Search results for: machine learning approach for neurological disorder assessment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 24631

Search results for: machine learning approach for neurological disorder assessment

871 Understanding Everyday Insecurities Emerging from Fragmented Territorial Control in Post-Accord Colombia

Authors: Clara Voyvodic

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Transitions from conflict to peace are by no means smooth nor linear, particularly from the perspective of those living through them. Over the last few decades, the changing focus in peacebuilding studies has come to appreciate the everyday experience of communities and how that provides a lens through which the relative success or efficacy of these transitions can be understood. In particular, the demobilization of a significant conflict actor is not without consequences, not just for the macro-view of state stabilization and peace, but for the communities who find themselves without a clear authority of territorial control. In Colombia, the demobilization and disarmament of the FARC guerilla group provided a brief respite to the conflict and a major political win for President Manuel Santos. However, this victory has proven short-lived. Drawing from extensive field research in Colombia within the last year, including interviews with local communities and actors operating in these regions, field observations, and other primary resources, this paper examines the post-accord transitions in Colombia and the everyday security experiences of local communities in regions formerly controlled by the FARC. In order to do so, the research focused on a semi-ethnographic approach in the northern region of the department of Antioquia and the coastal area of the border department of Nariño that documented how individuals within these marginalized communities have come to understand and negotiate their security in the years following the accord and the demobilization of the FARC. This presentation will argue that the removal of the FARC as an informal governance actor opened a space for multiple actors to attempt to control the same territory, including the state. This shift has had a clear impact on the everyday security experiences of the local communities. With an exploration of the dynamics of local governance and its impact on lived security experiences, this research seeks to demonstrate how distinct patterns of armed group behavior are emerging not only from a vacuum of control left by the FARC but from an increase in state presence that nonetheless remains inconsistent and unpersuasive as a monopoly of force in the region. The increased multiplicity of actors, particularly the state, has meant that the normal (informal) rules for communities to navigate these territories are no longer in play as the identities, actions, and intentions of different competing groups have become frustratingly opaque. This research provides a prescient analysis on how the shifting dynamics of territorial control in a post-peace accord landscape produce uncertain realities that affect the daily lives of the local communities and endanger the long-term prospect of human-centered security.

Keywords: armed actors, conflict transitions, informal governance, post-accord, security experiences

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870 Approximate Spring Balancing for the Arm of a Humanoid Robot to Reduce Actuator Torque

Authors: Apurva Patil, Ashay Aswale, Akshay Kulkarni, Shubham Bharadiya

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The potential benefit of gravity compensation of linkages in mechanisms using springs to reduce actuator requirements is well recognized, but practical applications have been elusive. Although existing methods provide exact spring balance, they require additional masses or auxiliary links, or all the springs used originate from the ground, which makes the resulting device bulky and space-inefficient. This paper uses a method of static balancing of mechanisms with conservative loads such as gravity and spring loads using non-zero-free-length springs with child–parent connections and no auxiliary links. Application of this method to the developed arm of a humanoid robot is presented here. Spring balancing is particularly important in this case because the serial chain of linkages has to work against gravity.This work involves approximate spring balancing of the open-loop chain of linkages using minimization of potential energy variance. It uses the approach of flattening the potential energy distribution over the workspace and fuses it with numerical optimization. The results show the considerable reduction in actuator torque requirement with practical spring design and arrangement. Reduced actuator torque facilitates the use of lower end actuators which are generally smaller in weight and volume thereby lowering the space requirements and the total weight of the arm. This is particularly important for humanoid robots where the parent actuator has to handle the weight of the subsequent actuators as well. Actuators with lower actuation requirements are more energy efficient, thereby reduce the energy consumption of the mechanism. Lower end actuators are lower in cost and facilitate the development of low-cost devices. Although the method provides only an approximate balancing, it is versatile, flexible in choosing appropriate control variables that are relevant to the design problem and easy to implement. The true potential of this technique lies in the fact that it uses a very simple optimization to find the spring constant, free-length of the spring and the optimal attachment points subject to the optimization constraints. Also, it uses physically realizable non-zero-free-length springs directly, thereby reducing the complexity involved in simulating zero-free-length springs from non-zero-free-length springs. This method allows springs to be attached to the preceding parent link, which makes the implementation of spring balancing practical. Because auxiliary linkages can be avoided, the resultant arm of the humanoid robot is compact. The cost benefits and reduced complexity can be significant advantages in the development of this arm of the humanoid robot.

Keywords: actuator torque, child-parent connections, spring balancing, the arm of a humanoid robot

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869 Building an Opinion Dynamics Model from Experimental Data

Authors: Dino Carpentras, Paul J. Maher, Caoimhe O'Reilly, Michael Quayle

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Opinion dynamics is a sub-field of agent-based modeling that focuses on people’s opinions and their evolutions over time. Despite the rapid increase in the number of publications in this field, it is still not clear how to apply these models to real-world scenarios. Indeed, there is no agreement on how people update their opinion while interacting. Furthermore, it is not clear if different topics will show the same dynamics (e.g., more polarized topics may behave differently). These problems are mostly due to the lack of experimental validation of the models. Some previous studies started bridging this gap in the literature by directly measuring people’s opinions before and after the interaction. However, these experiments force people to express their opinion as a number instead of using natural language (and then, eventually, encoding it as numbers). This is not the way people normally interact, and it may strongly alter the measured dynamics. Another limitation of these studies is that they usually average all the topics together, without checking if different topics may show different dynamics. In our work, we collected data from 200 participants on 5 unpolarized topics. Participants expressed their opinions in natural language (“agree” or “disagree”). We also measured the certainty of their answer, expressed as a number between 1 and 10. However, this value was not shown to other participants to keep the interaction based on natural language. We then showed the opinion (and not the certainty) of another participant and, after a distraction task, we repeated the measurement. To make the data compatible with opinion dynamics models, we multiplied opinion and certainty to obtain a new parameter (here called “continuous opinion”) ranging from -10 to +10 (using agree=1 and disagree=-1). We firstly checked the 5 topics individually, finding that all of them behaved in a similar way despite having different initial opinions distributions. This suggested that the same model could be applied for different unpolarized topics. We also observed that people tend to maintain similar levels of certainty, even when they changed their opinion. This is a strong violation of what is suggested from common models, where people starting at, for example, +8, will first move towards 0 instead of directly jumping to -8. We also observed social influence, meaning that people exposed with “agree” were more likely to move to higher levels of continuous opinion, while people exposed with “disagree” were more likely to move to lower levels. However, we also observed that the effect of influence was smaller than the effect of random fluctuations. Also, this configuration is different from standard models, where noise, when present, is usually much smaller than the effect of social influence. Starting from this, we built an opinion dynamics model that explains more than 80% of data variance. This model was also able to show the natural conversion of polarization from unpolarized states. This experimental approach offers a new way to build models grounded on experimental data. Furthermore, the model offers new insight into the fundamental terms of opinion dynamics models.

