Search results for: Eric Williams

Authors: Micah J. Dobson

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After-school programs of physical education provide children with opportunities to engage in physical activities while developing healthy habits. To ensure that these programs are inclusive, diverse, and engaging, however, schools must consider various factors when designing and implementing them. This study sought to bring out efficient strategies for structuring after-school programs of physical education. The literature review was conducted using various databases and search engines. Some databases that index the journals include ERIC, Google Scholar, Scopus, Web of Science, and EBSCOhost. The search terms were combinations of keywords such as “after-school,” “physical education,” “inclusion,” “diversity,” “engagement,” “program design,” “program implementation,” “program effectiveness,” and “best practices.” The findings of this study suggest that schools that desire inclusivity must consider four key factors when designing and implementing after-school physical education programs. First, the programs must be designed with variety and fun by incorporating activities such as dance, sports, and games that appeal to all students. Second, instructors must be trained to create supportive and positive environments that foster student engagement while promoting physical literacy. Third, schools must collaborate with community stakeholders and organizations to ensure that programs are culturally inclusive and responsive. Fourth, schools can incorporate technology into their programs to enhance engagement and provide additional growth and learning opportunities.In conclusion, this study provides valuable insights into efficient strategies for structuring after-school programs of physical education that are inclusive, diverse, and engaging for all students. By considering these factors when designing and implementing their programs, schools can promote physical activity while supporting students’ overall well-being and health.

Keywords: after-school programs of physical education, community partnership, inclusivity, instructor training, technology

Procedia PDF Downloads 47

Authors: Fei Sun, Meilan Xu, Jianghui Zhu, Maria Stefanie Dwiyanti, Cheolwoo Park, Fanjiang Kong, Baohui Liu, Tetsuya Yamada, Jun Abe

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Reduced or lack of sensitivity to long daylengths is a key character for soybean, a short-day crop, to adapt to higher latitudinal environments. However, the photoperiod-insensitivity often results in a reduction of the duration of vegetative growth and final yield. To overcome this limitation, a photoperiod insensitive line (RIL16) was developed in this study that delayed flowering from the recombinant inbred population derived from a cross between a photoperiod-insensitive cultivar AGS292 and a late-flowering Thai cultivar K3. Expression analyses under SD and LD conditions revealed that the expression levels of FLOWERING LOCUS T (FT) orthologues, FT2a and FT5a, were lowered in RIL16 relative to AGS292, although the expression of E1, a soybean-specific suppressor for FTs, was inhibited in both conditions. A soybean orthologue of TARGET OF EAT1 (TOE1), another suppressor of FT, showed an upregulated expression in RIL16, which appeared to reflect a lower expression of miR172a. Our data suggest that the delayed flowering of RIL16 most likely is controlled by genes involved in an age-dependent pathway in flowering. The QTL analysis based on 1,125 SNPs obtained from Restriction Site Associated DNA Sequencing revealed two major QTLs for flowering dates in Chromosome 16 and two minor QTLs in Chromosome 4, all of which accounted for 55% and 48% of the whole variations observed in natural day length and artificially-induced long day length conditions, respectively. The intervals of the major QTLs harbored FT2a and FT5a, respectively, on the basis of annotated genes in the Williams 82 reference genome. Sequencing analysis further revealed a nonsynonymous mutation in FT2a and an SNP in the 3′ UTR region of FT5a. A further study may elucidate a detailed mechanism underlying the QTL for late flowering. The alleles from K3 at the two QTLs can be used singly or in combination to retain an appropriate duration of vegetative growth to maximize the final yield of photoperiod-insensitive soybeans.

Keywords: FT genes, miR72a, photoperiod-insensitive, soybean flowering

Procedia PDF Downloads 185

Authors: Rebecca S. Hock, Cyralene P. Bryce, Kevin Williams, Arielle G. Rabinowitz, Janina R. Galler

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Background: Findings have been mixed regarding whether offspring of parents who were abused or neglected as children have a greater risk of experiencing abuse or neglect themselves. In addition, many studies on this topic are restricted to physical abuse and take place in a limited number of countries, representing a small segment of the world's population. Methods: We examined relationships between childhood maltreatment history assessed in a subset (N=68) of the original longitudinal birth cohort (G1) of the Barbados Nutrition Study and their now-adult offspring (G2) (N=111) using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We used Pearson correlations to assess relationships between parent and offspring CTQ-SF total and subscale scores (physical, emotional, and sexual abuse; physical and emotional neglect). Next, we ran multiple regression analyses, using the parental CTQ-SF total score and the parental Sexual Abuse score as primary predictors separately in our models of G2 CTQ-SF (total and subscale scores). Results: G1 total CTQ-SF scores were correlated with G2 offspring Emotional Neglect and total scores. G1 Sexual Abuse history was significantly correlated with G2 Emotional Abuse, Sexual Abuse, Emotional Neglect, and Total Score. In fully-adjusted regression models, parental (G1) total CTQ-SF scores remained significantly associated with G2 offspring reports of Emotional Neglect, and parental (G1) Sexual Abuse was associated with offspring (G2) reports of Emotional Abuse, Physical Abuse, Emotional Neglect, and overall CTQ-SF scores. Conclusions: Our findings support a link between parental exposure to childhood maltreatment and their offspring's self-reported exposure to childhood maltreatment. Of note, there was not an exact correspondence between the subcategory of maltreatment experienced from one generation to the next. Compared with other subcategories, G1 Sexual Abuse history was the most likely to predict G2 offspring maltreatment. Further studies are needed to delineate underlying mechanisms and to develop intervention strategies aimed at preventing intergenerational transmission.

