Search results for: Interim National Water Quality Standard for Malaysia (INWQS)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 23743

Search results for: Interim National Water Quality Standard for Malaysia (INWQS)

253 The Effects of Aging on Visuomotor Behaviors in Reaching

Authors: Mengjiao Fan, Thomson W. L. Wong

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It is unavoidable that older adults may have to deal with aging-related motor problems. Aging is highly likely to affect motor learning and control as well. For example, older adults may suffer from poor motor function and quality of life due to age-related eye changes. These adverse changes in vision results in impairment of movement automaticity. Reaching is a fundamental component of various complex movements, which is therefore beneficial to explore the changes and adaptation in visuomotor behaviors. The current study aims to explore how aging affects visuomotor behaviors by comparing motor performance and gaze behaviors between two age groups (i.e., young and older adults). Visuomotor behaviors in reaching under providing or blocking online visual feedback (simulated visual deficiency) conditions were investigated in 60 healthy young adults (Mean age=24.49 years, SD=2.12) and 37 older adults (Mean age=70.07 years, SD=2.37) with normal or corrected-to-normal vision. Participants in each group were randomly allocated into two subgroups. Subgroup 1 was provided with online visual feedback of the hand-controlled mouse cursor. However, in subgroup 2, visual feedback was blocked to simulate visual deficiency. The experimental task required participants to complete 20 times of reaching to a target by controlling the mouse cursor on the computer screen. Among all the 20 trials, start position was upright in the center of the screen and target appeared at a randomly selected position by the tailor-made computer program. Primary outcomes of motor performance and gaze behaviours data were recorded by the EyeLink II (SR Research, Canada). The results suggested that aging seems to affect the performance of reaching tasks significantly in both visual feedback conditions. In both age groups, blocking online visual feedback of the cursor in reaching resulted in longer hand movement time (p < .001), longer reaching distance away from the target center (p<.001) and poorer reaching motor accuracy (p < .001). Concerning gaze behaviors, blocking online visual feedback increased the first fixation duration time in young adults (p<.001) but decreased it in older adults (p < .001). Besides, under the condition of providing online visual feedback of the cursor, older adults conducted a longer fixation dwell time on target throughout reaching than the young adults (p < .001) although the effect was not significant under blocking online visual feedback condition (p=.215). Therefore, the results suggested that different levels of visual feedback during movement execution can affect gaze behaviors differently in older and young adults. Differential effects by aging on visuomotor behaviors appear on two visual feedback patterns (i.e., blocking or providing online visual feedback of hand-controlled cursor in reaching). Several specific gaze behaviors among the older adults were found, which imply that blocking of visual feedback may act as a stimulus to seduce extra perceptive load in movement execution and age-related visual degeneration might further deteriorate the situation. It indeed provides us with insight for the future development of potential rehabilitative training method (e.g., well-designed errorless training) in enhancing visuomotor adaptation for our aging population in the context of improving their movement automaticity by facilitating their compensation of visual degeneration.

Keywords: aging effect, movement automaticity, reaching, visuomotor behaviors, visual degeneration

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252 Modern Technology-Based Methods in Neurorehabilitation for Social Competence Deficit in Children with Acquired Brain Injury