Keywords: experimental validation, micro-dynamics rule, opinion dynamics, update rule

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868 Performance Evaluation of Fingerprint, Auto-Pin and Password-Based Security Systems in Cloud Computing Environment

Authors: Emmanuel Ogala

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Cloud computing has been envisioned as the next-generation architecture of Information Technology (IT) enterprise. In contrast to traditional solutions where IT services are under physical, logical and personnel controls, cloud computing moves the application software and databases to the large data centres, where the management of the data and services may not be fully trustworthy. This is due to the fact that the systems are opened to the whole world and as people tries to have access into the system, many people also are there trying day-in day-out on having unauthorized access into the system. This research contributes to the improvement of cloud computing security for better operation. The work is motivated by two problems: first, the observed easy access to cloud computing resources and complexity of attacks to vital cloud computing data system NIC requires that dynamic security mechanism evolves to stay capable of preventing illegitimate access. Second; lack of good methodology for performance test and evaluation of biometric security algorithms for securing records in cloud computing environment. The aim of this research was to evaluate the performance of an integrated security system (ISS) for securing exams records in cloud computing environment. In this research, we designed and implemented an ISS consisting of three security mechanisms of biometric (fingerprint), auto-PIN and password into one stream of access control and used for securing examination records in Kogi State University, Anyigba. Conclusively, the system we built has been able to overcome guessing abilities of hackers who guesses people password or pin. We are certain about this because the added security system (fingerprint) needs the presence of the user of the software before a login access can be granted. This is based on the placement of his finger on the fingerprint biometrics scanner for capturing and verification purpose for user’s authenticity confirmation. The study adopted the conceptual of quantitative design. Object oriented and design methodology was adopted. In the analysis and design, PHP, HTML5, CSS, Visual Studio Java Script, and web 2.0 technologies were used to implement the model of ISS for cloud computing environment. Note; PHP, HTML5, CSS were used in conjunction with visual Studio front end engine design tools and MySQL + Access 7.0 were used for the backend engine and Java Script was used for object arrangement and also validation of user input for security check. Finally, the performance of the developed framework was evaluated by comparing with two other existing security systems (Auto-PIN and password) within the school and the results showed that the developed approach (fingerprint) allows overcoming the two main weaknesses of the existing systems and will work perfectly well if fully implemented.

Keywords: performance evaluation, fingerprint, auto-pin, password-based, security systems, cloud computing environment

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867 Interface Designer as Cultural Producer: A Dialectic Materialist Approach to the Role of Visual Designer in the Present Digital Era

Authors: Cagri Baris Kasap

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In this study, how interface designers can be viewed as producers of culture in the current era will be interrogated from a critical theory perspective. Walter Benjamin was a German Jewish literary critical theorist who, during 1930s, was engaged in opposing and criticizing the Nazi use of art and media. ‘The Author as Producer’ is an essay that Benjamin has read at the Communist Institute for the Study of Fascism in Paris. In this article, Benjamin relates directly to the dialectics between base and superstructure and argues that authors, normally placed within the superstructure should consider how writing and publishing is production and directly related to the base. Through it, he discusses what it could mean to see author as producer of his own text, as a producer of writing, understood as an ideological construct that rests on the apparatus of production and distribution. So Benjamin concludes that the author must write in ways that relate to the conditions of production, he must do so in order to prepare his readers to become writers and even make this possible for them by engineering an ‘improved apparatus’ and must work toward turning consumers to producers and collaborators. In today’s world, it has become a leading business model within Web 2.0 services of multinational Internet technologies and culture industries like Amazon, Apple and Google, to transform readers, spectators, consumers or users into collaborators and co-producers through platforms such as Facebook, YouTube and Amazon’s CreateSpace Kindle Direct Publishing print-on-demand, e-book and publishing platforms. However, the way this transformation happens is tightly controlled and monitored by combinations of software and hardware. In these global-market monopolies, it has become increasingly difficult to get insight into how one’s writing and collaboration is used, captured, and capitalized as a user of Facebook or Google. In the lens of this study, it could be argued that this criticism could very well be considered by digital producers or even by the mass of collaborators in contemporary social networking software. How do software and design incorporate users and their collaboration? Are they truly empowered, are they put in a position where they are able to understand the apparatus and how their collaboration is part of it? Or has the apparatus become a means against the producers? Thus, when using corporate systems like Google and Facebook, iPhone and Kindle without any control over the means of production, which is closed off by opaque interfaces and licenses that limit our rights of use and ownership, we are already the collaborators that Benjamin calls for. For example, the iPhone and the Kindle combine a specific use of technology to distribute the relations between the ‘authors’ and the ‘prodUsers’ in ways that secure their monopolistic business models by limiting the potential of the technology.

Keywords: interface designer, cultural producer, Walter Benjamin, materialist aesthetics, dialectical thinking

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866 The Impression of Adaptive Capacity of the Rural Community in the Indian Himalayan Region: A Way Forward for Sustainable Livelihood Development

Authors: Rommila Chandra, Harshika Choudhary

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The value of integrated, participatory, and community based sustainable development strategies is eminent, but in practice, it still remains fragmentary and often leads to short-lived results. Despite the global presence of climate change, its impacts are felt differently by different communities based on their vulnerability. The developing countries have the low adaptive capacity and high dependence on environmental variables, making them highly susceptible to outmigration and poverty. We need to understand how to enable these approaches, taking into account the various governmental and non-governmental stakeholders functioning at different levels, to deliver long-term socio-economic and environmental well-being of local communities. The research assessed the financial and natural vulnerability of Himalayan networks, focusing on their potential to adapt to various changes, through accessing their perceived reactions and local knowledge. The evaluation was conducted by testing indices for vulnerability, with a major focus on indicators for adaptive capacity. Data for the analysis were collected from the villages around Govind National Park and Wildlife Sanctuary, located in the Indian Himalayan Region. The villages were stratified on the basis of connectivity via road, thus giving two kinds of human settlements connected and isolated. The study focused on understanding the complex relationship between outmigration and the socio-cultural sentiments of local people to not abandon their land, assessing their adaptive capacity for livelihood opportunities, and exploring their contribution that integrated participatory methodologies can play in delivering sustainable development. The result showed that the villages having better road connectivity, access to market, and basic amenities like health and education have a better understanding about the climatic shift, natural hazards, and a higher adaptive capacity for income generation in comparison to the isolated settlements in the hills. The participatory approach towards environmental conservation and sustainable use of natural resources were seen more towards the far-flung villages. The study helped to reduce the gap between local understanding and government policies by highlighting the ongoing adaptive practices and suggesting precautionary strategies for the community studied based on their local conditions, which differ on the basis of connectivity and state of development. Adaptive capacity in this study has been taken as the externally driven potential of different parameters, leading to a decrease in outmigration and upliftment of the human environment that could lead to sustainable livelihood development in the rural areas of Himalayas.

Keywords: adaptive capacity, Indian Himalayan region, participatory, sustainable livelihood development

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865 Effective Service Provision and Multi-Agency Working in Service Providers for Children and Young People with Special Educational Needs and Disabilities: A Mixed Methods Systematic Review

Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove

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It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.

