Search results for: Andrew Cummings
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 263

Search results for: Andrew Cummings

83 Hidden Hot Spots: Identifying and Understanding the Spatial Distribution of Crime

Authors: Lauren C. Porter, Andrew Curtis, Eric Jefferis, Susanne Mitchell

Abstract:

A wealth of research has been generated examining the variation in crime across neighborhoods. However, there is also a striking degree of crime concentration within neighborhoods. A number of studies show that a small percentage of street segments, intersections, or addresses account for a large portion of crime. Not surprisingly, a focus on these crime hot spots can be an effective strategy for reducing community level crime and related ills, such as health problems. However, research is also limited in an important respect. Studies tend to use official data to identify hot spots, such as 911 calls or calls for service. While the use of call data may be more representative of the actual level and distribution of crime than some other official measures (e.g. arrest data), call data still suffer from the 'dark figure of crime.' That is, there is most certainly a degree of error between crimes that occur versus crimes that are reported to the police. In this study, we present an alternative method of identifying crime hot spots, that does not rely on official data. In doing so, we highlight the potential utility of neighborhood-insiders to identify and understand crime dynamics within geographic spaces. Specifically, we use spatial video and geo-narratives to record the crime insights of 36 police, ex-offenders, and residents of a high crime neighborhood in northeast Ohio. Spatial mentions of crime are mapped to identify participant-identified hot spots, and these are juxtaposed with calls for service (CFS) data. While there are bound to be differences between these two sources of data, we find that one location, in particular, a corner store, emerges as a hot spot for all three groups of participants. Yet it does not emerge when we examine CFS data. A closer examination of the space around this corner store and a qualitative analysis of narrative data reveal important clues as to why this store may indeed be a hot spot, but not generate disproportionate calls to the police. In short, our results suggest that researchers who rely solely on official data to study crime hot spots may risk missing some of the most dangerous places.

Keywords: crime, narrative, video, neighborhood

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

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

Abstract:

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

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

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81 Rheumatoid Arthritis, Periodontitis and the Subgingival Microbiome: A Circular Relationship

Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

Procedia PDF Downloads 61
80 Improving the Weekend Handover in General Surgery: A Quality Improvement Project

Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

Abstract:

Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

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79 Humanity's Still Sub-Quantum Core-Self Intelligence

Authors: Andrew Shugyo Daijo Bonnici

Abstract:

Core-Self Intelligence (CSI) is an absolutely still, non-verbal, non-cerebral intelligence. Our still core-self intelligence is felt at our body's center point of gravity, just an inch below our navel, deep within our lower abdomen. The still sub-quantum depth of core-Self remains untouched by the conditioning influences of family, society, culture, religion, and spiritual views that shape our personalities and ego-self identities. As core-Self intelligence is inborn and unconditioned, it exists within all human beings regardless of age, race, color, creed, mental acuity, or national origin. Our core-self intelligence functions as a wise and compassionate guide that advances our health and well-being, our mental clarity and emotional resiliency, our fearless peace and behavioral wisdom, and our ever-deepening compassion for self and others. Although our core-Self, with its absolutely still non-judgmental intelligence, operates far beneath the functioning of our ego-self identity and our thinking mind, it effectively coexists with our passing thoughts, all of our figuring and thinking, our logical and rational way of knowing, the ebb and flow of our feelings, and the natural or triggered emergence of our emotions. When we allow our whole inner somatic awareness to gently sink into the intelligent center point of gravity within our lower abdomen, the felt arising of our core- Self’s inborn stillness has a serene and relaxing effect on our ego-self and thinking mind. It naturally slows down the speedy passage of our involuntary thoughts, diminishes our ego-self's defensive and reactive functioning, and decreases narcissistic reflections on I, me, and mine. All of these healthy cognitive benefits advance our innate wisdom and compassion, facilitate our personal and interpersonal growth, and liberate the ever-fresh wonder and curiosity of our beginner's heartmind. In conclusion, by studying, exploring, and researching our core-Self intelligence, psychologists and psychotherapists can unlock new avenues for advancing the farther reaches of our mental, emotional, and spiritual health and well-being, our innate behavioral wisdom and boundless empathy, our lucid compassion for self and others, and our unwavering confidence in the still guiding light of our core-Self that exists at the abdominal center point of all human beings.

Keywords: intelligence, transpersonal, beginner’s heartmind, compassionate wisdom

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78 An Overview of Posterior Fossa Associated Pathologies and Segmentation

Authors: Samuel J. Ahmad, Michael Zhu, Andrew J. Kobets

Abstract:

Segmentation tools continue to advance, evolving from manual methods to automated contouring technologies utilizing convolutional neural networks. These techniques have evaluated ventricular and hemorrhagic volumes in the past but may be applied in novel ways to assess posterior fossa-associated pathologies such as Chiari malformations. Herein, we summarize literature pertaining to segmentation in the context of this and other posterior fossa-based diseases such as trigeminal neuralgia, hemifacial spasm, and posterior fossa syndrome. A literature search for volumetric analysis of the posterior fossa identified 27 papers where semi-automated, automated, manual segmentation, linear measurement-based formulas, and the Cavalieri estimator were utilized. These studies produced superior data than older methods utilizing formulas for rough volumetric estimations. The most commonly used segmentation technique was semi-automated segmentation (12 studies). Manual segmentation was the second most common technique (7 studies). Automated segmentation techniques (4 studies) and the Cavalieri estimator (3 studies), a point-counting method that uses a grid of points to estimate the volume of a region, were the next most commonly used techniques. The least commonly utilized segmentation technique was linear measurement-based formulas (1 study). Semi-automated segmentation produced accurate, reproducible results. However, it is apparent that there does not exist a single semi-automated software, open source or otherwise, that has been widely applied to the posterior fossa. Fully-automated segmentation via such open source software as FSL and Freesurfer produced highly accurate posterior fossa segmentations. Various forms of segmentation have been used to assess posterior fossa pathologies and each has its advantages and disadvantages. According to our results, semi-automated segmentation is the predominant method. However, atlas-based automated segmentation is an extremely promising method that produces accurate results. Future evolution of segmentation technologies will undoubtedly yield superior results, which may be applied to posterior fossa related pathologies. Medical professionals will save time and effort analyzing large sets of data due to these advances.