Authors: M. Saard, A. Kolk, K. Sepp, L. Pertens, L. Reinart, C. Kööp

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Introduction: Social competence is often impaired in children with acquired brain injury (ABI), but evidence-based rehabilitation for social skills has remained undeveloped. Modern technology-based methods create effective and safe learning environments for pediatric social skills remediation. The aim of the study was to implement our structured model of neuro rehab for socio-cognitive deficit using multitouch-multiuser tabletop (MMT) computer-based platforms and virtual reality (VR) technology. Methods: 40 children aged 8-13 years (yrs) have participated in the pilot study: 30 with ABI -epilepsy, traumatic brain injury and/or tic disorder- and 10 healthy age-matched controls. From the patients, 12 have completed the training (M = 11.10 yrs, SD = 1.543) and 20 are still in training or in the waiting-list group (M = 10.69 yrs, SD = 1.704). All children performed the first individual and paired assessments. For patients, second evaluations were performed after the intervention period. Two interactive applications were implemented into rehabilitation design: Snowflake software on MMT tabletop and NoProblem on DiamondTouch Table (DTT), which allowed paired training (2 children at once). Also, in individual training sessions, HTC Vive VR device was used with VR metaphors of difficult social situations to treat social anxiety and train social skills. Results: At baseline (B) evaluations, patients had higher deficits in executive functions on the BRIEF parents’ questionnaire (M = 117, SD = 23.594) compared to healthy controls (M = 22, SD = 18.385). The most impaired components of social competence were emotion recognition, Theory of Mind skills (ToM), cooperation, verbal/non-verbal communication, and pragmatics (Friendship Observation Scale scores only 25-50% out of 100% for patients). In Sentence Completion Task and Spence Anxiety Scale, the patients reported a lack of friends, behavioral problems, bullying in school, and social anxiety. Outcome evaluations: Snowflake on MMT improved executive and cooperation skills and DTT developed communication skills, metacognitive skills, and coping. VR, video modelling and role-plays improved social attention, emotional attitude, gestural behaviors, and decreased social anxiety. NEPSY-II showed improvement in Affect Recognition [B = 7, SD = 5.01 vs outcome (O) = 10, SD = 5.85], Verbal ToM (B = 8, SD = 3.06 vs O = 10, SD = 4.08), Contextual ToM (B = 8, SD = 3.15 vs O = 11, SD = 2.87). ToM Stories test showed an improved understanding of Intentional Lying (B = 7, SD = 2.20 vs O = 10, SD = 0.50), and Sarcasm (B=6, SD = 2.20 vs O = 7, SD = 2.50). Conclusion: Neurorehabilitation based on the Structured Model of Neurorehab for Socio-Cognitive Deficit in children with ABI were effective in social skills remediation. The model helps to understand theoretical connections between components of social competence and modern interactive computerized platforms. We encourage therapists to implement these next-generation devices into the rehabilitation process as MMT and VR interfaces are motivating for children, thus ensuring good compliance. Improving children’s social skills is important for their and their families’ quality of life and social capital.

Keywords: acquired brain injury, children, social skills deficit, technology-based neurorehabilitation

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251 Three-Stage Least Squared Models of a Station-Level Subway Ridership: Incorporating an Analysis on Integrated Transit Network Topology Measures

Authors: Jungyeol Hong, Dongjoo Park

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The urban transit system is a critical part of a solution to the economic, energy, and environmental challenges. Furthermore, it ultimately contributes the improvement of people’s quality of lives. For taking these kinds of advantages, the city of Seoul has tried to construct an integrated transit system including both subway and buses. The effort led to the fact that approximately 6.9 million citizens use the integrated transit system every day for their trips. Diagnosing the current transit network is a significant task to provide more convenient and pleasant transit environment. Therefore, the critical objective of this study is to establish a methodological framework for the analysis of an integrated bus-subway network and to examine the relationship between subway ridership and parameters such as network topology measures, bus demand, and a variety of commercial business facilities. Regarding a statistical approach to estimate subway ridership at a station level, many previous studies relied on Ordinary Least Square regression, but there was lack of studies considering the endogeneity issues which might show in the subway ridership prediction model. This study focused on both discovering the impacts of integrated transit network topology measures and endogenous effect of bus demand on subway ridership. It could ultimately contribute to developing more accurate subway ridership estimation accounting for its statistical bias. The spatial scope of the study covers Seoul city in South Korea, and it includes 243 subway stations and 10,120 bus stops with the temporal scope set during twenty-four hours with one-hour interval time panels each. The subway and bus ridership information in detail was collected from the Seoul Smart Card data in 2015 and 2016. First, integrated subway-bus network topology measures which have characteristics regarding connectivity, centrality, transitivity, and reciprocity were estimated based on the complex network theory. The results of integrated transit network topology analysis were compared to subway-only network topology. Also, the non-recursive approach which is Three-Stage Least Square was applied to develop the daily subway ridership model as capturing the endogeneity between bus and subway demands. Independent variables included roadway geometry, commercial business characteristics, social-economic characteristics, safety index, transit facility attributes, and dummies for seasons and time zone. Consequently, it was found that network topology measures were significant size effect. Especially, centrality measures showed that the elasticity was a change of 4.88% for closeness centrality, 24.48% for betweenness centrality while the elasticity of bus ridership was 8.85%. Moreover, it was proved that bus demand and subway ridership were endogenous in a non-recursive manner as showing that predicted bus ridership and predicted subway ridership is statistically significant in OLS regression models. Therefore, it shows that three-stage least square model appears to be a plausible model for efficient subway ridership estimation. It is expected that the proposed approach provides a reliable guideline that can be used as part of the spectrum of tools for evaluating a city-wide integrated transit network.

