Search results for: Matthew Taylor
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 332

Search results for: Matthew Taylor

92 Caregiver Training Results in Accurate Reporting of Stool Frequency

Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

Abstract:

Background:Accuracy of caregiver reported outcomes is essential for infant growth and tolerability study success. Crying/fussiness, stool consistencies, and other gastrointestinal characteristics are important parameters regarding tolerability, and inter-caregiver reporting can see a significant amount of subjectivity and vary greatly within a study, compromising data. This study sought to elucidate how caregiver reported questions related to stool frequency are answered before and after a short amount of training and how training impacts caregivers’ understanding, and how they would answer the question. Methods:A digital survey was issued for 90 daysin the US (n=121) and 30 days in Mexico (n=88), targeting respondents with children ≤4 years of age. Respondents were asked a question in two formats, first without a line of training text and second with a line of training text. The question set was as follows, “If your baby had stool in his/her diaper and you changed the diaper and 10 min later there was more stool in the diaper, how many stools would you report this as?” followed by the same question beginning with “If you were given the instruction that IF there are at least 5 minutes in between stools, then it counts as two (2) stools…”.Four response items were provided for both questions, 1) 2 stools, 2) 1stool, 3) it depends on how much stool was in the first versus the second diaper, 4) There is not enough information to be able to answer the question. Response frequencies between questions were compared. Results: Responses to the question without training saw some variability in the US, with 69% selecting “2 stools”,11% selecting “1 stool”, 14% selecting “it depends on how much stool was in the first versus the second diaper”, and 7% selecting “There is not enough information to be able to answer the question” and in Mexico respondents selected 9%, 78%, 13%, and 0% respectively. However, responses to the question after training saw more consolidation in the US, with 85% of respondents selecting“2 stools,” representing an increase in those selecting the correct answer. Additionally in Mexico, with 84% of respondents selecting “1 episode” representing an increase in the those selecting the correct response. Conclusions: Caregiver reported outcomes are critical for infant growth and tolerability studies, however, they can be highly subjective and see a high variability of responses without guidance. Training is critical to standardize all caregivers’ perspective regarding how to answer questions accurately in order to provide an accurate dataset.

Keywords: infant nutrition, clinical trial optimization, stool reporting, decentralized clinical trials

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91 Improving Numeracy Standards for UK Pharmacy Students

Authors: Luke Taylor, Samantha J. Hall, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy, as part of an Equality Diversity and Inclusivity (EDI) initiative run by the University of Kent, decided to take steps to try and negate disparities in numeracy competencies within students undertaking the Master of Pharmacy degree in order to combat a trend in pharmacy students’ numerical abilities upon entry. This included a research driven project 1) to identify if pharmacy students are aware of weaknesses in their numeracy capabilities, and 2) recognise where their numeracy skillset is lacking. In addition to gaining this student perspective, a number of actions have been implemented to support students in improving their numeracy competencies. Reflective and quantitative analysis has shown promising improvements for the final year cohort of 2014/15 when compared to previous years. The method of involving student feedback into the structure of numeracy teaching/support has proven to be extremely beneficial to both students and teaching staff alike. Students have felt empowered and in control of their own learning requirements, leading to increased engagement and attainment. School teaching staff have received quality data to help improve existing initiatives and to innovate further in the area of numeracy teaching. In light of the recognised improvements, further actions are currently being trialled in the area of numeracy support. This involves utilising Virtual Learning Environment platforms to provide individualised support as a supplement to the increased numeracy mentoring (staff and peer) provided to students. Mentors who provide group or one-to-one sessions are now given significant levels of training in dealing with situations that commonly arise from mentoring schemes. They are also provided with continued support throughout the life of their degree. Following results from this study, Medway School of Pharmacy hopes to drive increasing numeracy standards within Pharmacy (primarily through championing peer mentoring) as well as other healthcare professions including Midwifery and Nursing.

Keywords: attainment, ethnicity, numeracy, pharmacy, support

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90 Portrait of Musical Creativity or Indolence: A Critique of Unoka Character in Achebe’s Things Fall Apart

Authors: Ebim Matthew Abua

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In Chinua Achebe’s Things Fall Apart (henceforth, TFA), the character Unoka is portrayed as a weakling and indolent person even when he was a creative artist, a talented musician, and a mathematician. His lack of achievement becomes the barometer for measuring his success. Right from time, music is considered to be of great significance because of its capacity to recreate and retell social events. To this end, music is both a social act and a creative art. As a social act, music is a discursive medium that exploits the dynamics of art in its evaluation of society. Music is so much a part of human existence that its presence in literature can help readers relate to fictional situations and characters. In this paper, the character Unoka is examined against the backdrop of his musical proclivities and his contributions to the overall development of TFA. Unfortunately, Achebe’s Things Fall Apart, a product of artistic creativity, portrays the personality of Unoka as lazy and uninspiring because he (Unoka) is a musician who is busy playing his flute and hardly doing anything productive. This paper is significant because it examines the literary and or linguistic depiction of Unoka and the aftermath of that depiction on the entire novel and, by extension, the larger society. Methodologically, this paper adopted the qualitative approach from the ethnography of communication (EOC), which is the analysis of communication within the wider context of the social and cultural practices and beliefs of the members of a particular culture or speech community. The aim of this qualitative research method includes the ability to discern which communication acts and/or codes are important to different groups, what types of meanings groups apply to different communication events, and how group members learn these codes to provide insight into particular communities. The study reveals that the people of Umuofia were mono-directional in their economy, and there was no room for diversification. One was either a farmer, or such a person was relegated to the background. Unoka, taking up a new challenge of diversifying the economy from the perspective of entertainment, was viewed as a misnomer. This study opens the door to other areas of studying Achebe’s epic novel apart from the critical works of literary artists that have been dished out over time.

Keywords: literature, popular culture, unoka, things fall apart

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89 Iron Supplementation for Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Authors: Matthew Cameron, Stephen Yang, Latifa Al Kharusi, Adam Gosselin, Anissa Chirico, Pouya Gholipour Baradari

Abstract:

Background: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for the potential to increase baseline hemoglobin and decrease the incidence of red blood cell (RBC) transfusion during cardiac surgery. This study's main objective was to evaluate the evidence for iron administration in cardiac surgery patients for its effect on the incidence of perioperative RBC transfusion. Methods: This systematic review protocol was registered with PROSPERO (CRD42020161927) on Dec. 19th, 2019, and was prepared as per the PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar were searched for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. Each abstract was independently reviewed by two reviewers using predefined eligibility criteria. The primary outcome was perioperative RBC transfusion, with secondary outcomes of the number of RBC units transfused, change in ferritin level, reticulocyte count, hemoglobin, and adverse events, after iron administration. The risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and the primary and secondary outcomes were analyzed with a random-effects model. Results: Out of 1556 citations reviewed, five studies (n = 554 patients) met the inclusion criteria. The use of iron demonstrated no difference in transfusion incidence (RR 0.86; 95% CI 0.65 to 1.13). There was a low heterogeneity between studies (I²=0%). The trial sequential analysis suggested an optimal information size of 1132 participants, which the accrued information size did not reach. Conclusion: The current literature does not support the routine use of iron supplementation before cardiac surgery; however, insufficient data is available to draw a definite conclusion. A critical knowledge gap has been identified, and more robust RCTs are required on this topic.

