Search results for: transparency report

Authors: Angélique Laurent, Marie-Josée Letarte, Jean-Pascal Lemelin, Marie-France Morin

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This study aims at exploring teacher-child interactions within learning contexts in public prekindergartens of the province of Québec (Canada). It is based on previous research showing that teacher-child interactions in preschools have direct and determining effects on the quality of early childhood education and could directly or indirectly influence child development. However, throughout a typical preschool day, children experience different learning contexts to promote their learning opportunities. Depending on these specific contexts, teacher-child interactions could vary, for example, between free play and shared book reading. Indeed, some studies have found that teacher-directed or child-directed contexts might lead to significant variations in teacher-child interactions. This study drew upon both the bioecological and the Teaching Through Interactions frameworks. It was conducted through a descriptive and correlational design. Fifteen teachers were recruited to participate in the study. At Time 1 in October, they completed a diary to report the learning contexts they proposed in their classroom during a typical week. At Time 2, seven months later (May), they were videotaped three times in the morning (two weeks’ time between each recording) during a typical morning class. The quality of teacher-child interactions was then coded with the Classroom Assessment Scoring System (CLASS) through the contexts identified. This tool measures three main domains of interactions: emotional support, classroom organization, and instruction support, and10 dimensions scored on a scale from 1 (low quality) to 7 (high quality). Based on the teachers’ reports, five learning contexts were identified: 1) shared book reading, 2) free play, 3) morning meeting, 4) teacher-directed activity (such as craft), and 5) snack. Based on preliminary statistical analyses, little variation was observed within the learning contexts for each domain of the CLASS. However, the instructional support domain showed lower scores during specific learning contexts, specifically free play and teacher-directed activity. Practical implications for how preschool teachers could foster specific domains of interactions depending on learning contexts to enhance children’s social and academic development will be discussed.

Keywords: teacher practices, teacher-child interactions, preschool education, learning contexts, child development

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Authors: Zainab S. Ahmed, Mohammed S. Ali, Nadia A. Elshiekh, Sami Adam Ibrahim, Ghada M. El-Tayeb, Ahmed H. Elsadig, Rihab A. Omer, Sofia B. Mohamed

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Maple syrup urine (MSUD) is an autosomal recessive disease that causes a deficiency in the enzyme branched-chain alpha-keto acid (BCKA) dehydrogenase. The development of disease has been associated with SNPs in the DBT gene. Despite that, the computational analysis of SNPs in coding and noncoding and their functional impacts on protein level still remains unknown. Hence, in this study, we carried out a comprehensive in silico analysis of missense that was predicted to have a harmful influence on DBT structure and function. In this study, eight different in silico prediction algorithms; SIFT, PROVEAN, MutPred, SNP&GO, PhD-SNP, PANTHER, I-Mutant 2.0 and MUpo were used for screening nsSNPs in DBT including. Additionally, to understand the effect of mutations in the strength of the interactions that bind protein together the ELASPIC servers were used. Finally, the 3D structure of DBT was formed using Mutation3D and Chimera servers respectively. Our result showed that a total of 15 nsSNPs confirmed by 4 software (R301C, R376H, W84R, S268F, W84C, F276C, H452R, R178H, I355T, V191G, M444T, T174A, I200T, R113H, and R178C) were found damaging and can lead to a shift in DBT gene structure. Moreover, we found 7 nsSNPs located on the 2-oxoacid_dh catalytic domain, 5 nsSNPs on the E_3 binding domain and 3 nsSNPs on the Biotin Domain. So these nsSNPs may alter the putative structure of DBT’s domain. Furthermore, we detected all these nsSNPs are on the core residues of the protein and have the ability to change the stability of the protein. Additionally, we found W84R, S268F, and M444T have high significance, and they affected Leucine, Isoleucine, and Valine, which reduces or disrupt the function of BCKD complex, E2-subunit which the DBT gene encodes. In conclusion, based on our extensive in-silico analysis, we report 15 nsSNPs that have possible association with protein deteriorating and disease-causing abilities. These candidate SNPs can aid in future studies on Maple Syrup Urine Disease type II base in the genetic level.

Keywords: DBT gene, ELASPIC, in silico analysis, UCSF chimer

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

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Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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Authors: Cláudia Moço, Maria Santos, Carlos Arsénio, Débora Mendes, Miguel Oliveira. José Paulo Da Silva

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Construction industry generates large amounts of waste all over the world. About 450 million tons of construction and demolition wastes (C&DW) are produced annually in the European Union. C&DW are highly heterogeneous materials in size and composition, which imposes strong difficulties on their management. Directive n.º 2008/98/CE, of the European Parliament and of the Council of 6 November establishes that 70 % of the C&DW have to be recycled by 2020. To evaluate possible applications of these materials, a detailed physical, chemical and environmental characterization is necessary. Multi Triagem, Lda. is a company located in Algarve (Portugal) and was supported by the European Regional Development Fund (grant QREN 30307 Multivalor) to quantify and characterize the received C&DW, in order to evaluate their possible applications. This evaluation, performed in collaboration with the University of Algarve, involves a physical, chemical and environmental detailed characterization of the received C&DW. In this work we report on the amounts, trial procedures and properties of the C&DW received over a period of fifteen month. In this period the company received C&DW coming from 393 different origins. The total amount was 32.458 tons, mostly mixtures containing concrete, masonry/mortar and soil/rock. Most of C&DW came from demodulation constructions and diggings. The organic/inert component, namely metal, glass, wood and plastics, were screened first and account for about 3 % of the received materials. The remaining materials were screened and grouped according to their origin and contents, the latter evaluated by visual inspection. Twenty five samples were prepared and submitted to a detailed physical, chemical and environmental analysis. The C&DW aggregates show lower quality properties than natural aggregates for concrete preparation and unbound layers of road pavements. However, chemical analyzes indicated that most samples are environmentally safe. A continuous monitoring of the presence of heavy metals and organic compounds is needed in order to perform a proper screening of the C&DW. C&DW aggregates provide a good alternative to natural aggregates.