Keywords: integrated transit system, network topology measures, three-stage least squared, endogeneity, subway ridership

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250 Neuroanatomical Specificity in Reporting & Diagnosing Neurolinguistic Disorders: A Functional & Ethical Primer

Authors: Ruairi J. McMillan

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Introduction: This critical analysis aims to ascertain how well neuroanatomical aetiologies are communicated within 20 case reports of aphasia. Neuroanatomical visualisations based on dissected brain specimens were produced and combined with white matter tract and vascular taxonomies of function in order to address the most consistently underreported features found within the aphasic case study reports. Together, these approaches are intended to integrate aphasiological knowledge from the past 20 years with aphasiological diagnostics, and to act as prototypal resources for both researchers and clinical professionals. The medico-legal precedent for aphasia diagnostics under Canadian, US and UK case law and the neuroimaging/neurological diagnostics relative to the functional capacity of aphasic patients are discussed in relation to the major findings of the literary analysis, neuroimaging protocols in clinical use today, and the neuroanatomical aetiologies of different aphasias. Basic Methodology: Literature searches of relevant scientific databases (e.g, OVID medline) were carried out using search terms such as aphasia case study (year) & stroke induced aphasia case study. A series of 7 diagnostic reporting criteria were formulated, and the resulting case studies were scored / 7 alongside clinical stroke criteria. In order to focus on the diagnostic assessment of the patient’s condition, only the case report proper (not the discussion) was used to quantify results. Statistical testing established if specific reporting criteria were associated with higher overall scores and potentially inferable increases in quality of reporting. Statistical testing of whether criteria scores were associated with an unclear/adjusted diagnosis were also tested, as well as the probability of a given criterion deviating from an expected estimate. Major Findings: The quantitative analysis of neuroanatomically driven diagnostics in case studies of aphasia revealed particularly low scores in the connection of neuroanatomical functions to aphasiological assessment (10%), and in the inclusion of white matter tracts within neuroimaging or assessment diagnostics (30%). Case studies which included clinical mention of white matter tracts within the report itself were distributed among higher scoring cases, as were case studies which (as clinically indicated) related the affected vascular region to the brain parenchyma of the language network. Concluding Statement: These findings indicate that certain neuroanatomical functions are integrated less often within the patient report than others, despite a precedent for well-integrated neuroanatomical aphasiology also being found among the case studies sampled, and despite these functions being clinically essential in diagnostic neuroimaging and aphasiological assessment. Therefore, ultimately the integration and specificity of aetiological neuroanatomy may contribute positively to the capacity and autonomy of aphasic patients as well as their clinicians. The integration of a full aetiological neuroanatomy within the reporting of aphasias may improve patient outcomes and sustain autonomy in the event of medico-ethical investigation.