Keywords: cardiac surgery, iron, iron supplementation, perioperative medicine, meta-analysis, systematic review, randomized controlled trial

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88 Alternative Epinephrine Injector to Combat Allergy Induced Anaphylaxis

Authors: Jeremy Bost, Matthew Brett, Jacob Flynn, Weihui Li

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One response during anaphylaxis is reduced blood pressure due to blood vessels relaxing and dilating. Epinephrine causes the blood vessels to constrict, which raises blood pressure to counteract the symptoms. When going through an allergic reaction, an Epinephrine injector is used to administer a shot of epinephrine intramuscularly. Epinephrine injectors have become an integral part of day-to-day life for people with allergies. Current Epinephrine injectors (EpiPen) are completely mechanical and have no sensors to monitor the vital signs of patients or give suggestions the optimal time for the shot. The EpiPens are also large and inconvenient to carry daily. The current price of an EpiPen is roughly 600$ for a pack of two. This makes carrying an EpiPen very expensive, especially when they need to be switched out when the epinephrine expires. This new design is in the form of a bracelet, which has the ability to inject epinephrine. The bracelet will be equipped with vital signs monitors that can aid the patient to sense the allergic reaction. The vital signs that would be of interest are blood pressure, heart rate and Electrodermal activity (EDA). The heart rate of the patient will be tracked by a photoplethysmograph (PPG) that is incorporated into the sensors. The heart rate is expected to increase during anaphylaxis. Blood pressure will be monitored through a radar sensor, which monitors the phase changes in electromagnetic waves as they reflect off of the blood vessel. EDA is under autonomic control. Allergen-induced anaphylaxis is caused by a release of chemical mediators from mast cells and basophils, thus changes the autonomic activity of the patient. So by measuring EDA, it will give the wearer an alert on how their autonomic nervous system is reacting. After the vital signs are collected, they will be sent to an application on a smartphone to be analyzed, which can then alert an emergency contact if the epinephrine injector on the bracelet is activated. Overall, this design creates a safer system by aiding the user in keeping track of their epinephrine injector, while making it easier to track their vital signs. Also, our design will be more affordable and more convenient to replace. Rather than replacing the entire product, only the needle and drug will be switched out and not the entire design.

Keywords: allergy, anaphylaxis, epinephrine, injector, vital signs monitor

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87 Role of Gender in Apparel Stores' Consumer Review: A Sentiment Analysis

Authors: Sarif Ullah Patwary, Matthew Heinrich, Brandon Payne

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The ubiquity of web 2.0 platforms, in the form of wikis, social media (e.g., Facebook, Twitter, etc.) and online review portals (e.g., Yelp), helps shape today’s apparel consumers’ purchasing decision. Online reviews play important role towards consumers’ apparel purchase decision. Each of the consumer reviews carries a sentiment (positive, negative or neutral) towards products. Commercially, apparel brands and retailers analyze sentiment of this massive amount of consumer review data to update their inventory and bring new products in the market. The purpose of this study is to analyze consumer reviews of selected apparel stores with a view to understand, 1) the difference of sentiment expressed through men’s and woman’s text reviews, 2) the difference of sentiment expressed through men’s and woman’s star-based reviews, and 3) the difference of sentiment between star-based reviews and text-based reviews. A total of 9,363 reviews (1,713 men and 7,650 women) were collected using Yelp Dataset Challenge. Sentiment analysis of collected reviews was carried out in two dimensions: star-based reviews and text-based reviews. Sentiment towards apparel stores expressed through star-based reviews was deemed: 1) positive for 3 or 4 stars 2) negative for 1 or 2 stars and 3) neutral for 3 stars. Sentiment analysis of text-based reviews was carried out using Bing Liu dictionary. The analysis was conducted in IPyhton 5.0. Space. The sentiment analysis results revealed the percentage of positive text reviews by men (80%) and women (80%) were identical. Women reviewers (12%) provided more neutral (e.g., 3 out of 5 stars) star reviews than men (6%). Star-based reviews were more negative than the text-based reviews. In other words, while 80% men and women wrote positive reviews for the stores, less than 70% ended up giving 4 or 5 stars in those reviews. One of the key takeaways of the study is that star reviews provide slightly negative sentiment of the consumer reviews. Therefore, in order to understand sentiment towards apparel products, one might need to combine both star and text aspects of consumer reviews. This study used a specific dataset consisting of selected apparel stores from particular geographical locations (the information was not given for privacy concern). Future studies need to include more data from more stores and locations to generalize the findings of the study.

Keywords: apparel, consumer review, sentiment analysis, gender

Procedia PDF Downloads 141
86 Algorithm for Predicting Cognitive Exertion and Cognitive Fatigue Using a Portable EEG Headset for Concussion Rehabilitation

Authors: Lou J. Pino, Mark Campbell, Matthew J. Kennedy, Ashleigh C. Kennedy

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A concussion is complex and nuanced, with cognitive rest being a key component of recovery. Cognitive overexertion during rehabilitation from a concussion is associated with delayed recovery. However, daily living imposes cognitive demands that may be unavoidable and difficult to quantify. Therefore, a portable tool capable of alerting patients before cognitive overexertion occurs could allow patients to maintain their quality of life while preventing symptoms and recovery setbacks. EEG allows for a sensitive measure of cognitive exertion. Clinical 32-lead EEG headsets are not practical for day-to-day concussion rehabilitation management. However, there are now commercially available and affordable portable EEG headsets. Thus, these headsets can potentially be used to continuously monitor cognitive exertion during mental tasks to alert the wearer of overexertion, with the aim of preventing the occurrence of symptoms to speed recovery times. The objective of this study was to test an algorithm for predicting cognitive exertion from EEG data collected from a portable headset. EEG data were acquired from 10 participants (5 males, 5 females). Each participant wore a portable 4 channel EEG headband while completing 10 tasks: rest (eyes closed), rest (eyes open), three levels of the increasing difficulty of logic puzzles, three levels of increasing difficulty in multiplication questions, rest (eyes open), and rest (eyes closed). After each task, the participant was asked to report their perceived level of cognitive exertion using the NASA Task Load Index (TLX). Each participant then completed a second session on a different day. A customized machine learning model was created using data from the first session. The performance of each model was then tested using data from the second session. The mean correlation coefficient between TLX scores and predicted cognitive exertion was 0.75 ± 0.16. The results support the efficacy of the algorithm for predicting cognitive exertion. This demonstrates that the algorithms developed in this study used with portable EEG devices have the potential to aid in the concussion recovery process by monitoring and warning patients of cognitive overexertion. Preventing cognitive overexertion during recovery may reduce the number of symptoms a patient experiences and may help speed the recovery process.