Keywords: trauma, family, adolescents, intergenerational trauma, child abuse, child neglect, global mental health, North America

Procedia PDF Downloads 56

Authors: Eric Beyegue, Boris Azantza, Judith Laure Ngondi, Julius E. Oben

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Background: Dietary supplement may potentially help to fight obesity and other metabolic disorders such as adipogenesis, insulin resistance, and inflammation. The present study aimed to test whether supplementation with African walnuts (Aw) could have an effect on adipogenesis and others dysfunctions associated with obesity in rats. Methods: Wistar rats were fed with standard diet (SD) or high-fat high-sucrose diet (HFS) and HFS with supplemented (HFS-Aw) for eight weeks. Results: HFS diet-induced body weight gain and increased fat mass compared to SD. In addition HFS-fed rats developed fasting hyperglycaemia and insulinaemia as well as insulin resistance. Aw supplementation in HFS rats had a protective effect against adipose tissues weigh gain but slightly against body weight gain and major study related disorders. This could be mainly due to decreased food intake dependently of effect in food intake in central nervous system, which decreased in HFS rats supplemented with African walnut compared to the HFS-diet group. Interestingly, African walnut supplementation induced a slight decrease of fasting glycaemia, insulinaemia and Nitric Oxide which could partially explain its minor protective effect against diet-induced insulin resistance. Additionally a decrease in hepatic TG and transaminases levels suggesting a protective effect against liver injury. Conclusion: Taken together these data suggested that supplementation of African walnut could be used to prevent adipose weight gain and related disorders on the other hand, minimally reduced insulin resistance.

Keywords: African walnut, dietary fiber, insulin resistance, oxidative stress

Procedia PDF Downloads 256

Authors: Justin D. Olmanson, Fitsum Abebe, Valerie Jones, Eric Kyle, Xianquan Liu, Katherine Robbins, Guieswende Rouamba

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The history of education technology--and designing, adapting, and adopting technologies for use in educational spaces--is nuanced, complex, and dynamic. Yet, despite a range of continually emerging technologies, the design and development process often yields results that appear quite similar in terms of affordances and interactions. Through this study we (1) verify the extent to which designs have been constrained, (2) consider what might account for it, and (3) offer a way forward in terms of how we might identify and strategically sidestep these influences--thereby increasing the diversity of our designs with a given technology or within a particular learning domain. We begin our inquiry from the perspective that a host of co-influencing elements, fields, and meta narratives converge on the education technology design process to exert a tangible, often homogenizing effect on the resultant designs. We identify several elements that influence design in often implicit or unquestioned ways (e.g. curriculum, learning theory, economics, learning context, pedagogy), we describe our methodology for identifying the elemental positionality embedded in a design, we direct our analysis to a particular subset of technologies in the field of literacy, and unpack our findings. Our early analysis suggests that the majority of education technologies designed for use/used in US public schools are heavily influenced by a handful of mainstream theories and meta narratives. These findings have implications for how we approach the education technology design process--which we use to suggest alternative methods for designing/ developing with emerging technologies. Our analytical process and re conceptualized design process hold the potential to diversify the ways emerging and established technologies get incorporated into our designs.

Keywords: curriculum, design, innovation, meta narratives

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Authors: Eric Gismondi, Aurelie Bigot-Clivot

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Endocrine disruptors (EDCs) are well known to disrupt the development and the reproduction of exposed organisms. Although this point has been studied in vertebrate models, the limited knowledge of the endocrine system of invertebrates makes the evaluation of EDCs effects difficult. However, invertebrates represent the major part of aquatic ecosystems, such as amphipods Gammaridea, which are crucial for their functioning (e.g., litter degradation, food resource). Moreover, gammarids are hosts of parasites such as vertically-transmitted microsporidia (microsporidia VT), which could be confounding factors in assessment of EDC effects. Indeed, some microsporidia VT could have endocrine effects by their own present in the host since it was observed for example, a feminization of juvenile males, which become phenotypic females. This work evaluated the impact of ethinylestradiol (EE₂, estrogenic), cyproterone acetate (CPA, anti-androgenic), 4-hydroxytamoxifen (4HT, anti-estrogenic) and 17α-methyltestosterone (17MT - androgenic), on the 20-hydroxyecdysone concentration (i.e. 20HE - molt process) and the vitellogenin gene expression (i.e. reproduction) in the freshwater amphipod Gammarus pulex, after a 96h laboratory exposure. In addition, the presence of microsporidia VT was verified in order to analyze the effect of this confounding factor. Results of this study shown that, although endocrine systems of invertebrates and vertebrates are different, EDCs proved in vertebrates could also affect biological functions hormonally controlled in invertebrates. Indeed, the molt process of crustaceans was disrupted in the first stage (i.e. 20-HE concentration) and therefore, could affect, at the long term, the population dynamic. In addition, it was observed that G. pulex was differently impacted according to the gender and parasitism, which underline the importance to take into account these confounding factors to better evaluate the EDCs impact on invertebrate populations.

Keywords: endocrine disruption, gammarus sp., molt, parasitism

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Authors: Julius K. Gane, Mohamad N. Nahil, Paul T. Williams