Keywords: aphasia, language network, functional neuroanatomy, aphasiological diagnostics, medico-legal ethics

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249 The Use of Graphic Design Elements for Design of Newspaper for Women

Authors: Pibool Waijittragum

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This paper has its objectives to reveal contents and personality suitable to women’s newspapers. The research methodology employed in this study is the questionnaire which is derived from a literature review related to newspapers, graphic elements method for print media design and 12 sample sizes of different daily newspapers. In order to acquire an in-depth understanding and comprehensible view of desirable for a women’s newspaper design, graphic elements that related to that personality as well as other preferable elements for a women’s newspaper, including seven editorial Many Thai newspapers were offer a women’s documentary and column space. With its feminine looks, most of them appeared with warm tones and friendly mood through their headlines, contents, illustrations and graphics. The study found that most desirable personalities for a women’s newspaper design in Thailand are: Modern, Chic and Natural. Each personality has significant graphic elements as follows: 1. Modern: significant elements of modern personality comprises of the composition with graduation pattern which creates attractiveness by using an anomalous alignment layout grid and outstanding structure to create focal points and dynamic movement. Dark to black color that has narrowed, limited hue coupled with bright color tones. The round shape of the Thai font style was suitable for this concept. Such Thai fonts have harmonious proportion and consistent stroke with the urban-polite look. 2. Chic: significant elements of chic personality comprises of the proper composition with distinctive scale, using rhythmic repetition and a contrast of scale to draw in reader attention. Vivid and bright color tones with extensive hues coupled with similar color tones and round shape of the Thai font style with a light stroke and consistent line. 3. Natural: significant elements of natural personality comprises of the proper composition using rhythmic repetition that creates a focal point through striking images and harmonious perspective. Warm color tones with restricted hues that appear to look natural. Duo tone color was suitable through the gradually increasing gradient. The Thai style with hand writing font was suitable through the inconsistent stroke. There are 10 types of daily content that were revealed to be the most desirable for Thai women readers, these are: Daily News, Economics News, Education News, Entertainment News, International news, Political News, Public Health News, Scientific News, Social News and Sports News. As well, there are 16 topics identified as very desirable for Thai women readers, such as: Art and Culture, Automobile, Classified, Special Scoop, Editorial, Advertisement, Entertainment, Health and Quality of Life, History, Horoscope, Lifestyle and Fashion, Literature, Nature - Environment and Tourism, Night Life, Stars and Jet Set Gossip, Women’s Issue.

Keywords: women behaviors, feminine looks, newspaper design, news content

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248 Bio-Hub Ecosystems: Profitability through Circularity for Sustainable Forestry, Energy, Agriculture and Aquaculture

Authors: Kimberly Samaha

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The Bio-Hub Ecosystem model was developed to address a critical area of concern within the global energy market regarding biomass as a feedstock for power plants. Yet the lack of an economically-viable business model for bioenergy facilities has resulted in the continuation of idled and decommissioned plants. This study analyzed data and submittals to the Born Global Maine Innovation Challenge. The Innovation Challenge was a global innovation challenge to identify process innovations that could address a ‘whole-tree’ approach of maximizing the products, byproducts, energy value and process slip-streams into a circular zero-waste design. Participating companies were at various stages of developing bioproducts and included biofuels, lignin-based products, carbon capture platforms and biochar used as both a filtration medium and as a soil amendment product. This case study shows the QCA (Qualitative Comparative Analysis) methodology of the prequalification process and the resulting techno-economic model that was developed for the maximizing profitability of the Bio-Hub Ecosystem through continuous expansion of system waste streams into valuable process inputs for co-hosts. A full site plan for the integration of co-hosts (biorefinery, land-based shrimp and salmon aquaculture farms, a tomato green-house and a hops farm) at an operating forestry-based biomass to energy plant in West Enfield, Maine USA. This model and process for evaluating the profitability not only proposes models for integration of forestry, aquaculture and agriculture in cradle-to-cradle linkages of what have typically been linear systems, but the proposal also allows for the early measurement of the circularity and impact of resource use and investment risk mitigation, for these systems. In this particular study, profitability is assessed at two levels CAPEX (Capital Expenditures) and in OPEX (Operating Expenditures). Given that these projects start with repurposing facilities where the industrial level infrastructure is already built, permitted and interconnected to the grid, the addition of co-hosts first realizes a dramatic reduction in permitting, development times and costs. In addition, using the biomass energy plant’s waste streams such as heat, hot water, CO₂ and fly ash as valuable inputs to their operations and a significant decrease in the OPEX costs, increasing overall profitability to each of the co-hosts bottom line. This case study utilizes a proprietary techno-economic model to demonstrate how utilizing waste streams of a biomass energy plant and/or biorefinery, results in significant reduction in OPEX for both the biomass plants and the agriculture and aquaculture co-hosts. Economically viable Bio-Hubs with favorable environmental and community impacts may prove critical in garnering local and federal government support for pilot programs and more wide-scale adoption, especially for those living in severely economically depressed rural areas where aging industrial sites have been shuttered and local economies devastated.