Keywords: collaboration, joint commissioning, service delivery, service improvement

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864 Hydroxyapatite Based Porous Scaffold for Tooth Tissue Engineering

Authors: Pakize Neslihan Taslı, Alev Cumbul, Gul Merve Yalcın, Fikrettin Sahin

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A key experimental trial in the regeneration of large oral and craniofacial defects is the neogenesis of osseous and ligamentous interfacial structures. Currently, oral regenerative medicine strategies are unpredictable for repair of tooth supporting tissues destroyed as a consequence of trauma, chronic infection or surgical resection. A different approach combining the gel-casting method with Hydroxy Apatite HA-based scaffold and different cell lineages as a hybrid system leads to successively mimic the early stage of tooth development, in vitro. HA is widely accepted as a bioactive material for guided bone and tooth regeneration. In this study, it was reported that, HA porous scaffold preparation, characterization and evaluation of structural and chemical properties. HA is the main factor that exists in tooth and it is in harmony with structural, biological, and mechanical characteristics. Here, this study shows mimicking immature tooth at the late bell stage design and construction of HA scaffolds for cell transplantation of human Adipose Stem Cells (hASCs), human Bone Marrow Stem Cells (hBMSCs) and Gingival Epitelial cells for the formation of human tooth dentin-pulp-enamel complexes in vitro. Scaffold characterization was demonstrated by SEM, FTIR and pore size and density measurements. The biological contraction of dental tissues against each other was demonstrated by mRNA gene expressions, histopatologic observations and protein release profile by ELISA tecnique. The tooth shaped constructs with a pore size ranging from 150 to 300 µm arranged by gathering right amounts of materials provide interconnected macro-porous structure. The newly formed tissue like structures that grow and integrate within the HA designed constructs forming tooth cementum like tissue, pulp and bone structures. These findings are important as they emphasize the potential biological effect of the hybrid scaffold system. In conclusion, this in vitro study clearly demonstrates that designed 3D scaffolds shaped as a immature tooth at the late bell stage were essential to form enamel-dentin-pulp interfaces with an appropriate cell and biodegradable material combination. The biomimetic architecture achieved here is providing a promising platform for dental tissue engineering.

Keywords: tooth regeneration, tissue engineering, adipose stem cells, hydroxyapatite tooth engineering, porous scaffold

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863 Experimental and Computational Fluid Dynamic Modeling of a Progressing Cavity Pump Handling Newtonian Fluids

Authors: Deisy Becerra, Edwar Perez, Nicolas Rios, Miguel Asuaje

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Progressing Cavity Pump (PCP) is a type of positive displacement pump that is being awarded greater importance as capable artificial lift equipment in the heavy oil field. The most commonly PCP used is driven single lobe pump that consists of a single external helical rotor turning eccentrically inside a double internal helical stator. This type of pump was analyzed by the experimental and Computational Fluid Dynamic (CFD) approach from the DCAB031 model located in a closed-loop arrangement. Experimental measurements were taken to determine the pressure rise and flow rate with a flow control valve installed at the outlet of the pump. The flowrate handled was measured by a FLOMEC-OM025 oval gear flowmeter. For each flowrate considered, the pump’s rotational speed and power input were controlled using an Invertek Optidrive E3 frequency driver. Once a steady-state operation was attained, pressure rise measurements were taken with a Sper Scientific wide range digital pressure meter. In this study, water and three Newtonian oils of different viscosities were tested at different rotational speeds. The CFD model implementation was developed on Star- CCM+ using an Overset Mesh that includes the relative motion between rotor and stator, which is one of the main contributions of the present work. The simulations are capable of providing detailed information about the pressure and velocity fields inside the device in laminar and unsteady regimens. The simulations have a good agreement with the experimental data due to Mean Squared Error (MSE) in under 21%, and the Grid Convergence Index (GCI) was calculated for the validation of the mesh, obtaining a value of 2.5%. In this case, three different rotational speeds were evaluated (200, 300, 400 rpm), and it is possible to show a directly proportional relationship between the rotational speed of the rotor and the flow rate calculated. The maximum production rates for the different speeds for water were 3.8 GPM, 4.3 GPM, and 6.1 GPM; also, for the oil tested were 1.8 GPM, 2.5 GPM, 3.8 GPM, respectively. Likewise, an inversely proportional relationship between the viscosity of the fluid and pump performance was observed, since the viscous oils showed the lowest pressure increase and the lowest volumetric flow pumped, with a degradation around of 30% of the pressure rise, between performance curves. Finally, the Productivity Index (PI) remained approximately constant for the different speeds evaluated; however, between fluids exist a diminution due to the viscosity.

Keywords: computational fluid dynamic, CFD, Newtonian fluids, overset mesh, PCP pressure rise

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862 Glycyrrhizic Acid Inhibits Lipopolysaccharide-Stimulated Bovine Fibroblast-Like Synoviocyte, Invasion through Suppression of TLR4/NF-κB-Mediated Matrix Metalloproteinase-9 Expression