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In today’s world of rapid population growth and a changing climate, one way to mitigate various negative effects is via renewable energy solutions. Energy and power as basic requirements in almost all human endeavours are also the banes of the changing climate and the impacts thereof. Thus it is crucial to develop innovative and environmentally friendly energy options to ameliorate various negative repercussions. Upgrading of fast pyrolysis bio-oil via hydro-treatment offers such opportunities, as quality renewable liquid transportation fuels can be produced. The process, however, is typically accompanied by bio-char formation as a by-product. The goal of this work was to study the yield and some properties of bio-chars formed from a hydrotreatment process, with an overall aim to promote the valuable utilization of wastes or by-products from renewable energy technologies. It is assumed that bio-chars that have comparable energy contents with coals will be more desirable as solid energy materials due to renewability and environmental friendliness. Therefore, the analytical work in this study focused mainly on determining the higher heating value (HHV) of the chars. The method involved the reaction of bio-oil in an autoclave supplied by the Parr Instrument Company, IL, USA. Two main parameters (different temperatures and resident times) were investigated. The chars were characterized using a Thermo EA2000 CHNS analyser, then oxygen contents and HHVs computed based on the literature. From the results, these bio-chars can readily serve as feedstocks for the production of renewable solid fuels. Their HHVs ranged between 29.26-39.18 MJ/kg, affected by different temperatures and retention times. There was an inverse relationship between the oxygen content and the HHVs of the chars. It can, therefore, be concluded that it is possible to optimize the process efficiency of the hydrotreatment process used through the production of renewable energy materials from the 'waste’ char by-products. Future work should consider developing a suitable balance between the primary objective of bio-oil upgrading processes (which is to improve the quality of the liquid fuels) and the conversion of its solid wastes into value-added products such as smokeless briquettes.

Keywords: bio-char, renewable solid biofuels, valorisation, waste-to-energy

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Authors: Ju May Wen, Chun Hung Lin, Eric Zhi Feng Liu

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Flow theory implies that people are persuaded by happiness. By focusing on an activity, people turn a blind eye to external factors. This study explores the influence of educational board games and fundamental Chinese language teaching on students’ learning motivation and flow experience. Fifty-three students studying Chinese language fundamental courses were used in the study. These students were divided into three groups: (1) flash card teaching group; (2) educational original board game teaching group; and (3) educational Chinese board game teaching group. Chinese language teaching was integrated with the educational board game titled ‘Transportation GO.’ The students were observed playing this game as the teacher collected quantitative and qualitative data. Quantitative data was collected from the learning motivation scale and flow experience scale. Qualitative data was collected through observing, recording, and visiting. The first result found that the three groups integrated with Chinese language teaching could maintain students’ high learning motivation and high flow experience. Second, there was no significant difference between the flow experience of the flash card group and the educational original board game group. Third, there was a significant difference in the flow experience and learning motivation of the educational Chinese board game group vs. the other groups. This study suggests that the experimental model can be applied to advanced Chinese language teaching. Apart from oral and literacy skills, the study of educational board games integrated with Chinese language teaching to enforce student writing skills will be continued.

Keywords: Chinese language instruction, educational board game, learning motivation, flow experience

Procedia PDF Downloads 148

Authors: Lohendy Munoz-Vargas, Stephen O. Opiyo, Rose Digianantonio, Michele L. Williams, Asela Wijeratne, Gregory Habing

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Non-typhoidal Salmonella enterica is a zoonotic pathogen with critical importance in animal and public health. The persistence of Salmonella on farms affects animal productivity and health, and represents a risk for food safety. The intestinal microbiota plays a fundamental role in the colonization and invasion of this ubiquitous microorganism. To overcome the colonization resistance imparted by the gut microbiome, Salmonella uses invasion strategies and the host inflammatory response to survive, proliferate, and establish infections with diverse clinical manifestations. Cattle serve as reservoirs of Salmonella, and periparturient cows have high prevalence of Salmonella shedding; however, to author`s best knowledge, little is known about the association between the gut microbiome and the onset of Salmonella shedding during the periparturient period. Thus, the objective of this study was to assess the association between changes in bacterial communities and the onset of Salmonella shedding in cattle approaching parturition. In a prospective cohort study, fecal samples from 98 dairy cows originating from four different farms were collected at four time points relative to calving (-3 wks, -1 wk, +1 wk, +3 wks). All 392 samples were cultured for Salmonella. Sequencing of the V4 region of the 16S rRNA gene using the Illumina platform was completed to evaluate the fecal microbiome in a selected sample subset. Analyses of microbial composition, diversity, and structure were performed according to time points, farm, and Salmonella onset status. Individual cow fecal microbiomes, predominated by Bacteroidetes, Firmicutes, Spirochaetes, and Proteobacteria phyla, significantly changed before and after parturition. Microbial communities from different farms were distinguishable based on multivariate analysis. Although there were significant differences in some bacterial taxa between Salmonella positive and negative samples, our results did not identify differences in the fecal microbial diversity or structure for cows with and without the onset of Salmonella shedding. These data suggest that determinants other than the significant changes in the fecal microbiome influence the periparturient onset of Salmonella shedding in dairy cattle.

Keywords: dairy cattle, microbiome, periparturient, Salmonella

Procedia PDF Downloads 142

Authors: Eric Sitorus, Septian Prahastudhi, Turgod Nainggolan, Erwin Riyanto

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Mining by block or panel caving is a mining method that takes advantage of fractures within an ore body, coupled with gravity, to extract material from a predetermined column of ore. The caving column is weakened from beneath through the use of undercutting, after which the ore breaks up and is extracted from below in a continuous cycle. The nature of this method induces cyclical stresses on the pillars of excavations as stress is built up and released over time, which has a detrimental effect on both the installed ground support and the rock mass itself. Ground support capacity, especially on the production where excavation void ratio is highest, is subjected to heavy loading. Strain above threshold of the elongation of support capacity can yield resulting in damage to excavations. Geotechnical engineers must evaluate not only the remnant capacity of ground support systems but also investigate depth of rock mass yield within pillars, backs and floors. Ground Penetrating Radar (GPR) is a geophysical method that has the ability to evaluate rock mass damage using electromagnetic waves. This paper illustrates a case study from the Grasberg mining complex where non-invasive information on the depth of damage and condition of the remaining rock mass was required. GPR with 100 MHz antenna resolution was used to obtain images of the subsurface to determine rehabilitation requirements prior to recommencing production activities. The GPR surveys were used to calibrate the reflection coefficient response of varying rock mass conditions to known Rock Quality Designation (RQD) parameters observed at the mine. The calibrated GPR survey allowed site engineers to map subsurface conditions and plan rehabilitation accordingly.

