Search results for: heritage interpretation and presentation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3151

Search results for: heritage interpretation and presentation

691 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital

Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

Abstract:

Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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690 Alteration Quartz-Kfeldspar-Apatite-Molybdenite at B Anomaly Prospection with Artificial Neural Network to Determining Molydenite Economic Deposits in Malala District, Western Sulawesi

Authors: Ahmad Lutfi, Nikolas Dhega

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The Malala deposit in northwest Sulawesi is the only known porphyry molybdenum and the only source for rhenium, occurrence in Indonesia. The neural network method produces results that correspond very closely to those of the knowledge-based fuzzy logic method and weights of evidence method. This method required data of solid geology, regional faults, airborne magnetic, gamma-ray survey data and GIS data. This interpretation of the network output fits with the intuitive notion that a prospective area has characteristics that closely resemble areas known to contain mineral deposits. Contrasts with the weights of evidence and fuzzy logic methods, where, for a given grid location, each input-parameter value automatically results in an increase in the prospective estimated. Malala District indicated molybdenum anomalies in stream sediments from in excess of 15 km2 were obtained, including the Takudan Fault as most prominent structure with striking 40̊ to 60̊ over a distance of about 30 km and in most places weakly at anomaly B, developed over an area of 4 km2, with a ‘shell’ up to 50 m thick at the intrusive contact with minor mineralization occurring in the Tinombo Formation. Series of NW trending, steeply dipping fracture zones, named the East Zone has an estimated resource of 100 Mt at 0.14% MoS2 and minimum target of 150 Mt 0.25%. The Malala porphyries occur as stocks and dykes with predominantly granitic, with fluorine-poor class of molybdenum deposits and belongs to the plutonic sub-type. Unidirectional solidification textures consisting of subparallel, crenulated layers of quartz that area separated by layers of intrusive material textures. The deuteric nature of the molybdenum mineralization and the dominance of carbonate alteration.The nature of the Stage I with alteration barren quartz K‐feldspar; and Stage II with alteration quartz‐K‐feldspar‐apatite-molybdenite veins combined with the presence of disseminated molybdenite with primary biotite in the host intrusive.

Keywords: molybdenite, Malala, porphyries, anomaly B

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689 Fostering Social Challenges Within Entrepreneur University Systems: The Case of UPV

Authors: Cristobal Miralles Insa

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The network of chairs of the "Valencian Public System of Social Services" (VPSSS) is sponsored by the Valencian Institute of Training, Research, and Quality in Social Services and aims to promote research, dissemination, and evaluation of the needs that arise in the field of the public system of social services. It also seeks to transfer knowledge to foster the development of public policies in this field. Given that it is an Interuniversity Chair among the five public universities in Valencia, there is coordination of complementary themes and roles for this objective, with Universitat Politènica de València focusing primarily on promoting innovation and social entrepreneurship to address multiple social challenges through its platform INSSPIRA. This approach is aimed at the entire university community and its various interest groups, carrying out research, teaching, and dissemination activities that promote social inclusion, personal development, and autonomy for groups in situations of vulnerability, lack of protection, dependence, or social urgency. Although it focuses on the Valencian context, both the issues in this context and the tools in process to address them, often have a universal and scalable character and has been inspiring for the innovation system of UPV. This entrepreneurial incubator goes along from early stages of students on the campus until the so-called “StartUPV” system, where students are challenged with social problems that require creative solutions. Therefore, the Chair is conceived with a holistic spirit and an inspiring vocation that engages the whole university community. In this communication, it is described the entities and individuals participating in this UPV Chair of VPSSS, followed by the presentation of different work lines and objectives for the chair. Subsequently, a description of various activities undertaken to promote innovation in social services are described, where support to teaching and extracurricular activities in this field are exposed. It must be noted that some awareness and dissemination of activities are carried out in a transversal mode as they contribute to different objectives simultaneously; with special focus on Learning-Service approaches that achieved very good results which are also summarized.

Keywords: social innovation, entrepeneurship, university, vulnerable sectors

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688 Primary Fallopian Tube Carcinoma: A Case Report

Authors: Mary Abigail T. Ty, Mary Jocelyn Yu-Laygo, Jocelyn Z. Mariano

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This is a case of L.S.T., a 61 year old, G6P4 (3124) who presented with a one month history of intermittent, brownish, watery, non foul smelling vaginal discharge. There were no other accompanying symptoms. On rectovaginal examination, a palpable adnexal mass on the left was appreciated, with the lower border measuring 3 cm. The mass was non-tender, had irregular borders and solid areas. On transvaginal sonography, it revealed a left pelvic mass measuring 3 x 4 x 2 cm, with a Sassone score of 9. It had vascularization. The primary consideration was Ovarian Newgrowth, probably malignant in nature. CA-125 results were slightly elevated at 43.2 u/ml (NV: 0-35 u/ml). After intraoperative evaluation, the left fallopian tube was converted into a 9 x 4.5 x 3 cm bulbous cystic mass with solid areas. On cut section, the ampullary portion of the fallopian tube contained necrotic and friable looking tissues. Specimen was sent for frozen section and results revealed adenocarcinoma of the left fallopian tube. Patient subsequently underwent complete surgical staging with unremarkable post-operative course. The Surg Ico pathologic diagnosis was G6P4 (3124) Fallopian tube serous cystadenocarcinoma stage 1. The mean incidence of PFTC is 3.6 per million women yearly. This is associated with a generally low survival rate. The primary diagnosis is very difficult to establish because only 0–10% of patients suffering from PFTC are diagnosed pre-operatively. Symptoms play a very important role in the discovery of this disease, because there will be no presentation to the hospital without symptoms. The most common of which may be vaginal bleeding, abdominal pain, a palpable mass and ascites. A conglomerate of manifestations may be encountered, but not at all times. This is termed hydrops tubae profluens where there is presence of colicky pain with relief from intermittent passage of serosanguinous vaginal discharge. The significance of this report is to emphasize the rarity of the case and how the dilemma in the diagnosis is almost always present despite ancillary procedures.