Keywords: chiari, posterior fossa, segmentation, volumetric

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77 Canthin-6-One Alkaloid Inhibits NF-κB and AP-1 Activity: An Inhibitory Action At Transcriptional Level

Authors: Fadia Gafri, Kathryn Mckintosh, Louise Young, Alan Harvey, Simon Mackay, Andrew Paul, Robin Plevin

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Nuclear factor-kappa B (NF-κB) is a ubiquitous transcription factor found originally to play a key role in regulating inflammation. However considerable evidence links this pathway to the suppression of apoptosis, cellular transformation, proliferation and invasion (Aggarwal et al., 2006). Moreover, recent studies have also linked inflammation to cancer progression making NF-κB overall a promising therapeutic target for drug discovery (Dobrovolskaia & Kozlov, 2005). In this study we examined the effect of the natural product canthin-6-one (SU182) as part of a CRUK small molecule drug discovery programme for effects upon the NF-κB pathway. Initial studies demonstrated that SU182 was found to have good potency against the inhibitory kappa B kinases (IKKs) at 30M in vitro. However, at concentrations up to 30M, SU182 had no effect upon TNFα stimulated loss in cellular IκBα or p65 phosphorylation in the keratinocyte cell line NCTC2544. Nevertheless, 30M SU182 reduced TNF-α / PMA-induced NF-κB-linked luciferase reporter activity to (22.9 ± 5%) and (34.6± 3 %, P<0.001) respectively, suggesting an action downstream of IKK signalling. Indeed, SU182 neither decreased NF-κB-DNA binding as assayed by EMSA nor prevented the translocation of p65 (NF-κB) to the nucleus assessed by immunofluorescence and subcellular fractionation. In addition to the inhibition of transcriptional activity of TNFα-induced NF-κB reporter activity SU182 significantly reduced PMA-induced AP-1-linked luciferase reporter activity to about (48± 9% at 30M, P<0.001) . This mode of inhibition was not sufficient to prevent the activation of NF-κB dependent induction of other proteins such as COX-2 and iNOS, or activated MAP kinases (p38, JNK and ERK1/2) in LPS stimulated RAW 264.7 macrophages. Taken together these data indicate the potential for SU182 to interfere with the transcription factors NF-κB and AP-1 at transcriptional level. However, no potential anti-inflammatory effect was indicated, further investigation for other NF-κB dependent proteins linked to survival are also required to identify the exact mechanism of action.

Keywords: Canthin-6-one, NF-κB, AP-1, phosphorylation, Nuclear translocation, DNA-binding activity, inflammatory proteins.

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76 Reduction of the Cellular Infectivity of SARS-CoV-2 by a Mucoadhesive Nasal Spray

Authors: Adam M. Pitz, Gillian L. Phillipson, Jayant E. Khanolkar, Andrew M. Middleton

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New emerging evidence suggests that the nose is the predominant route for entry of the SARS-CoV-2 virus into the host. A virucidal suspension test (conforming in principle to the European Standard EN14476) was conducted to determine whether a commercial liquid gel intranasal spray containing 1% of the mucoadhesive hydroxypropyl methylcellulose (HPMC) could inhibit the cellular infectivity of the SARS-CoV-2 coronavirus. Virus was added to the test product samples and to controls in a 1:8 ratio and mixed with one part bovine serum albumin as an interfering substance. The test samples were pre-equilibrated to 34 ± 2°C (representing the temperature of the nasopharynx) with the temperature maintained at 34 ± 2°C for virus contact times of 1, 5 and 10 minutes. Neutralized aliquots were inoculated onto host cells (Vero E6 cells, ATCC CRL-1586). The host cells were then incubated at 36 ± 2°C for a period of 7 days. The residual infectious virus in both test and controls was detected by viral-induced cytopathic effect. The 50% tissue culture infective dose per mL (TCID50/mL) was determined using the Spearman-Karber method with results reported as the reduction of the virus titer due to treatment with test product, expressed as log10. The controls confirmed the validity of the results with no cytotoxicity or viral interference observed in the neutralized test product samples. The HPMC formulation reduced SARS-CoV-2 titer, expressed as log10TCID50, by 2.30 ( ± 0.17), 2.60 ( ± 0.19), and 3.88 ( ± 0.19) with the respective contact times of 1, 5 and 10 minutes. The results demonstrate that this 1% HPMC gel formulation can reduce the cellular infectivity of the SARS-CoV-2 virus with an increasing viral inhibition observed with increasing exposure time. This 1% HMPC gel is well tolerated and can reside, when delivered via nasal spray, for up to one hour in the nasal cavity. We conclude that this intranasal gel spray with 1% HPMC repeat-dosed every few hours may offer an effective preventive or early intervention solution to limit the transmission and impact of the SARS-CoV-2 coronavirus.

Keywords: hydroxypropyl methylcellulose, mucoadhesive nasal spray, respiratory viruses, SARS-CoV-2

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75 A Furniture Industry Concept for a Sustainable Generative Design Platform Employing Robot Based Additive Manufacturing

Authors: Andrew Fox, Tao Zhang, Yuanhong Zhao, Qingping Yang

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The furniture manufacturing industry has been slow in general to adopt the latest manufacturing technologies, historically relying heavily upon specialised conventional machinery. This approach not only requires high levels of specialist process knowledge, training, and capital investment but also suffers from significant subtractive manufacturing waste and high logistics costs due to the requirement for centralised manufacturing, with high levels of furniture product not re-cycled or re-used. This paper aims to address the problems by introducing suitable digital manufacturing technologies to create step changes in furniture manufacturing design, as the traditional design practices have been reported as building in 80% of environmental impact. In this paper, a 3D printing robot for furniture manufacturing is reported. The 3D printing robot mainly comprises a KUKA industrial robot, an Arduino microprocessor, and a self-assembled screw fed extruder. Compared to traditional 3D printer, the 3D printing robot has larger motion range and can be easily upgraded to enlarge the maximum size of the printed object. Generative design is also investigated in this paper, aiming to establish a combined design methodology that allows assessment of goals, constraints, materials, and manufacturing processes simultaneously. ‘Matrixing’ for part amalgamation and product performance optimisation is enabled. The generative design goals of integrated waste reduction increased manufacturing efficiency, optimised product performance, and reduced environmental impact institute a truly lean and innovative future design methodology. In addition, there is massive future potential to leverage Single Minute Exchange of Die (SMED) theory through generative design post-processing of geometry for robot manufacture, resulting in ‘mass customised’ furniture with virtually no setup requirements. These generatively designed products can be manufactured using the robot based additive manufacturing. Essentially, the 3D printing robot is already functional; some initial goals have been achieved and are also presented in this paper.

