Search results for: suicide rates

Authors: Kennedy Zinn, Chris Anderson

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Chronic Covid syndrome (CCS) is a condition in which individuals who test positive for Covid-19 experience persistent symptoms after recovering from the virus. CCS affects every organ system, including the central nervous system. Neurological “long-haul” symptoms last from a few weeks to several months and include brain fog, chronic fatigue, dyspnea, mood dysregulation, and headaches. Data suggest that 10-30% of individuals testing positive for Covid-19 develop CCS. Current literature indicates a decreased quality of life in persistent symptoms. CCS is a pervasive and pernicious COVID-19 sequelae. More research is needed to understand risk factors, impact, and possible interventions. Research frequently cites cytokine storming as noteworthy etiology in CCS. Cytokine storming is a malfunctional immune response and facilitates multidimensional interconnected physiological responses. The most prominent responses include abnormal blood flow, hypoxia/hypoxemia, inflammation, and endothelial damage. Neurological impairments and pathogenesis in CCS parallel that of traumatic brain injury (TBI). Both exhibit impairments in memory, cognition, mood, sustained attention, and chronic fatigue. Evidence suggests abnormal blood flow, inflammation, and hypoxemia as shared causal factors. Cytokine storming is also typical in mTBI. The shared characteristics in symptoms and etiology suggest potential parallel routes of investigation that allow for better understanding of CCS. Research on the effect of altitude in mTBI varies. Literature finds decreased rates of concussions at higher altitudes. Other studies suggest that at a higher altitude, pre-existing mTBI symptoms are exacerbated. This may mean that in CCS, the geographical location where individuals live and the location where individuals experienced acute Covid-19 symptoms may influence the severity and risk of developing CCS. It also suggests that clinics which treat mTBI patients could also provide benefits for those with CCS. This study aims to examine the relationships between altitude and CCS as a risk factor and investigate the longevity and severity of symptoms in different altitudes. Existing patient data from a concussion clinic using fMRI scans and self-reported symptoms will be used for approximately 30 individuals with CCS symptoms. The association between acclimated altitude and CCS severity will be analyzed. Patients will be classified into low, medium, and high altitude groups and compared for differences on fMRI severity scores and self-reported measures. It is anticipated that individuals living in lower altitudes are at higher risk of developing more severe neuropsychological symptoms in CCS. It is also anticipated that a treatment approach for mTBI will also be beneficial to those with CCS.

Keywords: altitude, chronic covid syndrome, concussion, covid brain, EPIC treatment, fMRI, traumatic brain injury

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Authors: Ekin Esen, Mohammad Alipour, Riza Kizilel

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Rechargeable lithium-ion batteries have been replacing lead-acid batteries for the last decade due to their outstanding properties such as high energy density, long shelf life, and almost no memory effect. Besides these, being very light compared to lead acid batteries has gained them their dominant place in the portable electronics market, and they are now the leading candidate for electric vehicles (EVs) and hybrid electric vehicles (HEVs). However, their performance strongly depends on temperature, and this causes some inconveniences for their utilization in extreme temperatures. Since weather conditions vary across the globe, this situation limits their utilization for EVs and HEVs and makes a thermal management system obligatory for the battery units. The objective of this study is to understand thermal characteristics of Li-ion battery modules for various operation conditions and design a thermal management system to enhance battery performance in EVs and HEVs. In the first part of our study, we investigated thermal behavior of commercially available pouch type 20Ah LiFePO₄ (LFP) cells under various conditions. Main parameters were chosen as ambient temperature and discharge current rate. Each cell was charged and discharged at temperatures of 0°C, 10°C, 20°C, 30°C, 40°C, and 50°C. The current rate of charging process was 1C while it was 1C, 2C, 3C, 4C, and 5C for discharge process. Temperatures of 7 different points on the cells were measured throughout charging and discharging with N-type thermocouples, and a detailed temperature profile was obtained. In the second part of our study, we connected 4 cells in series by clinching and prepared 4S1P battery modules similar to ones in EVs and HEVs. Three reference points were determined according to the findings of the first part of the study, and a thermocouple is placed on each reference point on the cells composing the 4S1P battery modules. In the end, temperatures of 6 points in the module and 3 points on the top surface were measured and changes in the surface temperatures were recorded for different discharge rates (0.2C, 0.5C, 0.7C, and 1C) at various ambient temperatures (0°C – 50°C). Afterwards, aluminum plates with channels were placed between the cells in the 4S1P battery modules, and temperatures were controlled with airflow. Airflow was provided with a regular compressor, and the effect of flow rate on cell temperature was analyzed. Diameters of the channels were in mm range, and shapes of the channels were determined in order to make the cell temperatures uniform. Results showed that the designed thermal management system could help keeping the cell temperatures in the modules uniform throughout charge and discharge processes. Other than temperature uniformity, the system was also beneficial to keep cell temperature close to the optimum working temperature of Li-ion batteries. It is known that keeping the temperature at an optimum degree and maintaining uniform temperature throughout utilization can help obtaining maximum power from the cells in battery modules for a longer time. Furthermore, it will increase safety by decreasing the risk of thermal runaways. Therefore, the current study is believed to be beneficial for wider use of Li batteries for battery modules of EVs and HEVs globally.

Keywords: lithium ion batteries, thermal management system, electric vehicles, hybrid electric vehicles

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Authors: Aboulkacem El Mehdi

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We develop a theoretical model at the crossroads of labour and urban economics, used for explaining the mechanism through which the duration of home-workplace trips and their monetary costs impact the labour demand and supply in a spatially scattered labour market and how they are impacted by a change in passenger transport infrastructures and services. The spatial disconnection between home and job opportunities is referred to as the spatial mismatch hypothesis (SMH). Its harmful impact on employment has been subject to numerous theoretical propositions. However, all the theoretical models proposed so far are patterned around the American context, which is particular as it is marked by racial discrimination against blacks in the housing and the labour markets. Therefore, it is only natural that most of these models are developed in order to reproduce a steady state characterized by agents carrying out their economic activities in a mono-centric city in which most unskilled jobs being created in the suburbs, far from the Blacks who dwell in the city-centre, generating a high unemployment rates for blacks, while the White population resides in the suburbs and has a low unemployment rate. Our model doesn't rely on any racial discrimination and doesn't aim at reproducing a steady state in which these stylized facts are replicated; it takes the main principle of the SMH -the spatial disconnection between homes and workplaces- as a starting point. One of the innovative aspects of the model consists in dealing with a SMH related issue at an aggregate level. We link the parameters of the passengers transport system to employment in the whole area of a city. We consider here a city that consists of four areas: two of them are residential areas with unemployed workers, the other two host firms looking for labour force. The workers compare the indirect utility of working in each area with the utility of unemployment and choose between submitting an application for the job that generate the highest indirect utility or not submitting. This arbitration takes account of the monetary and the time expenditures generated by the trips between the residency areas and the working areas. Each of these expenditures is clearly and explicitly formulated so that the impact of each of them can be studied separately than the impact of the other. The first findings show that the unemployed workers living in an area benefiting from good transport infrastructures and services have a better chance to prefer activity to unemployment and are more likely to supply a higher 'quantity' of labour than those who live in an area where the transport infrastructures and services are poorer. We also show that the firms located in the most accessible area receive much more applications and are more likely to hire the workers who provide the highest quantity of labour than the firms located in the less accessible area. Currently, we are working on the matching process between firms and job seekers and on how the equilibrium between the labour demand and supply occurs.

Keywords: labour market, passenger transport infrastructure, spatial mismatch hypothesis, urban economics

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Authors: Brian Yulianto, Syachrial, Saeful Aziz, Anggita Clara Shinta

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Indonesia, with a population of about two hundred and fifty million people in quantity, indicates the outstanding wealth of human resources. Hundreds of millions of the population scattered in various communities in various regions in Indonesia with the different characteristics of economic, social and unique culture. Broadly speaking, the community in Indonesia is divided into two classes, namely urban communities and rural communities. The rural communities characterized by low potential and management of natural and human resources, limited access of development, and lack of social and economic infrastructure, and scattered and isolated population. West Java is one of the provinces with the largest population in Indonesia. Based on data from the Central Bureau of Statistics in 2015 the number of population in West Java reached 46.7096 million souls spread over 18 districts and 9 cities. The big difference in geographical and social conditions of people in West Java from one region to another, especially the south to the north causing the gap is high. It is closely related to the flow of investment to promote the area. Poverty and underdevelopment are the classic problems that occur on a massive scale in the region as the effects of inequity in development. South Cianjur and Tasikmalaya area South became one of the portraits area where the existing potential has not been capable of prospering society. Tri Dharma College not only define the College as a pioneer implementation of education and research to improve the quality of human resources but also demanded to be a pioneer in the development through the concept of public service. Bandung Institute of Technology as one of the institutions of higher education to implement community service system through collaborative community work program "one of the university community" as one approach to developing villages. The program is based Community Service, where students are not only required to be able to take part in community service, but also able to develop a community development strategy that is comprehensive and integrity in cooperation with government agencies and non-government related as a real form of effort alignment potential, position and role from various parties. Areas of western Java in particular have high poverty rates and disparity. On the other hand, there are three fundamental pillars in the development of rural communities, namely economic development, community development, and the integrated infrastructure development. These pillars require the commitment of all components of community, including the students and colleges for upholding success. College’s community program is one of the approaches in the development of rural communities. ITB is committed to implement as one form of student community service as community-college programs that integrate all elements of the community which is called Kuliah Kerja Nyata-Thematic.