Keywords: block caving, ground penetrating radar, reflectivity, RQD

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Authors: Mina Kalantarzadeh, Claire Lockie-Williams, Caroline Howard

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DNA barcoding is increasingly used for identification of medicinal plants worldwide. In the last decade, a large number of DNA barcodes have been generated, and their application in species identification explored. The success of DNA barcoding process relies on the accuracy of the results from polymerase chain reaction (PCR) amplification step which could be negatively affected due to a presence of inhibitors or degraded DNA in herbal samples. An established DNA reference material can be used to support molecular characterisation protocols and prove system suitability, for fast and accurate identification of plant species. The present study describes the use of a novel reference material, the trnH-psbA British Pharmacopoeia Nucleic Acid Reference Material (trnH-psbA BPNARM), which was produced to aid in the identification of Ocimum tenuiflorum L., a widely used herb. During DNA barcoding of O. tenuiflorum, PCR amplifications of isolated DNA produced inconsistent results, suggesting an issue with either the method or DNA quality of the tested samples. The trnH-psbA BPNARM was produced and tested to check for the issues caused during PCR amplification. It was added to the plant material as control DNA before extraction and was co-extracted and amplified by PCR. PCR analyses revealed that the amplification was not as successful as expected which suggested that the amplification is affected by presence of inhibitors co-extracted from plant materials. Various potential issues were assessed during DNA extraction and optimisations were made accordingly. A DNA barcoding protocol for O. tenuiflorum was published in the British Pharmacopoeia 2016, which included the reference sequence. The trnH-psbA BPNARM accelerated degradation test which investigates the stability of the reference material over time demonstrated that it has been stable when stored at 56 °C for a year. Using this protocol and trnH-psbA reference material provides a fast and accurate method for identification of O. tenuiflorum. The optimisations of the DNA extraction using the trnH-psbA BPNARM provided a signposting method which can assist in overcoming common problems encountered when using molecular methods with medicinal plants.

Keywords: degradation, DNA extraction, nucleic acid reference material, trnH-psbA

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Authors: Eric Yi-Hsiu Huang, Meng-Chun Kao, Wen-Chuan Kuo

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For every laparoscopic surgery, a safe pneumoperitoneumcreation (gaining access to the peritoneal cavity) is the first and essential step. However, closed pneumoperitoneum is usually obtained by blind insertion of a Veress needle into the peritoneal cavity, which may carry potential risks suchas bowel and vascular injury.Until now, there remains no definite measure to visually confirm the position of the needle tip inside the peritoneal cavity. Therefore, this study established an image-guided Veress needle method by combining a fiber probe with optical coherence tomography (OCT). An algorithm was also proposed for determining the exact location of the needle tip through the acquisition of OCT images. Our method not only generates a series of “live” two-dimensional (2D) images during the needle puncture toward the peritoneal cavity but also can eliminate operator variation in image judgment, thus improving peritoneal access safety. This study was approved by the Ethics Committee of Taipei Veterans General Hospital (Taipei VGH IACUC 2020-144). A total of 2400 in vivo OCT images, independent of each other, were acquired from experiments of forty peritoneal punctures on two piglets. Characteristic OCT image patterns could be observed during the puncturing process. The ROC curve demonstrates the discrimination capability of these quantitative image features of the classifier, showing the accuracy of the classifier for determining the inside vs. outside of the peritoneal was 98% (AUC=0.98). In summary, the present study demonstrates the ability of the combination of our proposed automatic identification method and OCT imaging for automatically and objectively identifying the location of the needle tip. OCT images translate the blind closed technique of peritoneal access into a visualized procedure, thus improving peritoneal access safety.

Keywords: pneumoperitoneum, optical coherence tomography, automatic identification, veress needle

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

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Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

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Authors: Andreas Ateke Njoh, Shalom Tchokfe Ndoula, Amani Adidja, Germain Nguessan Menan, Annie Mengue, Eric Mboke, Hassan Ben Bachir, Sangwe Clovis Nchinjoh, Yauba Saidu, Laurent Cleenewerck De Kiev

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Vaccines serve a great deal in protecting the population globally. Vaccine products are subject to rigorous quality control and approval before use to ensure safety. Even if all actors take the required precautions, some people could still have adverse events following immunization (AEFI) caused by the vaccine composition or an error in its administration. AEFI underreporting is pronounced in low-income settings like Cameroon. The Country introduced electronic platforms to strengthen surveillance. With the introduction of many novel vaccines, like COVID-19 and the novel Oral Polio Vaccine (nOPV) 2, there was a need to monitor AEFI in the Country. A cross-sectional study was conducted from July to December 2022. Data on AEFI per region of Cameroon were reviewed for the past five years. Data were analyzed with MS Excel, and the results were presented in proportions. AEFI reporting was uncommon in Cameroon. With the introduction of novel vaccines in 2021, the health authorities engaged in new tools and training to capture cases. AEFI detected almost doubled using the open data kit (ODK) compared to previous platforms, especially following the introduction of the nOPV2 and COVID-19 vaccines. The AEFI rate was 1.9 and 160 per administered 100 000 doses of nOPV2 and COVID-19 vaccines, respectively. This mobile tool captured individual information for people with AEFI from all regions. The platform helped to identify common AEFI following the use of these new vaccines. The ODK mobile technology was vital in improving AEFI reporting and providing data to monitor using new vaccines in Cameroon.