Keywords: construction and demolition wastes, waste classification, waste composition, waste screening

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Authors: Diptoshi Roy, G. Sreevidya Varma, S. Asokan, Chandasree Das

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Germanium Telluride based quaternary thin film switching devices with composition Ge₁₅In₅Te₅₆Ag_24, have been deposited in sandwich geometry on glass substrate with aluminum as top and bottom electrodes. The bulk glassy form of the said composition is prepared by melt quenching technique. In this technique, appropriate quantity of elements with high purity are taken in a quartz ampoule and sealed under a vacuum of 10^-5 mbar. Then, it is allowed to rotate in a horizontal rotary furnace for 36 hours to ensure homogeneity of the melt. After that, the ampoule is quenched into a mixture of ice - water and NaOH to get the bulk ingot of the sample. The sample is then coated on a glass substrate using flash evaporation technique at a vacuum level of 10^-6 mbar. The XRD report reveals the amorphous nature of the thin film sample and Energy - Dispersive X-ray Analysis (EDAX) confirms that the film retains the same chemical composition as that of the base sample. Electrical switching behavior of the device is studied with the help of Keithley (2410^c) source-measure unit interfaced with Lab VIEW 7 (National Instruments). Switching studies, mainly SET (changing the state of the material from amorphous to crystalline) operation is conducted on the thin film form of the sample. This device is found to manifest memory switching as the device remains 'ON' even after the removal of the electric field. Also it is found that amorphous Ge₁₅In₅Te₅₆Ag₂₄ thin film unveils clean memory type of electrical switching behavior which can be justified by the absence of fluctuation in the I-V characteristics. The I-V characteristic also reveals that the switching is faster in this sample as no data points could be seen in the negative resistance region during the transition to on state and this leads to the conclusion of fast phase change during SET process. Scanning Electron Microscopy (SEM) studies are performed on the chosen sample to study the structural changes at the time of switching. SEM studies on the switched Ge₁₅In₅Te₅₆Ag₂₄ sample has shown some morphological changes at the place of switching wherein it can be explained that a conducting crystalline channel is formed in the device when the device switches from high resistance to low resistance state. From these studies it can be concluded that the material may find its application in fast switching Non-Volatile Phase Change Memory (PCM) Devices.

Keywords: Chalcogenides, Vapor deposition, Electrical switching, PCM.

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Authors: Valdir Moura, Raniele dos Anjos de Souza, Fernando Gomes de Souza, Jose Vagner da Silva, Jerry Adriani Johann

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The estimate of the Area of Land to be planted with annual crops and its stratification by the municipality are important variables in crop forecast. Nowadays in Brazil, these information’s are obtained by the Brazilian Institute of Geography and Statistics (IBGE) and published under the report Assessment of the Agricultural Production. Due to the high cloud cover in the main crop growing season (October to March) it is difficult to acquire good orbital images. Thus, one alternative is to work with remote sensing data from dates before the crop growing season. This work presents the use of multitemporal Landsat data gathered on July and September (before the summer growing season) in order to estimate the area of land to be planted with summer crops in an area of São Paulo State, Brazil. Geographic Information Systems (GIS) and digital image processing techniques were applied for the treatment of the available data. Supervised and non-supervised classifications were used for data in digital number and reflectance formats and the multitemporal Normalized Difference Vegetation Index (NDVI) images. The objective was to discriminate the tracts with higher probability to become planted with summer crops. Classification accuracies were evaluated using a sampling system developed basically for this study region. The estimated areas were corrected using the error matrix derived from these evaluations. The classification techniques presented an excellent level according to the kappa index. The proportion of crops stratified by municipalities was derived by a field work during the crop growing season. These proportion coefficients were applied onto the area of land to be planted with summer crops (derived from Landsat data). Thus, it was possible to derive the area of each summer crop by the municipality. The discrepancies between official statistics and our results were attributed to the sampling and the stratification procedures. Nevertheless, this methodology can be improved in order to provide good crop area estimates using remote sensing data, despite the cloud cover during the growing season.

Keywords: area intended for summer culture, estimated area planted, agriculture, Landsat, planting schedule

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Authors: Portia Murphy, Danica Vasic, Anoja W. Gunaratne, Encarnita Sitchon, Teresita Tugonon, Marou Ison, Antoinette Le Busque, Christelle Pagonis, Thomas J. Borody