Keywords: fallopian tube carcinoma, prognosis, rare, risk factors

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687 The Alliance for Grassland Renewal: A Model for Teaching Endophyte Technology

Authors: C. A. Roberts, J. G. Andrae, S. R. Smith, M. H. Poore, C. A. Young, D. W. Hancock, G. J. Pent

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To the author’s best knowledge, there are no published reports of effective methods for teaching fescue toxicosis and grass endophyte technology in the USA. To address this need, a group of university scientists, industry representatives, government agents, and livestock producers formed an organization called the Alliance for Grassland Renewal. One goal of the Alliance was to develop a teaching method that could be employed across all regions in the USA and all sectors of the agricultural community. The first step in developing this method was identification of experts who were familiar with the science and management of fescue toxicosis. The second step was curriculum development. Experts wrote a curriculum that addressed all aspects of toxicosis and management, including toxicology, animal nutrition, pasture management, economics, and mycology. The curriculum was created for presentation in lectures, laboratories, and in the field. The curriculum was in that it could be delivered across state lines, regardless of peculiar, in-state recommendations. The curriculum was also unique as it was unanimously supported by private companies otherwise in competition with each other. The final step in developing this teaching method was formulating a delivery plan. All experts, including university, industry, government, and production, volunteered to travel from any state in the USA, converge in one location, teach a 1-day workshop, then travel to the next location. The results of this teaching method indicate widespread success. Since 2012, experts across the entire USA have converged to teach Alliance workshops in Kansas, Oklahoma, Missouri, Kentucky, Georgia, South Carolina, North Carolina, and Virginia, with ongoing workshops in Arkansas and Tennessee. Data from post-workshop surveys indicate that instruction has been effective, as at least 50% of the participants stated their intention to adopt the endophyte technology presented in these workshops. The teaching method developed by the Alliance for Grassland Renewal has proved to be effective, and the Alliance continues to expand across the USA.

Keywords: endophyte, Epichloe coenophiala, ergot alkaloids, fescue toxicosis, tall fescue

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686 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome

Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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685 Saving the Decolonized Subject from Neglected Tropical Diseases: Public Health Campaign and Household-Centred Sanitation in Colonial West Africa, 1900-1960

Authors: Adebisi David Alade

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In pre-colonial West Africa, the deadliness of the climate vis-a- vis malaria and other tropical diseases to Europeans turned the region into the “white man’s grave.” Thus, immediately after the partition of Africa in 1885, civilisatrice and mise en valeur not only became a pretext for the establishment of colonial rule; from a medical point of view, the control and possible eradication of disease in the continent emerged as one of the first concerns of the European colonizers. Though geared toward making Africa exploitable, historical evidence suggests that some colonial Water, Sanitation and Hygiene (WASH) policies and projects reduced certain tropical diseases in some West African communities. Exploring some of these disease control interventions by way of historical revisionism, this paper challenges the orthodox interpretation of colonial sanitation and public health measures in West Africa. This paper critiques the deployment of race and class as analytical tools for the study of colonial WASH projects, an exercise which often reduces the complexity and ambiguity of colonialism to the binary of colonizer and the colonized. Since West Africa presently ranks high among regions with Neglected Tropical Diseases (NTDs), it is imperative to decentre colonial racism and economic exploitation in African history in order to give room for Africans to see themselves in other ways. Far from resolving the problem of NTDs by fiat in the region, this study seeks to highlight important blind spots in African colonial history in an attempt to prevent post-colonial African leaders from throwing away the baby with the bath water. As scholars researching colonial sanitation and public health in the continent rarely examine its complex meaning and content, this paper submits that the outright demonization of colonial rule across space and time continues to build ideological wall between the present and the past which not only inhibit fruitful borrowing from colonial administration of West Africa, but also prevents a wide understanding of the challenges of WASH policies and projects in most West African states.

Keywords: colonial rule, disease control, neglected tropical diseases, WASH

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684 Analysing the Applicability of a Participatory Approach to Life Cycle Sustainability Assessment: Case Study of a Housing Estate Regeneration in London

Authors: Sahar Navabakhsh, Rokia Raslan, Yair Schwartz

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Decision-making on regeneration of housing estates, whether to refurbish or re-build, has been mostly triggered by economic factors. To enable sustainable growth, it is vital that environmental and social impacts of different scenarios are also taken into account. The methodology used to include all the three sustainable development pillars is called Life Cycle Sustainability Assessment (LCSA), which comprises of Life Cycle Assessment (LCA) for the assessment of environmental impacts of buildings. Current practice of LCA is regularly conducted post design stage and by sustainability experts. Not only is undertaking an LCA at this stage less effective, but issues such as the limited scope for the definition and assessment of environmental impacts, the implication of changes in the system boundary and the alteration of each of the variable metrics, employment of different Life Cycle Impact Assessment Methods and use of various inventory data for Life Cycle Inventory Analysis can result in considerably contrasting results. Given the niche nature and scarce specialist domain of LCA of buildings, the majority of the stakeholders do not contribute to the generation or interpretation of the impact assessment, and the results can be generated and interpreted subjectively due to the mentioned uncertainties. For an effective and democratic assessment of environmental impacts, different stakeholders, and in particular the community and design team should collaborate in the process of data collection, assessment and analysis. This paper examines and evaluates a participatory approach to LCSA through the analysis of a case study of a housing estate in South West London. The study has been conducted throughout tier-based collaborative methods to collect and share data through surveys and co-design workshops with the community members and the design team as the main stakeholders. The assessment of lifecycle impacts is conducted throughout the process and has influenced the decision-making on the design of the Community Plan. The evaluation concludes better assessment transparency and outcome, alongside other socio-economic benefits of identifying and engaging the most contributive stakeholders in the process of conducting LCSA.

Keywords: life cycle assessment, participatory LCA, life cycle sustainability assessment, participatory processes, decision-making, housing estate regeneration

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683 Big Data Analytics and Public Policy: A Study in Rural India

Authors: Vasantha Gouri Prathapagiri

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Innovations in ICT sector facilitate qualitative life style for citizens across the globe. Countries that facilitate usage of new techniques in ICT, i.e., big data analytics find it easier to fulfil the needs of their citizens. Big data is characterised by its volume, variety, and speed. Analytics involves its processing in a cost effective way in order to draw conclusion for their useful application. Big data also involves into the field of machine learning, artificial intelligence all leading to accuracy in data presentation useful for public policy making. Hence using data analytics in public policy making is a proper way to march towards all round development of any country. The data driven insights can help the government to take important strategic decisions with regard to socio-economic development of her country. Developed nations like UK and USA are already far ahead on the path of digitization with the support of Big Data analytics. India is a huge country and is currently on the path of massive digitization being realised through Digital India Mission. Internet connection per household is on the rise every year. This transforms into a massive data set that has the potential to improvise the public services delivery system into an effective service mechanism for Indian citizens. In fact, when compared to developed nations, this capacity is being underutilized in India. This is particularly true for administrative system in rural areas. The present paper focuses on the need for big data analytics adaptation in Indian rural administration and its contribution towards development of the country on a faster pace. Results of the research focussed on the need for increasing awareness and serious capacity building of the government personnel working for rural development with regard to big data analytics and its utility for development of the country. Multiple public policies are framed and implemented for rural development yet the results are not as effective as they should be. Big data has a major role to play in this context as can assist in improving both policy making and implementation aiming at all round development of the country.