Keywords: cognitive activity, EEG, machine learning, personalized recovery

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85 The Impacts of the Sit-Stand Workplace Intervention on Cardiometabolic Risk

Authors: Rebecca M. Dagger, Katy Hadgraft, Matthew Teggart, Peter Angell

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Background: There is a growing body of evidence that demonstrates the association between sedentary behaviour, cardiometabolic risk and all-cause mortality. Since full time working adults spend approximately 8 hours per day in the workplace, interventions to reduce sedentary behaviour at work may alleviate some of the negative health outcomes associated with sedentary behaviour. The aims of this pilot study were to assess the impacts of using a Sit-Stand workstation on markers of cardiometabolic health in a cohort of desk workers. Methods: Twenty eight participants were recruited and randomly assigned to a control (n=5 males, 9 females, mean age 37 years ± 9.4 years) or intervention group (n= 5 males, 9 females, mean age 42 years ± 12.7 years). All participants attended the labs on 2 occasion’s pre and post intervention, following baseline measurements the intervention participants had the Sit Stand Workstations (Ergotron, USA) installed for a 10 week intervention period. The Sit Stand workstations allow participants to stand or sit at their usual workstation and participants were encouraged to the use the desk in a standing position at regular intervals throughout the working day. Cardiometabolic risk markers assessed were body mass, body composition (using bio impedance analysis; Tanita, Tokyo), fasting blood Total Cholesterol (TC), lipid profiles (HDL-C, LDL-C, TC: HDL-C ratio), triglycerides and fasting glucose (Cholestech LDX), resting systolic and diastolic blood pressure and resting heart rate. ANCOVA controlling for baseline values was used to assess the group difference in changes in risk markers between pre and post intervention. Results: The 10 week intervention was associated with significant reductions in some cardiometabolic risk factors. There were significant group effects on change in body mass (F (1,25)=5.915, p<0.05), total body fat percentage (F(1,25)=12.615, p<0.01), total fat mass (F (1,25)=6.954, p<0.05), and systolic blood pressure (F (1,25)=5.012, p<0.05). There were no other significant group effects on changes in other cardiometabolic risk markers. Conclusion: This pilot study highlights the importance of reducing sedentary behaviour in the workplace for reduction in cardiometabolic risk markers. Further research is required to support these findings.

Keywords: sedentary behaviour, caridometabolic risk, evidence, risk makers

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84 Lovely, Lyrical, Lilting: Kubrick’s Translation of Lolita’s Voice

Authors: Taylor La Carriere

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“What I had madly possessed was not she, but my own creation, another, fanciful Lolita perhaps, more real than Lolita; overlapping, encasing he and having no will, no consciousness indeed, no life of her own,” Vladimir Nabokov writes in his seminal work, Lolita. Throughout Nabokov’s novel, the eponymous character is rendered nonexistent through unreliable narrator Humbert Humbert’s impenetrable narrative, infused with lyrical rationalization. Instead, Lolita is “safely solipsised,” as Humbert muses, solidifying the potential for the erasure of Lolita’s agency and identity. In this literary work, Lolita’s voice is reduced to a nearly invisible presence, only seen through the eyes of her captor. However, in Stanley Kubrick’s film adaptation of Lolita (1962), the “nymphet,” as Nabokov coins, reemerges with a voice of her own, fueled by a lyric impulse, that displaces Humbert’s first-person narration. The lyric, as defined by Catherine Ing, is the voice of the invisible; it is also characterized by performance, the concentrated utterance of individual emotion, and the appearance of spontaneity. The novel’s lyricism is largely in the service of Humbert’s “seductive” voice, while the film reorients it more to Lolita’s subjectivity. Through a close analysis of Kubrick’s cinematic techniques, this paper examines the emergence and translation of Lolita’s voice in contrast with Humbert’s attempts to silence her in Nabokov’s Lolita, hypothesizing that Kubrick translates Lolita’s presence into a visual and aural voice with lyrical attributes, exemplified through the establishment of an altered power dynamic, Sue Lyon’s transformative performance as the titular character, Nelson Riddle and Bob Harris’ musical score, and the omission of Humbert’s first-person point-of-view. In doing so, the film reclaims Lolita’s agency by taking instances of Lolita’s voice in the novel as depicted in the last half of the work and expanding upon them in a way only cinematic depictions could allow. The results of this study suggest that Lolita’s voice in Kubrick’s adaptation functions without disrupting the lyricism present in Nabokov’s source text, materializing through the actions, expressions, and performance of Sue Lyon in the film. This voice, fueled by a lyric impulse of its own, refutes the silence bestowed upon the titular character and enables its ultimate reclamation upon the silver screen.

Keywords: cinema, adaptation, Lolita, lyric voice

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83 Rural School Superintendent Perceptions of Rural Development in Three U.S. States: A Collective Case Study

Authors: Jerry D. Johnson, Jason A. LaFrance, Matthew A. Ohlson, Shane C. Shope

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The public school system is the largest employer and most impactful factor in the local economy for many rural communities in the United States. The relationship between the school system and the community is symbiotic—they thrive together or decline together. Understanding the perceptions of rural school superintendents (the titular head of the local school district) with regard to rural development is foundational to understanding how the school and community interact and collaborate in key areas like economic development, community development, and workforce development. To investigate those perceptions as they manifest among superintendents in thriving rural communities, a collective case study was designed and conducted to disclose and characterize superintendent perceptions about rural development in three diverse rural settings in the U.S.: Florida, Kansas, and Ohio. Appreciative Inquiry (AI) served as the conceptual framework and supported a focus on identifying and describing assets and strategies/activities that helped explain the positive results in the communities of interest. Implementation of a criterion-based purposive sampling process (using extant data and a nomination process to identify rural superintendents in communities with vibrant economies and recognized the contribution by the schools in rural development) resulted in two superintendents from each of these state settings who participated in semi-structured interviews. Interview transcripts and relevant extant documents were coded and analyzed to produce individual cases with representative themes, after which a cross-case analysis was conducted to generate overarching themes. The overarching themes were then scrutinized and tested through the application of appropriate credibility techniques to promote the trustworthiness of the results. Findings include the importance of building and maintaining relationships that extend beyond the immediate collaboration activity, the importance of collaboration skills, intentionality of practice, and organizational systems/structures as facilitators/affordances. The results offer potential guidance for leveraging the potential for public schools to contribute to their rural development in the communities they serve.