Keywords: additive manufacturing, generative design, robot, sustainability

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

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

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

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

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73 Experimental and Numerical Investigation of Micro-Welding Process and Applications in Digital Manufacturing

Authors: Khaled Al-Badani, Andrew Norbury, Essam Elmshawet, Glynn Rotwell, Ian Jenkinson , James Ren

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Micro welding procedures are widely used for joining materials, developing duplex components or functional surfaces, through various methods such as Micro Discharge Welding or Spot Welding process, which can be found in the engineering, aerospace, automotive, biochemical, biomedical and numerous other industries. The relationship between the material properties, structure and processing is very important to improve the structural integrity and the final performance of the welded joints. This includes controlling the shape and the size of the welding nugget, state of the heat affected zone, residual stress, etc. Nowadays, modern high volume productions require the welding of much versatile shapes/sizes and material systems that are suitable for various applications. Hence, an improved understanding of the micro welding process and the digital tools, which are based on computational numerical modelling linking key welding parameters, dimensional attributes and functional performance of the weldment, would directly benefit the industry in developing products that meet current and future market demands. This paper will introduce recent work on developing an integrated experimental and numerical modelling code for micro welding techniques. This includes similar and dissimilar materials for both ferrous and non-ferrous metals, at different scales. The paper will also produce a comparative study, concerning the differences between the micro discharge welding process and the spot welding technique, in regards to the size effect of the welding zone and the changes in the material structure. Numerical modelling method for the micro welding processes and its effects on the material properties, during melting and cooling progression at different scales, will also be presented. Finally, the applications of the integrated numerical modelling and the material development for the digital manufacturing of welding, is discussed with references to typical application cases such as sensors (thermocouples), energy (heat exchanger) and automotive structures (duplex steel structures).

Keywords: computer modelling, droplet formation, material distortion, materials forming, welding

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72 Production of High Purity Cellulose Products from Sawdust Waste Material

Authors: Simiksha Balkissoon, Jerome Andrew, Bruce Sithole

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Approximately half of the wood processed in the Forestry, Timber, Pulp and Paper (FTPP) sector is accumulated as waste. The concept of a “green economy” encourages industries to employ revolutionary, transformative technologies to eliminate waste generation by exploring the development of new value chains. The transition towards an almost paperless world driven by the rise of digital media has resulted in a decline in traditional paper markets, prompting the FTTP sector to reposition itself and expand its product offerings by unlocking the potential of value-adding opportunities from renewable resources such as wood to generate revenue and mitigate its environmental impact. The production of valuable products from wood waste such as sawdust has been extensively explored in recent years. Wood components such as lignin, cellulose and hemicelluloses, which can be extracted selectively by chemical processing, are suitable candidates for producing numerous high-value products. In this study, a novel approach to produce high-value cellulose products, such as dissolving wood pulp (DWP), from sawdust was developed. DWP is a high purity cellulose product used in several applications such as pharmaceutical, textile, food, paint and coatings industries. The proposed approach demonstrates the potential to eliminate several complex processing stages, such as pulping and bleaching, which are associated with traditional commercial processes to produce high purity cellulose products such as DWP, making it less chemically energy and water-intensive. The developed process followed the path of experimentally designed lab tests evaluating typical processing conditions such as residence time, chemical concentrations, liquid-to-solid ratios and temperature, followed by the application of suitable purification steps. Characterization of the product from the initial stage was conducted using commercially available DWP grades as reference materials. The chemical characteristics of the products thus far have shown similar properties to commercial products, making the proposed process a promising and viable option for the production of DWP from sawdust.

Keywords: biomass, cellulose, chemical treatment, dissolving wood pulp

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71 A PHREEQC Reactive Transport Simulation for Simply Determining Scaling during Desalination

Authors: Andrew Freiburger, Sergi Molins

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Freshwater is a vital resource; yet, the supply of clean freshwater is diminishing as the consequence of melting snow and ice from global warming, pollution from industry, and an increasing demand from human population growth. The unsustainable trajectory of diminishing water resources is projected to jeopardize water security for billions of people in the 21st century. Membrane desalination technologies may resolve the growing discrepancy between supply and demand by filtering arbitrary feed water into a fraction of renewable, clean water and a fraction of highly concentrated brine. The leading hindrance of membrane desalination is fouling, whereby the highly concentrated brine solution encourages micro-organismal colonization and/or the precipitation of occlusive minerals (i.e. scale) upon the membrane surface. Thus, an understanding of brine formation is necessary to mitigate membrane fouling and to develop efficacious desalination technologies that can bolster the supply of available freshwater. This study presents a reactive transport simulation of brine formation and scale deposition during reverse osmosis (RO) desalination. The simulation conceptually represents the RO module as a one-dimensional domain, where feed water directionally enters the domain with a prescribed fluid velocity and is iteratively concentrated in the immobile layer of a dual porosity model. Geochemical PHREEQC code numerically evaluated the conceptual model with parameters for the BW30-400 RO module and for real water feed sources – e.g. the Red and Mediterranean seas, and produced waters from American oil-wells, based upon peer-review data. The presented simulation is computationally simpler, and hence less resource intensive, than the existent and more rigorous simulations of desalination phenomena, like TOUGHREACT. The end-user may readily prepare input files and execute simulations on a personal computer with open source software. The graphical results of fouling-potential and brine characteristics may therefore be particularly useful as the initial tool for screening candidate feed water sources and/or informing the selection of an RO module.