Keywords: development in rural area, collaborative, student community service, Kuliah Kerja Nyata-Thematic ITB

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Authors: Panagiotis Lemonakis, Nikolaos Moisiadis, Andromachi Gkoutzini, George Kaliabetsos, Nikos Eliou

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The proper surface water drainage not only affects vehicle movement dynamics but also increases the likelihood of an accident due to the fact that inadequate drainage is associated with potential hydroplaning and splash and spray driving conditions. Nine solutions have been proposed to address hydroplaning in sections with inadequate drainage, e.g., augmented superelevation and longitudinal rates, reduction of runoff length, and skew superelevation. The latter has been extensively implemented in highways recently, enhancing the safety level in the applied road segments in regards to the effective drainage of the rainwater. However, the concept of the skew superelevation has raised concerns regarding the driver’s comfort when traveling over skew superelevation sections, particularly at high speeds. These concerns alleviated through the concept of the round-up skew superelevation, which reduces both the lateral and the vertical acceleration imposed to the drivers and hence, improves comfort and traffic safety. Various research studies aimed at investigating driving comfort by evaluating the lateral and vertical accelerations sustained by the road users and vehicles. These studies focused on the influence of the skew superelevation to passenger cars, buses and trucks, and the drivers themselves, traveling at a certain range of speeds either below or above the design speed. The outcome of these investigations which based on the use of simulations, revealed that the imposed accelerations did not exceed the statutory thresholds even when the travelling speed was significantly greater than the design speed. Nevertheless, the effect of the skew superelevation to other vehicle types for instance, motorcycles, has not been investigated so far. The present research study aims to bridge this gap by investigating the impact of skew superelevation on the motorcycle rider’s comfort. Power two-wheeler riders are susceptible to any changes on the pavement surface and therefore a comparison between the traditional superelevation practice and the skew superelevation concept is of paramount importance. The methodology based on the utilization of sophisticated software in order to design the model of the road for several values of the longitudinal slope. Based on the values of the slopes and the use of a mathematical equation, the accelerations imposed on the wheel of the motorcycle were calculated. Due to the fact that the final aim of the study is the influence of the skew superelevation to the rider, it was deemed necessary to convey the calculated accelerations from the wheel to the rider. That was accomplished by implementing the quarter car suspension model adjusted to the features of two-wheeler vehicles. Finally, the accelerations derived from this process evaluated according to specific thresholds originated from the International Organization for Standardization, which correspond to certain levels of comfort. The most important conclusion drawn is that the comfort of the riders is not dependent on the form of road gradient to a great extent due to the fact that the vertical acceleration imposed to the riders took similar values regardless of the value of the longitudinal slope.

Keywords: acceleration, comfort, motorcycle, safety, skew superelevation

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Authors: Karishma Kashyap, Subha D. Parida

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Rapid population growth and urbanization is creating pressure throughout the world. This has a dramatic effect on a lot of elements which include water, food, transportation, energy, infrastructure etc. as few of the key services. Built environment sector is growing concurrently to meet the needs of urbanization. Due to such large scale development of buildings, there is a need for them to be monitored and managed efficiently. Along with appropriate management, climate adaptation is highly crucial as well because buildings are one of the major sources of greenhouse gas emission in their operation phase. Buildings to be adaptive need to provide a triple bottom approach to sustainability i.e., being socially, environmentally and economically sustainable. Hence, in order to deliver these sustainability outcomes, there is a growing understanding and thrive towards switching to green buildings or renovating new ones as per green standards wherever possible. Academic institutions in particular have been following this trend globally. This is highly significant as universities usually have high occupancy rates because they manage a large building portfolio. Also, as universities accommodate the future generation of architects, policy makers etc., they have the potential of setting themselves as a best industry practice model for research and innovation for the rest to follow. Hence their climate adaptation, sustainable growth and performance management becomes highly crucial in order to provide the best services to users. With the objective of evaluating appropriate management mechanisms within academic institutions, a feasibility study was carried out in a recent 5-Star Green Star rated university building (housing the School of Construction) in Victoria (south-eastern state of Australia). The key aim was to understand the behavioral and social aspect of the building users, management and the impact of their relationship on overall building sustainability. A survey was used to understand the building occupant’s response and reactions in terms of their work environment and management. A report was generated based on the survey results complemented with utility and performance data which were then used to evaluate the management structure of the university. Followed by the report, interviews were scheduled with the facility and asset managers in order to understand the approach they use to manage the different buildings in their university campuses (old, new, refurbished), respective building and parameters incorporated in maintaining the Green Star performance. The results aimed at closing the communication and feedback loop within the respective institutions and assist the facility managers to deliver appropriate stakeholder engagement. For the wider design community, analysis of the data highlights the applicability and significance of prioritizing key stakeholders, integrating desired engagement policies within an institution’s management structures and frameworks and their effect on building performance

Keywords: building optimization, green building, post occupancy evaluation, stakeholder engagement

Procedia PDF Downloads 357

Authors: Lina Psarra, Manogj Sundaresan, Purjeet Sutar

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In response to the global imperative for sustainable solutions, this article proposes the development of a comprehensive circularity index applicable to a wide range of products across various industries. The absence of a consensus on using a universal metric to assess circularity performance presents a significant challenge in prioritizing and effectively managing sustainable initiatives. This circularity index serves as a quantitative measure to evaluate the adherence of products, processes, and systems to the principles of a circular economy. Unlike traditional distinct metrics such as recycling rates or material efficiency, this index considers the entire lifecycle of a product in one single metric, also incorporating additional factors such as reusability, scarcity of materials, reparability, and recyclability. Through a systematic approach and by reviewing existing metrics and past methodologies, this work aims to address this gap by formulating a circularity index that can be applied to diverse product portfolio and assist in comparing the circularity of products on a scale of 0%-100%. Project objectives include developing a formula, designing and implementing a pilot tool based on the developed Product Circularity Index (PCI), evaluating the effectiveness of the formula and tool using real product data, and assessing the feasibility of integration into various sustainability initiatives. The research methodology involves an iterative process of comprehensive research, analysis, and refinement where key steps include defining circularity parameters, collecting relevant product data, applying the developed formula, and testing the tool in a pilot phase to gather insights and make necessary adjustments. Major findings of the study indicate that the PCI provides a robust framework for evaluating product circularity across various dimensions. The Excel-based pilot tool demonstrated high accuracy and reliability in measuring circularity, and the database proved instrumental in supporting comprehensive assessments. The PCI facilitated the identification of key areas for improvement, enabling more informed decision-making towards circularity and benchmarking across different products, essentially assisting towards better resource management. In conclusion, the development of the Product Circularity Index represents a significant advancement in global sustainability efforts. By providing a standardized metric, the PCI empowers companies and stakeholders to systematically assess product circularity, track progress, identify improvement areas, and make informed decisions about resource management. This project contributes to the broader discourse on sustainable development by offering a practical approach to enhance circularity within industrial systems, thus paving the way towards a more resilient and sustainable future.

Keywords: circular economy, circular metrics, circularity assessment, circularity tool, sustainable product design, product circularity index

Procedia PDF Downloads 28

Authors: Laura C. Loaiza, Elodie Salager, Nicolas Louvain, Athmane Boulaoued, Antonella Iadecola, Patrik Johansson, Lorenzo Stievano, Vincent Seznec, Laure Monconduit