Keywords: collaboration, leadership, rural development, rural schools

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82 Factors Influencing Public Attitudes Towards Mental Illness in the Togolese Population

Authors: Myriam Roy

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The perspectives of the Togolese public towards mental illness were assessed, looking at religious affiliation, personal knowledge of someone with a mental illness, and education level as influencers. The goal was to observe which factors influenced most strongly the general public’s attitudes towards mental illness. The Togolese population was surveyed within the context of mental health awareness workshops and involved college and university students, rural community members, and company employees. Taylor and Dear’s Community Attitudes towards the Mentally Ill (CAMI) questionnaire was used to assess these influencers and includes four dimensions of community attitudes towards mental illness: authoritarianism, benevolence, social restrictiveness, and community mental health ideology (CMHI). Demographic questions were also included, tailored to the various realities of the Togolese population. These questions looked, among others, at religious, ethnical (region of origin within Togo), and educational background. It was found that religious affiliation and personal knowledge did not correlate significantly with changes in the four dimensions of the CAMI scale. It suggests that public perspectives towards mental illness might not be as associated with these variables as was previously thought. The dimensions, however, did correlate with themselves as was expected. Authoritarianism was associated positively with social restrictiveness, benevolence was associated negatively with social restrictiveness and positively with CMHI, and CMHI was associated negatively with social restrictiveness, indicating the CAMI did not suffer from reliability and validity issues when used with this population. Interestingly, level of education significantly impacted authoritarianism level, with higher education associated with a decrease in authoritarianism. This finding would support the notion that education is likely to provide access to a wide array of information as well as interaction with people from various backgrounds and situations. Providing increased awareness regarding mental health and illness in schools could be beneficial to favor the impact that education appears to have on public perspectives towards mental illness in Togo. Future studies could assess which mental health interventions in schools would be the most useful in Togo.

Keywords: CAMI questionnaire, cross-cultural psychology, stigma towards mental illness, West African psychology

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81 Elevated Reductive Defluorination of Branched Per and Polyfluoroalkyl Substances by Soluble Metal-Porphyrins and New Mechanistic Insights on the Degradation

Authors: Jun Sun, Tsz Tin Yu, Maryam Mirabediny, Matthew Lee, Adele Jones, Denis M. O’Carroll, Michael J. Manefield, Björn Åkermark, Biswanath Das, Naresh Kumar

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Reductive defluorination has emerged as a sustainable approach to clean water from Per and polyfluoroalkyl substances (PFASs), also known as forever organic containments. For last few decades, nano zero valent metals (nZVMs) have been intensively applied in the reductive remediation of groundwater contaminated with chlorinated organic compounds due to its low redox potential, easy application, and low production cost. However, there is inadequate information on the effective reductive defluorination of linear or branched PFAS using nZVMs as reductants because of the lack of suitable catalysts. CoII-5,10,15,20-Tetraphenyl-21H,23H-porphyrin (CoTPP) has been recently reported for effective catalyzing reductive defluorination of branched (br-) perfluorooctane sulfonate (PFOS) by using TiIII citrate as reductant. However, the low water solubility of CoTPP limited its applicability. Here, we explored a series of structurally related soluble cobalt porphyrin catalysts based on our previously reported best performing CoTPP. All soluble porphyrins [[meso-tetra(4-carboxyphenyl)porphyrinato]cobalt(III)]Cl·₇H₂O (CoTCPP), [[meso-tetra(4-sulfonatophenyl) porphyrinato]cobalt(III)]·9H2O (CoTPPS), and [[meso-tetra(4-N-methylpyridyl) porphyrinato]cobalt(II)](I)₄·₄H₂O (CoTMpyP) displayed better defluorination efficiencies than CoTPP. Especially, CoTMpyP presented the best defluorination efficiency for br-PFOS (94 %), branched perfluorooctanoic acid (PFOA) (89 %), and 3,7-Perfluorodecanoic acid (PFDA) (60 %) after 1 day at 70 0C. CoTMpyP-nZn0 system showed 88-164 times higher defluorination rate than VB12-nZn0 system in terms of all investigated br-PFASs. The CoTMpyP-nZn0 also performed effectively at room temperature, demonstrating the potential prospect for in-situ reductive systems. Based on the analysis of the intermediate products, the calculated bond dissociation energies (BDEs) and possible first interaction between CoTMpyP and PFAS, degradation pathways of 3,7-PFDA and 6-PFOS are proposed.

Keywords: cationic, soluble porphyrin, cobalt, vitamin b12, pfas, reductive defluorination

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80 Addressing Food Grain Losses in India: Energy Trade-Offs and Nutrition Synergies

Authors: Matthew F. Gibson, Narasimha D. Rao, Raphael B. Slade, Joana Portugal Pereira, Joeri Rogelj

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Globally, India’s population is among the most severely impacted by nutrient deficiency, yet millions of tonnes of food are lost before reaching consumers. Across food groups, grains represent the largest share of daily calories and overall losses by mass in India. If current losses remain unresolved and follow projected population rates, we estimate, by 2030, losses from grains for human consumption could increase by 1.3-1.8 million tonnes (Mt) per year against current levels of ~10 Mt per year. This study quantifies energy input to minimise storage losses across India, responsible for a quarter of grain supply chain losses. In doing so, we identify and explore a Sustainable Development Goal (SDG) triplet between SDG₂, SDG₇, and SDG₁₂ and provide insight for development of joined up agriculture and health policy in the country. Analyzing rice, wheat, maize, bajra, and sorghum, we quantify one route to reduce losses in supply chains, by modelling the energy input to maintain favorable climatic conditions in modern silo storage. We quantify key nutrients (calories, protein, zinc, iron, vitamin A) contained within these losses and calculate roughly how much deficiency in these dietary components could be reduced if grain losses were eliminated. Our modelling indicates, with appropriate uncertainty, maize has the highest energy input intensity for storage, at 110 kWh per tonne of grain (kWh/t), and wheat the lowest (72 kWh/t). This energy trade-off represents 8%-16% of the energy input required in grain production. We estimate if grain losses across the supply chain were saved and targeted to India’s nutritionally deficient population, average protein deficiency could reduce by 46%, calorie by 27%, zinc by 26%, and iron by 11%. This study offers insight for development of Indian agriculture, food, and health policy by first quantifying and then presenting benefits and trade-offs of tackling food grain losses.