Keywords: Digital India Mission, public service delivery system, public policy, Indian administration

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682 A Web-Based Systems Immunology Toolkit Allowing the Visualization and Comparative Analysis of Publically Available Collective Data to Decipher Immune Regulation in Early Life

Authors: Mahbuba Rahman, Sabri Boughorbel, Scott Presnell, Charlie Quinn, Darawan Rinchai, Damien Chaussabel, Nico Marr

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Collections of large-scale datasets made available in public repositories can be used to identify and fill gaps in biomedical knowledge. But first, these data need to be made readily accessible to researchers for analysis and interpretation. Here a collection of transcriptome datasets was made available to investigate the functional programming of human hematopoietic cells in early life. Thirty two datasets were retrieved from the NCBI Gene Expression Omnibus (GEO) and loaded in a custom, interactive web application called the Gene Expression browser (GXB), designed for visualization and query of integrated large-scale data. Multiple sample groupings and gene rank lists were created based on the study design and variables in each dataset. Web links to customized graphical views can be generated by users and subsequently be used to graphically present data in manuscripts for publication. The GXB tool also enables browsing of a single gene across datasets, which can provide information on the role of a given molecule across biological systems. The dataset collection is available online. As a proof-of-principle, one of the datasets (GSE25087) was re-analyzed to identify genes that are differentially expressed by regulatory T cells in early life. Re-analysis of this dataset and a cross-study comparison using multiple other datasets in the above mentioned collection revealed that PMCH, a gene encoding a precursor of melanin-concentrating hormone (MCH), a cyclic neuropeptide, is highly expressed in a variety of other hematopoietic cell types, including neonatal erythroid cells as well as plasmacytoid dendritic cells upon viral infection. Our findings suggest an as yet unrecognized role of MCH in immune regulation, thereby highlighting the unique potential of the curated dataset collection and systems biology approach to generate new hypotheses which can be tested in future mechanistic studies.

Keywords: early-life, GEO datasets, PMCH, interactive query, systems biology

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681 The Consequence of Being Perceived as An 'Immodest Woman': The Kuwaiti Criminal Justice System’s Response to Allegations of Sexual Violence

Authors: Eiman Alqattan

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Kuwaiti criminal justice system’s responses to allegations of sexual violence against women during the pre-trial process, suggesting that the system in Kuwait is affected by an ethos that is male dominated and patriarchal, and which results in prejudicial, unfair, and unequal treatment of female victims of serious sexual offenses. Data derived from qualitative semi-structured face-to-face interviews with four main groups of criminal justice system personnel in Kuwait (prosecutors, police investigators, police officers, and investigators) reveal the characteristics of a complaint of sexual violence that contribute to cases being either sent to court or dismissed. This proposed paper will suggest that Arab cultural views of women appear to influence and even shape the views, perceptions, and conduct of the interviewed Kuwaiti criminal justice system personnel regarding complaints of sexual violence made by citizens. Data from the interviews show how the image of the ‘modest woman’ that exists within Arabic cultural views and norms greatly contributes to shaping the characteristics of what the majority of the interviewed officials considered to be a ‘credible’ allegation of sexual violence. In addition, it is clear that the interviewees’ definitions of ‘modesty’ varied. Yet the problem is not only about the stereotypical perceptions of complainants or the consequences of those perceptions on the decision to send the case to court. These perceptions also affected the behaviours of criminal justice system personnel towards citizen complainants. When complainants’ allegations were questioned, investigators went as far as abusing the women verbally or physically, often in order to force them to withdraw the so-called ‘false’ complaint in order to protect the ‘real’ victim: the ‘innocent defendant’. The proposed presentation will discuss these police approaches to women and the techniques used in assessing the credibility of their accusations, including how they differ depending on whether the complainant was under or over 21 years old.

Keywords: criminal justice system, law and Arab culture, modest woman, sexual violence

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680 Professional Skills Development of Educational Leaders Through Drama in Education: An Example of Best Practice in Greece

Authors: Christina Zourna, Ioanna Papavassiliou-Alexiou

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Drama in Education (DiE) is a dynamic experiential method that can be used in many interdisciplinary contexts. In the Educational and Social Policy Department, University of Macedonia, Thessaloniki, Greece, DiE is being used as a core method for developing professional competences in pre- and postgraduate courses as well as adult education training programs. In this presentation, an innovative DiE application will be described concerning the development of educational leaders’ skills necessary to meet unprecedented, unexpected challenges in the 21st century schools. In a non-threatening risk-taking no-penalty environment, future educational leaders live-in-role problems, challenges, and dilemmas before having to face similar ones in their profession. Through personal involvement, emotional engagement, and reflection, via individual and group activities, they experience the behaviour, dilemmas, decision-making processes, and informed choices of a recognized leader and are able to make connections with their own life. As pretext serves the life of Alexander the Great, the Macedonian King who defeated the vast Persian empire in the 4th century BC and, by uniting all Greeks, conquered the up-to-date known eastern world thanks to his authentic leadership skills and exceptional personality traits. Since the early years of his education mastered by the famous Greek philosopher Aristotle, Alexander proved his unique qualities by providing the world with the example of an undeniably genuine, inspirational, effective, and most recognizable authentic leader. Through questionnaires and individual interviews, participants in these workshops revealed how they developed active listening, empathy, creativity, imagination, critical strategic and out-of-the-box thinking, cooperation and own vision communicating, crisis management skills, self-efficacy, self-awareness, self-exposure, information management, negotiation and inspiration skills, enhanced sense of responsibility and commitment, and decision-making skills.