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Lithium-ion batteries (LIBs) have an important place among energy storage devices due to their high capacity and good cyclability. However, the advancements in portable and transportation applications have extended the research towards new horizons, and today the development is hampered, e.g., by the capacity of the electrodes employed. Silicon and germanium are among the considered modern anode materials as they can undergo alloying reactions with lithium while delivering high capacities. It has been demonstrated that silicon in its highest lithiated state can deliver up to ten times more capacity than graphite (372 mAh/g): 4200 mAh/g for Li₂₂Si₅ and 3579 mAh/g for Li₁₅Si₄, respectively. On the other hand, germanium presents a capacity of 1384 mAh/g for Li₁₅Ge₄, and a better electronic conductivity and Li ion diffusivity as compared to Si. Nonetheless, the commercialization potential of Ge is limited by its cost. The synergetic effect of Si₁₋ₓGeₓ alloys has been proven, the capacity is increased compared to Ge-rich electrodes and the capacity retention is increased compared to Si-rich electrodes, but the exact performance of this type of electrodes will depend on factors like specific capacity, C-rates, cost, etc. There are several reports on various formulations of Si₁₋ₓGeₓ alloys with promising LIB anode performance with most work performed on complex nanostructures resulting from synthesis efforts implying high cost. In the present work, we studied the electrochemical mechanism of the Si₀.₅Ge₀.₅ alloy as a realistic micron-sized electrode formulation using carboxymethyl cellulose (CMC) as the binder. A combination of a large set of in situ and operando techniques were employed to investigate the structural evolution of Si₀.₅Ge₀.₅ during lithiation and delithiation processes: powder X-ray diffraction (XRD), X-ray absorption spectroscopy (XAS), Raman spectroscopy, and 7Li solid state nuclear magnetic resonance spectroscopy (NMR). The results have presented a whole view of the structural modifications induced by the lithiation/delithiation processes. The Si₀.₅Ge₀.₅ amorphization was observed at the beginning of discharge. Further lithiation induces the formation of a-Liₓ(Si/Ge) intermediates and the crystallization of Li₁₅(Si₀.₅Ge₀.₅)₄ at the end of the discharge. At really low voltages a reversible process of overlithiation and formation of Li₁₅₊δ(Si₀.₅Ge₀.₅)₄ was identified and related with a structural evolution of Li₁₅(Si₀.₅Ge₀.₅)₄. Upon charge, the c-Li₁₅(Si₀.₅Ge₀.₅)₄ was transformed into a-Liₓ(Si/Ge) intermediates. At the end of the process an amorphous phase assigned to a-SiₓGey was recovered. Thereby, it was demonstrated that Si and Ge are collectively active along the cycling process, upon discharge with the formation of a ternary Li₁₅(Si₀.₅Ge₀.₅)₄ phase (with a step of overlithiation) and upon charge with the rebuilding of the a-Si-Ge phase. This process is undoubtedly behind the enhanced performance of Si₀.₅Ge₀.₅ compared to a physical mixture of Si and Ge.

Keywords: lithium ion battery, silicon germanium anode, in situ characterization, X-Ray diffraction

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Authors: Sara Qandil, Harriet Bothwell, Lowri Evans, Kevin Jones, Simon Collin

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Background: Uganda suffers from high rates of HIV. Misconceptions around HIV are known to be prevalent in Sub-Saharan Africa (SSA). Two of the most common misconceptions in Uganda are that HIV can be transmitted by mosquito bites or from sharing food. The aim of this project was to establish the local misconceptions around HIV in a Central Ugandan population, and identify if there is a role for patient education leaflets. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: The study was conducted at Villa Maria Hospital; a private, rural hospital in Kalungu District, Central Uganda. 36 patients, 23 from the hospital clinic and 13 from the community were interviewed regarding their understanding of HIV and by what channels they had obtained this understanding. Interviews were conducted using local student nurses as translators. Verbal responses were translated and then transcribed by the researcher. The same 36 patients then undertook a 'misconception' test consisting of 35 questions. Quantitative data was analysed using descriptive statistics and results were scored based on three components of 'transmission knowledge', 'prevention knowledge' and 'misconception rejection'. Each correct response to a question was scored one point, otherwise zero e.g. correctly rejecting a misconception scored one point, but answering ‘yes’ or ‘don’t know’ scored zero. Scores ≤ 27 (the average score) were classified as having ‘poor understanding’. Mean scores were compared between participants seen at the HIV clinic and in the community, and p-values (including Fisher’s exact test) were calculated using Stata 2015. Level of significance was set at 0.05. Interviews with 7 members of staff working in the HIV clinic were undertaken to establish what methods of communication are used to educate patients. Interviews were transcribed and thematic analysis undertaken. Results: The commonest misconceptions which failed to be rejected included transmission of HIV by kissing (78%), mosquitoes (69%) and touching (36%). 33% believed HIV may be prevented by praying. The overall mean scores for transmission knowledge (87.5%) and prevention knowledge (81.1%) were better than misconception rejection scores (69.3%). HIV clinic respondents did tend to have higher scores, i.e. fewer misconceptions, although there was statistical evidence of a significant difference only for prevention knowledge (p=0.03). Analysis of the qualitative data is ongoing but several patients expressed concerns about not being able to read and therefore leaflets not having a helpful role. Conclusions: Results from this paper identified that a high proportion of the population studied held misconceptions about HIV. Qualitative data suggests that there may be a role for patient education leaflets, if pictorial-based and suitable for those with low literacy skill.

Keywords: HIV, human immunodeficiency virus, misconceptions, patient education, Sub-Saharan Africa, Uganda

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Authors: O. Bilbao, I. Loizaga, F. A. Girot, A. Torregaray

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The current energetical situation and the high competitiveness in industrial sectors as the automotive one have become the development of new manufacturing processes with less energy and raw material consumption a real necessity. As consequence, new forming processes related with high temperature hot forging in closed dies have emerged in the last years as new solutions to expand the possibilities of hot forging and iron casting in the automotive industry. These technologies are mid-way between hot forging and semi-solid metal processes, working at temperatures higher than the hot forging but below the solidus temperature or the semi solid range, where no liquid phase is expected. This represents an advantage comparing with semi-solid forming processes as thixoforging, by the reason that no so high temperatures need to be reached in the case of high melting point alloys as steels, reducing the manufacturing costs and the difficulties associated to semi-solid processing of them. Comparing with hot forging, this kind of technologies allow the production of parts with as forged properties and more complex and near-net shapes (thinner sidewalls), enhancing the possibility of designing lightweight components. From the process viewpoint, the forging forces are significantly decreased, and a significant reduction of the raw material, energy consumption, and the forging steps have been demonstrated. Despite the mentioned advantages, from the material behavior point of view, the expansion of these technologies has shown the necessity of developing new material flow behavior models in the process working temperature range to make the simulation or the prediction of these new forming processes feasible. Moreover, the knowledge of the material flow behavior at the working temperature range also allows the design of the new closed dies concept required. In this work, the flow behavior characterization in the mentioned temperature range of the widely used in automotive commercial components 42CrMo4 steel has been studied. For that, hot compression tests have been carried out in a thermomechanical tester in a temperature range that covers the material behavior from the hot forging until the NDT (Nil Ductility Temperature) temperature (1250 ºC, 1275 ºC, 1300 ºC, 1325 ºC, 1350ºC, and 1375 ºC). As for the strain rates, three different orders of magnitudes have been considered (0,1 s-1, 1s-1, and 10s-1). Then, results obtained from the hot compression tests have been treated in order to adapt or re-write the Spittel model, widely used in automotive commercial softwares as FORGE® that restrict the current existing models up to 1250ºC. Finally, the obtained new flow behavior model has been validated by the process simulation in a commercial automotive component and the comparison of the results of the simulation with the already made experimental tests in a laboratory cellule of the new technology. So as a conclusion of the study, a new flow behavior model for the 42CrMo4 steel in the new working temperature range and the new process simulation in its application in automotive commercial components has been achieved and will be shown.

Keywords: 42CrMo4 high temperature flow behavior, high temperature hot forging in closed dies, simulation of automotive commercial components, spittel flow behavior model

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Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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Contraceptives are an effective public health achievement, allowing for family planning and reducing the risk of sexually transmitted diseases (STDs). California’s rural Central Valley has high rates of teenage pregnancy and STDs. Factors affecting contraceptive usage here may include religious concerns, financial issues, and regional variations in the accessibility and availability of contraceptives. The increasing population and diversity of the Central Valley make the understanding of the determinants of unintended pregnancy and STDs increasingly nuanced. Patients in California’s Central Valley were surveyed at 6 surgical clinics to assess attitudes toward contraceptives. The questionnaire consisted of demographics and 14 Likert-scale statements investigating patients’ feelings regarding contraceptives. Parametric and non-parametric analysis was performed on the Likert statements. A correlation matrix for the Likert-scale statements was used to evaluate the strength of the relationship between each question. 76 patients aged 18-75 years completed the questionnaire. 90% of the participants were female, 76% Hispanic, 36% married, 44% with an income range between 30-60K, and 83% were between childbearing ages. 60% of participants stated they are currently using or had used some type of contraceptive. 25% of participants had at least one unplanned pregnancy. The most common type of contraceptives used were oral contraceptives(28%) and condoms(38%). The top reasons for patients’ contraceptive usage were: prevention of pregnancy (72%), safe sex/prevention of STDs (32%), and regulation of menstrual cycle (19%). Further analysis of Likert responses revealed that contraception usage increased due to approval of contraceptives (x̄=3.98, σ =1.02); partner approval of contraceptives (x̄=3.875, σ =1.16); and reduced anxiety about pregnancy (x̄=3.875, σ =1.23). Younger females (18-34 years old) agreed more with the statement that the cost of contraceptive supplies is too expensive than older females (35-75 years old), (x̄=3.2, σ = 1.4 vs x̄=2.8, σ =1.3, p<0.05). Younger females (44%) were also more likely to use short-acting contraceptive methods (oral and male condoms) compared to older females (64%) who use long-acting methods (implants/ intrauterine devices). 51% of Hispanic females were using some type of contraceptive. Of those Hispanic females who do not use contraceptives, 33% stated having no children, and all plan to have at least one child in the future. 35% of participants had a bachelor's degree. Those with bachelor’s degrees were more likely to use contraceptives, 58% vs 51%, p<0.05, and less likely to have unplanned pregnancy, 50% vs. 12%, p<0.01. There is increasing use and awareness among patients in rural settings concerning contraceptives. Our finding shows that younger women and women with higher educational attainment tend to have more positive attitudes towards the use of contraceptives. This work gives physicians an understanding of patients’ concerns about contraceptive methods and offers insight into culturally competent intervention programs that respect individual values.