Keywords: energy, food loss, grain storage, hunger, India, sustainable development goal, SDG

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79 Identification and Optimisation of South Africa's Basic Access Road Network

Authors: Diogo Prosdocimi, Don Ross, Matthew Townshend

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Road authorities are mandated within limited budgets to both deliver improved access to basic services and facilitate economic growth. This responsibility is further complicated if maintenance backlogs and funding shortfalls exist, as evident in many countries including South Africa. These conditions require authorities to make difficult prioritisation decisions, with the effect that Road Asset Management Systems with a one-dimensional focus on traffic volumes may overlook the maintenance of low-volume roads that provide isolated communities with vital access to basic services. Given these challenges, this paper overlays the full South African road network with geo-referenced information for population, primary and secondary schools, and healthcare facilities to identify the network of connective roads between communities and basic service centres. This connective network is then rationalised according to the Gross Value Added and number of jobs per mesozone, administrative and functional road classifications, speed limit, and road length, location, and name to estimate the Basic Access Road Network. A two-step floating catchment area (2SFCA) method, capturing a weighted assessment of drive-time to service centres and the ratio of people within a catchment area to teachers and healthcare workers, is subsequently applied to generate a Multivariate Road Index. This Index is used to assign higher maintenance priority to roads within the Basic Access Road Network that provide more people with better access to services. The relatively limited incidence of Basic Access Roads indicates that authorities could maintain the entire estimated network without exhausting the available road budget before practical economic considerations get any purchase. Despite this fact, a final case study modelling exercise is performed for the Namakwa District Municipality to demonstrate the extent to which optimal relocation of schools and healthcare facilities could minimise the Basic Access Road Network and thereby release budget for investment in roads that best promote GDP growth.

Keywords: basic access roads, multivariate road index, road prioritisation, two-step floating catchment area method

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78 Approaches to Integrating Entrepreneurial Education in School Curriculum

Authors: Kofi Nkonkonya Mpuangnan, Samantha Govender, Hlengiwe Romualda Mhlongo

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In recent years, a noticeable and worrisome pattern has emerged in numerous developing nations which is a steady and persistent rise in unemployment rates. This escalation of economic struggles has become a cause of great concern for parents who, having invested significant resources in their children's education, harboured hopes of achieving economic prosperity and stability for their families through secure employment. To effectively tackle this pressing unemployment issue, it is imperative to adopt a holistic approach, and a pivotal aspect of this approach involves incorporating entrepreneurial education seamlessly into the entire educational system. In this light, the authors explored approaches to integrating entrepreneurial education into school curriculum focusing on the following questions. How can an entrepreneurial mindset among learners be promoted in school? And how far have pedagogical approaches improved entrepreneurship in schools? To find answers to these questions, a systematic literature review underpinned by Human Capital Theory was adopted. This method was supported by the three stages of guidelines like planning, conducting, and reporting. The data were specifically sought from publishers with expansive coverage of scholarly literature like Sage, Taylor & Francis, Emirate, and Springer, covering publications from 1965 to 2023. The search was supported by two broad terms such as promoting entrepreneurial mindset in learners and pedagogical strategies for enhancing entrepreneurship. It was found that acquiring an entrepreneurial mindset through an innovative classroom environment, resilience, and guest speakers and industry experts. Also, teachers can promote entrepreneurial education through the adoption of pedagogical approaches such as hands-on learning and experiential activities, role-playing, business simulation games and creative and innovative teaching. It was recommended that the Ministry of Education should develop tailored training programs and workshops aimed at empowering educators with the essential competencies and insights to deliver impactful entrepreneurial education.

Keywords: education, entrepreneurship, school curriculum, pedagogical approaches, integration

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77 The ICC, International Criminal Justice and International Politics

Authors: Girma Y. Iyassu Menelik

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The international community has gone through indescribable atrocities resulting from acts of war. These atrocities turned Europe and Africa into a wilderness of bloodshed and crime. In the period 1960- 1970s Africa witnessed unprecedented and well-documented assaults on life and property. This necessitated the adoption, signing and ratification of the International Criminal Court, establishment of the International Court of Justice which is a great achievement for the protection and fulfilling of human rights in the context of international political instability. The ICC came as an important opportunity to advance justice for serious crimes committed in violation of international law. Thus the Rome statute has become a formidable contribution to peace and security. There are concerns that the ICC is targeting African states. However, the ICC cannot preside over cases that are not parties to the Rome statute unless the UN Security council refers the situation or the relevant state asks the court to become involved. The instable international political situation thus deals with criminal prosecutions where amnesty is not permissible or is strongly repudiated. The court has become important justice instruments for states that are unable or unwilling to fulfill their obligation to address legacies of massive human rights violations. The ICJ as a court has a twofold role; to settle legal disputes submitted to it by states, and to give advisory opinions on legal questions referred to it by duly authorized United Nations organs and specialized agencies. All members of the UN are ipso facto parties to the statute of the ICJ. The court gives advisory opinion on any legal question. These courts are the most appropriate fora to pronounce on international crimes and are in a better position to know and apply international law. Cases that have been brought to the courts include Rwanda’s genocide, Liberia’s Charles Taylor etc. The receptiveness and cooperation of the local populations are important to the courts and if the ICC and ICJ can provide appropriate protections for the physical and economic safety of victims then peace and human rights observance can be attained. This paper will look into the effectiveness and impediments of these courts in handling criminal and injustices in international politics as while as what needs to be done to strengthen the capacity of these courts.

Keywords: ICC, international politics, justice, UN security council, violence, protection, fulfilling

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76 Stratafix Barbed Suture Versus Polydioxanone Suture on the Rate of Pancreatic Fistula After Pancreaticoduodenectomy