Keywords: drama in education method, educational leadership, professional competences, skills’ development

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679 Digitalising the Instruction: Between Technology Integration and Instrumental Use

Authors: H. Zouar, I. Kassous, F. Benzert

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The relentless pace of technology development in the last two decades has pervaded much of the recent educational discourse on a nation-wide scale. The rippling echoes of the buzz that account for the myriad of advantages the new technologies bring to the pedagogical activity has inevitably transcended from the western world to the Algerian educational contexts. Attempts have been made by Algerian practitioners to heed this digital advancement and push their instructional practices forward. However, due to the still largely existing first-order barriers as exemplified in the forms of deficient institutional infrastructure and unavailability of sufficient digital materials, the results of those attempts have polarised the views of Algerian academics regarding technology integration within higher education context. Hence, this study aims at measuring the possibility of integrating technology in our classrooms in a way that conforms to the philosophy of hybrid education. It also attempts to re-consider teachers’ understanding of technology integration in our context. Furthermore, the purpose of this research is also to reveal the level of teachers’ awareness regarding the distinction between technology integration and instrumental use. In view of the nature of these aims, a mixed-methods mode of investigation has been adopted to collect both qualitative and quantitative data from different perspectives. The data collection tools comprise of an observation as well as students’ and teachers’ questionnaires. The findings show that despite the fact that the examined context is not without its technological limitations, technology integration can be successfully incorporated contingent on teachers' level of knowledge and agency. Technology integration in Algerian universities does not proceed as the bedrock theory of it entails due to issues within teachers' general understanding of utilizing technology in class. It seems that technology is a means to an end, depending on the teachers who make use of it in order to deliver lessons (PowerPoint presentation) and issue commands (Facebook posting). Teachers' ability to clearly discern between integrating technology in their practices versus employing it as an instrument of instruction needs further consideration in order to establish a solid understanding of technology integration within higher education context.

Keywords: technology integration, hybrid education, teachers' understanding, teachers' awareness, instrumental use

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678 Some Issues of Measurement of Impairment of Non-Financial Assets in the Public Sector

Authors: Mariam Vardiashvili

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The economic value of the asset impairment process is quite large. Impairment reflects the reduction of future economic benefits or service potentials itemized in the asset. The assets owned by public sector entities bring economic benefits or are used for delivery of the free-of-charge services. Consequently, they are classified as cash-generating and non-cash-generating assets. IPSAS 21 - Impairment of non-cash-generating assets, and IPSAS 26 - Impairment of cash-generating assets, have been designed considering this specificity.  When measuring impairment of assets, it is important to select the relevant methods. For measurement of the impaired Non-Cash-Generating Assets, IPSAS 21 recommends three methods: Depreciated Replacement Cost Approach, Restoration Cost Approach, and  Service Units Approach. Impairment of Value in Use of Cash-Generating Assets (according to IPSAS 26) is measured by discounted value of the money sources to be received in future. Value in use of the cash-generating asserts (as per IPSAS 26) is measured by the discounted value of the money sources to be received in the future. The article provides classification of the assets in the public sector  as non-cash-generating assets and cash-generating assets and, deals also with the factors which should be considered when evaluating  impairment of assets. An essence of impairment of the non-financial assets and the methods of measurement thereof evaluation are formulated according to IPSAS 21 and IPSAS 26. The main emphasis is put on different methods of measurement of the value in use of the impaired Cash-Generating Assets and Non-Cash-Generation Assets and the methods of their selection. The traditional and the expected cash flow approaches for calculation of the discounted value are reviewed. The article also discusses the issues of recognition of impairment loss and its reflection in the financial reporting. The article concludes that despite a functional purpose of the impaired asset, whichever method is used for measuring the asset, presentation of realistic information regarding the value of the assets should be ensured in the financial reporting. In the theoretical development of the issue, the methods of scientific abstraction, analysis and synthesis were used. The research was carried out with a systemic approach. The research process uses international standards of accounting, theoretical researches and publications of Georgian and foreign scientists.

Keywords: cash-generating assets, non-cash-generating assets, recoverable (usable restorative) value, value of use

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677 Computational Assistance of the Research, Using Dynamic Vector Logistics of Processes for Critical Infrastructure Subjects Continuity

Authors: Urbánek Jiří J., Krahulec Josef, Urbánek Jiří F., Johanidesová Jitka

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These Computational assistance for the research and modelling of critical infrastructure subjects continuity deal with this paper. It enables us the using of prevailing operation system MS Office (SmartArt...) for mathematical models, using DYVELOP (Dynamic Vector Logistics of Processes) method. It serves for crisis situations investigation and modelling within the organizations of critical infrastructure. In the first part of the paper, it will be introduced entities, operators and actors of DYVELOP method. It uses just three operators of Boolean algebra and four types of the entities: the Environments, the Process Systems, the Cases and the Controlling. The Process Systems (PrS) have five “brothers”: Management PrS, Transformation PrS, Logistic PrS, Event PrS and Operation PrS. The Cases have three “sisters”: Process Cell Case, Use Case and Activity Case. They all need for the controlling of their functions special Ctrl actors, except ENV – it can do without Ctrl. Model´s maps are named the Blazons and they are able mathematically - graphically express the relationships among entities, actors and processes. In the second part of this paper, the rich blazons of DYVELOP method will be used for the discovering and modelling of the cycling cases and their phases. The blazons need live PowerPoint presentation for better comprehension of this paper mission. The crisis management of energetic crisis infrastructure organization is obliged to use the cycles for successful coping of crisis situations. Several times cycling of these cases is a necessary condition for the encompassment of the both the emergency event and the mitigation of organization´s damages. Uninterrupted and continuous cycling process bring for crisis management fruitfulness and it is a good indicator and controlling actor of organizational continuity and its sustainable development advanced possibilities. The research reliable rules are derived for the safety and reliable continuity of energetic critical infrastructure organization in the crisis situation.

Keywords: blazons, computational assistance, DYVELOP method, critical infrastructure

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676 The Application of Sensory Integration Techniques in Science Teaching Students with Autism

Authors: Joanna Estkowska

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The Sensory Integration Method is aimed primarily at children with learning disabilities. It can also be used as a complementary method in treatment of children with cerebral palsy, autistic, mentally handicapped, blind and deaf. Autism is holistic development disorder that manifests itself in the specific functioning of a child. The most characteristic are: disorders in communication, difficulties in social relations, rigid patterns of behavior and impairment in sensory processing. In addition to these disorders may occur abnormal intellectual development, attention deficit disorders, perceptual disorders and others. This study was focused on the application sensory integration techniques in science education of autistic students. The lack of proper sensory integration causes problems with complicated processes such as motor coordination, movement planning, visual or auditory perception, speech, writing, reading or counting. Good functioning and cooperation of proprioceptive, tactile and vestibular sense affect the child’s mastery of skills that require coordination of both sides of the body and synchronization of the cerebral hemispheres. These include, for example, all sports activities, precise manual skills such writing, as well as, reading and counting skills. All this takes place in stages. Achieving skills from the first stage determines the development of fitness from the next level. Any deficit in the scope of the first three stages can affect the development of new skills. This ultimately reflects on the achievements at school and in further professional and personal life. After careful analysis symptoms from the emotional and social spheres appear to be secondary to deficits of sensory integration. During our research, the students gained knowledge and skills in the classroom of experience by learning biology, chemistry and physics with application sensory integration techniques. Sensory integration therapy aims to teach the child an adequate response to stimuli coming to him from both the outside world and the body. Thanks to properly selected exercises, a child can improve perception and interpretation skills, motor skills, coordination of movements, attention and concentration or self-awareness, as well as social and emotional functioning.