Authors: Hosein Maghsoudi

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Rheumatois arthritis (RA) is progressive inflammatory autoimmune diseases that primarily affect the joints, characterized by synovial hyperplasia and inflammatory cell infiltration, deformed and painful joints, which can lead tissue destruction, functional disability systemic complications, and early dead and socioeconomic costs. The cause of rheumatoid arthritis is unknown, but genetic and environmental factors are contributory and the prognosis is guarded. However, advances in understanding the pathogenesis of the disease have fostered the development of new therapeutics, with improved outcomes. The current treatment strategy, which reflects this progress, is to initiate aggressive therapy soon after diagnosis and to escalate the therapy, guided by an assessment of disease activity, in pursuit of clinical remission. The pathobiology of RA is multifaceted and involves T cells, B cells, fibroblast-like synoviocyte (FLSc) and the complex interaction of many pro-inflammatory cytokine. Novel biologic agents that target tumor necrosis or interlukin (IL)-1 and Il-6, in addition T- and B-cells inhibitors, have resulted in favorable clinical outcomes in patients with RA. Despite this, at least 30% of RA patients are résistance to available therapies, suggesting novel mediators should be identified that can target other disease-specific pathway or cell lineage. Among the inflammatory cell population that might participated in RA pathogenesis, FLSc are crucial in initiaing and driving RA in concert of cartilage and bone by secreting metalloproteinase (MMPs) into the synovial fluid and by direct invasion into extracellular matrix (ECM), further exacerbating joint damage. Invasion of fibroblast-like synoviocytes (FLSc) is critical in the pathogenesis of rheumatoid-arthritis. The metalloproteinase (MMPs) and activator of Toll-like receptor 4 (TLR4)/nuclear factor- κB pthway play a critical role in RA-FLS invasion induced by lipopolysaccharide (LPS). The present study aimed to explore the anti-invasion activity of Glycyrrhizic Acid as a pharmacologically safe phytochemical agent with potent anti-inflammatory properties on IL-1beta and TNF-alpha signalling pathways in Bovine fibroblast-like synoviocyte ex- vitro, on LPS-stimulated bovine FLS migration and invasion as well as MMP expression and explored the upstream signal transduction. Results showed that Glycyrrhizic Acid suppressed LPS-stimulated bovine FLS migration and invasion by inhibition MMP-9 expression and activity. In addition our results revealed that Glycyrrhizic Acid inhibited the transcriptional activity of MMP-9 by suppression the nbinding activity of NF- κB in the MMP-9 promoter pathway. The extract of licorice (Glycyrrhiza glabra L.) has been widely used for many centuries in the traditional Chinese medicine as native anti-allergic agent. Glycyrrhizin (GL), a triterpenoidsaponin, extracted from the roots of licorice is the most effective compound for inflammation and allergic diseases in human body. The biological and pharmacological studies revealed that GL possesses many pharmacological effects, such as anti-inflammatory, anti-viral and liver protective effects, and the biological effects, such as induction of cytokines (interferon-γ and IL-12), chemokines as well as extrathymic T and anti-type 2 T cells. GL is known in the traditional Chinese medicine for its anti-inflammatory effect, which is originally described by Finney in 1959. The mechanism of the GL-induced anti-inflammatory effect is based on different pathways of the GL-induced selective inhibition of the prostaglandin E2 production, the CK-II- mediated activation of both GL-binding lipoxygenas (gbLOX; 17) and PLA2, an anti-thrombin action of GL and production of the reactive oxygen species (ROS; GL exerts liver protection properties by inhibiting PLA2 or by the hydroxyl radical trapping action, leading to the lowering of serum alanine and aspartate transaminase levels. The present study was undertaken to examine the possible mechanism of anti-inflammatory properties GL on IL-1beta and TNF-alpha signalling pathways in bovine fibroblast-like synoviocyte ex-vivo, on LPS-stimulated bovine FLS migration and invasion as well as MMP expression and explored the upstream signal transduction. Our results clearly showed that treatment of bovine fibroblast-like synoviocyte with GL suppressed LPS-induced cell migration and invasion. Furthermore, it revealed that GL inhibited the transcription activity of MMP-9 by suppressing the binding activity of NF-κB in the MM-9 promoter. MMP-9 is an important ECM-degrading enzyme and overexpression of MMPs in important of RA-FLSs. LPS can stimulate bovine FLS to secret MMPs, and this induction is regulated at the transcription and translational levels. In this study, LPS treatment of bovine FLS caused an increase in MMP-2 and MMP-9 levels. The increase in MMP-9 expression and secretion was inhibited by ex- vitro. Furthermore, these effects were mimicked by MMP-9 siRNA. These result therefore indicate the the inhibition of LPS-induced bovine FLS invasion by GL occurs primarily by inhibiting MMP-9 expression and activity. Next we analyzed the functional significance of NF-κB transcription of MMP-9 activation in Bovine FLSs. Results from EMSA showed that GL suppressed LPS-induced NF-κB binding to the MMP-9 promotor, as NF-κB regulates transcriptional activation of multiple inflammatory cytokines, we predicted that GL might target NF-κB to suppress MMP-9 transcription by LPS. Myeloid differentiation-factor 88 (MyD88) and TIR-domain containing adaptor protein (TIRAP) are critical proteins in the LPS-induced NF-κB and apoptotic signaling pathways, GL inhibited the expression of TLR4 and MYD88. These results demonstrated that GL suppress LPS-induced MMP-9 expression through the inhibition of the induced TLR4/NFκB signaling pathway. Taken together, our results provide evidence that GL exerts anti-inflammatory effects by inhibition LPS-induced bovine FLSs migration and invasion, and the mechanisms may involve the suppression of TLR4/NFκB –mediated MMP-9 expression. Although further work is needed to clarify the complicated mechanism of GL-induced anti-invasion of bovine FLSs, GL might be used as a further anti-invasion drug with therapeutic efficacy in the treatment of immune-mediated inflammatory disease such as RA.

Keywords: glycyrrhizic acid, bovine fibroblast-like synoviocyte, tlr4/nf-κb, metalloproteinase-9

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861 Possibilities and Limits for the Development of Care in Primary Health Care in Brazil

Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

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Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

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860 A Literature Review on the Use of Information and Communication Technology within and between Emergency Medical Teams during a Disaster

Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems

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859 Response Surface Methodology for the Optimization of Radioactive Wastewater Treatment with Chitosan-Argan Nutshell Beads

Authors: Fatima Zahra Falah, Touria El. Ghailassi, Samia Yousfi, Ahmed Moussaif, Hasna Hamdane, Mouna Latifa Bouamrani

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The management and treatment of radioactive wastewater pose significant challenges to environmental safety and public health. This study presents an innovative approach to optimizing radioactive wastewater treatment using a novel biosorbent: chitosan-argan nutshell beads. By employing Response Surface Methodology (RSM), we aimed to determine the optimal conditions for maximum removal efficiency of radioactive contaminants. Chitosan, a biodegradable and non-toxic biopolymer, was combined with argan nutshell powder to create composite beads. The argan nutshell, a waste product from argan oil production, provides additional adsorption sites and mechanical stability to the biosorbent. The beads were characterized using Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), and X-ray Diffraction (XRD) to confirm their structure and composition. A three-factor, three-level Box-Behnken design was utilized to investigate the effects of pH (3-9), contact time (30-150 minutes), and adsorbent dosage (0.5-2.5 g/L) on the removal efficiency of radioactive isotopes, primarily focusing on cesium-137. Batch adsorption experiments were conducted using synthetic radioactive wastewater with known concentrations of these isotopes. The RSM analysis revealed that all three factors significantly influenced the adsorption process. A quadratic model was developed to describe the relationship between the factors and the removal efficiency. The model's adequacy was confirmed through analysis of variance (ANOVA) and various diagnostic plots. Optimal conditions for maximum removal efficiency were pH 6.8, a contact time of 120 minutes, and an adsorbent dosage of 0.8 g/L. Under these conditions, the experimental removal efficiency for cesium-137 was 94.7%, closely matching the model's predictions. Adsorption isotherms and kinetics were also investigated to elucidate the mechanism of the process. The Langmuir isotherm and pseudo-second-order kinetic model best described the adsorption behavior, indicating a monolayer adsorption process on a homogeneous surface. This study demonstrates the potential of chitosan-argan nutshell beads as an effective and sustainable biosorbent for radioactive wastewater treatment. The use of RSM allowed for the efficient optimization of the process parameters, potentially reducing the time and resources required for large-scale implementation. Future work will focus on testing the biosorbent's performance with real radioactive wastewater samples and investigating its regeneration and reusability for long-term applications.

Keywords: adsorption, argan nutshell, beads, chitosan, mechanism, optimization, radioactive wastewater, response surface methodology

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858 Exploring Male and Female Consumers’ Perceptions of Clothing Retailers’ CSR Initiatives in South Africa

Authors: Gerhard D. Muller, Nadine C. Sonnenberg, Suné Donoghue

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This study delves into the intricacies of male and female consumers’ perceptions of Corporate Social Responsibility (CSR) in the South African clothing retail sector, a sector experiencing increasing consumption, yet facing significant environmental and social challenges. The aim is to discern between male and female consumers’ perceptions of clothing retailers’ CSR initiatives based on the Triple Bottom Line (TBL) framework, which evaluates organizational sustainability across social, environmental, and economic domains. Methodologically, the study is embedded in a quantitative research paradigm adopting a cross-sectional survey design. A purposive sampling strategy was used to recruit male and female respondents from a diverse South African demographic background. A structured questionnaire was developed and included established consumer CSR perception scales that were adapted for the purposes of this study. The questionnaire was distributed via online platforms. The data collected from the online survey, were split by gender to allow for comparison between male and female consumers’ perceptions of clothing retailers’ CSR initiatives. Exploratory Factor Analysis (EFA) was conducted on each of the datasets. The EFA for females revealed a five-factor solution, whereas the male EFA presented a six-factor solution, with the notable addition of an Economic Performance dimension. Results indicate subtle differences in the gender groups’ CSR perceptions. While both genders seem to value clothing retailers’ focus on quality services, females seem to have more pronounced perceptions surrounding clothing retailers’ contributions to social and environmental causes. Males, on the other hand, seem to be more discerning in their perceptions surrounding clothing retailers’ support of social and environmental causes. Ethical stakeholder relationships emerged as a shared concern across genders. Still, males presented a distinct factor, Economic Performance, highlighting a gendered divergence in the weighting of economic success and financial performance in CSR evaluation. The implications of these results are multifaceted. Theoretically, the study enriches the discourse on CSR by integrating gender insights into the TBL framework, offering a greater understanding of consumers’ CSR perceptions in the South African clothing retail context. Practically, it provides actionable insights for clothing retailers, suggesting that CSR initiatives should be gender-sensitive and communicate the TBL's elements effectively to resonate with the pertinent concerns of each segment. Additionally, the findings advocate for a contextualized approach to CSR in emerging markets that aligns with local cultural and social differences.