Keywords: adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK

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Authors: Hugo Carronnier, Wassim Almouallem, Eric Branquet

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Per- and polyfluoroalkyl Substances (PFAS) are a group of man-made refractory compounds that have been widely used in a variety of industrial and commercial products since the 1940s, leading to contamination of groundwater and surface water systems. They are persistent, bioaccumulative and toxic chemicals. Foam fractionation is a potential remedial technique for treating PFAS-contaminated water, taking advantage of the high surface activity to remove them from the solution by adsorption onto the surface of the air bubbles. Nevertheless, traditional foam fractionation technology developed for PFAS is challenging and found to be ineffective in treating the less surface-active compounds. Different chemicals were the subject of investigation as amendments to achieve better removal. However, most amendments are toxic, expensive and complicated to use. In this situation, patent-pending PFAS technology overcomes these challenges by using rather biological amendments. Results from the first laboratory trial showed remarkable results using a simple and cheap BioFoam Fractionation (BioFF) process based on biomimetics. The study showed that the BioFF process is effective in removing greater than 99% of PFOA (C8), PFOS (C8), PFHpS (C7) and PFHxS (C6) in PFAS-contaminated water. For other PFAS such as PFDA (C10) and 6:2 FTAB, a slightly less stable removal between 94% and 96% was achieved while between 34% and 73% removal efficiency was observed for PFBA (C4), PFBS (C4), PFHxA (C6), and Gen-X. In sum, the advantages of the BioFF presented as a low-waste production, a cost and energy-efficient operation and the use of a biodegradable amendment requiring no separation step after treatment, coupled with these first findings, suggest that the BioFF process is a highly applicable treatment technology for PFAS contaminated water. Additional investigations are currently carried on in order to optimize the process and establish a promising strategy for on-site PFAS remediation.

Keywords: PFAS, treatment, foam fractionation, contaminated amendments

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Authors: Siobhan Hegarty, Michael Bloomfield, Kim Entholt, Dorothy Williams, Helen Kennerley

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Complex Post-Traumatic Stress Disorder (CPTSD) confers greater risk of poor outcomes than does Post-Traumatic Stress Disorder (PTSD). Despite this, the current treatment guidelines for CPTSD aim to reduce only the ‘core’ symptoms of re-experiencing, hyper-vigilance and avoidance, while not addressing the Disturbances of Self Organisation (DSO) symptoms that distinguish this novel diagnosis from PTSD. The Recovering from Child Abuse Programme (RCAP) is a group protocol, based on the principles of cognitive behavioural therapy (CBT). Preliminary evidence suggests the program is effective at reducing DSO symptoms. This pilot study is the first to investigate the potential effectiveness of the RCAP for the specific treatment of CPTSD. This study was conducted as a service evaluation in a secondary care, traumatic stress service. Treatment was delivered once a week, in two-hour sessions, to ten existing female CPTSD patients of the service, who had experienced sexual abuse in childhood. The programme was administered by two therapists and two additional facilitators, following the RCAP protocol manual. Symptom severity was measured before the administration of therapy and was tracked across a range of measures (International Trauma Questionnaire; Patient Health Questionnaire; Community Assessment of Psychic Experience; Work and Social Adjustment Scale) at five time points, over the course of treatment. Qualitative appraisal of the programme was gathered via weekly feedback forms and from audio-taped recordings of verbal feedback given during group sessions. Preliminary results suggest the programme causes a slight reduction in CPTSD and depressive symptom severity and preliminary qualitative analysis suggests that the RCAP is both helpful and acceptable to group members. Final results and conclusions will follow completed thematic analysis of results.

Keywords: Child sexual abuse, Cognitive behavioural therapy, Complex post-traumatic stress disorder, Recovering from child abuse programme

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Authors: Eric Muñoz de la Torre, Julián González Trinidad, Efrén González Ramírez

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Rain varies greatly in its duration, intensity, and spatial coverage, it is important to have sub-daily rainfall data for various applications, including risk prevention. However, the ground measurements are limited by the low and irregular density of rain gauges. An alternative to this problem are the Satellite Precipitation Products (SPPs) that use passive microwave and infrared sensors to estimate rainfall, as IMERG, however, these SPPs have to be validated before their application. The aim of this study is to evaluate the performance of the IMERG: Integrated Multi-satellitE Retrievals for Global Precipitation Measurament final run V06B SPP in a semi-arid region of Mexico, using 4 automatic rain gauges (pluviographs) sub-daily data of October 2019 and June to September 2021, using the Minimum inter-event Time (MIT) criterion to separate unique rain events with a dry period of 10 hrs. for the purpose of evaluating the rainfall properties (depth, duration and intensity). Point to pixel analysis, continuous, categorical, and volumetric statistical metrics were used. Results show that IMERG is capable to estimate the rainfall depth with a slight overestimation but is unable to identify the real duration and intensity of the rain events, showing large overestimations and underestimations, respectively. The study zone presented 80 to 85 % of convective rain events, the rest were stratiform rain events, classified by the depth magnitude variation of IMERG pixels and pluviographs. IMERG showed poorer performance at detecting the first ones but had a good performance at estimating stratiform rain events that are originated by Cold Fronts.

Keywords: IMERG, rainfall, rain gauge, remote sensing, statistical evaluation

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Authors: Christina Williams, Mehari Weldemariam, Ann M. Farese, Thomas J. MacVittie, Maureen A. Kane