Keywords: autism spectrum disorder, science education, sensory integration, special educational needs

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675 Using Two-Mode Network to Access the Connections of Film Festivals

Authors: Qiankun Zhong

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In a global cultural context, film festival awards become authorities to define the aesthetic value of films. To study which genres and producing countries are valued by different film festivals and how those evaluations interact with each other, this research explored the interactions between the film festivals through their selection of movies and the factors that lead to the tendency of film festivals to nominate the same movies. To do this, the author employed a two-mode network on the movies that won the highest awards at five international film festivals with the highest attendance in the past ten years (the Venice Film Festival, the Cannes Film Festival, the Toronto International Film Festival, Sundance Film Festival, and the Berlin International Film Festival) and the film festivals that nominated those movies. The title, genre, producing country and language of 50 movies, and the range (regional, national or international) and organizing country or area of 129 film festivals were collected. These created networks connected by nominating the same films and awarding the same movies. The author then assessed the density and centrality of these networks to answer the question: What are the film festivals that tend to have more shared values with other festivals? Based on the Eigenvector centrality of the two-mode network, Palm Springs, Robert Festival, Toronto, Chicago, and San Sebastian are the festivals that tend to nominate commonly appreciated movies. In contrast, Black Movie Film Festival has the unique value of generally not sharing nominations with other film festivals. A homophily test was applied to access the clustering effects of film and film festivals. The result showed that movie genres (E-I index=0.55) and geographic location (E-I index=0.35) are possible indicators of film festival clustering. A blockmodel was also created to examine the structural roles of the film festivals and their meaning in real-world context. By analyzing the same blocks with film festival attributes, it was identified that film festivals either organized in the same area, with the same history, or with the same attitude on independent films would occupy the same structural roles in the network. Through the interpretation of the blocks, language was identified as an indicator that contributes to the role position of a film festival. Comparing the result of blockmodeling in the different periods, it is seen that international film festivals contrast with the Hollywood industry’s dominant value. The structural role dynamics provide evidence for a multi-value film festival network.

Keywords: film festivals, film studies, media industry studies, network analysis

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674 Origins of the Tattoo: Decoding the Ancient Meanings of Terrestrial Body Art to Establish a Connection between the Natural World and Humans Today

Authors: Sangeet Anand

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Body art and tattooing have long been practiced as a form of self-expression for centuries, and this study studies and analyzes the pertinence of tattoo culture in our everyday lives and ancient past. Individuals of different cultures represent ideas, practices, and elements of their cultures through symbolic representation. These symbols come in all shapes and sizes and can be as simple as the makeup you put on every day to something more permanent such as a tattoo. In the long run, these individuals who choose to display art on their bodies are seeking to express their individuality. In addition, these visuals are ultimately a reflection of our own appropriate cultures deem as beautiful, important, and powerful to the human eye. They make us known to the world and give us a plausible identity in an ever-changing world. We have lived through and seen a rise in hippie culture today. This type of bodily decoration displayed by this fad has made it seem as though body art is a visual language that is relatively new. But quite to the contrary, it is not. Through cultural symbolic exploration, we can answer key questions to ideas that have been raised for centuries. Through careful, in-depth interviews, this study takes a broad subject matter-art, and symbolism-and culminates it into a deeper philosophical connection between the world and its past. The basic methodologies used in this sociocultural study include interview questionnaires and textual analysis, which encompass a subject and interviewer as well as source material. The major findings of this study contain a distinct connection between cultural heritage and the day-to-day likings of an individual. The participant that was studied during this project demonstrated a clear passion for hobbies that were practiced even by her ancestors. We can conclude, through these findings, that there is a deeper cultural connection between modern day humans, the first humans, and the surrounding environments. Our symbols today are a direct reflection of the elements of nature that our human ancestors were exposed to, and, through cultural acceptance, we can adorn ourselves with these representations to help others identify our pasts. Body art embraces the different aspects of different cultures and holds significance, tells stories, and persists, even as the human population rapidly integrates. With this pattern, our human descendents will continue to represent their cultures and identities in the future. Body art is an integral element in understanding how and why people identify with certain aspects of life over others and broaden the scope for conducting more analysis cross-culturally.

Keywords: natural, symbolism, tattoo, terrestrial

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673 Non-Invasive Assessment of Peripheral Arterial Disease: Automated Ankle Brachial Index Measurement and Pulse Volume Analysis Compared to Ultrasound Duplex Scan

Authors: Jane E. A. Lewis, Paul Williams, Jane H. Davies

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Introduction: There is, at present, a clear and recognized need to optimize the diagnosis of peripheral arterial disease (PAD), particularly in non-specialist settings such as primary care, and this arises from several key facts. Firstly, PAD is a highly prevalent condition. In 2010, it was estimated that globally, PAD affected more than 202 million people and furthermore, this prevalence is predicted to further escalate. The disease itself, although frequently asymptomatic, can cause considerable patient suffering with symptoms such as lower limb pain, ulceration, and gangrene which, in worse case scenarios, can necessitate limb amputation. A further and perhaps the most eminent consequence of PAD arises from the fact that it is a manifestation of systemic atherosclerosis and therefore is a powerful predictor of coronary heart disease and cerebrovascular disease. Objective: This cross sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (i) ankle brachial index (ABI) and (ii) pulse volume waveform (PVW) recorded by the same automated device, with the presence or absence of peripheral arterial disease (PAD) being verified by an Ultrasound Duplex Scan (UDS). Methods: Patients (n = 205) referred for lower limb arterial assessment underwent an ABI and PVW measurement using volume plethysmography followed by a UDS. Presence of PAD was recorded for ABI if < 0.9 (noted if > 1.30) if PVW was graded as 2, 3 or 4 or a hemodynamically significant stenosis > 50% with UDS. Outcome measure was agreement between measured ABI and interpretation of the PVW for PAD diagnosis, using UDS as the reference standard. Results: Sensitivity of ABI was 80%, specificity 91%, and overall accuracy 88%. Cohen’s kappa revealed good agreement between ABI and UDS (k = 0.7, p < .001). PVW sensitivity 97%, specificity 81%, overall accuracy 84%, with a good level of agreement between PVW and UDS (k = 0.67, p < .001). The combined sensitivity of ABI and PVW was 100%, specificity 76%, and overall accuracy 85% (k = 0.67, p < .001). Conclusions: Combing these two diagnostic modalities within one device provided a highly accurate method of ruling out PAD. Such a device could be utilized within the primary care environment to reduce the number of unnecessary referrals to secondary care with concomitant cost savings, reduced patient inconvenience, and prioritization of urgent PAD cases.

