s light August, gender, sexuality, diversity

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Authors: Caspar Goeke, Holger Finger, Dorena Diekamp, Peter König

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Online-based research has recently gained increasing attention from various fields of research in the cognitive sciences. Technological advances in the form of online crowdsourcing (Amazon Mechanical Turk), open data repositories (Open Science Framework), and online analysis (Ipython notebook) offer rich possibilities to improve, validate, and speed up research. However, until today there is no cross-platform integration of these subsystems. Furthermore, implementation of online studies still suffers from the complex implementation (server infrastructure, database programming, security considerations etc.). Here we propose and test a new JavaScript framework that enables researchers to conduct any kind of behavioral research in the browser without the need to program a single line of code. In particular our framework offers the possibility to manipulate and combine the experimental stimuli via a graphical editor, directly in the browser. Moreover, we included an action-event system that can be used to handle user interactions, interactively change stimuli properties or store participants’ responses. Besides traditional recordings such as reaction time, mouse and keyboard presses, the tool offers webcam based eye and face-tracking. On top of these features our framework also takes care about the participant recruitment, via crowdsourcing platforms such as Amazon Mechanical Turk. Furthermore, the build in functionality of google translate will ensure automatic text translations of the experimental content. Thereby, thousands of participants from different cultures and nationalities can be recruited literally within hours. Finally, the recorded data can be visualized and cleaned online, and then exported into the desired formats (csv, xls, sav, mat) for statistical analysis. Alternatively, the data can also be analyzed online within our framework using the integrated Ipython notebook. The framework was designed such that studies can be used interchangeably between researchers. This will support not only the idea of open data repositories but also constitutes the possibility to share and reuse the experimental designs and analyses such that the validity of the paradigms will be improved. Particularly, sharing and integrating the experimental designs and analysis will lead to an increased consistency of experimental paradigms. To demonstrate the functionality of the framework we present the results of a pilot study in the field of spatial navigation that was conducted using the framework. Specifically, we recruited over 2000 subjects with various cultural backgrounds and consequently analyzed performance difference in dependence on the factors culture, gender and age. Overall, our results demonstrate a strong influence of cultural factors in spatial cognition. Such an influence has not yet been reported before and would not have been possible to show without the massive amount of data collected via our framework. In fact, these findings shed new lights on cultural differences in spatial navigation. As a consequence we conclude that our new framework constitutes a wide range of advantages for online research and a methodological innovation, by which new insights can be revealed on the basis of massive data collection.

Keywords: cultural differences, crowdsourcing, JavaScript framework, methodological innovation, online data collection, online study, spatial cognition

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Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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