Keywords: consumer perceptions, corporate Social responsibility, gender differentiation, triple bottom line

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857 Application of Multiwall Carbon Nanotubes with Anionic Surfactant to Cement Paste

Authors: Maciej Szelag

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The discovery of the carbon nanotubes (CNT), has led to a breakthrough in the material engineering. The CNT is characterized by very large surface area, very high Young's modulus (about 2 TPa), unmatched durability, high tensile strength (about 50 GPa) and bending strength. Their diameter usually oscillates in the range from 1 to 100 nm, and the length from 10 nm to 10-2 m. The relatively new approach is the CNT’s application in the concrete technology. The biggest problem in the use of the CNT to cement composites is their uneven dispersion and low adhesion to the cement paste. Putting the nanotubes alone into the cement matrix does not produce any effect because they tend to agglomerate, due to their large surface area. Most often, the CNT is used as an aqueous suspension in the presence of a surfactant that has previously been sonicated. The paper presents the results of investigations of the basic physical properties (apparent density, shrinkage) and mechanical properties (compression and tensile strength) of cement paste with the addition of the multiwall carbon nanotubes (MWCNT). The studies were carried out on four series of specimens (made of two different Portland Cement). Within each series, samples were made with three w/c ratios – 0.4, 0.5, 0.6 (water/cement). Two series were an unmodified cement matrix. In the remaining two series, the MWCNT was added in amount of 0.1% by cement’s weight. The MWCNT was used as an aqueous dispersion in the presence of a surfactant – SDS – sodium dodecyl sulfate (C₁₂H₂₅OSO₂ONa). So prepared aqueous solution was sonicated for 30 minutes. Then the MWCNT aqueous dispersion and cement were mixed using a mechanical stirrer. The parameters were tested after 28 days of maturation. Additionally, the change of these parameters was determined after samples temperature loading at 250°C for 4 hours (thermal shock). Measurement of the apparent density indicated that cement paste with the MWCNT addition was about 30% lighter than conventional cement matrix. This is due to the fact that the use of the MWCNT water dispersion in the presence of surfactant in the form of SDS resulted in the formation of air pores, which were trapped in the volume of the material. SDS as an anionic surfactant exhibits characteristics specific to blowing agents – gaseous and foaming substances. Because of the increased porosity of the cement paste with the MWCNT, they have obtained lower compressive and tensile strengths compared to the cement paste without additive. It has been observed, however, that the smallest decreases in the compressive and tensile strength after exposure to the elevated temperature achieved samples with the MWCNT. The MWCNT (well dispersed in the cement matrix) can form bridges between hydrates in a nanoscale of the material’s structure. Thus, this may result in an increase in the coherent cohesion of the cement material subjected to a thermal shock. The obtained material could be used for the production of an aerated concrete or using lightweight aggregates for the production of a lightweight concrete.

Keywords: cement paste, elevated temperature, mechanical parameters, multiwall carbon nanotubes, physical parameters, SDS

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856 Combination Therapies Targeting Apoptosis Pathways in Pediatric Acute Myeloid Leukemia (AML)

Authors: Ahlam Ali, Katrina Lappin, Jaine Blayney, Ken Mills

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Leukaemia is the most frequently (30%) occurring type of paediatric cancer. Of these, approximately 80% are acute lymphoblastic leukaemia (ALL) with acute myeloid leukaemia (AML) cases making up the remaining 20% alongside other leukaemias. Unfortunately, children with AML do not have promising prognosis with only 60% surviving 5 years or longer. It has been highlighted recently the need for age-specific therapies for AML patients, with paediatric AML cases having a different mutational landscape compared with AML diagnosed in adult patients. Drug Repurposing is a recognized strategy in drug discovery and development where an already approved drug is used for diseases other than originally indicated. We aim to identify novel combination therapies with the promise of providing alternative more effective and less toxic induction therapy options. Our in-silico analysis highlighted ‘cell death and survival’ as an aberrant, potentially targetable pathway in paediatric AML patients. On this basis, 83 apoptotic inducing compounds were screened. A preliminary single agent screen was also performed to eliminate potentially toxic chemicals, then drugs were constructed into a pooled library with 10 drugs per well over 160 wells, with 45 possible pairs and 120 triples in each well. Seven cell lines were used during this study to represent the clonality of AML in paediatric patients (Kasumi-1, CMK, CMS, MV11-14, PL21, THP1, MOLM-13). Cytotoxicity was assessed up to 72 hours using CellTox™ Green reagent. Fluorescence readings were normalized to a DMSO control. Z-Score was assigned to each well based on the mean and standard deviation of all the data. Combinations with a Z-Score <2 were eliminated and the remaining wells were taken forward for further analysis. A well was considered ‘successful’ if each drug individually demonstrated a Z-Score <2, while the combination exhibited a Z-Score >2. Each of the ten compounds in one well (155) had minimal or no effect as single agents on cell viability however, a combination of two or more of the compounds resulted in a substantial increase in cell death, therefore the ten compounds were de-convoluted to identify a possible synergistic pair/triple combinations. The screen identified two possible ‘novel’ drug pairing, with BCL2 inhibitor ABT-737, combined with either a CDK inhibitor Purvalanol A, or AKT/ PI3K inhibitor LY294002. (ABT-737- 100 nM+ Purvalanol A- 1 µM) (ABT-737- 100 nM+ LY294002- 2 µM). Three possible triple combinations were identified (LY2409881+Akti-1/2+Purvalanol A, SU9516+Akti-1/2+Purvalanol A, and ABT-737+LY2409881+Purvalanol A), which will be taken forward for examining their efficacy at varying concentrations and dosing schedules, across multiple paediatric AML cell lines for optimisation of maximum synergy. We believe that our combination screening approach has potential for future use with a larger cohort of drugs including FDA approved compounds and patient material.