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Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects an estimated 11% of the population globally with the most predominant symptoms being abdominal pain, bloating and altered bowel movements. All age groups suffer from IBS although the prevalence of IBS decreases for age groups over 50 years. Women are more likely to suffer from IBS than men. IBS can be categorized into 3 groups based on the type of altered bowel movement: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-C) and IBS with mixed bowel habit (IBS-M). The contribution of the gut microbiome to the etiology of IBS is becoming increasingly recognized with rising use of anti-microbial agents. Previous studies on vancomycin and rifaximin used as monotherapy or in combination have been conducted mainly on IBS-C and showed marked improvements in the symptoms. According to our knowledge, no studies reported using these two combinations of antibiotics for IBS-D. Here, we report a consecutive cohort of 18 patients treated with both vancomycin and rifaximin for IBS-D. These patients’ records were reviewed retrospectively. In this cohort, patients ages were between 24-74 years (mean 44 years) and 9 were female. Baseline all patients had diarrhea, 4 with mucus and one with blood. Patients reported other symptoms were abdominal pain (n=11) bloating (n=9), flatulence (n=7), fatigue (n=4) and nausea (n=3). Patients treatments were personalized according to their symptom severity and tolerability and were treated with combination of rifaximin (500 - 3000mg/d) and vancomycin (500mg - 1500mg/d) for an ongoing period. Follow-ups were conducted between 2-32 weeks’ time. Of all patients, 89% patients reported improvement of the symptoms, 1 reported no change and 1 patient’s symptoms got worse. The mechanism of action for both vancomycin and rifaximin involves the inhibition of bacterial cell wall and protein synthesis respectively. The role of these medications in improving the symptoms of this cohort suggests that IBS-D may be microbiome infection driven. In this cohort, similar patient presentations to Clostridium difficile, as well as symptom improvement with the use of rifaximin and particularly vancomycin, suggest that the infectious agent may be an unidentified Clostridium. These preliminary results offer an alternative etiology for IBS-D not previously considered and open the avenue for new research.

Keywords: clostridium deficile, diarrhea predominant Irritable Bowel Syndrome, microbiome, vancomycin/rifaximin combination

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Authors: Eun Kyong Park

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This study explores the relationships between immigrant parents’ beliefs about bilingualism, family literacy practices, and their children’s identity development in Sydney, Australia. This project examines how these parents’ ideological beliefs and knowledge are related to their provision of family literacy practices and management of the environment for their bilingual children based on family language policy (FLP). This is a follow-up study of the author’s prior thesis that presented Korean immigrant mothers’ beliefs and decision-making in support of their children’s bilingualism. It includes fathers’ perspectives within the participating families as a whole by foregrounding their perceptions of bilingual and identity development. It adopts a qualitative approach with twelve immigrant mothers and fathers living in a Korean-Australian community whose child attends one of the communities Korean language programs. This time, it includes introspective and self-evocative auto-ethnographic data. The initial data set collected from the first part of this study demonstrated the mothers provided rich, diverse, and specific family literacy activities for their children. These mothers selected specific practices to facilitate their child’s bilingual development at home. The second part of data has been collected over a three month period: 1) a focus group interview with mothers; 2) a brief self-report of fathers; 3) the researcher’s reflective diary. To analyze these multiple data, thematic analysis and coding were used to reveal the parents’ ideologies surrounding bilingualism and bilingual identities. It will highlight the complexity of language and literacy practices in the family domain interrelated with sociocultural factors. This project makes an original contribution to the field of bilingualism and FLP and a methodological contribution by introducing auto-ethnographic input of this community’s lived practices. This project will empower Korean-Australian immigrant families and other multilingual communities to reflect their beliefs and practices for their emerging bilingual children. It will also enable educators and policymakers to access authentic information about how bilingualism is practiced within these immigrant families in multiple ways and to help build the culturally appropriate partnership between home and school community.

Keywords: bilingualism, beliefs, identity, family language policy, Korean immigrant parents in Australia

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Authors: Taku Numao, Kazu Amimoto, Tomoko Shimada, Kyohei Ichikawa

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Background: Unilateral spatial neglect (USN) is a common syndrome following damage to one hemisphere of the brain (usually the right side), in which a patient fails to report or respond to stimulation from the contralesional side. These symptoms are not due to primary sensory or motor deficits, but instead, reflect an inability to process input from that side of their environment. Prism adaptation (PA) is a therapeutic treatment for USN, wherein a patient’s visual field is artificially shifted laterally, resulting in a sensory-motor adaptation. However, patients with USN also tend to perceive a left-leaning subjective vertical in the frontal plane. The traditional PA cannot be used to correct a tilt in the subjective vertical, because a prism can only polarize, not twist, the surroundings. However, this can be accomplished using a head mounted display (HMD) and a web-camera. Therefore, this study investigated whether an HMD system could be used to correct the spatial perception of USN patients in the frontal as well as the horizontal plane. We recruited healthy subjects in order to collect data for the refinement of USN patient therapy. Methods: Eight healthy subjects sat on a chair wearing a HMD (Oculus rift DK2), with a web-camera (Ovrvision) displaying a 10 degree leftward rotation and a 10 degree counter-clockwise rotation along the frontal plane. Subjects attempted to point a finger at one of four targets, assigned randomly, a total of 48 times. Before and after the intervention, each subject’s body-centre judgment (BCJ) was tested by asking them to point a finger at a touch panel straight in front of their xiphisternum, 10 times sight unseen. Results: Intervention caused the location pointed to during the BCJ to shift 35 ± 17 mm (Ave ± SD) leftward in the horizontal plane, and 46 ± 29 mm downward in the frontal plane. The results in both planes were significant by paired-t-test (p<.01). Conclusions: The results in the horizontal plane are consistent with those observed following PA. Furthermore, the HMD and web-camera were able to elicit 3D effects, including in both the horizontal and frontal planes. Future work will focus on applying this method to patients with and without USN, and investigating whether subject posture is also affected by the HMD system.