Keywords: contraceptives, public health, rural california, women of child baring age

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Authors: Ieva Jokubauskaite, Alvyra Slepetiene, Danute Karcauskiene, Inga Liaudanskiene, Kristina Amaleviciute

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Soil organic carbon (SOC) is the key soil quality and ecological stability indicator, therefore, carbon accumulation in stable forms not only supports and increases the organic matter content in the soil, but also has a positive effect on the quality of soil and the whole ecosystem. Soil liming is one of the most common ways to improve the carbon sequestration in the soil. Determination of the optimum intensity and combinations of liming in order to ensure the optimal carbon quantitative and qualitative parameters is one of the most important tasks of this work. The field experiments were carried out at the Vezaiciai Branch of Lithuanian Research Centre for Agriculture and Forestry (LRCAF) during the 2011–2013 period. The effect of liming with different intensity (at a rate 0.5 every 7 years and 2.0 every 3-4 years) was investigated in the topsoil of acid moraine loam Bathygleyic Dystric Glossic Retisol. Chemical analyses were carried out at the Chemical Research Laboratory of Institute of Agriculture, LRCAF. Soil samples for chemical analyses were taken from the topsoil after harvesting. SOC was determined by the Tyurin method modified by Nikitin, measuring with spectrometer Cary 50 (VARIAN) at 590 nm wavelength using glucose standards. SOC fractional composition was determined by Ponomareva and Plotnikova version of classical Tyurin method. Dissolved organic carbon (DOC) was analyzed using an ion chromatograph SKALAR in water extract at soil-water ratio 1:5. Spectral properties (E4/E6 ratio) of humic acids were determined by measuring the absorbance of humic and fulvic acids solutions at 465 and 665 nm. Our study showed a negative statistically significant effect of periodical liming (at 0.5 and 2.0 liming rates) on SOC content in the soil. The content of SOC was 1.45% in the unlimed treatment, while in periodically limed at 2.0 liming rate every 3–4 years it was approximately by 0.18 percentage points lower. It was revealed that liming significantly decreased the DOC concentration in the soil. The lowest concentration of DOC (0.156 g kg-1) was established in the most intensively limed (2.0 liming rate every 3–4 years) treatment. Soil liming exerted an increase of all humic acids and fulvic acid bounded with calcium fractions content in the topsoil. Soil liming resulted in the accumulation of valuable humic acids. Due to the applied liming, the HR/FR ratio, indicating the quality of humus increased to 1.08 compared with that in unlimed soil (0.81). Intensive soil liming promoted the formation of humic acids in which groups of carboxylic and phenolic compounds predominated. These humic acids are characterized by a higher degree of condensation of aromatic compounds and in this way determine the intensive organic matter humification processes in the soil. The results of this research provide us with the clear information on the characteristics of SOC change, which could be very useful to guide the climate policy and sustainable soil management.

Keywords: acid soil, carbon sequestration, long–term liming, soil organic carbon

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Authors: Alastair Hales, Xi Jiang

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Numerical methods are used to evaluate the operation of confined face-to-face piezoelectric fan arrays as pitch, P, between the blades is varied. Both in-phase and counter-phase oscillation are considered. A piezoelectric fan consists of a fan blade, which is clamped at one end, and an extremely low powered actuator. This drives the blade tip’s oscillation at its first natural frequency. Sufficient blade tip speed, created by the high oscillation frequency and amplitude, is required to induce vortices and downstream volume flow in the surrounding air. A single piezoelectric fan may provide the ideal solution for low powered hot spot cooling in an electronic device, but is unable to induce sufficient downstream airflow to replace a conventional air mover, such as a convection fan, in power electronics. Piezoelectric fan arrays, which are assemblies including multiple fan blades usually in face-to-face orientation, must be developed to widen the field of feasible applications for the technology. The potential energy saving is significant, with a 50% power demand reduction compared to convection fans even in an unoptimised state. A numerical model of a typical piezoelectric fan blade is derived and validated against experimental data. Numerical error is found to be 5.4% and 9.8% using two data comparison methods. The model is used to explore the variation of pitch as a function of amplitude, A, for a confined two-blade piezoelectric fan array in face-to-face orientation, with the blades oscillating both in-phase and counter-phase. It has been reported that in-phase oscillation is optimal for generating maximum downstream velocity and flow rate in unconfined conditions, due at least in part to the beneficial coupling between the adjacent blades that leads to an increased oscillation amplitude. The present model demonstrates that confinement has a significant detrimental effect on in-phase oscillation. Even at low pitch, counter-phase oscillation produces enhanced downstream air velocities and flow rates. Downstream air velocity from counter-phase oscillation can be maximally enhanced, relative to that generated from a single blade, by 17.7% at P = 8A. Flow rate enhancement at the same pitch is found to be 18.6%. By comparison, in-phase oscillation at the same pitch outputs 23.9% and 24.8% reductions in peak downstream air velocity and flow rate, relative to that generated from a single blade. This optimal pitch, equivalent to those reported in the literature, suggests that counter-phase oscillation is less affected by confinement. The optimal pitch for generating bulk airflow from counter-phase oscillation is large, P > 16A, due to the small but significant downstream velocity across the span between adjacent blades. However, by considering design in a confined space, counterphase pitch should be minimised to maximise the bulk airflow generated from a certain cross-sectional area within a channel flow application. Quantitative values are found to deviate to a small degree as other geometric and operational parameters are varied, but the established relationships are maintained.

Keywords: piezoelectric fans, low energy cooling, power electronics, computational fluid dynamics

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Authors: Federica Ceccoli

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Italy is undergoing one of its largest migratory waves, and Italian schools are reporting the highest numbers of multilingual students coming from immigrant families and speaking minority languages. For these pupils, who have not perfectly acquired their mother tongue yet, learning a second language may represent a burden on their linguistic development and may have some repercussions on their school performances and relational skills. These are some of the reasons why they have turned out to be those who have the worst grades and the highest school drop-out rates. However, despite these negative outcomes, it has been demonstrated that multilingual immigrant students frequently act as translators or language brokers for their peers or family members who do not speak Italian fluently. This activity has been defined as Child Language Brokering (hereinafter CLB) and it has become a common practice especially in minority communities as immigrants’ children often learn the host language much more quickly than their parents, thus contributing to their family life by acting as language and cultural mediators. This presentation aims to analyse the data collected by a research carried out during the school year 2014-2015 in the province of Ravenna, in the Northern Italian region of Emilia-Romagna, among 126 immigrant students attending junior high schools. The purpose of the study was to analyse by means of a structured questionnaire whether multilingualism matched with language brokering experiences or not and to examine the perspectives of those students who reported having acted as translators using their linguistic knowledge to help people understand each other. The questionnaire consisted of 34 items roughly divided into 2 sections. The first section required multilingual students to provide personal details like their date and place of birth, as well as details about their families (number of siblings, parents’ jobs). In the second section, they were asked about the languages spoken in their families as well as their language brokering experience. The in-depth questionnaire sought to investigate a wide variety of brokering issues such as frequency and purpose of the activity, where, when and which documents young language brokers translate and how they feel about this practice. The results have demonstrated that CLB is a very common practice among immigrants’ children living in Ravenna and almost all students reported positive feelings when asked about their brokering experience with their families and also at school. In line with previous studies, responses to the questionnaire item regarding the people they brokered for revealed that the category ranking first is parents. Similarly, language-brokering activities tend to occur most often at home and the documents they translate the most (either orally or in writing) are notes from teachers. Such positive feelings towards this activity together with the evidence that it occurs very often in schools have laid the foundation for further projects on how this common practice may be valued and used to strengthen the linguistic skills of these multilingual immigrant students and thus their school performances.