Keywords: desalination, PHREEQC, reactive transport, scaling

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70 Case-Based Reasoning Application to Predict Geological Features at Site C Dam Construction Project

Authors: Shahnam Behnam Malekzadeh, Ian Kerr, Tyson Kaempffer, Teague Harper, Andrew Watson

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The Site C Hydroelectric dam is currently being constructed in north-eastern British Columbia on sub-horizontal sedimentary strata that dip approximately 15 meters from one bank of the Peace River to the other. More than 615 pressure sensors (Vibrating Wire Piezometers) have been installed on bedding planes (BPs) since construction began, with over 80 more planned before project completion. These pressure measurements are essential to monitor the stability of the rock foundation during and after construction and for dam safety purposes. BPs are identified by their clay gouge infilling, which varies in thickness from less than 1 to 20 mm and can be challenging to identify as the core drilling process often disturbs or washes away the gouge material. Without the use of depth predictions from nearby boreholes, stratigraphic markers, and downhole geophysical data, it is difficult to confidently identify BP targets for the sensors. In this paper, a Case-Based Reasoning (CBR) method was used to develop an empirical model called the Bedding Plane Elevation Prediction (BPEP) to help geologists and geotechnical engineers to predict geological features and bedding planes at new locations in a fast and accurate manner. To develop CBR, a database was developed based on 64 pressure sensors already installed on key bedding planes BP25, BP28, and BP31 on the Right Bank, including bedding plane elevations and coordinates. Thirteen (20%) of the most recent cases were selected to validate and evaluate the accuracy of the developed model, while the similarity was defined as the distance between previous cases and recent cases to predict the depth of significant BPs. The average difference between actual BP elevations and predicted elevations for above BPs was ±55cm, while the actual results showed that 69% of predicted elevations were within ±79 cm of actual BP elevations while 100% of predicted elevations for new cases were within ±99cm range. Eventually, the actual results will be used to develop the database and improve BPEP to perform as a learning machine to predict more accurate BP elevations for future sensor installations.

Keywords: case-based reasoning, geological feature, geology, piezometer, pressure sensor, core logging, dam construction

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69 Maternal Adverse Childhood Experiences and Preschool Children’s Behavioural Problems: Mediation via Adult Attachment and Moderation by Maternal Mental Health, Social Support, and Child Sex

Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

Abstract:

Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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68 Numerical Simulation of the Fractional Flow Reserve in the Coronary Artery with Serial Stenoses of Varying Configuration

Authors: Mariia Timofeeva, Andrew Ooi, Eric K. W. Poon, Peter Barlis

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Atherosclerotic plaque build-up, commonly known as stenosis, limits blood flow and hence oxygen and nutrient supplies to the heart muscle. Thus, assessment of its severity is of great interest to health professionals. Numerical simulation of the fractional flow reserve (FFR) has proved to be well correlated with invasively measured FFR used for physiological assessment of the severity of coronary stenosis in arteries. Atherosclerosis may impact the diseased artery in several locations causing serial stenoses, which is a complicated subset of coronary artery disease that requires careful treatment planning. However, hemodynamic of the serial sequential stenoses in coronary arteries has not been extensively studied. The hemodynamics of the serial stenoses is complex because the stenoses in the series interact and affect the flow through each other. To address this, serial stenoses in a 3.4 mm left anterior descending (LAD) artery are examined in this study. Two diameter stenoses (DS) are considered, 30 and 50 percent of the reference diameter. Serial stenoses configurations are divided into three groups based on the order of the stenoses in the series, spacing between them, and deviation of the stenoses’ symmetry (eccentricity). A patient-specific pulsatile waveform is used in the simulations. Blood flow within the stenotic artery is assumed to be laminar, Newtonian, and incompressible. Results for the FFR are reported. Based on the simulation results, it can be deduced that the larger drop in pressure (smaller value of the FFR) is expected when the percentage of the second stenosis in the series is bigger. Varying the distance between the stenoses affects the location of the maximum drop in the pressure, while the minimal FFR in the artery remains unchanged. Eccentric serial stenoses are characterized by a noticeably larger decrease in pressure through the stenoses and by the development of the chaotic flow downstream of the stenoses. The largest drop in the pressure (about 4% difference compared to the axisymmetric case) is obtained for the serial stenoses, where both the stenoses are highly eccentric with the centerlines deflected to the different sides of the LAD. In conclusion, varying configuration of the sequential serial stenoses results in a different distribution of FFR through the LAD. Results presented in this study provide insight into the clinical assessment of the severity of the coronary serial stenoses, which is proved to depend on the relative position of the stenoses and the deviation of the stenoses’ symmetry.

Keywords: computational fluid dynamics, coronary artery, fractional flow reserve, serial stenoses

Procedia PDF Downloads 158
67 Improving Access and Quality of Patient Information Resources for Orthognathic Treatment: A Quality Improvement Project

Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

Procedia PDF Downloads 36
66 Sharing Personal Information for Connection: The Effect of Social Exclusion on Consumer Self-Disclosure to Brands