Keywords: head mounted display, posture, prism adaptation, unilateral spatial neglect

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Authors: Ashraf M. Khalifa, Hwat Bing So, Greg Maddocks

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Changes to the mining environmental approvals process in Queensland have been rolled out under the MERFP Act (2018). This includes requirements for a Progressive Rehabilitation and Closure Plan (PRC Plan). Key considerations of the landform design report within the PRC Plan must include: (i) identification of materials available for landform rehabilitation, including their ability to achieve the required landform design outcomes, (ii) erosion assessments to determine landform heights, gradients, profiles, and material placement, (iii) slope profile design considering the interactions between soil erodibility, rainfall erosivity, landform height, gradient, and vegetation cover to identify acceptable erosion rates over a long-term average, (iv) an analysis of future stability based on the factors described above e.g., erosion and /or landform evolution modelling. ACARP funded an extensive and thorough erosion assessment program using rainfall simulators from 1998 to 2010. The ACARP program included laboratory assessment of 35 soil and spoil samples from 16 coal mines and samples from a gold mine in Queensland using 3 x 0.8 m laboratory rainfall simulator. The reliability of the laboratory rainfall simulator was verified through field measurements using larger flumes 20 x 5 meters and catchment scale measurements at three sites (3 different catchments, average area of 2.5 ha each). Soil cover systems are a primary component of a constructed mine landform. The primary functions of a soil cover system are to sustain vegetation and limit the infiltration of water and oxygen into underlying reactive mine waste. If the external surface of the landform erodes, the functions of the cover system cannot be maintained, and the cover system will most likely fail. Assessing a constructed landform’s potential ‘long-term’ erosion stability requires defensible erosion rate thresholds below which rehabilitation landform designs are considered acceptably erosion-resistant or ‘stable’. The process used to quantify erosion rates using rainfall simulators (flumes) to measure rill and inter-rill erosion on bulk samples under laboratory conditions or on in-situ material under field conditions will be explained.

Keywords: open-cut, mining, erosion, rainfall simulator

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Authors: Stephens Oluyemi Adetunji, Nel Norma Margaret, Naidu Narainsamy

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Empathy has been identified by researchers to be a crucial factor in helping adolescents to refrain from delinquent behavior. Adolescent delinquent behavior is a social problem that has become a source of concern to parents, psychologists, educators, correctional services, researchers as well as governments of nations. Empathy is a social skill that enables an individual to understand and to share another’s emotional state. An individual with a high level of empathy will avoid any act or behavior that will affect another person negatively. The need for this study is predicated on the fact that delinquent adolescent behavior could lead to adult criminality. This, in the long run, has the potential of resulting in an increase in crime rate thereby threatening public safety. It has therefore become imperative to explore the level of empathy of delinquent adolescents who have committed crime and are awaiting trial. It is the conjecture of this study that knowledge of the empathy level of delinquent adolescents will provide an opportunity to design an intervention strategy to remediate the deficit. This study was therefore designed to determine the level of empathy of delinquent adolescents. In addition, this study provides a better understanding of factors that may prevent adolescents from developing delinquent behavior, in this case, delinquents’ empathy levels. In the case of participants who have a low level of empathy, remediation strategies to improve their empathy level would be designed. Two research questions were raised to guide this study. A mixed methods research design was employed for the study. The sample consists of fifteen male adolescents who are between 13-18 years old with a mean age of 16.5 years old. The participants are adolescents who are awaiting trial. The non-probability sampling technique was used to obtain the sample for the quantitative study while purposive sampling was used in the case of the qualitative study. A self–report questionnaire and structured interview were used to assess the level of empathy of participants. The data obtained was analysed using the simple percentages for the quantitative data and transcribing the qualitative data. The result indicates that most of the participants have low level of empathy. It is also revealed that there is a difference in the empathy level on the basis of whether they are from parents living together and those whose parents are separated. Based on the findings of this study, it is recommended that the level of empathy of participants be improved through training and emphasizing the importance of stimulating family environment for children. It is also recommended that programs such as youth mentoring and youth sheltering be established by the government of South Africa to address the menace of delinquent adolescents.

Keywords: adolescents, behavior, delinquents, empathy

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Authors: Shola H. Adeosun, Lekan M. Togunwa, Kolawole Z. Amos

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This paper appraises ‘Newspaper Coverage of 2015 General Election: A study of The Punch and Guardian Newspapers’. The objectives of the study were to examine how credible newspaper reports of 2015 election were and to examine the significant role Nigeria Newspapers played in the 2015 general elections. Also this study examined the extent at which the print media contributed to the success of 2015 general election and to ascertain the extent at which print media reports serve as a tool for sensitizing the masses. The research questions that guided this research include: How credible was newspaper report of 2015 general election? To what extent did the print media contributed to the success of 2015 general elections? To what extent did the print media reports serve as a tool for sensitizing the masses? The research work was given solid theoretical foundation with the review of Agenda-setting theory, Media System Dependency Theory and Normative theories. This study was given solid theoretical foundation with the review of Agenda-setting theory, Media Dependency Theory and Normative theories. The theory was conducted using content analysis method of research and 30 publications of both The Guardian and Punch Newspaper between January 1st and March 30, 2015 forms the population for this research work. Selection of the dates and editions of Newspaper under study were done using the composite week sampling technique. All the days of the week were used for the newspapers because they (The Punch and The Guardian) are published all the days of the week. Coding sheet was the tool of data collection for the content analysis of this study. Findings of the study revealed that by the Punch newspaper and Guardian has played a significant role in eradicating election malpractices in Nigeria. It therefore concludes that media is metaphoric when we termed it to be a watchdog of the nation as well the mirror through which the nation see and recognize itself. The study also recommends that Nigerian media should strike balance between entertainment stories, crisis stories, economic stories, law story, education stories, terrorism stories, health stories, sport stories, metropolitan stories instead of portraying the country as being crime oriented.