Authors: Saniya Ablatt, Matthew Jacobsson, Jamie Whisler, Austin Forbes

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Postoperative pancreatic fistula (POPF) is a complication that occurs in up to 41% of patients after pancreaticoduodenectomy. Although certain characteristics such as individual patient anatomy are known risk factors for POPF, the effect of barbed suture techniques remains underexplored. This study examines whether the use of Stratafix barbed suture versus PDS impacts the risk of developing POPF. After obtaining IRB exemption, a retrospective chart review was initiated involving patients who underwent pancreaticoduodenectomy for the treatment of malignant or premalignant lesions of the pancreas at our institution between April 1st 2020 and April 30th 2022. Patients were stratified into 2 groups respective to the technique used to suture the pancreatico-jejunal anastomosis: Group 1 was composed to patients in which 4.0 Stratafix® suture was used n=41. Group 1 was composed to patients in which 4.0 PDS suture was used n=42. Data regarding patient age, sex, BMI, presence or absence of biochemical leak, presence or absence of grade B & C postoperative pancreatic fistulas, rate and type of in hospital complication, rate of reoperation, 30 day readmission rate, 90 day mortality, and total mortality were compared between groups. 83 patients were included in our study with 42 receiving Stratafix and 41 receiving PDS (50.6% vs 49.4%). Stratafix patients had less biochemical leaks (0.0% vs 4.8%, p=0.19) and higher rates of POPF but this was not statistically significant (7.2% vs 2.4%, p=0.26). Additionally, there was no difference between the use of stratafix versus PDS on the risk of clinically relevant grade B or C POPF (p=0.26, OR=3.25 [CI= 0.74-16.43]). Of the independent variables including age, race, sex, BMI, and ASA class, BMI greater than 25 increased the risk of clinically relevant POPF by 7.7 times compared to patients with BMI less than 25 (p=0.03, OR=7.79 [1.04-88.51]). Despite no significant difference in primary outcomes, the Stratafix group had lower rates of secondary outcomes including 90-day mortality; bleeding, cardiac, and infectious complications; reoperation; and 30-day readmission. On statistical analysis, Stratafix decreased the risk of 30-day readmission (p=0.04, OR=0.21, CI=0.04-0.97) and had a marginally significant effect on the risk of reoperation (p=0.08, OR=0.24, CI=0.04-1.26). There was no difference between the use of Stratafix versus PDS on the risk of POPF (p=0.26). However, Stratafix decreased the risk of 30-day readmission (p=0.04) and BMI greater than 25 increased the risk of clinically relevant POPF (p=0.03).

Keywords: pancreas, hepatobiliary surgery, hepatobiliary, pancreatic leak, biochemical leak, fistula, pancreatic fistula

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75 Observation of a Phase Transition in Adsorbed Hydrogen at 101 Kelvin

Authors: Raina J. Olsen, Andrew K. Gillespie, John W. Taylor, Cristian I. Contescu, Peter Pfeifer, James R. Morris

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While adsorbent surfaces such as graphite are known to increase the melting temperature of solid H2, this effect is normally rather small, increasing to 20 Kelvin (K) relative to 14 K in the bulk. An as-yet unidentified phase transition has been observed in a system of H2 adsorbed in a porous, locally graphitic, Saran carbon with sub-nanometer sized pores at temperatures (74-101 K) and pressures ( > 76 bar) well above the critical point of bulk H2 using hydrogen adsorption and neutron scattering experiments. Adsorption data shows a discontinuous pressure jump in the kinetics at 76 bar after nearly an hour of equilibration time, which is identified as an exothermic phase transition. This discontinuity is observed in the 87 K isotherm, but not the 77 K isotherm. At higher pressures, the measured isotherms show greater excess adsorption at 87 K than 77 K. Inelastic neutron scattering measurements also show a striking phase transition, with the amount of high angle scattering (corresponding to large momentum transfer/ large effective mass) increasing by up to a factor of 5 in the novel phase. During the course of the neutron scattering experiment, three of these reversible spectral phase transitions were observed to occur in response to only changes in sample temperature. The novel phase was observed by neutron scattering only at high H2 pressure (123 bar and 187 bar) and temperatures between 74-101 K in the sample of interest, but not at low pressure (30 bar), or in a control activated carbon at 186 bar of H2 pressure. Based on several of the more unusual observations, such as the slow equilibration and the presence of both an upper and lower temperature bound, a reasonable hypothesis is that this phase forms only in the presence of a high concentration of ortho-H2 (nuclear spin S=1). The increase in adsorption with temperature, temperatures which cross the lower temperature bound observed by neutron scattering, indicates that this novel phase is denser. Structural characterization data on the adsorbent shows that it may support a commensurate solid phase denser than those known to exist on graphite at much lower temperatures. Whatever this phase is eventually proven to be, these results show that surfaces can have a more striking effect on hydrogen phases than previously thought.

Keywords: adsorbed phases, hydrogen, neutron scattering, nuclear spin

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74 The Impact of Intestinal Ischaemia-Reperfusion Injury upon the Biological Function of Mesenteric Lymph

Authors: Beth Taylor, Kojima Mituaki, Atsushi Senda, Koji Morishita, Yasuhiro Otomo

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Intestinal ischaemia-reperfusion injury drives systemic inflammation and organ failure following trauma/haemorrhagic shock (T/HS), through the release of pro-inflammatory mediators into the mesenteric lymph (ML). However, changes in the biological function of ML are not fully understood, and therefore, a specific model of intestinal ischaemia-reperfusion injury is required to obtain ML for the study of its biological function upon inflammatory cells. ML obtained from a model of intestinal ischaemia-reperfusion injury was used to assess biological function upon inflammatory cells and investigate changes in the biological function of individual ML components. An additional model was used to determine the effect of vagal nerve stimulation (VNS) upon biological function. Rat ML was obtained by mesenteric lymphatic duct cannulation before and after occlusion of the superior mesenteric artery (SMAO). ML was incubated with human polymorphonuclear neutrophils (PMNs), monocytes and lymphocytes, and the biological function of these cells was assessed. ML was then separated into supernatant, exosome and micro-vesicle components, and biological activity was compared in monocytes. A model with an additional VNS phase was developed, in which the right cervical vagal nerve was exposed and stimulated, and ML collected for comparison of biological function with the conventional model. The biological function of ML was altered by intestinal ischaemia-reperfusion injury, increasing PMN activation, monocyte activation, and lymphocyte apoptosis. Increased monocyte activation was only induced by the exosome component of ML, with no significant changes induced by the supernatant or micro-vesicle components. VNS partially attenuated monocyte activation, but no attenuation of PMN activation was observed. Intestinal ischaemia-reperfusion injury induces changes in the biological function of ML upon both innate and adaptive inflammatory cells, supporting the role of intestinal ischaemia-reperfusion injury in driving systemic inflammation following T/HS. The exosome component of ML appears to be critical to the transport of pro-inflammatory mediators in ML. VNS partially attenuates changes in innate inflammatory cell biological activity observed, presenting possibilities for future novel treatment development in multiple organ failure patients.