Keywords: immigration, language brokering, multilingualism, students' points of view

Procedia PDF Downloads 179

Authors: Nicholas Anderson, Steven Petersen, Tom Bates, Val Anderson

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Under the multiple-use management regime established in the United States for federally owned lands, government agencies have come under pressure from commercial apiaries to grant permits for the summer pasturing of honeybees on government lands. Federal agencies have struggled to integrate honeybees into their management plans and have little information to make regulations that resolve how many colonies should be allowed in a single location and at what distance sets of hives should be placed. Many conservation groups have voiced their concerns regarding the introduction of honeybees to these natural lands, as they may outcompete and displace native pollinating species. Assessing the quality of an area in regard to its floral resources, pollen, and nectar can be important when attempting to create regulations for the integration of commercial honeybee operations into a native ecosystem. Areas with greater floral resources may be able to support larger numbers of honeybee colonies, while poorer resource areas may be less resilient to introduced disturbances. Attempts are made in this study to determine flower cover using high resolution drone imagery to help assess the floral resource availability to pollinators in high elevation, tall forb communities. This knowledge will help in determining the potential that different areas may have for honeybee pasturing and honey production. Roughly 700 images were captured at 23m above ground level using a drone equipped with a Sony QX1 RGB 20-megapixel camera. These images were stitched together using Pix4D, resulting in a 60m diameter high-resolution mosaic of a tall forb meadow. Using the program ENVI, a supervised maximum likelihood classification was conducted to calculate the percentage of total flower cover and flower cover by color (blue, white, and yellow). A complete vegetation inventory was taken on site, and the major flowers contributing to each color class were noted. An accuracy assessment was performed on the classification yielding an 89% overall accuracy and a Kappa Statistic of 0.855. With this level of accuracy, drones provide an affordable and time efficient method for the assessment of floral cover in large areas. The proximal step of this project will now be to determine the average pollen and nectar loads carried by each flower species. The addition of this knowledge will result in a quantifiable method of measuring pollen and nectar resources of entire landscapes. This information will not only help land managers determine stocking rates for honeybees on public lands but also has applications in the agricultural setting, aiding producers in the determination of the number of honeybee colonies necessary for proper pollination of fruit and nut crops.

Keywords: honeybee, flower, pollinator, remote sensing

Procedia PDF Downloads 141

Authors: Marina Sofia, Alexios Giannakopoulos, Antonia Touloudi, Dimitris C Chatzopoulos, Zoi Athanasakopoulou, Vassiliki Spyrou, Charalambos Billinis

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Fertility of dairy cattle can be affected by heat stress when the ambient temperature increases above 30°C and the relative humidity ranges from 35% to 50%. The present study was conducted on dairy cattle farms during summer months in Greece and aimed to identify the serological profile against pathogens that could affect fertility and to associate the positive serological results at herd level with temperature factors. A total of 323 serum samples were collected from clinically healthy dairy cows of 8 herds, located in Central and Northern Greece. ELISA tests were performed to detect antibodies against selected pathogens that affect fertility, namely Chlamydophila abortus, Coxiella burnetii, Neospora caninum, Toxoplasma gondii and Infectious Bovine Rhinotracheitis Virus (IBRV). Eleven climatic variables were derived from the WorldClim version 1.4. and ArcGIS V.10.1 software was used for analysis of the spatial information. Five different MaxEnt models were applied to associate the temperature variables with the locations of seropositive Chl. abortus, C. burnetii, N. caninum, T. gondii and IBRV herds (one for each pathogen). The logistic outputs were used for the interpretation of the results. ROC analyses were performed to evaluate the goodness of fit of the models’ predictions. Jackknife tests were used to identify the variables with a substantial contribution to each model. The seropositivity rates of pathogens varied among the 8 herds (0.85-4.76% for Chl. abortus, 4.76-62.71% for N. caninum, 3.8-43.47% for C. burnetii, 4.76-39.28% for T. gondii and 47.83-78.57% for IBRV). The variables of annual temperature range, mean diurnal range and maximum temperature of the warmest month gave a contribution to all five models. The regularized training gains, the training AUCs and the unregularized training gains were estimated. The mean diurnal range gave the highest gain when used in isolation and decreased the gain the most when it was omitted in the two models for seropositive Chl.abortus and IBRV herds. The annual temperature range increased the gain when used alone and decreased the gain the most when it was omitted in the models for seropositive C. burnetii, N. caninum and T. gondii herds. In conclusion, antibodies against Chl. abortus, C. burnetii, N. caninum, T. gondii and IBRV were detected in most herds suggesting circulation of pathogens that could cause infertility. The results of the spatial analyses demonstrated that the annual temperature range, mean diurnal range and maximum temperature of the warmest month could affect positively the possible pathogens’ presence. Acknowledgment: This research has been co‐financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH–CREATE–INNOVATE (project code: T1EDK-01078).

Keywords: dairy cows, seropositivity, spatial analysis, temperature factors

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Authors: Sean Yao Zu Kong, Khong Yik Chew

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Introduction: We described a case report of the successful use of advanced surgical techniques in a patient with recurrent breast cancer who underwent a wide resection including the hemi-sternum, clavicle, multiple ribs, and a lobe of the lung due to tumor involvement. This extensive resection exposed critical structures, requiring a creative approach to reconstruction. To address this complex chest wall reconstruction, a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap were successfully utilized. The use of a free vascularized bone flap allowed for rapid osteointegration and resistance against osteoradionecrosis after adjuvant radiation, while a four-zone tram flap allowed for reconstruction of both the chest wall and breast mound. Although limited recipient vessels made free flaps challenging, the free fibula flap served as both a bony reconstruction and vascular conduit, supercharged with the distal peroneal artery and veins of the peroneal artery from the fibula graft. Our approach highlights the potential of advanced surgical techniques to improve outcomes in complex cases of chest wall reconstruction in patients with recurrent breast cancer, which is becoming increasingly relevant as breast cancer incidence rates increases. Case presentation: This report describes a successful reconstruction of a patient with recurrent breast cancer who required extensive resection, including the anterior chest wall, clavicle, and sternoclavicular joint. Challenges arose due to the loss of accessory muscles and the non-rigid rib cage, which could lead to compromised ventilation and instability. A free fibula osteocutaneous flap and a four-zone TRAM flap with vascular supercharging were utilized to achieve long-term stability and function. The patient has since fully recovered, and during the review, both flaps remained viable, and chest mound reconstruction was satisfactory. A planned nipple/areolar reconstruction was offered pending the patient’s decision after adjuvant radiotherapy. Conclusion: In conclusion, this case report highlights the successful use of innovative surgical techniques in addressing a complex case of recurrent breast cancer requiring extensive resection and radical reconstruction. Our approach, utilized a combination of a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap, demonstrates the potential for advanced techniques in chest wall reconstruction to minimize complications and ensure long-term stability and function. As the incidence of breast cancer continues to rise, it is crucial that healthcare professionals explore and utilize innovative techniques to improve patient outcomes and quality of life.

Keywords: free fibula flap, rectus abdominis musculocutaneous flap, post-adjuvant radiotherapy, reconstructive surgery, malignancy

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Authors: Munqeth Othman Agha

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The historical formation of urban centres in the eastern Arab world was shaped by rapid urbanization and sudden transformation from the age of the pre-industrial to a post-industrial economy, coupled with uneven development, informal urban expansion, and constant surges in unemployment and poverty rates. The city was stratified accordingly as overlapping layers of division and inequality that have been built on top of each other, creating complex horizontal and vertical divisions based on economic, social, political, and ethno-sectarian basis. This has been further exacerbated during the neoliberal era, which transferred the city into a sort of dual city that is inhabited by heterogeneous and often antagonistic social groups. Economic deprivation combined with a growing sense of marginalization and inequality across the city planted the seeds of political instability, outbreaking in 2011. Unlike other popular uprisings that occupy central squares, as in Egypt and Tunisia, the Syrian uprising in 2011 took place mainly within inner streets and neighborhood squares, mobilizing primarily on more or less upon the lines of stratification. This has emphasized the role of micro-urban and social settings in shaping mobilization and resistance tactics, which necessitates us to understand the way the city was stratified and place it at the center of the city-conflict nexus analysis. This research aims to understand to what extent pre-conflict urban stratification lines played a role in determining the different trajectories of three cities’ neighborhoods (Homs, Dara’a and Deir-ez-Zor). The main argument of the paper is that the way the Syrian city has been stratified creates various social groups within the city who have enjoyed different levels of accessibility to life chances, material resources and social statuses. This determines their relationship with other social groups in the city and, more importantly, their relationship with the state. The advent of a political opportunity will be depicted differently across the city’s different social groups according to their perceived interests and threats, which consequently leads to either political mobilization or demobilization. Several factors, including the type of social structures, built environment, and state response, determine the ability of social actors to transfer the repertoire of contention to collective action or transfer from social actors to political actors. The research uses urban stratification lines as the basis for understanding the different patterns of political upheavals in urban areas while explaining why neighborhoods with different social and urban environment settings had different abilities and capacities to mobilize, resist state repression and then descend into a military conflict. It particularly traces the transformation from social groups to social actors and political actors by applying the Explaining-outcome Process-Tracing method to depict the causal mechanisms that led to including or excluding different neighborhoods from each stage of the uprising, namely mobilization (M1), response (M2), and control (M3).