Keywords: newspaper, coverage, general elections, impact

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Authors: Pankaj Kumar Jha, Mahendra Singh Hada, Brijendra Singh, Sandeep Yadav

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Protective relays are commonly connected to the secondary windings of instrument transformers, i.e., current transformers (CTs) and/or capacitive voltage transformers (CVTs). The purpose of CT and CVT is to provide galvanic isolation from high voltages and reduce primary currents and voltages to a nominal quantity recognized by the protective relays. Selecting the correct instrument transformers for an application is imperative: failing to do so may compromise the relay’s performance, as the output of the instrument transformer may no longer be an accurately scaled representation of the primary quantity. Having an accurately rated instrument transformer is of no use if these devices are not properly connected. The performance of the protective relay is reliant on its programmed settings and on the current and voltage inputs from the instrument transformers secondary. This paper will help in understanding the fundamental concepts of the connections of Instrument Transformers to the protection relays and the effect of incorrect connection on the performance of protective relays. Multiple case studies of protection system mal-operations due to incorrect connections of instrument transformers will be discussed in detail in this paper. Apart from the connection issue of instrument transformers to protective relays, this paper will also discuss the effect of multiple earthing of CTs and CVTs secondary on the performance of the protection system. Case studies presented in this paper will help the readers to analyse the problem through real-world challenges in complex power system networks. This paper will also help the protection engineer in better analysis of disturbance records. CT and CVT connection errors can lead to undesired operations of protection systems. However, many of these operations can be avoided by adhering to industry standards and implementing tried-and-true field testing and commissioning practices. Understanding the effect of missing neutral of CVT, multiple earthing of CVT secondary, and multiple grounding of CT star points on the performance of the protection system through real-world case studies will help the protection engineer in better commissioning the protection system and maintenance of the protection system.

Keywords: bus reactor, current transformer, capacitive voltage transformer, distance protection, differential protection, directional earth fault, disturbance report, instrument transformer, ICT, REF protection, shunt reactor, voltage selection relay, VT fuse failure

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Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet

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Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.

Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass

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Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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Authors: Nor Hafizah Selamat, Intan Hashima Mohd Hashim, Noraida Endut, Shariffah Suraya Syed Jamaludin, Sharifah Zahhura Syed Abdullah, Suziana Mat Yasin, Nurul Jannah Ambak

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In Malaysia, report on discrimination against pregnant women at work does exist, and this issue should be taken seriously as large proportion of women in the workforce in Malaysia are of reproductive age. It has been well established that women tend to leave the workforce because of their responsibility in raising the family, to care for family members and, also due to lack of work-life balance. In this case, women find themselves disadvantaged in career and job advancements due to gender roles and expectations connected with maternity. This maternity discrimination have pushed women out of work although The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), to which Malaysia is a party, considers discrimination on the ground of maternity is a form of gender discrimination because it hinders women of their effective right to work and requires that special protection be provided for women during maternity to ensure their ability to enjoy the right to work (Article 11(2). What factors prevent women from returning to work and at the same time performing their gender roles expectations? Using semi-structured in-depth interviews this paper explores the experiences of maternity discrimination and their perspectives towards their work employment. 15 women employees who were pregnant or had given birth during her employment period in public and private organizations in Malaysia were participated in this study. While data were analyzed using narrative analysis, respondents were asked on issues related to managing pregnancy, maternity leave and returning to work. The findings revealed that several respondents from private companies stated that they were either dismissed or forced to take unpaid leave due to the company policies. In some cases, respondents also shared how they were treated poorly that they felt that they had to leave their jobs. However, in public organization, the maternity policy implemented showed the support that the employees received from their employer. Study shows that supportive family and employers will encourage employees to return to work. Reasonable adjustments in terms of maternity policies at workplace such as allowing sufficient time in postnatal appointments, offering clear explanation on maternity issues at workplace are something that employees expected from their employers.

Keywords: maternity discrimination, women and work, gender, maternity protection, Malaysia

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Authors: Atif Alenezi

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The low global oil price poses economic challenges for Saudi Arabia, as oil revenues still make up a great percentage of its Gross Domestic Product (GDP). At the end of 2014, the Consultative Assembly considered a report from the Committee on Economic Affairs and Energy which highlights that the economy had not been successfully diversified. There thus exist ample reasons for modernising the Foreign Direct Investment (FDI) regime, primarily to achieve and maintain prosperity and facilitate peace in the region. Therefore, this paper aims at identifying specific problems with the existing FDI regime in Saudi Arabia and subsequently some solutions to those problems. Saudi Arabia adopted its first specific legislation in 1956, which imposed significant restrictions on foreign ownership. Since then, Saudi Arabia has modernised its FDI framework with the passing of the Foreign Capital Investment Act 1979 and the Foreign Investment Law2000 and the accompanying Executive Rules 2000 and the recently adopted Implementing Regulations 2014.Nonetheless, the legislative provisions contain various gaps and the failure to address these gaps creates risks and uncertainty for investors. For instance, the important topic of mergers and acquisitions has not been addressed in the Foreign Investment Law 2000. The circumstances in which expropriation can be considered to be in the public interest have not been defined. Moreover, Saudi Arabia has not entered into many bilateral investment treaties (BITs). This has an effect on the investment climate, as foreign investors are not afforded typical rights. An analysis of the BITs which have been entered into reveals that the national treatment standard and stabilisation, umbrella or renegotiation provisions have not been included. This is problematic since the 2000 Act does not spell out the applicable standard in accordance with which foreign investors should be treated. Moreover, the most-favoured-nation (MFN) or fair and equitable treatment (FET) standards have not been put on a statutory footing. Whilst the Arbitration Act 2012 permits that investment disputes can be internationalised, restrictions have been retained. The effectiveness of international arbitration is further undermined because Saudi Arabia does not enforce non-domestic arbitral awards which contravene public policy. Furthermore, the reservation to the Convention on the Settlement of Investment Disputes allows Saudi Arabia to exclude petroleum and sovereign disputes. Interviews with foreign investors, who operate in Saudi Arabia highlight additional issues. Saudi Arabia ought not to procrastinate far-reaching structural reforms.