Keywords: exosomes, inflammation, intestinal ischaemia, mesenteric lymph, vagal stimulation

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73 Streamwise Vorticity in the Wake of a Sliding Bubble

Authors: R. O’Reilly Meehan, D. B. Murray

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In many practical situations, bubbles are dispersed in a liquid phase. Understanding these complex bubbly flows is therefore a key issue for applications such as shell and tube heat exchangers, mineral flotation and oxidation in water treatment. Although a large body of work exists for bubbles rising in an unbounded medium, that of bubbles rising in constricted geometries has received less attention. The particular case of a bubble sliding underneath an inclined surface is common to two-phase flow systems. The current study intends to expand this knowledge by performing experiments to quantify the streamwise flow structures associated with a single sliding air bubble under an inclined surface in quiescent water. This is achieved by means of two-dimensional, two-component particle image velocimetry (PIV), performed with a continuous wave laser and high-speed camera. PIV vorticity fields obtained in a plane perpendicular to the sliding surface show that there is significant bulk fluid motion away from the surface. The associated momentum of the bubble means that this wake motion persists for a significant time before viscous dissipation. The magnitude and direction of the flow structures in the streamwise measurement plane are found to depend on the point on its path through which the bubble enters the plane. This entry point, represented by a phase angle, affects the nature and strength of the vortical structures. This study reconstructs the vorticity field in the wake of the bubble, converting the field at different instances in time to slices of a large-scale wake structure. This is, in essence, Taylor’s ”frozen turbulence” hypothesis. Applying this to the vorticity fields provides a pseudo three-dimensional representation from 2-D data, allowing for a more intuitive understanding of the bubble wake. This study provides insights into the complex dynamics of a situation common to many engineering applications, particularly shell and tube heat exchangers in the nucleate boiling regime.

Keywords: bubbly flow, particle image velocimetry, two-phase flow, wake structures

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72 Management of Third Stage Labour in a Rural Ugandan Hospital

Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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71 Treating Voxels as Words: Word-to-Vector Methods for fMRI Meta-Analyses

Authors: Matthew Baucum

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With the increasing popularity of fMRI as an experimental method, psychology and neuroscience can greatly benefit from advanced techniques for summarizing and synthesizing large amounts of data from brain imaging studies. One promising avenue is automated meta-analyses, in which natural language processing methods are used to identify the brain regions consistently associated with certain semantic concepts (e.g. “social”, “reward’) across large corpora of studies. This study builds on this approach by demonstrating how, in fMRI meta-analyses, individual voxels can be treated as vectors in a semantic space and evaluated for their “proximity” to terms of interest. In this technique, a low-dimensional semantic space is built from brain imaging study texts, allowing words in each text to be represented as vectors (where words that frequently appear together are near each other in the semantic space). Consequently, each voxel in a brain mask can be represented as a normalized vector sum of all of the words in the studies that showed activation in that voxel. The entire brain mask can then be visualized in terms of each voxel’s proximity to a given term of interest (e.g., “vision”, “decision making”) or collection of terms (e.g., “theory of mind”, “social”, “agent”), as measured by the cosine similarity between the voxel’s vector and the term vector (or the average of multiple term vectors). Analysis can also proceed in the opposite direction, allowing word cloud visualizations of the nearest semantic neighbors for a given brain region. This approach allows for continuous, fine-grained metrics of voxel-term associations, and relies on state-of-the-art “open vocabulary” methods that go beyond mere word-counts. An analysis of over 11,000 neuroimaging studies from an existing meta-analytic fMRI database demonstrates that this technique can be used to recover known neural bases for multiple psychological functions, suggesting this method’s utility for efficient, high-level meta-analyses of localized brain function. While automated text analytic methods are no replacement for deliberate, manual meta-analyses, they seem to show promise for the efficient aggregation of large bodies of scientific knowledge, at least on a relatively general level.

Keywords: FMRI, machine learning, meta-analysis, text analysis

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70 A Holistic Analysis of the Emergency Call: From in Situ Negotiation to Policy Frameworks and Back

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

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

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

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69 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures

Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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68 Standardizing and Achieving Protocol Objectives for ChestWall Radiotherapy Treatment Planning Process using an O-ring Linac in High-, Low- and Middle-income Countries

Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

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Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

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67 Application Reliability Method for the Analysis of the Stability Limit States of Large Concrete Dams

Authors: Mustapha Kamel Mihoubi, Essadik Kerkar, Abdelhamid Hebbouche

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According to the randomness of most of the factors affecting the stability of a gravity dam, probability theory is generally used to TESTING the risk of failure and there is a confusing logical transition from the state of stability failed state, so the stability failure process is considered as a probable event. The control of risk of product failures is of capital importance for the control from a cross analysis of the gravity of the consequences and effects of the probability of occurrence of identified major accidents and can incur a significant risk to the concrete dam structures. Probabilistic risk analysis models are used to provide a better understanding the reliability and structural failure of the works, including when calculating stability of large structures to a major risk in the event of an accident or breakdown. This work is interested in the study of the probability of failure of concrete dams through the application of the reliability analysis methods including the methods used in engineering. It is in our case of the use of level II methods via the study limit state. Hence, the probability of product failures is estimated by analytical methods of the type FORM (First Order Reliability Method), SORM (Second Order Reliability Method). By way of comparison, a second level III method was used which generates a full analysis of the problem and involving an integration of the probability density function of, random variables are extended to the field of security by using of the method of Mont-Carlo simulations. Taking into account the change in stress following load combinations: normal, exceptional and extreme the acting on the dam, calculation results obtained have provided acceptable failure probability values which largely corroborate the theory, in fact, the probability of failure tends to increase with increasing load intensities thus causing a significant decrease in strength, especially in the presence of combinations of unique and extreme loads. Shear forces then induce a shift threatens the reliability of the structure by intolerable values of the probability of product failures. Especially, in case THE increase of uplift in a hypothetical default of the drainage system.

Keywords: dam, failure, limit state, monte-carlo, reliability, probability, sliding, Taylor

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66 Living or Surviving in an Intercultural Context: A Study on Transformative Learning of UK Students in China and Chinese Students in the UK

Authors: Yiran Wang

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As international education continues to expand countries providing such opportunities not only benefit but also face challenges. For traditional destinations, including the United States and the United Kingdom, the number of international students has been falling. At the same time emerging economies, such as China, are witnessing a rapid increase in the number of international students enrolled in their universities. China is, therefore, beginning to play an important role in the competitive global market for higher education. This study analyses and compares the experiences of international students in the UK and China using Transformative Learning theory. While there is an extensive literature on both international higher education and also Transformative Learning theory there are currently three contributions this study makes. First, this research applies the theory to two international student groups: UK students in Chinese universities and Chinese students in UK universities.Second, this study includes a focus on the intercultural learning of Chinese doctoral students in the UK filling a gap in current research. Finally, this investigation has extended the very limited number of current research projects on UK students in China. It is generally acknowledged that international students will experience various challenges when they are in a culturally different context. Little research has focused on how, why, and why not learners are transformed through exposure to their new environment. This study applies Transformative Learning theory to address two research questions: first, do UK international students in Chinese universities and Chinese international students in UK universities experience transformational learning in/during their overseas studies? Second, what factors foster or impede international students’ experience of transformative learning? To answer the above questions, semi-structured interviews were used to investigate international students’ academic and social experiences. Based on the insights provided by Mezirow,Taylor,and previous studies on international students, this study argues that international students’ intercultural experience is a complex process.Transformation can occur in various ways and social and personal perspectives underpin the transformative learning of the students studied. Contributing factors include culture shock, educational conventions,the student’s motivation, expectations, personality, gender and previous work experience.The results reflect the significance of differences in teaching styles in the UK and China and the impact this can have on the student teaching and learning process when they move to a new university.