Authors: Jiyoung Lee, Andrew D. Gershoff, Jerry Jisang Han

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Most extant research on consumer privacy concerns and their willingness to share personal data has focused on contextual factors (e.g., types of information collected, type of compensation) that lead to consumers’ personal information disclosure. Unfortunately, the literature lacks a clear understanding of how consumers’ incidental psychological needs may influence consumers’ decisions to share their personal information with companies or brands. In this research, we investigate how social exclusion, which is an increasing societal problem, especially since the onset of the COVID-19 pandemic, leads to increased information disclosure intentions for consumers. Specifically, we propose and find that when consumers become socially excluded, their desire for social connection increases, and this desire leads to a greater willingness to disclose their personal information with firms. The motivation to form and maintain interpersonal relationships is one of the most fundamental human needs, and many researchers have found that deprivation of belongingness has negative consequences. Given the negative effects of social exclusion and the universal need to affiliate with others, people respond to exclusion with a motivation for social reconnection, resulting in various cognitive and behavioral consequences, such as paying greater attention to social cues and conforming to others. Here, we propose personal information disclosure as another form of behavior that can satisfy such social connection needs. As self-disclosure can serve as a strategic tool in creating and developing social relationships, those who have been socially excluded and thus have greater social connection desires may be more willing to engage in self-disclosure behavior to satisfy such needs. We conducted four experiments to test how feelings of social exclusion can influence the extent to which consumers share their personal information with brands. Various manipulations and measures were used to demonstrate the robustness of our effects. Through the four studies, we confirmed that (1) consumers who have been socially excluded show greater willingness to share their personal information with brands and that (2) such an effect is driven by the excluded individuals’ desire for social connection. Our findings shed light on how the desire for social connection arising from exclusion influences consumers’ decisions to disclose their personal information to brands. We contribute to the consumer disclosure literature by uncovering a psychological need that influences consumers’ disclosure behavior. We also extend the social exclusion literature by demonstrating that exclusion influences not only consumers’ choice of products but also their decision to disclose personal information to brands.

Keywords: consumer-brand relationship, consumer information disclosure, consumer privacy, social exclusion

Procedia PDF Downloads 69
65 Influence of the Popularity of Opera during Risorgimento on Foreign Presence in Italy

Authors: Andrew Wee

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As a result of the Italian Independence Wars starting in 1848, Italy began to change through unification. People gradually moved away from some of their traditional practices and values, such as the long-held belief that women were inferior to men, as part of the Risorgimento. Italians began to take interest in opera as a form of emotional release. As opera became more popular and prominent in their culture, it aided in the dissemination of ideas, especially stimulating the spread of imperialism, in the late 19th century, as Italy began extending its presence to other countries. In order to collect the information needed to analyze Italy’s foreign presence, it was necessary to consult texts concerning the culture of the Risorgimento. These texts included primary sources from operatic composers and contemporary recorded accounts. Letters from Giuseppe Verdi, a leader in opera during the Risorgimento, have been scrutinized for indications of popular attitudes of the time. The cultural context of the Risorgimento is essential to understanding the Italian motives and attitudes towards the outside world. On the more political side, research has also entailed the study of historical data of general laws, policies, and their purposes concerning geopolitical boundaries and foreign affairs, such as Edward Said’s thesis on Orientalism. By establishing these two characteristics of Italy, the paper will thoroughly illustrate Italy’s presence in foreign affairs. Texts have been searched with the intent of using information that reveals Italian attitudes toward exotic countries to determine whether their demeanor was positive or condescending. Motives behind sources have been interpreted in context in order to form a complete picture of the Italian sentiment towards foreigners. Additionally, research pertaining to Italian nationalism and imperialism such as song and literature has been used. The primary form of research has been the division of sources that are culturally based and those that are political in nature. Opera had always been developing since its creation in the 17th century, and in the 19th century, the bel canto movement revolutionized opera and its role in Italian society. This paper uses evidence that popular sentiment was influenced by opera to support the belief that the evolution of opera was as a result of the nationalist sentiment, and in turn fueled the cultural movement known as the Risorgimento. In this way, opera proceeded to affect Italian culture by spreading the idea of imperialism.

Keywords: opera, Italian unification, music history, imperialism

Procedia PDF Downloads 317
64 Influence of Pretreatment Magnetic Resonance Imaging on Local Therapy Decisions in Intermediate-Risk Prostate Cancer Patients

Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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63 Identifying the Determinants of Compliance with Maritime Environmental Legislation in the North and Baltic Sea Area: A Model Developed from Exploratory Qualitative Data Collection

Authors: Thea Freese, Michael Gille, Andrew Hursthouse, John Struthers

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Ship operators on the North and Baltic Sea have been experiencing increased political interest in marine environmental protection and cleaner vessel operations. Stricter legislation on SO2 and NOx emissions, ballast water management and other measures of protection are currently being phased in or will come into force in the coming years. These measures benefit the health of the marine environment, while increasing company’s operational costs. In times of excess shipping capacity and linked consolidation in the industry non-compliance with environmental rules is one way companies might hope to stay competitive with both intra- and inter-modal trade. Around 5-15% of industry participants are believed to neglect laws on vessel-source pollution willingly or unwillingly. Exploratory in-depth interviews conducted with 12 experts from various stakeholder groups informed the researchers about variables influencing compliance levels, including awareness and apprehension, willingness to comply, ability to comply and effectiveness of controls. Semi-structured expert interviews were evaluated using qualitative content analysis. A model of determinants of compliance was developed and is presented here. While most vessel operators endeavour to achieve full compliance with environmental rules, a lack of availability of technical solutions, expediency of implementation and operation and economic feasibility might prove a hindrance. Ineffective control systems on the other hand foster willing non-compliance. With respect to motivations, lacking time, lacking financials and the absence of commercial advantages decrease compliance levels. These and other variables were inductively developed from qualitative data and integrated into a model on environmental compliance. The outcomes presented here form part of a wider research project on economic effects of maritime environmental legislation. Research on determinants of compliance might inform policy-makers about actual behavioural effects of shipping companies and might further the development of a comprehensive legal system for environmental protection.