Keywords: FDI, Saudi, BITs, law

Procedia PDF Downloads 391

Authors: David Onen

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Staff exchanges amongst different work organizations are a growing international phenomenon. In higher education in particular, it is not only the staff participating on international exchange programs, but their students as well. The practice of exchanging staff is premised on the belief that participating members of staff would not only get the chance to network with colleagues from partner institutions but also gain the opportunity for knowledge sharing and skills development. As a result, it would not only benefit the participating individual staff but their institutions too. However, in practice, staff exchange programs everywhere are not all ‘a bed of roses’. In fact, some of the programs seem to be laden with unapparent source of trouble or danger for the participating staff. This paper is a report on an on-going study investigating the experiences of members of academic staff of Makerere University in Uganda who have ever participated on international staff exchange programs. The study is aimed at documenting individual experiences in order to stimulate, not only a debate, but practical ways of enriching the experiences of staff who engage on well-meant international staff exchange programs. The study has employed an exploratory survey research design in which self-administered questionnaire and interview guide are being used to collect data from university academic staff respondents selected through snow-ball and purposive sampling techniques. Data have been analysed with the use of appropriate descriptive and inferential statistics as well as content analysis techniques. Preliminary study findings reveal that the majority of the respondents (95.5%) were, to a large extent, fully satisfied with their participation on the staff exchange programs. Many attested to gaining new experience (97%), networking (75%), gaining new knowledge (94%), acquiring new skills (88%), and therefore bringing to their institutions something ‘new’ and ‘beneficial’. However, a reasonably large percentage (57%) of the participants too expressed dissatisfaction in the institutional support that Makerere University gave them during their participation on the exchange programs. Some respondents reported about the ‘unfriendly welcome’ they received upon returning ‘home’ because colleagues detested how they were chosen to participate on such programs. The researcher thus concluded that international staff exchange programs are truly beneficial to both the participating staff and their institutions though with pitfalls. The researcher thus recommended for mutual and preferably equal engagement of the participating institutions on staff exchange programs if such programs are to benefit both the participating staff and institutions. Besides, exchange programs require clear terms of cooperation including on how staff are selected, facilitated and what are expected of the sending and host institutions as well as the concerned staff.

Keywords: gains, exchange programs, higher education, pitfalls

Procedia PDF Downloads 323

Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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Authors: Maciej Zasuwa, Grzegorz Ptasinski, Antoni Kopyt

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Nowadays flight simulators offer tremendous possibilities for safe and cost-effective pilot training, by utilization of powerful, computational tools. Due to technology outpacing methodology, vast majority of training related work is done by human instructors. It makes assessment not efficient, and vulnerable to instructors’ subjectivity. The research presents an Objective Assessment Tool (gOAT) developed at the Warsaw University of Technology, and tested on SW-4 helicopter flight simulator. The tool uses database of the predefined manoeuvres, defined and integrated to the virtual environment. These were implemented, basing on Aeronautical Design Standard Performance Specification Handling Qualities Requirements for Military Rotorcraft (ADS-33), with predefined Mission-Task-Elements (MTEs). The core element of the gOAT enhanced algorithm that provides instructor a new set of information. In details, a set of objective flight parameters fused with report about psychophysical state of the pilot. While the pilot performs the task, the gOAT system automatically calculates performance using the embedded algorithms, data registered by the simulator software (position, orientation, velocity, etc.), as well as measurements of physiological changes of pilot’s psychophysiological state (temperature, sweating, heart rate). Complete set of measurements is presented on-line to instructor’s station and shown in dedicated graphical interface. The presented tool is based on open source solutions, and flexible for editing. Additional manoeuvres can be easily added using guide developed by authors, and MTEs can be changed by instructor even during an exercise. Algorithm and measurements used allow not only to implement basic stress level measurements, but also to reduce instructor’s workload significantly. Tool developed can be used for training purpose, as well as periodical checks of the aircrew. Flexibility and ease of modifications allow the further development to be wide ranged, and the tool to be customized. Depending on simulation purpose, gOAT can be adjusted to support simulator of aircraft, helicopter, or unmanned aerial vehicle (UAV).

Keywords: automated assessment, flight simulator, human factors, pilot training

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Authors: Taiwo Olusoji Lawrence, Peace Mawo Aaron

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Seismic analysis of bedforms has proven to be one of the best ways to study deepwater sedimentary features. Canyons are known to be sediment transportation conduit. Sediment wave are large-scale depositional bedforms in various parts of the world's oceans formed predominantly by suspended load transport. These undulating objects usually have tens of meters to a few kilometers in wavelength and a height of several meters. Cyclic steps have long long-wave upstream-migrating bedforms confined by internal hydraulic jumps. They usually occur in regions with high gradients and slope breaks. Cyclic steps and migrating sediment waves are the most common bedform on the seafloor. Cyclic steps and related sediment wave bedforms are significant to the morpho-dynamic evolution of deep-water depositional systems architectural elements, especially those located along tectonically active margins with high gradients and slope breaks that can promote internal hydraulic jumps in turbidity currents. This report examined sedimentary activities and sediment transportation in submarine canyons and provided distinctive insight into factors that created a complex seabed canyon system in the Ceara Fortaleza basin Brazilian Equatorial Margin (BEM). The growing importance of cyclic steps made it imperative to understand the parameters leading to their formation, migration, and architecture as well as their controls on sediment transport in canyon thalweg. We extracted the parameters of the observed bedforms and evaluated the aspect ratio and asymmetricity. We developed a relationship between the hydraulic jump magnitude, depth of the hydraulic fall and the length of the cyclic step therein. It was understood that an increase in the height of the cyclic step increases the magnitude of the hydraulic jump and thereby increases the rate of deposition on the preceding stoss side. An increase in the length of the cyclic steps reduces the magnitude of the hydraulic jump and reduces the rate of deposition at the stoss side. Therefore, flat stoss side was noticed at most preceding cyclic step and sediment wave.