Keywords: AML, drug repurposing, ABT-737, apoptosis

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855 The Effect of Group Counseling on the Victimhood Perceptions of Adolescent Who Are the Subject of Peer Victimization and on Their Coping Strategies

Authors: İsmail Seçer, Taştan Seçer

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In this study, the effect of the group counseling on the victimhood perceptions of the primary school 7th and 8th grade students who are determined to be the subject of peer victimization and their dealing way with it was analyzed. The research model is Solomon Four Group Experimental Model. In this model, there are four groups that were determined with random sampling. Two of the groups have been used as experimental group and the other two have been used as control group. Solomon model is defined as real experimental model. In real experimental models, there are multiple groups consisting of subject which have similar characteristics, and selection of the subjects is done with random sampling. For this purpose, 230 students from Kültür Kurumu Primary School in Erzurum were asked to fill Adolescent Peer Victim Form. 100 students whose victim scores were higher and who were determined to be the subject of bullying were talked face to face and informed about the current study, and they were asked if they were willing to participate or not. As a result of these interviews, 60 students were determined to participate in the experimental study and four group consisting of 15 people were created with simple random sampling method. After the groups had been formed, experimental and control group were determined with casting lots. After determining experimental and control groups, an 11-session group counseling activity which was prepared by the researcher according to the literature was applied. The purpose of applying group counseling is to change the ineffective dealing ways with bullying and their victimhood perceptions. Each session was planned to be 75 minutes and applied as planned. In the control groups, counseling activities in the primary school counseling curricula was applied for 11 weeks. As a result of the study, physical, emotional and verbal victimhood perceptions of the participants in the experimental groups were decreased significantly compared to pre-experimental situations and to those in control group. Besides, it was determined that this change observed in the victimhood perceptions of the experimental group occurred independently from the effect of variables such as gender, age and academic success. The first evidence of the study related to the dealing ways is that the scores of the participants in the experimental group related to the ineffective dealing ways such as despair and avoidance is decreased significantly compared to the pre-experimental situation and to those in control group. The second evidence related to the dealing ways is that the scores of the participants in the experimental group related to effective dealing ways such as seeking for help, consulting social support, resistance and optimism is increased significantly compared to the pre-experimental situation and to those in control group. According to the evidence obtained through the study, it can be said that group counseling is an effective approach to change the victimhood perceptions of the individuals who are the subject of bullying and their dealing strategies with it.

Keywords: bullying, perception of victimization, coping strategies, ancova analysis

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854 An Exploration of Policy-related Documents on District Heating and Cooling in Flanders: a Slow and Bottom-up Process

Authors: Isaura Bonneux

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District heating and cooling (DHC) is increasingly recognized as a viable path towards sustainable heating and cooling. While some countries like Sweden and Denmark have a longstanding tradition of DHC, Belgium is lacking behind. The Northern part of Belgium, Flanders, had only a total of 95 heating networks in July 2023. Nevertheless, it is increasingly exploring its possibilities to enhance the scope of DHC. DHC is a complex energy system, requiring a lot of collaboration between various stakeholders on various levels. Therefore, it is of interest to look closer at policy-related documents at the Flemish (regional) level, as these policies set the scene for DHC development in the Flemish region. This kind of analysis has not been undertaken so far. This paper has the following research question: “Who talks about DHC, and in which way and context is DHC discussed in Flemish policy-related documents?” To answer this question, the Overton policy database was used to search and retrieve relevant policy-related documents. Overton retrieves data from governments, think thanks, NGOs, and IGOs. In total, out of the 244 original results, 117 documents between 2009 and 2023 were analyzed. Every selected document included theme keywords, policymaking department(s), date, and document type. These elements were used for quantitative data description and visualization. Further, qualitative content analysis revealed patterns and main themes regarding DHC in Flanders. Four main conclusions can be drawn: First, it is obvious from the timeframe that DHC is a new topic in Flanders with still limited attention; 2014, 2016 and 2017 were the years with the most documents, yet this number is still only 12 documents. In addition, many documents talked about DHC but not much in depth and painted it as a future scenario with a lot of uncertainty around it. The largest part of the issuing government departments had a link to either energy or climate (e.g. Flemish Environmental Agency) or policy (e.g. Socio-Economic Council of Flanders) Second, DHC is mentioned most within an ‘Environment and Sustainability’ context, followed by ‘General Policy and Regulation’. This is intuitive, as DHC is perceived as a sustainable heating and cooling technique and this analysis compromises policy-related documents. Third, Flanders seems mostly interested in using waste or residual heat as a heating source for DHC. The harbors and waste incineration plants are identified as potential and promising supply sources. This approach tries to conciliate environmental and economic incentives. Last, local councils get assigned a central role and the initiative is mostly taken by them. The policy documents and policy advices demonstrate that Flanders opts for a bottom-up organization. As DHC is very dependent on local conditions, this seems a logic step. Nevertheless, this can impede smaller councils to create DHC networks and slow down systematic and fast implementation of DHC throughout Flanders.

Keywords: district heating and cooling, flanders, overton database, policy analysis

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853 Hybrid Manufacturing System to Produce 3D Structures for Osteochondral Tissue Regeneration

Authors: Pedro G. Morouço

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One utmost challenge in Tissue Engineering is the production of 3D constructs capable of mimicking the functional hierarchy of native tissues. This is well stated for osteochondral tissue due to the complex mechanical functional unit based on the junction of articular cartilage and bone. Thus, the aim of the present study was to develop a new additive manufacturing system coupling micro-extrusion with hydrogels printing. An integrated system was developed with 2 main features: (i) the printing of up to three distinct hydrogels; (ii) in coordination with the printing of a thermoplastic structural support. The hydrogel printing module was projected with a ‘revolver-like’ system, where the hydrogel selection was made by a rotating mechanism. The hydrogel deposition was then controlled by pressured air input. The use of specific components approved for medical use was incorporated in the material dispensing system (Nordson EDF Optimum® fluid dispensing system). The thermoplastic extrusion modulus enabled the control of required extrusion temperature through electric resistances in the polymer reservoir and the extrusion system. After testing and upgrades, a hydrogel modulus with 3 syringes (3cm3 capacity each), with a pressure range of 0-2.5bar, a rotational speed of 0-5rpm, and working with needles from 200-800µm was obtained. This modulus was successfully coupled to the extrusion system that presented a temperature up to 300˚C, a pressure range of 0-12bar, and working with nozzles from 200-500µm. The applied motor could provide a velocity range 0-2000mm/min. Although, there are distinct printing requirements for hydrogels and polymers, the novel system could develop hybrid scaffolds, combining the 2 moduli. The morphological analysis showed high reliability (n=5) between the theoretical and obtained filament and pore size (350µm and 300µm vs. 342±4µm and 302±3µm, p>0.05, respectively) of the polymer; and multi-material 3D constructs were successfully obtained. Human tissues present very distinct and complex structures regarding their mechanical properties, organization, composition and dimensions. For osteochondral regenerative medicine, a multiphasic scaffold is required as subchondral bone and overlying cartilage must regenerate at the same time. Thus, a scaffold with 3 layers (bone, intermediate and cartilage parts) can be a promising approach. The developed system may give a suitable solution to construct those hybrid scaffolds with enhanced properties. The present novel system is a step-forward regarding osteochondral tissue engineering due to its ability to generate layered mechanically stable implants through the double-printing of hydrogels with thermoplastics.