Keywords: compliance, marine environmental protection, exploratory qualitative research study, clean vessel operations, North and Baltic Sea area

Procedia PDF Downloads 353
62 Adoptability of Digital Payment for Community Health Workers in Wakiso District, Uganda

Authors: Veronica Kembabazi, Arnold Tigaiza, Juliet Aweko, Charles Opio, Michael Ediau, Elizabeth Ekirapa, Andrew Tusubira, Peter Waiswa

Abstract:

Background: Digital payments have been branded as key in solving health payment challenges, evidence on their adoptability is still limited especially among Community Health Workers (CHWs), yet vital for ensuring sustainability. We therefore assessed the adoptability of digital payments for CHWs in Wakiso district, Uganda. Methods: In December 2022, we conducted a convergent parallel mixed-methods study among 150 randomly selected CHWs in Wakiso district. Supplementary qualitative data were collected from the Digital payment coordinators as Key Informants (KIs). We adopted the Technology Acceptance Model (TAM) framework to assess the adoptability of digital payments among CHWS. Factor analysis was performed to extract composite variables from the original constituting variables. Kaiser-Meyer-Olkin statistics were assessed for each construct to determine appropriateness for data reduction. Using logistic regression for multivariate analysis, we assessed the association between adoptability constructs and the CHW intention to use digital payments. Quantitative data was analyzed using STATA, while qualitative data was transcribed verbatim and analyzed using ATLAS.ti software. Results: Overall, 150 respondents were interviewed and nearly all participants (98.0%) had previously received payments through mobile money, a digital-payment method. The majority (52%) of CHWs said they intend to use digital payment modalities. Perceived risk had an 83% negative influence on the adoptability of digital payment modalities (OR= 0.167, p < 0.01), perceived trust had an almost three times positive influence on the adoptability of digital payment modalities (OR= 2.823, p < 0.01). Qualitative interviews showed that most CHWs reported good experiences in their use of digital health payment modalities except for delays associated with mobile money payments. Mobile money was reported to be easy to use, in addition to fostering financial responsibility compared to cash. Conclusion: CHWs in Wakiso district intend to use digital payment modalities, particularly mobile money/e-cash, and the perceived risk of the payment method and trust are key determinants of its adoptability. Synergized efforts by both payment providers and service operators to manage payment delays and identified risks among mobile money operators could attenuate perceived risk and build trust in digital payment modalities.

Keywords: digital health payments, community health workers, adoptability, technology acceptance model

Procedia PDF Downloads 35
61 Traumatic Brain Injury in Cameroon: A Prospective Observational Study in a Level 1 Trauma Centre

Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

Procedia PDF Downloads 95
60 The Impact of Physical Activity for Recovering Cancer Patients

Authors: Martyn Queen, Diane Crone, Andrew Parker, Saul Bloxham

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Rationale: There is a growing body of evidence that supports the use of physical activity during and after cancer treatment. However, activity levels for patients remain low. As more cancer patients are treated successfully, and treatment costs continue to escalate, physical activity may be a promising adjunct to a person-centred healthcare approach to recovery. Aim: The aim was to further understand how physical activity may enhance the recovery process for a group of mixed-site cancer patients. Objectives: The research investigated longitudinal changes in physical activity and perceived the quality of life between two and six month’s post-exercise interventions. It also investigated support systems that enabled patients to sustain these perceived changes. Method: The respondent cohort comprised 14 mixed-site cancer patients aged 43-70 (11 women, 3 men), who participated in a two-phase physical activity intervention that took place at a university in the South West of England. Phase 1 consisted of an eight-week structured physical activity programme; Phase 2 consisted of four months of non-supervised physical activity. Semi-structured interviews took place three times over six months with each participant. Grounded theory informed the data collection and analysis which, in turn, facilitated theoretical development. Findings: Our findings propose three theories on the impact of physical activity for recovering cancer patients: 1) Knowledge gained through a structured exercise programme can enable recovering cancer patients to independently sustain physical activity to four-month follow-up. 2) Sustaining physical activity for six months promotes positive changes in the quality of life indicators of chronic fatigue, self-efficacy, the ability to self-manage and energy levels. 3) Peer support from patients facilitates adherence to a structured exercise programme and support from a spouse, or life partner facilitates independently sustained physical activity to four-month follow-up. Conclusions: This study demonstrates that qualitative research can provide an evidence base that could be used to support future care plans for cancer patients. Findings also demonstrate that a physical activity intervention can be effective at helping cancer patients recover from the side effects of their treatment, and recommends that physical activity should become an adjunct therapy alongside traditional cancer treatments.

Keywords: physical activity, health, cancer recovery, quality of life, support systems, qualitative, grounded theory, person-centred healthcare

Procedia PDF Downloads 255
59 Other Cancers in Patients With Head and Neck Cancer

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

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Introduction: Head and neck cancers (HNC) are often associated with the development of non-HNC primaries, as the risk factors that predispose patients to HNC are often risk factors for other cancers. Aim: We sought to evaluate whether there was an increased risk of smoking and alcohol-related cancers and also other cancers in HNC patients and to evaluate whether there is a difference between the rates of non-HNC primaries in Aboriginal compared with non-Aboriginal HNC patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single center in Western Australia, identifying 80 Aboriginal and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, treatments, outcomes, and past and subsequent HNCs and non-HNC primaries. Results: In the overall study population, there were 86 patients (26.9%) with a metachronous or synchronous non-HNC primary. Non-HNC primaries were actually significantly more common in the non-Aboriginal population compared with the Aboriginal population (30% vs. 17.5%, p=0.02); however, half of these were patients with cutaneous squamous or basal cell carcinomas (cSCC/BCC) only. When cSCC/BCCs were excluded, non-Aboriginal patients had a similar rate as Aboriginal patients (16.7% vs. 15%, p=0.73). There were clearly more cSCC/BCCs in non-Aboriginal patients compared with Aboriginal patients (16.7% vs. 2.5%, p=0.001) and more patients with melanoma (2.5% vs. 0%, p value not significant (p=NS). Rates of most cancers were similar between non-Aboriginal and Aboriginal patients, including prostate (2.9% vs. 3.8%), colorectal (2.9% vs. 2.5%), kidney (1.2% vs. 1.2%), and these rates appeared comparable to Australian Age Standardised Incidence Rates (ASIR) in the general community. Oesophageal cancer occurred at double the rate in Aboriginal patients (3.8%) compared with non-Aboriginal patients (1.7%), which was far in excess of ASIRs which estimated a lifetime risk of 0.59% in the general population. Interestingly lung cancer rates did not appear to be significantly increased in our cohort, with 2.5% of Aboriginal patients and 3.3% of non-Aboriginal patients having lung cancer, which is in line with ASIRs which estimates a lifetime risk of 5% (by age 85yo). Interestingly the rate of Glioma in the non-Aboriginal population was higher than the ASIR, with 0.8% of non-Aboriginal patients developing Glioma, with Australian averages predicting a 0.6% lifetime risk in the general population. As these are small numbers, this finding may well be due to chance. Unsurprisingly, second HNCs occurred at an increased incidence in our cohort, in 12.5% of Aboriginal patients and 11.2% of non-Aboriginal patients, compared to an ASIR of 17 cases per 100,000 persons, estimating a lifetime risk of 1.70%. Conclusions: Overall, 26.9% of patients had a non-HNC primary. When cSCC/BCCs were excluded, Aboriginal and non-Aboriginal patients had similar rates of non-HNC primaries, although non-Aboriginal patients had a significantly higher rate of cSCC/BCCs. Aboriginal patients had double the rate of oesophageal primaries; however, this was not statistically significant, possibly due to small case numbers.