Keywords: Ceara Fortaleza, submarine canyons, cyclic steps, sediment wave

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Authors: Volker Wannack

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Regional, national, and international strategies focusing on hydrogen (H₂) and blockchain are driving significant advancements in hydrogen and blockchain technology worldwide. These strategies lay the foundation for the groundbreaking "Blockchain Based Hydrogen Market (BBH₂)" project. The primary goal of this project is to develop a functional Blockchain Minimum Viable Product (B-MVP) for the hydrogen market. The B-MVP will leverage blockchain as an enabling technology with a common database and platform, facilitating secure and automated transactions through smart contracts. This innovation will revolutionize logistics, trading, and transactions within the hydrogen market. The B-MVP has transformative potential across various sectors. It benefits renewable energy producers, surplus energy-based hydrogen producers, hydrogen transport and distribution grid operators, and hydrogen consumers. By implementing standardized, automated, and tamper-proof processes, the B-MVP enhances cost efficiency and enables transparent and traceable transactions. Its key objective is to establish the verifiable integrity of climate-friendly "green" hydrogen by tracing its supply chain from renewable energy producers to end users. This emphasis on transparency and accountability promotes economic, ecological, and social sustainability while fostering a secure and transparent market environment. A notable feature of the B-MVP is its cross-border operability, eliminating the need for country-specific data storage and expanding its global applicability. This flexibility not only broadens its reach but also creates opportunities for long-term job creation through the establishment of a dedicated blockchain operating company. By attracting skilled workers and supporting their training, the B-MVP strengthens the workforce in the growing hydrogen sector. Moreover, it drives the emergence of innovative business models that attract additional company establishments and startups and contributes to long-term job creation. For instance, data evaluation can be utilized to develop customized tariffs and provide demand-oriented network capacities to producers and network operators, benefitting redistributors and end customers with tamper-proof pricing options. The B-MVP not only brings technological and economic advancements but also enhances the visibility of national and international standard-setting efforts. Regions implementing the B-MVP become pioneers in climate-friendly, sustainable, and forward-thinking practices, generating interest beyond their geographic boundaries. Additionally, the B-MVP serves as a catalyst for research and development, facilitating knowledge transfer between universities and companies. This collaborative environment fosters scientific progress, aligns with strategic innovation management, and cultivates an innovation culture within the hydrogen market. Through the integration of blockchain and hydrogen technologies, the B-MVP promotes holistic innovation and contributes to a sustainable future in the hydrogen industry. The implementation process involves evaluating and mapping suitable blockchain technology and architecture, developing and implementing the blockchain, smart contracts, and depositing certificates of origin. It also includes creating interfaces to existing systems such as nomination, portfolio management, trading, and billing systems, testing the scalability of the B-MVP to other markets and user groups, developing data formats for process-relevant data exchange, and conducting field studies to validate the B-MVP. BBH₂ is part of the "Technology Offensive Hydrogen" funding call within the research funding of the Federal Ministry of Economics and Climate Protection in the 7th Energy Research Programme of the Federal Government.

Keywords: hydrogen, blockchain, sustainability, innovation, structural change

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Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

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Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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Authors: Klazina T. Havinga, Hilde R. H. de Geus

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Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

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Authors: Marco Sewald

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Comparing present to past the numbers of Americans expatriating U. S. citizenship have risen. Even though these numbers are small compared to the immigrants, U. S. citizens expatriations have historically been much lower, making the uptick worrisome. In addition, the published lists and numbers from the U.S. government seems incomplete, with many not counted. Different branches of the U. S. government report different numbers and no one seems to know exactly how big the real number is, even though the IRS and the FBI both track and/or publish numbers of Americans who renounce. Since there is no single explanation, anecdotal evidence suggests this uptick is caused by global tax law and increased compliance burdens imposed by the U.S. lawmakers on U.S. citizens abroad. Within a research project the question arose about the reasons why a constant growing number of U.S. citizens are expatriating – the answers are believed helping to explain the underlying governmental policy rational, leading to such activities. While it is impossible to locate former U.S. citizens to conduct a survey on the reasons and the U.S. government is not commenting on the reasons given within the process of expatriation, the chosen methodology is Structural Equation Modeling (SEM), in the first step by re-using current surveys conducted by different researchers within the population of U. S. citizens residing abroad during the last years. Surveys questioning the personal situation in the context of tax, compliance, citizenship and likelihood to repatriate to the U. S. In general SEM allows: (1) Representing, estimating and validating a theoretical model with linear (unidirectional or not) relationships. (2) Modeling causal relationships between multiple predictors (exogenous) and multiple dependent variables (endogenous). (3) Including unobservable latent variables. (4) Modeling measurement error: the degree to which observable variables describe latent variables. Moreover SEM seems very appealing since the results can be represented either by matrix equations or graphically. Results: the observed variables (items) of the construct are caused by various latent variables. The given surveys delivered a high correlation and it is therefore impossible to identify the distinct effect of each indicator on the latent variable – which was one desired result. Since every SEM comprises two parts: (1) measurement model (outer model) and (2) structural model (inner model), it seems necessary to extend the given data by conducting additional research and surveys to validate the outer model to gain the desired results.