Keywords: 3D bioprinting, bone regeneration, cartilage regeneration, regenerative medicine, tissue engineering

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852 The GRIT Study: Getting Global Rare Disease Insights Through Technology Study

Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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851 Modeling of Foundation-Soil Interaction Problem by Using Reduced Soil Shear Modulus

Authors: Yesim Tumsek, Erkan Celebi

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In order to simulate the infinite soil medium for soil-foundation interaction problem, the essential geotechnical parameter on which the foundation stiffness depends, is the value of soil shear modulus. This parameter directly affects the site and structural response of the considered model under earthquake ground motions. Strain-dependent shear modulus under cycling loads makes difficult to estimate the accurate value in computation of foundation stiffness for the successful dynamic soil-structure interaction analysis. The aim of this study is to discuss in detail how to use the appropriate value of soil shear modulus in the computational analyses and to evaluate the effect of the variation in shear modulus with strain on the impedance functions used in the sub-structure method for idealizing the soil-foundation interaction problem. Herein, the impedance functions compose of springs and dashpots to represent the frequency-dependent stiffness and damping characteristics at the soil-foundation interface. Earthquake-induced vibration energy is dissipated into soil by both radiation and hysteretic damping. Therefore, flexible-base system damping, as well as the variability in shear strengths, should be considered in the calculation of impedance functions for achievement a more realistic dynamic soil-foundation interaction model. In this study, it has been written a Matlab code for addressing these purposes. The case-study example chosen for the analysis is considered as a 4-story reinforced concrete building structure located in Istanbul consisting of shear walls and moment resisting frames with a total height of 12m from the basement level. The foundation system composes of two different sized strip footings on clayey soil with different plasticity (Herein, PI=13 and 16). In the first stage of this study, the shear modulus reduction factor was not considered in the MATLAB algorithm. The static stiffness, dynamic stiffness modifiers and embedment correction factors of two rigid rectangular foundations measuring 2m wide by 17m long below the moment frames and 7m wide by 17m long below the shear walls are obtained for translation and rocking vibrational modes. Afterwards, the dynamic impedance functions of those have been calculated for reduced shear modulus through the developed Matlab code. The embedment effect of the foundation is also considered in these analyses. It can easy to see from the analysis results that the strain induced in soil will depend on the extent of the earthquake demand. It is clearly observed that when the strain range increases, the dynamic stiffness of the foundation medium decreases dramatically. The overall response of the structure can be affected considerably because of the degradation in soil stiffness even for a moderate earthquake. Therefore, it is very important to arrive at the corrected dynamic shear modulus for earthquake analysis including soil-structure interaction.

Keywords: clay soil, impedance functions, soil-foundation interaction, sub-structure approach, reduced shear modulus

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850 Flexible Design Solutions for Complex Free form Geometries Aimed to Optimize Performances and Resources Consumption

Authors: Vlad Andrei Raducanu, Mariana Lucia Angelescu, Ion Cinca, Vasile Danut Cojocaru, Doina Raducanu

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By using smart digital tools, such as generative design (GD) and digital fabrication (DF), problems of high actuality concerning resources optimization (materials, energy, time) can be solved and applications or products of free-form type can be created. In the new digital technology materials are active, designed in response to a set of performance requirements, which impose a total rethinking of old material practices. The article presents the design procedure key steps of a free-form architectural object - a column type one with connections to get an adaptive 3D surface, by using the parametric design methodology and by exploiting the properties of conventional metallic materials. In parametric design the form of the created object or space is shaped by varying the parameters values and relationships between the forms are described by mathematical equations. Digital parametric design is based on specific procedures, as shape grammars, Lindenmayer - systems, cellular automata, genetic algorithms or swarm intelligence, each of these procedures having limitations which make them applicable only in certain cases. In the paper the design process stages and the shape grammar type algorithm are presented. The generative design process relies on two basic principles: the modeling principle and the generative principle. The generative method is based on a form finding process, by creating many 3D spatial forms, using an algorithm conceived in order to apply its generating logic onto different input geometry. Once the algorithm is realized, it can be applied repeatedly to generate the geometry for a number of different input surfaces. The generated configurations are then analyzed through a technical or aesthetic selection criterion and finally the optimal solution is selected. Endless range of generative capacity of codes and algorithms used in digital design offers various conceptual possibilities and optimal solutions for both technical and environmental increasing demands of building industry and architecture. Constructions or spaces generated by parametric design can be specifically tuned, in order to meet certain technical or aesthetical requirements. The proposed approach has direct applicability in sustainable architecture, offering important potential economic advantages, a flexible design (which can be changed until the end of the design process) and unique geometric models of high performance.

Keywords: parametric design, algorithmic procedures, free-form architectural object, sustainable architecture

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849 Reframing Physical Activity for Health

Authors: M. Roberts

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We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.

Keywords: behaviour change, long term conditions, partnership, relatable

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848 The Effect of Psychosocial, Behavioral and Disease Specific Characteristics on Health-Related Quality of Life after Primary Surgery for Colorectal Cancer: A Cross Sectional Study of a Regional Australian Population

Authors: Lakmali Anthony, Madeline Gillies

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Background: Colorectal cancer (CRC) is usually managed with surgical resection. Many of the outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO), such as Health-Related Quality of life (HRQoL), provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. HRQoL has previously been shown to be impacted by psychosocial, behavioral and disease-specific characteristics. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods: Consecutive patients who had resection of colorectal cancer in a single regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey instrument designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Demographic and disease-specific data were also collected via medical record review. Results: Forty-six patients completed the survey. Clinically significant levels of fear of recurrence as well as emotional distress, were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for CRC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL; however, the operative approach (laparoscopic vs. open) was associated with HRQoL for these patients. All psychosocial factors measured were associated with HRQoL, including cancer worry, emotional distress, body image and dispositional optimism. Conclusion: HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative colorectal cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: surgery, colorectal, cancer, PRO, HRQoL

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847 Media Response to Kashmir Conflict: How Press Differed in Highlighting Protest Shutdowns between 1990-2010

Authors: Danish Gadda

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Kashmir has been a bleeding-spot in the South Asian politics since 1947 when the subcontinent was bifurcated into Hindu, India and Muslim Pakistan by the departing British colonisers. Kashmir couldn’t accede to either of the two new-born, sovereign nations until tribal invasion from Pakistan forced an unfortunate change of events. India, driven by conditional accession signed by the Kashmir’s last monarch, sent its army to defend Kashmir Valley, with a promise, made subsequently, that the region’s fate would be decided by the natives through an internationally-monitored plebiscite. The country, however, broke its promise, choosing not to withdraw its military to allow the plebiscite, and, instead, strengthened its claim over Kashmir, which it later started describing as her integral part. War, fought in the shape of three and a half bloody battles, ensued between India and Pakistan, even as the United Nations’ intervention managed a ceasefire as early as in the 1950s, though not before Kashmir had come to be divided into its India-controlled and Pakistan-controlled halves. Prolonged, the dispute over Kashmir took a violent turn in 1989-90 with the start of an anti-India armed rebellion. Kashmiris have been fighting for their right to self-determination, and bringing their own life to a grinding halt has been one of their preferred forms of protest against the Indian rule. This form of resistance is locally called ‘Hartals’, and recognised as shutdowns, which have often been prolonged and violent. Since 1989-90, the shutdowns have become only more frequent and forceful, and there are marked days on which Kashmir shuts down in protest every year, like a ritual. This paper is based on a study of how the Indian and Kashmir press covered the shutdowns observed in the troubled valley on four such days: January 26 (Indian Republic Day), February 11 (the day on which India executed a prominent Kashmiri resistance leader), August 15 (India’s Independence Day), and October 27 (the day on which the Indian military has landed in Kashmir). The coverage given by the Indian and Kashmiri press to the shutdowns observed on these days has been studied using the multi-tier content analysis approach: 1) Difference in the number of shutdowns covered by the two section is looked at, 2) the placement of the stories in the two section of the press is analysed, 3) the discourse highlighted by the two section of the press is compared, and 4) the editorials written by the two section of the press about the shutdowns are analysed. The findings show the Indian and the local press have been focussing on the two, predictable extremes of the situation: the Indian press has favoured the state, while the Kashmir or the local press has focussed on the narrative opposing the state’s. The difference is noticed in the quantitative as well as the qualitative aspects of their coverage.