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Radiation exposure results in dose-dependent and time-dependent multi-organ damage. Drug development of medical countermeasures (MCM) for radiation-induced injury occurs under the FDA Animal Rule because human efficacy studies are not ethical or feasible. The FDA Animal Rule requires the representation of both sexes and describes several uses for biomarkers in MCM drug development studies. Currently, MCMs are limited and there is no FDA-approved biomarker for any radiation injury. Sex as a variable is essential to identifying biomarkers and developing effective MCMs for acute radiation exposure (ARS) and delayed effects of acute radiation exposure (DEARE). These studies aim to address the death of information on sex differences that have not been determined by studies that included only male, single-sex cohorts. Studies have reported differences in radiosensitivity according to sex. As such, biomarker discovery for radiation-induced damage must consider sex as a variable. This study evaluated the plasma proteomic profile of Rhesus macaque non-human primates after different exposures and doses, as well as time points after radiation. Exposures and doses included total body irradiation between 5-7.5 Gy and partial body irradiation with 5% bone marrow sparing at 9, 9.5 and 10 Gy. Timepoints after irradiation included days 1, 3, 60, and 180, which encompassed both acute radiation syndromes and delayed effects of acute radiation exposure. Bottom-up proteomic analyses of plasma included equal numbers of males and females. In the control animals, few proteomic differences are observed between the sexes. In the irradiated animals, there are a few sex differences, with changes mostly consisting of proteins upregulated in the female animals. Multiple canonical pathways were upregulated in irradiated animals relative to the control animals when subjected to pathway analysis, but differential responses between the sexes are limited. These data provide critical baseline differences according to sex and establish sex differences in non-human primate models relevant to drug development of MCM under the FDA Animal Rule.

Keywords: ionizing radiation, sex differences, plasma proteomics, biomarker discovery

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Authors: Masita Mokeira, Kimani Rita, Obonyo Brian, Kwenda Kennedy, Mugambi Purity, Kirui Joan, Chomba Eric, Orwa Daniel, Waiganjo Peter

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Rugby is a highly intense and physical game requiring speed and strength. The need for physical fitness therefore cannot be over-emphasized. Sports are no longer about lifting weights so as to build muscle. Most professional teams are investing much more in the sport in terms of time, equipment and other resources. To play competitively, Kenyan players may therefore need to complement their ‘home-grown’ and sometimes ad-hoc training and nutrition regimes with carefully measured strength and conditioning, diet, nutrition, and supplementation. Nokia Research Center and University of Nairobi conducted an exploratory study on needs and behaviours surrounding sports in Africa. Rugby being one sport that is gaining ground in Kenya was selected as the main focus. The end goal of the research was to identify areas where mobile technology could be used to address gaps, challenges and/or unmet needs. Themes such as information gap, social culture, growth, and development, revenue flow, and technology adoption among others emerged about the sport. From the growth and development theme, it was clear that as rugby continues to grow in the country, teams, coaches, and players are employing interesting techniques both in training and playing. Though some of these techniques are indeed scientific, those employing them are sometimes not fully aware of their scientific basis. A further case study on sports science in rugby in Kenya focusing on physical fitness and nutrition revealed interesting findings. This paper discusses findings on emerging adoption of techniques in managing physiological and nutritional needs of rugby players across different levels of rugby in Kenya namely high school, club and national levels.

Keywords: rugby, nutrition, physiological needs, sports science

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Authors: Arwin Malabanan, Carl Chester Ragudo, Jerome Tadiosa, John Dee Mangoba, Eric Augustus Tingatinga, Romeo Eliezer Longalong

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Concrete hollow blocks (CHB) are the most commonly used masonry block for walls in residential houses, school buildings and public buildings in the Philippines. During the recent 2013 Bohol earthquake (Mw 7.2), it has been proven that CHB walls are very vulnerable to severe external action like strong ground motion. In this paper, a numerical model of CHB structures is proposed, and seismic behavior of CHB houses is presented. In modeling, the Rigid Body Spring-Discrete Element method (RBS-DEM)) is used wherein masonry blocks are discretized into rigid elements and connected by nonlinear springs at preselected contact points. The shear and normal stiffness of springs are derived from the material properties of CHB unit incorporating the grout and mortar fillings through the volumetric transformation of the dimension using material ratio. Numerical models of reinforced and unreinforced walls are first subjected to linearly-increasing in plane loading to observe the different failure mechanisms. These wall models are then assembled to form typical model masonry houses and then subjected to the El Centro and Pacoima earthquake records. Numerical simulations show that the elastic, failure and collapse behavior of the model houses agree well with shaking table tests results. The effectiveness of the method in replicating failure patterns will serve as a basis for the improvement of the design and provides a good basis of strengthening the structure.

Keywords: concrete hollow blocks, discrete element method, earthquake, rigid body spring model

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Authors: A. Anastasopoulou, A. Kolios, T. Somorin, A. Sowale, Y. Jiang, B. Fidalgo, A. Parker, L. Williams, M. Collins, E. J. McAdam, S. Tyrrel

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Developing countries are nowadays confronted with great challenges related to domestic sanitation services in view of the imminent water scarcity. Contemporary sanitation technologies established in these countries are likely to pose health risks unless waste management standards are followed properly. This paper provides a solution to sustainable sanitation with the development of an innovative toilet system, called Nano Membrane Toilet (NMT), which has been developed by Cranfield University and sponsored by the Bill & Melinda Gates Foundation. The particular technology converts human faeces into energy through gasification and provides treated wastewater from urine through membrane filtration. In order to evaluate the environmental profile of the NMT system, a deterministic life cycle assessment (LCA) has been conducted in SimaPro software employing the Ecoinvent v3.3 database. The particular study has determined the most contributory factors to the environmental footprint of the NMT system. However, as sensitivity analysis has identified certain critical operating parameters for the robustness of the LCA results, adopting a stochastic approach to the Life Cycle Inventory (LCI) will comprehensively capture the input data uncertainty and enhance the credibility of the LCA outcome. For that purpose, Monte Carlo simulations, in combination with an artificial neural network (ANN) model, have been conducted for the input parameters of raw material, produced electricity, NO_X emissions, amount of ash and transportation of fertilizer. The given analysis has provided the distribution and the confidence intervals of the selected impact categories and, in turn, more credible conclusions are drawn on the respective LCIA (Life Cycle Impact Assessment) profile of NMT system. Last but not least, the specific study will also yield essential insights into the methodological framework that can be adopted in the environmental impact assessment of other complex engineering systems subject to a high level of input data uncertainty.