Keywords: expatriation of U. S. citizens, SEM, structural equation modeling, validating

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Authors: Shahida Mohd Sharif, Norsidah Ujang

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Recent research has shown that many of the urban population in Kuala Lumpur, especially from the lower-income group, suffer from socio-psychological problems. They are reported as experiencing anxiety, depression, and stress, which is made worst by the recent COVID-19 pandemic. Much of the population was forced to observe the Movement Control Order (MCO), which is part of pandemic mitigation measures, pushing them to live in isolation as the new normal. The study finds the need to strategize for a better approach to help these people coping with the socio-psychological condition, especially the population from the lower-income group. In Kuala Lumpur, as part of the Local Agenda 21 programme, the Kuala Lumpur City Hall has introduced Green Initiative: Urban Farming, which among the approaches is the community garden. The local authority promotes the engagement to be capable of improving the social environment of the participants. Research has demonstrated that social interaction within community gardens can help the members improve their socio-psychological conditions. Therefore, the study explores the residents’ experience from low-cost flats participating in the community gardening initiative from a social attachment perspective. The study will utilise semi-structured interviews to collect the participants’ experience with community gardening and how the social interaction exchange between the members' forms and develop their ties and trust. For a context, the low-cost flats are part of the government social housing program (Program Perumahan Rakyat dan Perumahan Awam). Meanwhile, the community gardening initiative (Projek Kebun Kejiranan Bandar LA21 KL) is part of the local authority initiative to address the participants’ social, environmental, and economic issues. The study will conduct thematic analysis on the collected data and use the ATLAS.ti software for data organization and management purposes. The findings could help other researchers and stakeholders understand the social interaction experience within community gardens and its relation to ties and trusts. The findings could shed some light on how the participants could improve their social environment, and its report could provide the local authority with evidence-based documentation.

Keywords: community gardening participation, lower-income population, social attachment, social interaction

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Authors: Pawan Kumar, Pitamber Singh Negi

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Many of the regeneration failures in conifers are often being attributed to heavy insect attack and pathogens during the period of seed formation and under storage conditions. Conifer berries and seed insects occur throughout the known range of the hosts and also limit the production of seed for nursery stock. On occasion, even entire seed crops are lost due to insect attacks. The berry and seeds of both the species have been found to be infected with insects. Recently, heavy damage to the berry and seeds of Juniper and Chilgoza Pine was observed in the field as well as in stored conditions, leading to reduction in the viability of seeds to germinate. Both the species are under great threat and regeneration of the species is very low. Due to lack of adequate literature, the study on the damage potential of seed insects was urgently required to know the exact status of the insect-pests attacking seeds/berries of both the pine species so as to develop pest management practices against the insect pests attack. As both the species are also under threat and are fighting for survival, so the study is important to develop management practices for the insect-pests of seeds/berries of Juniper and Chilgoza pine so as to evaluate in the nursery, as these species form major vegetation of their distribution zones. A six-year study on the management of insect pests of seeds of Chilgoza revealed that seeds of this species are prone to insect pests mainly borers. During present investigations, it was recorded that cones of are heavily attacked only by Dioryctria abietella (Lepidoptera: Pyralidae) in natural conditions, but seeds which are economically important are heavily infected, (sometimes up to 100% damage was also recorded) by insect borer, Plodia interpunctella (Lepidoptera: Pyralidae) and is recorded for the first time ‘to author’s best knowledge’ infesting the stored Chilgoza seeds. Similarly, Juniper berries and seeds were heavily attacked only by a single borer, Homaloxestis cholopis (Lepidoptera: Lecithoceridae) recorded as a new report in natural habitat as well as in stored conditions. During the present investigation details of insect pest attack on Juniper and Chilgoza pine seeds and berries was observed and suitable management practices were also developed to contain the insect-pests attack.

Keywords: borer, chilgozapine, cones, conifer, Lepidoptera, juniper, management, seed

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Authors: Rosanna M. Rooney, Sharinaz Hassan, Maryanne McDevitt, Jacob D. Peckover, Robert T. Kane

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Anxiety and depression are the most common mental health problems experienced by Australian children and adolescents. Research into youth mental health points to the importance of considering emotional competence, parental influence on the child’s emotional development, and the fact that cognitions are still developing in childhood when designing and implementing positive psychology interventions. Additionally, research into such interventions has suggested the inclusion of a coaching component aimed at supporting those implementing the intervention enhances the effects of the intervention itself. In light of these findings and given the burden of anxiety and depression in the longer term, it is necessary to enhance the Aussie Optimism Positive Thinking Skills program and evaluate its efficacy in terms of children’s mental health outcomes. It was expected that the enhancement of the emotional and cognitive aspects of the Aussie Optimism Positive Thinking Skills program, the addition of coaching, and the inclusion of a parent manual would lead to significant prevention effects in internalizing problems at post-test, 6- and 18-months after the completion of the intervention. 502 students (9-11 years old) were randomly assigned to the intervention group (n = 347) or control group (n = 155). At each time point (baseline, post-test, 6-month follow-up, and 18-month follow-up), students completed a battery of self-report measures. The ten intervention sessions making up the enhanced Aussie Optimism Positive Thinking Skills program were run weekly. At post-test and 6-month follow-up, the intervention group reported significantly lower depression than the control group, with no group differences at the 18-month follow-up. The intervention group reported significantly lower anxiety than the control group only at the 6-month follow-up, with no group differences in the post-test or at the 18-month follow-up. Results suggest that the enhanced Aussie Optimism Positive Thinking Skills program can reduce depressive and anxious symptoms in the short term and highlight the importance of universally implemented positive psychology interventions.

Keywords: positive psychology, emotional competence, internalizing symptoms, universal implementation

Procedia PDF Downloads 54