Keywords: head and neck cancer, synchronous and metachronous primaries, other primaries, Aboriginal

Procedia PDF Downloads 39
58 The Role of EDTA and EDDS in Reducing Metal Toxicity for Aquaculture Shellfish Perna canaliculus

Authors: Daniel R. McDougall, Martin D. de Jonge, Gordon M. Miskelly, Duncan J. McGillivray, Andrew G. Jeffs

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The chelating agent ethylenediaminetetraacetic acid (EDTA) is commonly added as a cure-all to seawater in aquaculture hatcheries around the world to reduce heavy metal toxicity, significantly improve the survival of larval shellfish, and to therefore improve the overall production efficiency of the aquaculture industry. However, EDTA is not a biodegradable chemical and is considered to be a persistent organic pollutant, which will accumulate in the environment over time. This makes the use of EDTA unsustainable environmentally, and therefore alternatives should be considered. Ethylenediaminedisuccinic acid (EDDS) is a biodegradable alternative to EDTA with very similar metal chelation properties. This study investigates the effect of EDTA and EDDS at two different concentrations, on metal concentrations found within developing New Zealand green-lipped mussel (Perna canaliculus) larvae. P. canaliculus is New Zealand’s main shellfish aquaculture species, providing a major export for New Zealand’s economy, with excellent potential for increased production in the near future. It is well known that the early stages of bivalve development are the most vulnerable to metal toxicity and P. canaliculus is no exception. The commercially used concentration (12 µmol L⁻¹) of EDTA added to P. canaliculus larval rearing tanks often increases the yield of D-larvae by over 80%. This concentration of EDTA and EDDS will be tested in this study, along with a lower concentration (3 µmol L⁻¹). After 48 hours of larval development, the D-larvae will be analyzed for heavy metal content with Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and heavy metal distribution with synchrotron X-ray Fluorescence Microscopy (XFM). In this study, we found that EDDS also improves the yield of P. canaliculus larvae and could be a viable alternative to EDTA in aquaculture. Furthermore, results suggest a higher concentration of chelating agent is more effective for improving the yield of developing P. canaliculus larvae. Metals with significant differences in concentration with the addition of EDTA were Cr, Cu, Zn, Cd and Pb (P < 0.05). We observed for the first time to the author’s best knowledge, metal distribution within 100 µm P. canaliculus D-larvae using synchrotron XFM and found changes in the distribution of metals with the addition of EDTA. XFM also has the potential to provide information about the chemical state of the metals within mussel larvae. This research provides greater insight into the reasons for the effectiveness of adding the chelating agent to aquaculture culture water, and a more environmentally conscious alternative to the currently used EDTA, which could be extremely valuable for the aquaculture industry.

Keywords: EDDS, EDTA, heavy metals, P. canaliculus, toxicity, water treatment

Procedia PDF Downloads 169
57 Considerations for Effectively Using Probability of Failure as a Means of Slope Design Appraisal for Homogeneous and Heterogeneous Rock Masses

Authors: Neil Bar, Andrew Heweston

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Probability of failure (PF) often appears alongside factor of safety (FS) in design acceptance criteria for rock slope, underground excavation and open pit mine designs. However, the design acceptance criteria generally provide no guidance relating to how PF should be calculated for homogeneous and heterogeneous rock masses, or what qualifies a ‘reasonable’ PF assessment for a given slope design. Observational and kinematic methods were widely used in the 1990s until advances in computing permitted the routine use of numerical modelling. In the 2000s and early 2010s, PF in numerical models was generally calculated using the point estimate method. More recently, some limit equilibrium analysis software offer statistical parameter inputs along with Monte-Carlo or Latin-Hypercube sampling methods to automatically calculate PF. Factors including rock type and density, weathering and alteration, intact rock strength, rock mass quality and shear strength, the location and orientation of geologic structure, shear strength of geologic structure and groundwater pore pressure influence the stability of rock slopes. Significant engineering and geological judgment, interpretation and data interpolation is usually applied in determining these factors and amalgamating them into a geotechnical model which can then be analysed. Most factors are estimated ‘approximately’ or with allowances for some variability rather than ‘exactly’. When it comes to numerical modelling, some of these factors are then treated deterministically (i.e. as exact values), while others have probabilistic inputs based on the user’s discretion and understanding of the problem being analysed. This paper discusses the importance of understanding the key aspects of slope design for homogeneous and heterogeneous rock masses and how they can be translated into reasonable PF assessments where the data permits. A case study from a large open pit gold mine in a complex geological setting in Western Australia is presented to illustrate how PF can be calculated using different methods and obtain markedly different results. Ultimately sound engineering judgement and logic is often required to decipher the true meaning and significance (if any) of some PF results.