Keywords: sanitation systems, nano-membrane toilet, lca, stochastic uncertainty analysis, Monte Carlo simulations, artificial neural network

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Authors: Kanupriya Rawat, Aleksandra Błachnio, Paweł Izdebski

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Achievement motivation, which drives a person to strive for success, is an important construct in sports psychology. This systematic review aims to analyze the methods of measuring achievement motivation used in previous studies published over the past four decades and to find out which method of measuring achievement motivation is the most prevalent and the most effective by thoroughly examining measures of achievement motivation used in each study and by evaluating most highly cited achievement motivation measures in sport. In order to understand this latent construct, thorough measurement is necessary, hence a critical evaluation of measurement tools is required. The literature search was conducted in the following databases: EBSCO, MEDLINE, APA PsychARTICLES, Academic Search Ultimate, Open Dissertations, ERIC, Science direct, Web of Science, as well as Wiley Online Library. A total of 26 articles met the inclusion criteria and were selected. From this review, it was found that the Achievement Goal Questionnaire- Sport (AGQ-Sport) and the Task and Ego Orientation in Sport Questionnaire (TEOSQ) were used in most of the research, however, the average weighted impact factor of the Achievement Goal Questionnaire- Sport (AGQ-Sport) is the second highest and most relevant in terms of research articles related to the sport psychology discipline. Task and Ego Orientation in Sport Questionnaire (TEOSQ) is highly popular in cross-cultural adaptation but has the second last average IF among other scales due to the less impact factor of most of the publishing journals. All measures of achievement motivation have Cronbach’s alpha value of more than .70, which is acceptable. The advantages and limitations of each measurement tool are discussed, and the distinction between using implicit and explicit measures of achievement motivation is explained. Overall, both implicit and explicit measures of achievement motivation have different conceptualizations of achievement motivation and are applicable at either the contextual or situational level. The conceptualization and degree of applicability are perhaps the most crucial factors for researchers choosing a questionnaire, even though they differ in their development, reliability, and use.

Keywords: achievement motivation, task and ego orientation, sports psychology, measures of achievement motivation

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Authors: Eric Noe Hernandez Rodriguez, Cristian Esneider Penuela Cruz

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Magnesium is a biocompatible and biodegradable material that has gained increased interest for application in resorbable orthopedic implants. However, to date, much research is being conducted to overcome the main disadvantage: its low corrosion resistance. In this work, we report our findings on the development and application of TiO₂-MgO coatings to improve and modulate the corrosion resistance of magnesium pieces. The plasma electrolytic oxidation (PEO) technique was employed to obtain the TiO₂-MgO coatings. The effect of the experimental parameters on the modulation of the TiO₂:MgO ratio was investigated. The most critical parameters were the chemical composition of the precursor electrolytic solution and the current density. According to scanning electron microscopy (SEM) observations, the coatings were porous; however, they become more compact as the current density increases. XRD measurements showed that the coatings are formed by a composite consisting of TiO₂ and MgO oxides, whose ratio can be changed by the experimental conditions. TiO₂ had the anatase crystalline structure, while the MgO had the FCC crystalline structure. The corrosion resistance was evaluated through the corrosion current (Icorr) measured at room temperature by the polarization technique (Tafel). For doing it, Hank's solution was used in order to simulate the body fluids. Also, immersion tests were conducted. Tafel curves showed an improvement of the corrosion resistance at some coated magnesium pieces in contrast to control pieces (uncoated). Corrosion currents were lower, and the corrosion potential changed to positive values. It was observed that the experimental parameters allowed to modulate the protective capacity of the coatings by changing the TiO₂:MgO ratio. Coatings with a higher content of TiO₂ (measured by energy dispersive spectroscopy) showed higher corrosion resistance. Results showed that TiO₂-MgO coatings can be successfully applied to improve the corrosion resistance of Mg pieces in simulated body fluid; even more, the corrosion resistance can be tuned by changing the TiO₂:MgO ratio.

Keywords: biomaterials, PEO, corrosion resistance, magnesium

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Authors: Sidra Shaw, Sarenna Shaw, Chae Joon Lee, Irimpan Mathews, Eric Koehn

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One of the biggest public health concerns of our time is increasing antimicrobial resistance. As of 2019, the CDC has documented more than 2.8 million serious antibiotic resistant infections in the United States. Currently, antibiotic resistant infections are directly implicated in over 750,000 deaths per year globally. On our current trajectory, British economist Jim O’Neill predicts that by 2050, an additional 10 million people (about half the population of New York) will die annually due to drug resistant infections. As a result, new biochemical pathways must be targeted to generate next generation antibiotic drugs that will be effective against drug resistant bacteria. One enticing target is the biosynthesis of DNA within bacteria, as few drugs interrupt this essential life process. Thymidylate synthase enzymes are essential for life as they catalyze the synthesis of a DNA building block, 2′-deoxythymidine-5′-monophosphate (dTMP). In humans, the thymidylate synthase enzyme (TSase) has been shown to be distinct from the flavin-dependent thymidylate synthase (FDTS) produced by many pathogenic bacteria. TSase and FDTS have distinct structures and mechanisms of catalysis, which should allow selective inhibition of FDTS over human TSase. Currently, C. diff is one of the most antibiotic resistant bacteria, and no drugs that target thymine biosynthesis exist for C. diff. Here we present the initial biochemical characterization of FDTS from C. diff. Specifically, we examine enzyme kinetics and binding features of this enzyme to determine the nature of interaction with ligands/inhibitors and understand the molecular mechanism of catalysis. This research will provide more insight into the targetability of the C. diff FDTS enzyme for novel antibiotic drugs.