Keywords: intercultural learning, international higher education, transformative learning, UK and Chinese international students

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65 Library Support for the Intellectually Disabled: Book Clubs and Universal Design

Authors: Matthew Conner, Leah Plocharczyk

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This study examines the role of academic libraries in support of the intellectually disabled (ID) in post-secondary education. With the growing public awareness of the ID, there has been recognition of their need for post-secondary educational opportunities. This was an unforeseen result for a population that has been associated with elementary levels of education, yet the reasons are compelling. After aging out of the school system, the ID need and deserve educational and social support as much as anyone. Moreover, the commitment to diversity in higher education rings hollow if this group is excluded. Yet, challenges remain to integrating the ID into a college curriculum. This presentation focuses on the role of academic libraries. Neglecting this vital resource for the support of the ID is not to be thought of, yet the library’s contribution is not clear. Library collections presume reading ability and libraries already struggle to meet their traditional goals with the resources available. This presentation examines how academic libraries can support post-secondary ID. For context, the presentation first examines the state of post-secondary education for the ID with an analysis of data on the United States compiled by the ThinkCollege! Project. Geographic Information Systems (GIS) and statistical analysis will show regional and methodological trends in post-secondary support of the ID which currently lack any significant involvement by college libraries. Then, the presentation analyzes a case study of a book club at the Florida Atlantic University (FAU) libraries which has run for several years. Issues such as the selection of books, effective pedagogies, and evaluation procedures will be examined. The study has found that the instruction pedagogies used by libraries can be extended through concepts of Universal Learning Design (ULD) to effectively engage the ID. In particular, student-centered, participatory methodologies that accommodate different learning styles have proven to be especially useful. The choice of text is complex and determined not only by reading ability but familiarity of subject and features of the ID’s developmental trajectory. The selection of text is not only a necessity but also promises to give insight into the ID. Assessment remains a complex and unresolved subject, but the voluntary, sustained, and enthusiastic attendance of the ID is an undeniable indicator. The study finds that, through the traditional library vehicle of the book club, academic libraries can support ID students through training in both reading and socialization, two major goals of their post-secondary education.

Keywords: academic libraries, intellectual disability, literacy, post-secondary education

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64 Developing Social Responsibility Values in Nascent Entrepreneurs through Role-Play: An Explorative Study of University Students in the United Kingdom

Authors: David W. Taylor, Fernando Lourenço, Carolyn Branston, Paul Tucker

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There are an increasing number of students at Universities in the United Kingdom engaging in entrepreneurship role-play to explore business start-up as a career alternative to employment. These role-play activities have been shown to have a positive influence on students’ entrepreneurial intentions. Universities also play a role in developing graduates’ awareness of social responsibility. However, social responsibility is often missing from these entrepreneurship role-plays. It is important that these role-play activities include the development of values that support social responsibility, in-line with those running hybrid, humane and sustainable enterprises, and not simply focus on profit. The Young Enterprise (YE) Start-Up programme is an example of a role-play activity that is gaining in popularity amongst United Kingdom Universities seeking ways to give students insight into a business start-up. A Post-92 University in the North-West of England has adapted the traditional YE Directorship roles (e.g., Marketing Director, Sales Director) by including a Corporate Social Responsibility (CSR) Director in all of the team-based YE Start-Up businesses. The aim for introducing this Directorship was to observe if such a role would help create a more socially responsible value-system within each company and in turn shape business decisions. This paper investigates role-play as a tool to help enterprise educators develop socially responsible attitudes and values in nascent entrepreneurs. A mixed qualitative methodology approach has been used, which includes interviews, role-play, and reflection, to help students develop positive value characteristics through the exploration of unethical and selfish behaviors. The initial findings indicate that role-play helped CSR Directors learn and gain insights into the importance of corporate social responsibility, influenced the values and actions of their YE Start-Ups, and increased the likelihood that if the participants were to launch a business post-graduation, that the intent would be for the business to be socially responsible. These findings help inform educators on how to develop socially responsible nascent entrepreneurs within a traditionally profit orientated business model.

Keywords: student entrepreneurship, young enterprise, social responsibility, role-play, values

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63 Acoustic Emission Monitoring of Surface Roughness in Ultra High Precision Grinding of Borosilicate-Crown Glass

Authors: Goodness Onwuka, Khaled Abou-El-Hossein

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The increase in the demand for precision optics, coupled with the absence of much research output in the ultra high precision grinding of precision optics as compared to the ultrahigh precision diamond turning of optical metals has fostered the need for more research in the ultra high precision grinding of an optical lens. Furthermore, the increase in the stringent demands for nanometric surface finishes through lapping, polishing and grinding processes necessary for the use of borosilicate-crown glass in the automotive and optics industries has created the demand to effectively monitor the surface roughness during the production process. Acoustic emission phenomenon has been proven as useful monitoring technique in several manufacturing processes ranging from monitoring of bearing production to tool wear estimation. This paper introduces a rare and unique approach with the application of acoustic emission technique to monitor the surface roughness of borosilicate-crown glass during an ultra high precision grinding process. This research was carried out on a 4-axes Nanoform 250 ultrahigh precision lathe machine using an ultra high precision grinding spindle to machine the flat surface of the borosilicate-crown glass with the tip of the grinding wheel. A careful selection of parameters and design of experiment was implemented using Box-Behnken method to vary the wheel speed, feed rate and depth of cut at three levels with a 3-center point design. Furthermore, the average surface roughness was measured using Taylor Hobson PGI Dimension XL optical profilometer, and an acoustic emission data acquisition device from National Instruments was utilized to acquire the signals while the data acquisition codes were designed with National Instrument LabVIEW software for acquisition at a sampling rate of 2 million samples per second. The results show that the raw and root mean square amplitude values of the acoustic signals increased with a corresponding increase in the measured average surface roughness values for the different parameter combinations. Therefore, this research concludes that acoustic emission monitoring technique is a potential technique for monitoring the surface roughness in the ultra high precision grinding of borosilicate-crown glass.

Keywords: acoustic emission, borosilicate-crown glass, surface roughness, ultra high precision grinding

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