Keywords: ankle brachial index, peripheral arterial disease, pulse volume waveform, ultrasound duplex scan

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672 GPU-Based Back-Projection of Synthetic Aperture Radar (SAR) Data onto 3D Reference Voxels

Authors: Joshua Buli, David Pietrowski, Samuel Britton

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Processing SAR data usually requires constraints in extent in the Fourier domain as well as approximations and interpolations onto a planar surface to form an exploitable image. This results in a potential loss of data requires several interpolative techniques, and restricts visualization to two-dimensional plane imagery. The data can be interpolated into a ground plane projection, with or without terrain as a component, all to better view SAR data in an image domain comparable to what a human would view, to ease interpretation. An alternate but computationally heavy method to make use of more of the data is the basis of this research. Pre-processing of the SAR data is completed first (matched-filtering, motion compensation, etc.), the data is then range compressed, and lastly, the contribution from each pulse is determined for each specific point in space by searching the time history data for the reflectivity values for each pulse summed over the entire collection. This results in a per-3D-point reflectivity using the entire collection domain. New advances in GPU processing have finally allowed this rapid projection of acquired SAR data onto any desired reference surface (called backprojection). Mathematically, the computations are fast and easy to implement, despite limitations in SAR phase history data size and 3D-point cloud size. Backprojection processing algorithms are embarrassingly parallel since each 3D point in the scene has the same reflectivity calculation applied for all pulses, independent of all other 3D points and pulse data under consideration. Therefore, given the simplicity of the single backprojection calculation, the work can be spread across thousands of GPU threads allowing for accurate reflectivity representation of a scene. Furthermore, because reflectivity values are associated with individual three-dimensional points, a plane is no longer the sole permissible mapping base; a digital elevation model or even a cloud of points (collected from any sensor capable of measuring ground topography) can be used as a basis for the backprojection technique. This technique minimizes any interpolations and modifications of the raw data, maintaining maximum data integrity. This innovative processing will allow for SAR data to be rapidly brought into a common reference frame for immediate exploitation and data fusion with other three-dimensional data and representations.

Keywords: backprojection, data fusion, exploitation, three-dimensional, visualization

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671 Displaced People in International Marriage Law: Choice of Law and the 1951 Convention Relating to the Status of Refugees

Authors: Rorick Daniel Tovar Galvan

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The 1951 Convention relating to the status of refugees contains a conflict of law rule for the determination of the applicable law to marriage. The wording of this provision leaves much to be desired as it uses the domicile and the residence of the spouses as single main and subsidiary connecting factors. In cases where couples live in different countries, the law applicable to the case is unclear. The same problem arises when refugees are married to individuals outside of the convention’s scope of application. Different interpretations of this legal provision have arisen to solve this problem. Courts in a number of European countries apply the so-called modification doctrine: states should apply their domestic private international rules in all cases involving refugees. Courts shall, however, replace the national connecting factor by the domicile or residence in situations where nationality is used to determine the applicable law. The internal conflict of law rule will then be slightly modified in order to be applied according to the convention. However, this approach excludes these people from using their national law if they so desire. As nationality is, in all cases, replaced by domicile or residence as connecting factor, refugees are automatically deprived of the possibility to choose this law in jurisdictions that include the party autonomy in international marriage law. This contribution aims to shed light on the international legal framework applicable to marriages celebrated by refugees and the unnecessary restrictions to the exercise of the party autonomy these individuals are subjected to. The interest is motivated by the increasing number of displaced people, the significant number of states party to the Refugee Convention – approximately 150 – and the fact that more and more countries allow choice of law agreements in marriage law. Based on a study of German, Spanish and Swiss case law, the current practices in Europe, as well as some incoherencies derived from the current interpretation of the convention, will be discussed. The main objective is showing that there is neither an economic nor a legal basis to deny refugees the right to choose the law of their country of origin in those jurisdictions providing for this possibility to other foreigners. Quite the contrary, after analyzing other provisions contained in the conventions, this restriction would mean a contravention of other obligations included in the text.

Keywords: choice of law, conflict of laws, international marriage law, refugees

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670 Trip Reduction in Turbo Machinery

Authors: Pranay Mathur, Carlo Michelassi, Simi Karatha, Gilda Pedoto

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Industrial plant uptime is top most importance for reliable, profitable & sustainable operation. Trip and failed start has major impact on plant reliability and all plant operators focussed on efforts required to minimise the trips & failed starts. The performance of these CTQs are measured with 2 metrics, MTBT(Mean time between trips) and SR (Starting reliability). These metrics helps to identify top failure modes and identify units need more effort to improve plant reliability. Baker Hughes Trip reduction program structured to reduce these unwanted trip 1. Real time machine operational parameters remotely available and capturing the signature of malfunction including related boundary condition. 2. Real time alerting system based on analytics available remotely. 3. Remote access to trip logs and alarms from control system to identify the cause of events. 4. Continuous support to field engineers by remotely connecting with subject matter expert. 5. Live tracking of key CTQs 6. Benchmark against fleet 7. Break down to the cause of failure to component level 8. Investigate top contributor, identify design and operational root cause 9. Implement corrective and preventive action 10. Assessing effectiveness of implemented solution using reliability growth models. 11. Develop analytics for predictive maintenance With this approach , Baker Hughes team is able to support customer in achieving their Reliability Key performance Indicators for monitored units, huge cost savings for plant operators. This Presentation explains these approach while providing successful case studies, in particular where 12nos. of LNG and Pipeline operators with about 140 gas compressing line-ups has adopted these techniques and significantly reduce the number of trips and improved MTBT

Keywords: reliability, availability, sustainability, digital infrastructure, weibull, effectiveness, automation, trips, fail start

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669 Time's Arrow and Entropy: Violations to the Second Law of Thermodynamics Disrupt Time Perception