Keywords: Indo-Pak tension, Kashmir conflict, protest shutdowns, South-Asian politics

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846 Vagal Nerve Stimulator as a Treatment Approach in CHARGE Syndrome: A Case Report

Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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845 The Implementation of Human Resource Information System in the Public Sector: An Exploratory Study of Perceived Benefits and Challenges

Authors: Aneeqa Suhail, Shabana Naveed

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The public sector (in both developed and developing countries) has gone through various waves of radical reforms in recent decades. In Pakistan, under the influence of New Public Management(NPM) Reforms; best practices of private sector are introduced in the public sector to modernize public organizations. Human Resource Information System (HRIS) has been popular in the private sector and proven to be a successful system, therefore it is being adopted in the public sector too. However, implementation of private business practices in public organizations us very challenging due to differences in context. This implementation gets further critical in Pakistan due to a centralizing tendency and lack of autonomy in public organizations. Adoption of HRIS by public organizations in Pakistan raises several questions: What challenges are faced by public organizations in implementation of HRIS? Are benefits of HRIS such as efficiency, process integration and cost reduction achieved? How is the previous system improved with this change and what are the impacts? Yet, it is an under-researched topic, especially in public enterprises. This study contributes to the existing body of knowledge by empirically exploring benefits and challenges of implementation of HRIS in public organizations. The research adopts a case study approach and uses qualitative data based on in-depth interviews conducted at various levels in the hierarchy including top management, departmental heads and employees. The unit of analysis is LESCO, the Lahore Electric Supply Company, a state-owned entity that generates, transmits and distributes electricity to 4 big cities in Punjab, Pakistan. The findings of the study show that LESCO has not achieved the benefits of HRIS as established in literature. The implementation process remained quite slow and costly. Various functions of HR are still in isolation and integration is a big challenge for the organization. Although the data is automated, the previous system of manually record maintenance and paperwork is still in work, resulting in the presence of parallel practices. The findings also identified resistance to change from top management and labor workforce, lack of commitment and technical knowledge, and costly vendors as major barriers that affect the effective implementation of HRIS. The paper suggests some potential actions to overcome these barriers and to enhance effective implementation of HR-technology. The findings are explained in light of an institutional logics perspective. HRIS’ new logic of automated and integrated HR system is in sharp contrast with the prevailing logic of process-oriented manual data maintenance, leading to resistance to change and deadlock.

Keywords: human resource information system, technological changes, state-owned enterprise, implementation challenges

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844 Results and Insights from a Developmental Psychology Study on the Presentation of Juvenility in Punk Fanzines

Authors: Marc Dietrich

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Youth cultures like Punk as much as media relevant to the specific scenes associated with them offer ample opportunity for young people or juvenile adults to construct their personal identities. However, developmental psychology has largely neglected such identity construction processes during the last decades. Such was not always the case: Early developmental psychologists intensely studied youth cultures and their meaningful objects and media in the early 20th century but lost interest when cultural studies and the social sciences occupied the field after World War II. Our project Constructions of Juvenility and Generation(ality), funded by the German Federal Ministry for Education and Research, reintegrates the study of youth cultures and their meaningful objects and media in a developmental psychology perspective. We present an empirical study of the ways in which youth, juvenility, and generation (ality) are constructed and negotiated in underground media like punk fanzines (a portmanteau of fan and magazine), including both semantic and aesthetic aspects of these construction processes within punk culture. The fanzine sample was accessed by the theoretical sampling strategy typical for GTM studies. Acknowledging fanzines as artful self-produced media by scene members for scene members, we conceptualize them as authentic documents of scene norms and values. Drawing on an analysis of both text and (cover) images in Punk fanzines published in Germany (and within a sample dating from 1981 until 2015) using a novel Visual Grounded Theory approach, we found that: a) Juvenility is a highly contested concept in punk culture. Its semantic quality and valuation varies with the perspectives present within the culture (e.g. embryo punks versus older punks); b) Juvenility is constructed as having energy and being socio-critical that does not depend on biological age; c) Juvenility is regarded not an ideal per se in German Punk culture; Punk culture constructs old age in a largely positive way (e.g., as marker of being real and a historical innovator); d) Juvenility is constructed as a habit that should be kept for life as it is constantly adapted to individual biographical trajectories like specific job situations or having a family. Consequently, identity negotiation as documented in the zines attempts to balance subculturally driven perspectives on life and society with the pragmatic requirements of a bourgeois life. The proposed paper will present the main results of this large-scale study of punk fanzines and show how developmental psychology perspectives as represented in the novel methodology applied in it can advance the study of youth cultures.

Keywords: construction of juvenility, developmental psychology, visual GTM, youth culture, fanzines

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843 Addressing Supply Chain Data Risk with Data Security Assurance

Authors: Anna Fowler

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When considering assets that may need protection, the mind begins to contemplate homes, cars, and investment funds. In most cases, the protection of those assets can be covered through security systems and insurance. Data is not the first thought that comes to mind that would need protection, even though data is at the core of most supply chain operations. It includes trade secrets, management of personal identifiable information (PII), and consumer data that can be used to enhance the overall experience. Data is considered a critical element of success for supply chains and should be one of the most critical areas to protect. In the supply chain industry, there are two major misconceptions about protecting data: (i) We do not manage or store confidential/personally identifiable information (PII). (ii) Reliance on Third-Party vendor security. These misconceptions can significantly derail organizational efforts to adequately protect data across environments. These statistics can be exciting yet overwhelming at the same time. The first misconception, “We do not manage or store confidential/personally identifiable information (PII)” is dangerous as it implies the organization does not have proper data literacy. Enterprise employees will zero in on the aspect of PII while neglecting trade secret theft and the complete breakdown of information sharing. To circumvent the first bullet point, the second bullet point forges an ideology that “Reliance on Third-Party vendor security” will absolve the company from security risk. Instead, third-party risk has grown over the last two years and is one of the major causes of data security breaches. It is important to understand that a holistic approach should be considered when protecting data which should not involve purchasing a Data Loss Prevention (DLP) tool. A tool is not a solution. To protect supply chain data, start by providing data literacy training to all employees and negotiating the security component of contracts with vendors to highlight data literacy training for individuals/teams that may access company data. It is also important to understand the origin of the data and its movement to include risk identification. Ensure processes effectively incorporate data security principles. Evaluate and select DLP solutions to address specific concerns/use cases in conjunction with data visibility. These approaches are part of a broader solutions framework called Data Security Assurance (DSA). The DSA Framework looks at all of the processes across the supply chain, including their corresponding architecture and workflows, employee data literacy, governance and controls, integration between third and fourth-party vendors, DLP as a solution concept, and policies related to data residency. Within cloud environments, this framework is crucial for the supply chain industry to avoid regulatory implications and third/fourth party risk.

Keywords: security by design, data security architecture, cybersecurity framework, data security assurance

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842 Hospital Wastewater Treatment by Ultrafiltration Membrane System

Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

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