Keywords: probability of failure, point estimate method, Monte-Carlo simulations, sensitivity analysis, slope stability

Procedia PDF Downloads 187
56 Development of Structural Deterioration Models for Flexible Pavement Using Traffic Speed Deflectometer Data

Authors: Sittampalam Manoharan, Gary Chai, Sanaul Chowdhury, Andrew Golding

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The primary objective of this paper is to present a simplified approach to develop the structural deterioration model using traffic speed deflectometer data for flexible pavements. Maintaining assets to meet functional performance is not economical or sustainable in the long terms, and it would end up needing much more investments for road agencies and extra costs for road users. Performance models have to be included for structural and functional predicting capabilities, in order to assess the needs, and the time frame of those needs. As such structural modelling plays a vital role in the prediction of pavement performance. A structural condition is important for the prediction of remaining life and overall health of a road network and also major influence on the valuation of road pavement. Therefore, the structural deterioration model is a critical input into pavement management system for predicting pavement rehabilitation needs accurately. The Traffic Speed Deflectometer (TSD) is a vehicle-mounted Doppler laser system that is capable of continuously measuring the structural bearing capacity of a pavement whilst moving at traffic speeds. The device’s high accuracy, high speed, and continuous deflection profiles are useful for network-level applications such as predicting road rehabilitations needs and remaining structural service life. The methodology adopted in this model by utilizing time series TSD maximum deflection (D0) data in conjunction with rutting, rutting progression, pavement age, subgrade strength and equivalent standard axle (ESA) data. Then, regression analyses were undertaken to establish a correlation equation of structural deterioration as a function of rutting, pavement age, seal age and equivalent standard axle (ESA). This study developed a simple structural deterioration model which will enable to incorporate available TSD structural data in pavement management system for developing network-level pavement investment strategies. Therefore, the available funding can be used effectively to minimize the whole –of- life cost of the road asset and also improve pavement performance. This study will contribute to narrowing the knowledge gap in structural data usage in network level investment analysis and provide a simple methodology to use structural data effectively in investment decision-making process for road agencies to manage aging road assets.

Keywords: adjusted structural number (SNP), maximum deflection (D0), equant standard axle (ESA), traffic speed deflectometer (TSD)

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55 Queer Social Realism and Architecture in British Cinema: Tenement Housing, Unions and the Affective Body

Authors: Christopher Pullen

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This paper explores the significance of British cinema in the late 1950s and early 1960s as offering a renaissance of realist discourse, in the representation of everyday social issues. Offering a rejection of Hollywood cinema and the superficially of the middle classes, these ‘kitchen sink dramas’ often set within modest and sometimes squalid domestic and social environments, focused on the political struggle of the disenfranchised examining poverty, the oppressed and the outsider. While films like Look Back in Anger and Room at the Top looked primarily at male heterosexual subjectivity, films like A Taste of Honey and Victim focused on female and queer male narratives. Framing the urban landscape as a discursive architectural arena, representing basic living conditions and threatening social worlds, these iconic films established new storytelling processes for the outsider. This paper examines this historical context foregrounding the contemporary films Beautiful Thing (Hettie Macdonald, 1996), Weekend (Andrew Haigh, 2011) and Pride (Marcus Warchus, 2014), while employing the process of textual analysis in relation to theories of affect, defined by writers such as Lisa U. Marks and Sara Ahmed. Considering both romance narratives and public demonstrations of unity, where the queer ‘affective’ body is placed within architectural and social space, Beautiful Thing tells the story of gay male teenagers falling in love despite oppression from family and school, Weekend examines a one-night stand between young gay men and the unlikeliness of commitment, but the drive for sensitivity, and Pride foregrounds an historical relationship between queer youth activists and the miner’s union, who were on strike between 1984-5. These films frame the queer ‘affective’ body within politicized public space, evident in lower class men’s working clubs, tenement housing and brutal modernist tower blocks, focusing on architectural features such as windows, doorways and staircases, relating temporality, desire and change. Through such an examination a hidden history of gay male performativity is revealed, framing the potential of contemporary cinema to focus on the context of the outsider in encouraging social change.

Keywords: queer, affect, cinema, architecture, life chances

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54 Semi-Autonomous Surgical Robot for Pedicle Screw Insertion on ex vivo Bovine Bone: Improved Workflow and Real-Time Process Monitoring

Authors: Robnier Reyes, Andrew J. P. Marques, Joel Ramjist, Chris R. Pasarikovski, Victor X. D. Yang

Abstract:

Over the past three decades, surgical robotic systems have demonstrated their ability to improve surgical outcomes. The LBR Med is a collaborative robotic arm that is meant to work with a surgeon to streamline surgical workflow. It has 7 degrees of freedom and thus can be easily oriented. Position and torque sensors at each joint allow it to maintain a position accuracy of 150 µm with real-time force and torque feedback, making it ideal for complex surgical procedures. Spinal fusion procedures involve the placement of as many as 20 pedicle screws, requiring a great deal of accuracy due to proximity to the spinal canal and surrounding vessels. Any deviation from intended path can lead to major surgical complications. Assistive surgical robotic systems are meant to serve as collaborative devices easing the workload of the surgeon, thereby improving pedicle screw placement by mitigating fatigue related inaccuracies. Moreover, robotic spinal systems have shown marked improvements over conventional freehanded techniques in both screw placement accuracy and fusion quality and have greatly reduced the need for screw revision, intraoperatively and post-operatively. However, current assistive spinal fusion robots, such as the ROSA Spine, are limited in functionality to positioning surgical instruments. While they offer a small degree of improvement in pedicle screw placement accuracy, they do not alleviate surgeon fatigue, nor do they provide real-time force and torque feedback during screw insertion. We propose a semi-autonomous surgical robot workflow for spinal fusion where the surgeon guides the robot to its initial position and orientation, and the robot drives the pedicle screw accurately into the vertebra. Here, we demonstrate feasibility by inserting pedicle screws into ex-vivo bovine rib bone. The robot monitors position, force and torque with respect to predefined values selected by the surgeon to ensure the highest possible spinal fusion quality. The workflow alleviates the strain on the surgeon by having the robot perform the screw placement while the ability to monitor the process in real-time keeps the surgeon in the system loop. The approach we have taken in terms of level autonomy for the robot reflects its ability to safely collaborate with the surgeon in the operating room without external navigation systems.

Keywords: ex vivo bovine bone, pedicle screw, surgical robot, surgical workflow

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