Keywords: urban stratification, syrian conflict, social movement, process tracing, divided city

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Authors: Hansraj Bookun, Rachel Xuan, Angela Tan, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos, Jim Iliopoulos

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Introduction: Complex endovascular aortic aneursymal repairs with fenestrated and branched endografts require customised devices to exclude the pathology while reducing morbidity and mortality, which was historically associated with open repair of complex aneurysms. Such endovascular procedures have predominantly been performed in a large volume dedicated tertiary centres. We present here our nine year multidisciplinary experience with this technology in an Australian tertiary centre. Method: This was a cross-sectional, single-centre observational study of 670 patients who had undergone complex endovascular aortic aneurysmal repairs with conventional endografts, fenestrated endografts, and iliac-branched devices from January 2010 to July 2019. Descriptive statistics were used to characterise our sample with regards to demographic and perioperative variables. Homogeneity of the sample was tested using multivariant regression, which did not identify any statistically significant confounding variables. Results: 670 patients of mean age 74, were included (592 males) and the comorbid burden was as follows: ischemic heart disease (55%), diabetes (18%), hypertension (90%), stage four or greater kidney impairment (8%) and current or ex-smoking (78%). The main indications for surgery were elective aneurysms (86%), symptomatic aneurysms (5%), and rupture aneurysms (5%). 106 patients (16%) underwent fenestrated or branched endograft repairs. The mean length of stay was 7.6 days. 2 patients experienced reactionary bleeds, 11 patients had access wound complications (6 lymph fistulae, 5 haematoms), 11 patients had cardiac complications (5 arrhythmias, 3 acute myocadial infarctions, 3 exacerbation of congestive cardiac failure), 10 patients had respiratory complications, 8 patients had renal impairment, 4 patients had gastrointestinal complications, 2 patients suffered from paraplegia, 1 major stroke, 1 minor stroke, and 1 acute brain syndrome. There were 4 vascular occlusions requiring further arterial surgery, 4 type I endoleaks, 4 type II endoleaks, 3 episodes of thromboembolism, and 2 patients who required further arterial operations in the setting of patient vessels. There were 9 unplanned returns to the theatre. Discussion: Our numbers of 10 years suggest that we are not a dedicated high volume centre focusing on aortic repairs. However, we have achieved significantly low complication rates. This can be attributed to our multidisciplinary approach with the intraoperative involvement of skilled interventional radiologists and vascular surgeons as well as postoperative protocols with particular attention to spinal cord protection. Additionally, we have a ratified perioperative pathway that involves multidisciplinary team discussions of patient-related factors and lesion-centered characteristics, which allows for holistic, patient-centered care.

Keywords: aneurysm, aortic, endovascular, fenestrated

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Authors: Sahabettin Mete, Abdullah C. Hocagil, Hilal Hocagil, Volkan Ulker, Hasan C. Taskin

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Objectives and Goals: An emergency department is a place where people can come for a multitude of reasons 24 hours a day. As it is an easy, accessible place, thanks to self-sacrificing people who work in emergency departments. But the workload and overcrowding of emergency departments are increasing day by day. Under these circumstances, it is important to choose a quick, easily accessible and effective test for diagnosis. This results in laboratory and imaging tests being more than 40% of all emergency department costs. Despite all of the technological advances in imaging methods and available computerized tomography (CT), chest X-ray, the older imaging method, has not lost its appeal and effectiveness for nearly all emergency physicians. Progress in imaging methods are very convenient, but physicians should consider the radiation dose, cost, and effectiveness, as well as imaging methods to be carefully selected and used. The aim of the study was to investigate the effectiveness of chest X-ray in immediate diagnosis against the advancing technology by comparing chest X-ray and chest CT scan results of the patients in the emergency department. Methods: Patients who applied to Bulent Ecevit University Faculty of Medicine’s emergency department were investigated retrospectively in between 1 September 2014 and 28 February 2015. Data were obtained via MIAMED (Clear Canvas Image Server v6.2, Toronto, Canada), information management system which patients’ files are saved electronically in the clinic, and were retrospectively scanned. The study included 199 patients who were 18 or older, had both chest X-ray and chest CT imaging. Chest X-ray images were evaluated by the emergency medicine senior assistant in the emergency department, and the findings were saved to the study form. CT findings were obtained from already reported data by radiology department in the clinic. Chest X-ray was evaluated with seven questions in terms of technique and dose adequacy. Patients’ age, gender, application complaints, comorbid diseases, vital signs, physical examination findings, diagnosis, chest X-ray findings and chest CT findings were evaluated. Data saved and statistical analyses have made via using SPSS 19.0 for Windows. And the value of p < 0.05 were accepted statistically significant. Results: 199 patients were included in the study. In 38,2% (n=76) of all patients were diagnosed with pneumonia and it was the most common diagnosis. The chest X-ray imaging technique was appropriate in patients with the rate of 31% (n=62) of all patients. There was not any statistically significant difference (p > 0.05) between both imaging methods (chest X-ray and chest CT) in terms of determining the rates of displacement of the trachea, pneumothorax, parenchymal consolidation, increased cardiothoracic ratio, lymphadenopathy, diaphragmatic hernia, free air levels in the abdomen (in sections including the image), pleural thickening, parenchymal cyst, parenchymal mass, parenchymal cavity, parenchymal atelectasis and bone fractures. Conclusions: When imaging findings, showing cases that needed to be quickly diagnosed, were investigated, chest X-ray and chest CT findings were matched at a high rate in patients with an appropriate imaging technique. However, chest X-rays, evaluated in the emergency department, were frequently taken with an inappropriate technique.

Keywords: chest x-ray, chest computerized tomography, chest imaging, emergency department

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Authors: Pinar Erturk, Sevde Altuntas, Fatih Buyukserin

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In order to obtain an effective integration between an implant and a bone, implant surfaces should have similar properties to bone tissue surfaces. Especially mimicry of the chemical, mechanical and topographic properties of the implant to the bone is crucial for fast and effective osseointegration. Titanium-based biomaterials are more preferred in clinical use, and there are studies of coating these implants with oxide layers that have chemical/nanotopographic properties stimulating cell interactions for enhanced osseointegration. There are low success rates of current implantations, especially in craniofacial implant applications, which are large and vital zones, and the oxide layer coating increases bone-implant integration providing long-lasting implants without requiring revision surgery. Our aim in this study is to examine bone-cell behavior on titanium implants with an aluminum oxide layer (AAO) on effective osseointegration potential in the deformation of large zones with difficult spontaneous healing. In our study, aluminum layer coated titanium surfaces were anodized in sulfuric, phosphoric, and oxalic acid, which are the most common used AAO anodization electrolytes. After morphologic, chemical, and mechanical tests on AAO coated Ti substrates, viability, adhesion, and mineralization of adult bone cells on these substrates were analyzed. Besides with atomic layer deposition (ALD) as a sensitive and conformal technique, these surfaces were coated with pure alumina (5 nm); thus, cell studies were performed on ALD-coated nanoporous oxide layers with suppressed ionic content too. Lastly, in order to investigate the effect of the topography on the cell behavior, flat non-porous alumina layers on silicon wafers formed by ALD were compared with the porous ones. Cell viability ratio was similar between anodized surfaces, but pure alumina coated titanium and anodized surfaces showed a higher viability ratio compared to bare titanium and bare anodized ones. Alumina coated titanium surfaces, which anodized in phosphoric acid, showed significantly different mineralization ratios after 21 days over other bare titanium and titanium surfaces which anodized in other electrolytes. Bare titanium was the second surface that had the highest mineralization ratio. Otherwise, titanium, which is anodized in oxalic acid electrolyte, demonstrated the lowest mineralization. No significant difference was shown between bare titanium and anodized surfaces except AAO titanium surface anodized in phosphoric acid. Currently, osteogenic activities of these cells on the genetic level are investigated by quantitative real-time polymerase chain reaction (qRT-PCR) analysis results of RUNX-2, VEGF, OPG, and osteopontin genes. Also, as a result of the activities of the genes mentioned before, Western Blot will be used for protein detection. Acknowledgment: The project is supported by The Scientific and Technological Research Council of Turkey.

Keywords: alumina, craniofacial implant, MG-63 cell line, osseointegration, oxalic acid, phosphoric acid, sulphuric acid, titanium

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Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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Authors: Elisa Boatti, Ulisse Stefanelli, Alessandro Reali, Ferdinando Auricchio

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Thanks to their unusual properties, shape memory alloys (SMAs) are good candidates for advanced applications in a wide range of engineering fields, such as automotive, robotics, civil, biomedical, aerospace. In the last decades, the ever-growing interest for such materials has boosted several research studies aimed at modeling their complex nonlinear behavior in an effective and robust way. Since the constitutive response of SMAs is strongly thermomechanically coupled, the investigation of the non-isothermal evolution of the material must be taken into consideration. The present study considers an existing three-dimensional phenomenological model for SMAs, able to reproduce the main SMA properties while maintaining a simple user-friendly structure, and proposes a variational reformulation of the full non-isothermal version of the model. While the considered model has been thoroughly assessed in an isothermal setting, the proposed formulation allows to take into account the full nonisothermal problem. In particular, the reformulation is inspired to the GENERIC (General Equations for Non-Equilibrium Reversible-Irreversible Coupling) formalism, and is based on a generalized gradient flow of the total entropy, related to thermal and mechanical variables. Such phrasing of the model is new and allows for a discussion of the model from both a theoretical and a numerical point of view. Moreover, it directly implies the dissipativity of the flow. A semi-implicit time-discrete scheme is also presented for the fully coupled thermomechanical system, and is proven unconditionally stable and convergent. The correspondent algorithm is then implemented, under a space-homogeneous temperature field assumption, and tested under different conditions. The core of the algorithm is composed of a mechanical subproblem and a thermal subproblem. The iterative scheme is solved by a generalized Newton method. Numerous uniaxial and biaxial tests are reported to assess the performance of the model and algorithm, including variable imposed strain, strain rate, heat exchange properties, and external temperature. In particular, the heat exchange with the environment is the only source of rate-dependency in the model. The reported curves clearly display the interdependence between phase transformation strain and material temperature. The full thermomechanical coupling allows to reproduce the exothermic and endothermic effects during respectively forward and backward phase transformation. The numerical tests have thus demonstrated that the model can appropriately reproduce the coupled SMA behavior in different loading conditions and rates. Moreover, the algorithm has proved effective and robust. Further developments are being considered, such as the extension of the formulation to the finite-strain setting and the study of the boundary value problem.