Authors: Jason Clarke, Michaela Porubanova, Angela Mazzoli, Gulsah Kut

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What accounts for our perception that time inexorably passes in one direction, from the past to the future, the so-called arrow of time, given that the laws of physics permit motion in one temporal direction to also happen in the reverse temporal direction? Modern physics says that the reason for time’s unidirectional physical arrow is the relationship between time and entropy, the degree of disorder in the universe, which is evolving from low entropy (high order; thermal disequilibrium) toward high entropy (high disorder; thermal equilibrium), the second law of thermodynamics. Accordingly, our perception of the direction of time, from past to future, is believed to emanate as a result of the natural evolution of entropy from low to high, with low entropy defining our notion of ‘before’ and high entropy defining our notion of ‘after’. Here we explored this proposed relationship between entropy and the perception of time’s arrow. We predicted that if the brain has some mechanism for detecting entropy, whose output feeds into processes involved in constructing our perception of the direction of time, presentation of violations to the expectation that low entropy defines ‘before’ and high entropy defines ‘after’ would alert this mechanism, leading to measurable behavioral effects, namely a disruption in duration perception. To test this hypothesis, participants were shown briefly-presented (1000 ms or 500 ms) computer-generated visual dynamic events: novel 3D shapes that were seen either to evolve from whole figures into parts (low to high entropy condition) or were seen in the reverse direction: parts that coalesced into whole figures (high to low entropy condition). On each trial, participants were instructed to reproduce the duration of their visual experience of the stimulus by pressing and releasing the space bar. To ensure that attention was being deployed to the stimuli, a secondary task was to report the direction of the visual event (forward or reverse motion). Participants completed 60 trials. As predicted, we found that duration reproduction was significantly longer for the high to low entropy condition compared to the low to high entropy condition (p=.03). This preliminary data suggests the presence of a neural mechanism that detects entropy, which is used by other processes to construct our perception of the direction of time or time’s arrow.

Keywords: time perception, entropy, temporal illusions, duration perception

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668 Formal Development of Electronic Identity Card System Using Event-B

Authors: Tomokazu Nagata, Jawid Ahmad Baktash

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The goal of this paper is to explore the use of formal methods for Electronic Identity Card System. Nowadays, one of the core research directions in a constantly growing distributed environment is the improvement of the communication process. The responsibility for proper verification becomes crucial. Formal methods can play an essential role in the development and testing of systems. The thesis presents two different methodologies for assessing correctness. Our first approach employs abstract interpretation techniques for creating a trace based model for Electronic Identity Card System. The model was used for building a semi decidable procedure for verifying the system model. We also developed the code for the eID System and can cover three parts login to system sending of Acknowledgment from user side, receiving of all information from server side and log out from system. The new concepts of impasse and spawned sessions that we introduced led our research to original statements about the intruder’s knowledge and eID system coding with respect to secrecy. Furthermore, we demonstrated that there is a bound on the number of sessions needed for the analysis of System.Electronic identity (eID) cards promise to supply a universal, nation-wide mechanism for user authentication. Most European countries have started to deploy eID for government and private sector applications. Are government-issued electronic ID cards the proper way to authenticate users of online services? We use the eID project as a showcase to discuss eID from an application perspective. The new eID card has interesting design features, it is contact-less, it aims to protect people’s privacy to the extent possible, and it supports cryptographically strong mutual authentication between users and services. Privacy features include support for pseudonymous authentication and per service controlled access to individual data items. The article discusses key concepts, the eID infrastructure, observed and expected problems, and open questions. The core technology seems ready for prime time and government projects deploy it to the masses. But application issues may hamper eID adoption for online applications.

Keywords: eID, event-B, Pro-B, formal method, message passing

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667 Riverine Urban Heritage: A Basis for Green Infrastructure

Authors: Ioanna H. Lioliou, Despoina D. Zavraka

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The radical reformation that Greek urban space, has undergone over the last century, due to the socio-historical developments, technological development and political–geographic factors, has left its imprint on the urban landscape. While the big cities struggle to regain urban landscape balance, small towns are considered to offer high quality lifescapes, ensuring sustainable development potential. However, their unplanned urbanization process led to the loss of significant areas of nature, lack of essential infrastructure, chaotic built environment, incompatible land uses and urban cohesiveness. Natural environment reference points, such as springs, streams, rivers, forests, suburban greenbelts, and etc.; seems to be detached from urban space, while the public, open and green spaces, unequally distributed in the built environment, they are no longer able to offer a complete experience of nature in the city. This study focuses on Greek mainland, a small town Elassona, and aims to restore spatial coherence between the city’s homonymous river and its urban space surroundings. The existence of a linear aquatic ecosystem, is considered a precious greenway, also referred as blueway, able to initiate natural penetrations and ecosystems empowering. The integration of disconnected natural ecosystems forms the basis of a strategic intervention scheme, where the river becomes the urban integration tool / feature, constituting the main urban corridor and an indispensible part of a wider green network that connects open and green spaces, ensuring the function of all the established networks (transportation, commercial, social) of the town. The proposed intervention, introduces a green network highlighting the old stone bridge at the ‘entrance’ of the river in the town and expanding throughout the town with strategic uses and activities, providing accessibility for all the users. The methodology used, is based on the collection of design tools used in related urban river-design interventions around the world. The reinstallation/reactivation of the balance between natural and urban landscape, besides the environmental benefits, contributes decisively to the illustration/projection of urban green identity and re-enhancement of the quality of lifescape qualities and social interaction.

Keywords: green network, rehabilitation scheme, urban landscape, urban streams

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666 Oro-Facial Manifestations of Acute Myeloid Leukaemia -A Case Report

Authors: Aamna Tufail, Kajal Kotecha, Iordanis Toursounidis, Ravinder Pabla

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Introduction/Aims: Acute Myeloid Leukaemia (AML) is a part of leukaemic group of hematopoietic disorders with a varying range of presentations, including oro-facial manifestations. Early recognition and management are essential for favourable outcomes. Materials and Methods: We present our experience, clinical presentation, and clinical photographs of a patient with previously undiagnosed AML who presented with oral symptoms to the emergency department of our hospital. An analysis of clinical characteristics, diagnostic investigations, and management modalities was performed. Results/Statistics: A 58-year-old man presented to A&E reporting an 11-day history of right sided facial swelling, acute TMJ symptoms, and oral discomfort. A dentist ruled out acute dental causes one day post onset of symptoms. Initial assessment was anatomically inconsistent and did not reveal a routine oral or maxillofacial etiology. Detailed clinical examination demonstrated fever, generalised pallor, swelling and erythema of right nasolabial region, bilateral masseteric tenderness, intraoral palatal ecchymosis, palatal ulceration, buccal and labial petechiae, cervical lymphadenopathy, and haematoma on dorsum of right hand overlying right 2nd metacarpal joint. Suspecting a systemic medical cause, we requested haematological investigations, which revealed neutropenia, thrombocytopenia, and anaemia. Flow cytometry confirmed CD34 + AML. Oral discomfort was managed symptomatically. The patient was referred to a tertiary care centre for acute haematologic care, where he was treated with IV antibiotics and continuing cycles of chemotherapy. Conclusions/Clinical Relevance: Oro-facial manifestations may be the first clinical sign of AML. Awareness of its features is vital in early diagnosis. In this context, dentists and oral medicine specialists can play an important role in detecting clinical signs of haematological disorders such as AML.