Keywords: flavin-dependent thymidylate synthase, FDTS, clostridioides difficile, C. diff, antibiotic resistance, DNA synthesis, enzyme kinetics, binding features

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Authors: Eric Wilson Santos Cabral, Marta Monteiro Da Costa Cruz, Rodrigo Pirola Pestana, Vivian Andréa Parreira

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In the transportation sector in Brazil, there is a great challenge that is the maintenance of profit in the face of the great variation in the price of diesel. This directly affects the variable cost of transport companies. Within the railways, part of the great challenges is to overcome the annual budget, cargo and ore transported, thus reducing costs compared to previous years, becoming more efficient each year. Within this scenario, the railway companies are looking for effective measures, aiming at reducing the ratio of liter of diesel consumed by KTKB (Kilometer Gross Ton multiplied by thousand). This ratio represents the indicator of energy efficiency of some railroads in Brazil and in other countries. In this study, we sought to analyze the behavior of the energy efficiency indicator on two parts: The first, with the application of technologies used in locomotives, such as the start-stop system of the diesel engine and the system of tracking and monitoring of fuel. The second, evaluation of the behavior of the variation of the type of cargo transported (loading mix). The study focused on locomotive technology will be carried out using statistical analysis, behavioral evaluation in different operating conditions, such as maneuvers for trains, service trains and freight trains. The analysis will also cover the evaluation of the loading mix made using statistical analysis of the existing railroad database, comparing the energy efficiency per loading mine and type of product. With the completion of this study, the railway undertakings should be able to better target decision-making in order to achieve substantial reductions in transport costs.

Keywords: railway transport, energy efficiency, railway technology, fuel consumption

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Authors: Eric Fang, Robert Chen, Ghim Song Chia, Bien Soo Tan

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Objective and Rationale: Training of radiology residents hinges on practical, on-the-job training in all facets and modalities of diagnostic radiology. Although residency is structured to be comprehensive, clinical exposure depends on the case mix available locally and during the posting period. To supplement clinical training, there are several e-learning resources available to allow for greater exposure to radiological cases. The objective of this study was to survey residents and faculty on the usefulness of these e-learning resources. Methods: E-learning resources were shortlisted with input from radiology residents, Google search and online discussion groups, and screened by their purported focus. Twelve e-learning resources were found to meet the criteria. Both radiology residents and experienced radiology faculty were then surveyed electronically. The e-survey asked for ratings on breadth, depth, testing capability and user-friendliness for each resource, as well as for rankings for the top 3 resources. Statistical analysis was performed using SAS 9.4. Results: Seventeen residents and fifteen faculties completed an e-survey. Mean response rate was 54% ± 8% (Range: 14- 96%). Ratings and rankings were statistically identical between residents and faculty. On a 5-point rating scale, breadth was 3.68 ± 0.18, depth was 3.95 ± 0.14, testing capability was 2.64 ± 0.16 and user-friendliness was 3.39 ± 0.13. Top-ranked resources were STATdx (first), Radiopaedia (second) and Radiology Assistant (third). 9% of responders singled out R-ITI as potentially good but ‘prohibitively costly’. Statistically significant predictive factors for higher rankings are familiarity with the resource (p = 0.001) and user-friendliness (p = 0.006). Conclusion: A good e-learning system will complement on-the-job training with a broad case base, deep discussion and quality trainee evaluation. Based on our study on twelve e-learning resources, no single program fulfilled all requirements. The perception and use of radiology e-learning resources depended more on familiarity and user-friendliness than on content differences and testing capability.

Keywords: e-learning, medicine, radiology, survey

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Authors: Eric York, James Tadio, Silas Owusu Antwi

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Laundry wastewater contains a diverse range of chemical pollutants that can have detrimental effects on human health and the environment. In this study, simulation studies by Spyder Python software v 3.2 to assess the efficacy of biochar in removing PO₄³⁻ from wastewater were conducted. Through modeling and simulation, the mechanisms involved in the adsorption process of phosphate by biochar were studied by altering variables which is specific to the phosphate from common laundry phosphate detergents, such as the aqueous solubility, initial concentration, and temperature using the Dudinin Approach (DA). Results showed that the concentration equilibrate at near the highest concentrations for Sugar beet-120 mgL⁻¹, Tailing-85 mgL⁻¹, CaO- rich-50 mgL⁻¹, Eggshell and rice straw-48 mgL⁻¹, Undaria Pinnatifida Roots-190 mgL⁻¹, Ca-Alginate Granular Beads -240 mgL⁻¹, Laminaria Japonica Powder -900 mgL⁻¹, Pinesaw dust-57 mgL⁻¹, Ricehull-190 mgL⁻¹, sesame straw- 470 mgL⁻¹, Sugar Bagasse-380 mgL⁻¹, Miscanthus Giganteus-240 mgL⁻¹, Wood Bc-130 mgL⁻¹, Pine-25 mgL⁻¹, Sawdust-6.8 mgL⁻¹, Sewage Sludge-, Rice husk-12 mgL⁻¹, Corncob-117 mgL⁻¹, Maize straw- 1800 mgL⁻¹ while Peanut -Eucalyptus polybractea-, Crawfish equilibrated at near concentration. CO₂ activated Thalia, sewage sludge biochar, Broussonetia Papyrifera Leaves equilibrated just at the lower concentration. Only Soyer bean Stover exhibited a sharp rise and fall peak in mid-concentration at 2 mgL⁻¹ volume. The modelling results were consistent with experimental findings from the literature, ensuring the accuracy, repeatability, and reliability of the simulation study. The simulation study provided insights into adsorption for PO₄³⁻ from wastewater by biochar using concentration per volume that can be adsorbed ideally under the given conditions. Studies showed that applying the principle experimentally in real wastewater with all its complexity is warranted and not far-fetched.

Keywords: simulation studies, phosphate removal, biochar, adsorption, wastewater treatment

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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

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

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

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