Keywords: generalized gradient flow, GENERIC formalism, shape memory alloys, thermomechanical coupling

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Authors: Jenn Gallup, Onur Kocaoz, Onder Islek

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In their pursuit of postsecondary transitions, individuals with disabilities tend to experience, academic, behavioral, and emotional challenges to a greater extent than their typically developing peers. These challenges result in lower rates of graduation, employment, independent living, and participation in college than their peers without disabilities. The lack of friendships and support systems has had a negative impact on those with a disability transitioning to postsecondary settings to include, employment, independent living, and university settings. Establishing friendships and support systems early on is an indicator of potential success and persistence in postsecondary education, employment, and independent living for typically developing college students. It is evident that a deficit in friendships and supports is a key deficit also for individuals with disabilities. To address the specific needs of this group, a mentor program was developed for a transition program held at the university for youth aged 18-21. Pre-service teachers enrolled in the special education program engaged with youth in the transition program in a variety of activities on campus. The mentorship program had two purposes: to assist young adults with disabilities who were transitioning to a workforce setting to help increase social skills, self-advocacy, supports and friendships, and confidence; and to give their peers without disabilities who were enrolled in a secondary special education course as a pre-service teacher the experience of interacting with and forming friendships with peers who had a disability for the purposes of career development. Additionally, according to researchers mobile technology has created a virtual world of equality and opportunity for a large segment of the population that was once marginalized due to physical and cognitive impairments. All of the participants had access to smart phones; therefore, technology was explored during this study to determine if it could be used as a compensatory tool to allow the young adults with disabilities to do things that otherwise would have been difficult because of their disabilities. Additionally, all participants were asked to incorporate technology such as smart phones to communicate beyond the activities, collaborate using virtual platform games which would support and promote social skills, soft-skills, socialization, and relationships. The findings of this study confirmed that a peer mentorship program that harnessed the power of technology supported outcomes specific to young adults with and without disabilities. Mobile technology and virtual game-based platforms, were identified as a significant contributor to personal, academic, and career growth for both groups. The technology encouraged friendships, provided an avenue for rich social interactions, and increased soft-skills. Results will be shared along with the development of the program and potential implications to the field.

Keywords: career outcomes, mentorship, soft-skills, technology, transition

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Authors: Weijing Zhou, Yuting Lei, Francis Nolan

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In the domain of second language acquisition, whenever pronunciation errors or acquisition difficulties are found, researchers habitually attribute them to the negative transfer of the native language or local dialect. To what extent do Mandarin and local dialects affect English phonological acquisition for Chinese learners of English as a foreign language (EFL)? Little evidence, however, has been found via empirical research in China. To address this core issue, the present study conducted phonetic experiments to explore the roles of local dialects and Mandarin in Chinese EFL learners’ acquisition of L2 English consonants. Besides Mandarin, the sole national language in China, Suzhou dialect was selected as the target local dialect because of its distinct phonology from Mandarin. The experimental group consisted of 30 junior English majors at Yangzhou University, who were born and lived in Suzhou, acquired Suzhou Dialect since their early childhood, and were able to communicate freely and fluently with each other in Suzhou Dialect, Mandarin as well as English. The consonantal target segments were all the consonants of English, Mandarin and Suzhou Dialect in typical carrier words embedded in the carrier sentence Say again. The control group consisted of two Suzhou Dialect experts, two Mandarin radio broadcasters, and two British RP phoneticians, who served as the standard speakers of the three languages. The reading corpus was recorded and sampled in the phonetic laboratories at Yangzhou University, Soochow University and Cambridge University, respectively, then transcribed, segmented and analyzed acoustically via Praat software, and finally analyzed statistically via EXCEL and SPSS software. The main findings are as follows: First, in terms of correct acquisition rates (CARs) of all the consonants, Mandarin ranked top (92.83%), English second (74.81%) and Suzhou Dialect last (70.35%), and significant differences were found only between the CARs of Mandarin and English and between the CARs of Mandarin and Suzhou Dialect, demonstrating Mandarin was overwhelmingly more robust than English or Suzhou Dialect in subjects’ multilingual phonological ecology. Second, in terms of typical acoustic features, the average duration of all the consonants plus the voice onset time (VOT) of plosives, fricatives, and affricatives in 3 languages were much longer than those of standard speakers; the intensities of English fricatives and affricatives were higher than RP speakers but lower than Mandarin and Suzhou Dialect standard speakers; the formants of English nasals and approximants were significantly different from those of Mandarin and Suzhou Dialects, illustrating the inconsistent acoustic variations between the 3 languages. Thirdly, in terms of typical pronunciation variations or errors, there were significant interlingual interactions between the 3 consonant systems, in which Mandarin consonants were absolutely dominant, accounting for the strong transfer from L1 Mandarin to L2 English instead of from earlier-acquired L1 local dialect to L2 English. This is largely because the subjects were knowingly exposed to Mandarin since their nursery and were strictly required to speak in Mandarin through all the formal education periods from primary school to university.

Keywords: acquisition of L2 English consonants, role of Mandarin, role of local dialect, Chinese EFL learners from Suzhou Dialect areas

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Authors: Gleyce Assis Da Silva Barbosa

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In recent years, we have witnessed a vertiginous growth of large education companies. Daughters of national and world capital, these companies expand both through consolidated physical networks in the form of branches spread across the territory and through institutional networks such as business networks through mergers, acquisitions, creation of new companies and influence. They do this by incorporating small, medium and large schools and universities, teaching systems and other products and services. They are also able to weave their webs directly or indirectly in philanthropic circles, limited partnerships, family businesses and even in public education through various mechanisms of outsourcing, privatization and commercialization of products for the sector. Although the growth of these groups in basic education seems to us a recent phenomenon in peripheral countries such as Brazil, its diffusion is closely linked to higher education conglomerates and other sectors of the economy forming oligopolies, which began to expand in the 1990s with strong state support and through political reforms that redefined its role, transforming it into a fundamental agent in the formation of guidelines to boost the incorporation of neoliberal logic. This expansion occurred through the objectification of education, commodifying it and transforming students into consumer clients. Financial power combined with the neo-liberalization of state public policies allowed the profusion of social exclusion, the increase of individuals without access to basic services, deindustrialization, automation, capital volatility and the indetermination of the economy; in addition, this process causes capital to be valued and devalued at rates never seen before, which together generates various impacts such as the precariousness of work. Understanding the connection between these processes, which engender the economy, allows us to see their consequences in labor relations and in the territory. In this sense, it is necessary to analyze the geographic-economic context and the role of the facilitating agents of this process, which can give us clues about the ongoing transformations and the directions of education in the national and even international scenario since this process is linked to the multiple scales of financial globalization. Therefore, the present research has the general objective of analyzing the socio-spatial impacts of financialization and the formation of oligopolies in Brazilian basic education. For this, the survey of laws, data, and public policies on the subject in question was used as a methodology. As a methodology, the work was based on some data from these companies available on websites for investors. Survey of information from global and national companies that operate in Brazilian basic education. In addition to mapping the expansion of educational oligopolies using public data on the location of schools. With this, the research intends to provide information about the ongoing commodification process in the country. Discuss the consequences of the oligopolization of education, considering the impacts that financialization can bring to teaching work.