Keywords: acute myeloid leukaemia, oral symptoms, ulceration, diagnosis, management

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665 A Decrease in the Anxiety Levels of Participants with Autoimmune Disease: Efficacy of a Community-Based Educational Program

Authors: Jennifer Hunter, Francisco Ramirez, Neil A. Nedley, Thania Solorio, Christian Freed, Erica Kinjo

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People who have autoimmune disease are often at an increased risk for psychological disorders such as anxiety. Untreated psychological conditions can affect the development of disease and can affect one’s general quality of life. In this study, it was hypothesized that an educational community-based intervention would be useful in decreasing the anxiety levels of participants with autoimmune disease. Programs, 2-hours long each, were held weekly over a period of eight weeks. During every meeting, a 45-minute DVD presentation by a skilled physician was shown, a small group discussion was guided by trained facilitators, and weekly practical assignments were given to each participant. The focus of the program was to educate participants about healthy lifestyle behaviors such as exercise, nutrition, sleep hygiene, helpful thought patterns etc., and to provide a group environment in which each participant was supported. Participants were assessed pre-post program for anxiety using the Depression and Anxiety Assessment Test (registration TX 7-398-022), a validated mental health test based on DSM-5 criteria and demographics. Anxiety scores were classified according to the DSM-5 criteria into 4 categories: none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). Out of the participants who participated in programs conducted in the manner explained above (n=431), the average age was 54.9 (SD 16.6) and 81.9% were female. At baseline, the mean group anxiety level was 9.4 (SD 5.4). Within the baseline group, anxiety levels were as follows: none (21.1%), mild (22.0%), moderate (27.1%) and severe (29.7%). After the program, mean group anxiety decreased to 4.7 (SD 4.0). Post-program anxiety levels were as follows: none (54.8%), mild (27.1%), moderate (12.5%), severe (5.6%). The decrease in overall anxiety levels was significant t(431)=19.3 p<.001, 95% CI [0.815, 1.041]. It was concluded that the eight-week intensive was beneficial in decreasing the anxiety levels of participants. A long-term follow-up study would be beneficial in determining how lasting such improvements are especially since autoimmune diseases are often chronic. Additionally, future studies that utilize a control group would aid in establishing whether the improvements seen are due to the use of this specific lifestyle-educational program.

Keywords: anxiety, auto-immune disease, community-based educational program, lifestyle

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664 Aboriginal Head and Neck Cancer Patients Have Different Patterns of Metastatic Involvement, and Have More Advanced Disease at Diagnosis

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.

Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease

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663 Define Immersive Need Level for Optimal Adoption of Virtual Words with BIM Methodology

Authors: Simone Balin, Cecilia M. Bolognesi, Paolo Borin

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In the construction industry, there is a large amount of data and interconnected information. To manage this information effectively, a transition to the immersive digitization of information processes is required. This transition is important to improve knowledge circulation, product quality, production sustainability and user satisfaction. However, there is currently a lack of a common definition of immersion in the construction industry, leading to misunderstandings and limiting the use of advanced immersive technologies. Furthermore, the lack of guidelines and a common vocabulary causes interested actors to abandon the virtual world after the first collaborative steps. This research aims to define the optimal use of immersive technologies in the AEC sector, particularly for collaborative processes based on the BIM methodology. Additionally, the research focuses on creating classes and levels to structure and define guidelines and a vocabulary for the use of the " Immersive Need Level." This concept, matured by recent technological advancements, aims to enable a broader application of state-of-the-art immersive technologies, avoiding misunderstandings, redundancies, or paradoxes. While the concept of "Informational Need Level" has been well clarified with the recent UNI EN 17412-1:2021 standard, when it comes to immersion, current regulations and literature only provide some hints about the technology and related equipment, leaving the procedural approach and the user's free interpretation completely unexplored. Therefore, once the necessary knowledge and information are acquired (Informational Need Level), it is possible to transition to an Immersive Need Level that involves the practical application of the acquired knowledge, exploring scenarios and solutions in a more thorough and detailed manner, with user involvement, via different immersion scales, in the design, construction or management process of a building or infrastructure. The need for information constitutes the basis for acquiring relevant knowledge and information, while the immersive need can manifest itself later, once a solid information base has been solidified, using the senses and developing immersive awareness. This new approach could solve the problem of inertia among AEC industry players in adopting and experimenting with new immersive technologies, expanding collaborative iterations and the range of available options.

Keywords: AECindustry, immersive technology (IMT), virtual reality, augmented reality, building information modeling (BIM), decision making, collaborative process, information need level, immersive level of need

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662 Pleomorphic Dermal Sarcoma: A Management Challenge

Authors: Mona Nada, Fahmy Fahmy

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Background: Pleomorphic dermal sarcoma is a rare form of skin cancer affecting cutaneous layer and, in some cases associated with recurrence and metastasis, very commonly to seen in elderly patient affecting the area of head and neck. Pleomorphic dermal sarcoma rises in ultraviolet light exposed areas. The symptoms and severity of this kind of skin cancer varies according to histological factors. The differentiation of Pleomorphic dermal sarcoma needs extensive immunohistochemistry, as the diagnosis depends mainly on exclusion to rule out other malignancy like poorly differentiated squamous cell carcinoma, melanoma, angiosarcoma and leiomyosarcoma. Objective: assessing the management of Pleomorphic dermal sarcoma in our unit and compared to the updated guidelines. Design: Retrospective study Collection of patient data from medical records at countess of Chester plastic surgery unit of the last 5 years, all histologically confirmed Pleomorphic dermal sarcoma (2017-2023). Data were collected confirmed to be Pleomorphic dermal sarcoma were included in the study. The data collected: clinical description of the lesions at first presentation, operation time, multidisciplinary team discussion, plan, referral as well as second operation and investigation done. With comparison of histological examination, immunohistochemistry staining, the excision and rate of recurrence. Results: data collected N19 from (2017-2023) showed the disease predominantly affecting males and the lesion mainly in head and neck, the diagnosis needed extensive immunohistochemistry to differentiate between other malignancy. recurrence present in numbers of the cases which managed after multidisciplinary team discussion either by excision or radiotherapy. Conclusion: Pleomorphic dermal sarcoma is a rare malignancy which needs more understanding and avoid missing as it is aggressive form of skin cancer, there is a chance of metastasis and recurrence which makes it very important to understand the process of development of the cancer and frequent review of the management guidelines.

Keywords: pleomorphic dermal sarcoma, recurrence, radiotherapy, surgical

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