Keywords: financialization, oligopolies, education, Brazil

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Authors: Alexandra Sargent, Sarah Ferris, Ioannis Theofanous

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The Abbott RealTime High Risk HPV test (RealTime HPV) is one of five assays clinically validated and approved by the English NHS Cervical Screening Programme (CSP) for HPV triage of low grade dyskaryosis and test-of-cure of treated Cervical Intraepithelial Neoplasia. The assay is a highly automated multiplex real-time PCR test for detecting 14 high risk (hr) HPV types, with simultaneous differentiation of HPV 16 and HPV 18 versus non-HPV 16/18 hrHPV. An endogenous internal control ensures sample cellularity, controls extraction efficiency and PCR inhibition. The original cervical specimen collected in SurePath (SP) liquid-based cytology (LBC) medium (BD Diagnostics) and the SP post-gradient cell pellets (SPG) after cytological processing are both CE marked for testing with the RealTime HPV test. During the 2011 NHSCSP validation of new tests only the original aliquot of SP LBC medium was investigated. Residual sample volume left after cytology slide preparation is low and may not always have sufficient volume for repeat HPV testing or for testing of other biomarkers that may be implemented in testing algorithms in the future. The SPG samples, however, have sufficient volumes to carry out additional testing and necessary laboratory validation procedures. This study investigates the correlation of RealTime HPV results of cervical specimens collected in SP LBC medium from women with low grade cytological abnormalities observed with matched pairs of original SP LBC medium and SP post-gradient cell pellets (SPG) after cytology processing. Matched pairs of SP and SPG samples from 750 women with borderline (N = 392) and mild (N = 351) cytology were available for this study. Both specimen types were processed and parallel tested for the presence of hrHPV with RealTime HPV according to the manufacturer´s instructions. HrHPV detection rates and concordance between test results from matched SP and SPGCP pairs were calculated. A total of 743 matched pairs with valid test results on both sample types were available for analysis. An overall-agreement of hrHPV test results of 97.5% (k: 0.95) was found with matched SP/SPG pairs and slightly lower concordance (96.9%; k: 0.94) was observed on 392 pairs from women with borderline cytology compared to 351 pairs from women with mild cytology (98.0%; k: 0.95). Partial typing results were highly concordant in matched SP/SPG pairs for HPV 16 (99.1%), HPV 18 (99.7%) and non-HPV16/18 hrHPV (97.0%), respectively. 19 matched pairs were found with discrepant results: 9 from women with borderline cytology and 4 from women with mild cytology were negative on SPG and positive on SP; 3 from women with borderline cytology and 3 from women with mild cytology were negative on SP and positive on SPG. Excellent correlation of hrHPV DNA test results was found between matched pairs of SP original fluid and post-gradient cell pellets from women with low grade cytological abnormalities tested with the Abbott RealTime High-Risk HPV assay, demonstrating robust performance of the test with both specimen types and reassuring the utility of the assay for cytology triage with both specimen types.

Keywords: Abbott realtime test, HPV, SurePath liquid based cytology, surepath post-gradient cell pellet

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Authors: Seung Ah Lee, Sunghyun Cho, Kyong Mee Chung

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Rapid population aging became a worldwide demographic phenomenon due to rising life expectancy and declining fertility rates. Considering the current increasing rate of population aging, it is assumed that Korean society enters into a ‘super-aged’ society in 10 years, in which people aged 65 years or older account for more than 20% of entire population. In line with this trend, ICT services aimed to help elderly people to improve the quality of life have been suggested. However, existing ICT services mainly focus on supporting health or nursing care and are somewhat limited to meet a variety of specialized needs and challenges of this population. It is pointed out that the majority of services have been driven by technology-push policies. Given that the usage of ICT services greatly vary on individuals’ socio-economic status (SES), physical and psychosocial needs, this study systematically categorized elderly population into sub-groups and identified their needs and characteristics related to ICT usage in detail. First, three assessment criteria (demographic variables including SES, cognitive functioning level, and emotional functioning level) were identified based on previous literature, experts’ opinions, and focus group interview. Second, survey questions for needs assessment were developed based on the criteria and administered to 600 respondents from a national probability sample. The questionnaire consisted of 67 items concerning demographic information, experience on ICT services and information technology (IT) devices, quality of life and cognitive functioning, etc. As the result of survey, age (60s, 70s, 80s), education level (college graduates or more, middle and high school, less than primary school) and cognitive functioning level (above the cut-off, below the cut-off) were considered the most relevant factors for categorization and 18 sub-groups were identified. Finally, 18 sub-groups were clustered into 3 groups according to following similarities; computer usage rate, difficulties in using ICT, and familiarity with current or previous job. Group 1 (‘active users’) included those who with high cognitive function and educational level in their 60s and 70s. They showed favorable and familiar attitudes toward ICT services and used the services for ‘joyful life’, ‘intelligent living’ and ‘relationship management’. Group 2 (‘potential users’), ranged from age of 60s to 80s with high level of cognitive function and mostly middle to high school graduates, reported some difficulties in using ICT and their expectations were lower than in group 1 despite they were similar to group 1 in areas of needs. Group 3 (‘limited users’) consisted of people with the lowest education level or cognitive function, and 90% of group reported difficulties in using ICT. However, group 3 did not differ from group 2 regarding the level of expectation for ICT services and their main purpose of using ICT was ‘safe living’. This study developed a systematic needs assessment tool and identified three sub-groups of elderly ICT users based on multi-criteria. It is implied that current cognitive function plays an important role in using ICT and determining needs among the elderly population. Implications and limitations were further discussed.

Keywords: elderly population, ICT, needs assessment, population aging

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Authors: Maria L. McLeod

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This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers –The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, ten from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting repeated use of specific metaphors and tropes while charting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals with university affiliations, that emphasizes an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. Thus, the use of anecdotal evidence presented in patient narratives could be perceived as being in conflict with this evidence-based model, as the patient stories are not an accurate representation of scientific outcomes related to developing cancer, cancer reoccurrence, or cancer outcomes. The representative patient narratives tend to exclude or downplay adverse responses to treatment, survival rates, integrative and/or complementary cancer treatments, cancer prevention and causes, and barriers to treatment, such as the limitation of insurance plans, costs of treatment, and/or other issues related to access, potentially contributing to false narratives and inaccurate notions of cancer prevention, cancer care treatment and the potential for a cure. Both quantitative and qualitative findings demonstrate that cancer patient stories featured on the blogsites of the nation’s top cancer care centers deemphasize patient agency and, instead, emphasize deference and gratitude toward the institutions where the featured patients received treatment. Along these lines, language choices reflect positive framing of the cancer experience. Accompanying portrait photos of healthy appearing subjects as well as positive-framed headlines, subheads, and pull quotes function similarly, reflecting hopeful, transformative experiences and outcomes over hardship and suffering. Although patient narratives include real, factual scientific details and descriptions of actual events, the stories lack references to more negative realities of cancer diagnosis and treatment. Instead, they emphasize the triumph of survival by which the cancer care center, in the savior/hero role, enables the patient’s success, represented as a cathartic medical journey.

Keywords: cancer framing, cancer stories, medical gaze, patient narratives

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Authors: Seyedeh Pardis Hosseini

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With increased levels of clean and affordable water scarcity crises in many countries, wastewater treatment has been chosen as a viable method to produce freshwater for various consumptions. Even though reverse osmosis dominates the wastewater treatment market, forward osmosis (FO) processes have significant advantages, such as potentially using a renewable and low-grade energy source and improving water quality. FO is an osmotically driven membrane process that uses a high concentrated draw solution and a relatively low concentrated feed solution across a semi-permeable membrane. Among many novel FO membranes that have been introduced over the past decades, polybenzimidazole (PBI) membranes, a class of aromatic heterocyclic-based polymers, have shown high thermal and chemical stability because of their unique chemical structure. However, the studies reviewed indicate that the hydrophilicity of PBI membranes is comparatively low. Hence, there is an urgent need to develop novel FO membranes with modified PBI polymers to promote hydrophilicity. A few studies have been undertaken to improve the PBI hydrophilicity by fabricating mixed matrix polymeric membranes and surface modification. Thereby, in this study, two different sulfonated polybenzimidazole (SPBI) polymers with the same backbone but different functional groups, namely arylsulfonate PBI (PBI-AS) and propylsulfonate PBI (PBI-PS), are introduced as FO membranes and studied via the molecular dynamics (MD) simulation method. The FO simulation box consists of three distinct regions: a saltwater region, a membrane region, and a pure-water region. The pure-water region is situated at the upper part of the simulation box, while the saltwater region, which contains an aqueous salt solution of Na+ and Cl− ions along with water molecules, occupies the lower part of the simulation box. Specifically, the saltwater region includes 710 water molecules and 24 Na+ and 24 Cl− ions, resulting in a combined concentration of 10 weight percent (wt%). The pure-water region comprises 788 water molecules. Both the saltwater and pure-water regions have a density of 1.0 g/cm³. The membrane region, positioned between the saltwater and pure-water regions, is constructed from three types of polymers: PBI, PBI-AS, and PBI-PS, each consisting of three polymer chains with 30 monomers per chain. The structural and thermophysical properties of the polymers, water molecules, and Na+ and Cl− ions were analyzed using the COMPASS forcefield. All simulations were conducted using the BIOVIA Materials Studio 2020 software. By monitoring the variation in the number of water molecules over the simulation time within the saltwater region, the water permeability of the polymer membranes was calculated and subsequently compared. The results indicated that SPBI polymers exhibited higher water permeability compared to PBI polymers. This enhanced permeability can be attributed to the structural and compositional differences between SPBI and PBI polymers, which likely facilitate more efficient water transport through the membrane. Consequently, the adoption of SPBI polymers in the FO process is anticipated to result in significantly improved performance. This improvement could lead to higher water flux rates, better salt rejection, and overall more efficient use of resources in desalination and water purification applications.

Keywords: forward osmosis, molecular dynamics simulation, sulfonated polybenzimidazole, water permeability

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