Keywords: bio-economy, biomass energy, financing, zero-waste

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247 Defining a Framework for Holistic Life Cycle Assessment of Building Components by Considering Parameters Such as Circularity, Material Health, Biodiversity, Pollution Control, Cost, Social Impacts, and Uncertainty

Authors: Naomi Grigoryan, Alexandros Loutsioli Daskalakis, Anna Elisse Uy, Yihe Huang, Aude Laurent (Webanck)

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In response to the building and construction sectors accounting for a third of all energy demand and emissions, the European Union has placed new laws and regulations in the construction sector that emphasize material circularity, energy efficiency, biodiversity, and social impact. Existing design tools assess sustainability in early-stage design for products or buildings; however, there is no standardized methodology for measuring the circularity performance of building components. Existing assessment methods for building components focus primarily on carbon footprint but lack the comprehensive analysis required to design for circularity. The research conducted in this paper covers the parameters needed to assess sustainability in the design process of architectural products such as doors, windows, and facades. It maps a framework for a tool that assists designers with real-time sustainability metrics. Considering the life cycle of building components such as façades, windows, and doors involves the life cycle stages applied to product design and many of the methods used in the life cycle analysis of buildings. The current industry standards of sustainability assessment for metal building components follow cradle-to-grave life cycle assessment (LCA), track Global Warming Potential (GWP), and document the parameters used for an Environmental Product Declaration (EPD). Developed by the Ellen Macarthur Foundation, the Material Circularity Indicator (MCI) is a methodology utilizing the data from LCA and EPDs to rate circularity, with a "value between 0 and 1 where higher values indicate a higher circularity+". Expanding on the MCI with additional indicators such as the Water Circularity Index (WCI), the Energy Circularity Index (ECI), the Social Circularity Index (SCI), Life Cycle Economic Value (EV), and calculating biodiversity risk and uncertainty, the assessment methodology of an architectural product's impact can be targeted more specifically based on product requirements, performance, and lifespan. Broadening the scope of LCA calculation for products to incorporate aspects of building design allows product designers to account for the disassembly of architectural components. For example, the Material Circularity Indicator for architectural products such as windows and facades is typically low due to the impact of glass, as 70% of glass ends up in landfills due to damage in the disassembly process. The low MCI can be combatted by expanding beyond cradle-to-grave assessment and focusing the design process on disassembly, recycling, and repurposing with the help of real-time assessment tools. Design for Disassembly and Urban Mining has been integrated within the construction field on small scales as project-based exercises, not addressing the entire supply chain of architectural products. By adopting more comprehensive sustainability metrics and incorporating uncertainty calculations, the sustainability assessment of building components can be more accurately assessed with decarbonization and disassembly in mind, addressing the large-scale commercial markets within construction, some of the most significant contributors to climate change.

Keywords: architectural products, early-stage design, life cycle assessment, material circularity indicator

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246 Role of Functional Divergence in Specific Inhibitor Design: Using γ-Glutamyltranspeptidase (GGT) as a Model Protein

Authors: Ved Vrat Verma, Rani Gupta, Manisha Goel

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γ-glutamyltranspeptidase (GGT: EC 2.3.2.2) is an N-terminal nucleophile hydrolase conserved in all three domains of life. GGT plays a key role in glutathione metabolism where it catalyzes the breakage of the γ-glutamyl bonds and transfer of γ-glutamyl group to water (hydrolytic activity) or amino acids or short peptides (transpeptidase activity). GGTs from bacteria, archaea, and eukaryotes (human, rat and mouse) are homologous proteins sharing >50% sequence similarity and conserved four layered αββα sandwich like three dimensional structural fold. These proteins though similar in their structure to each other, are quite diverse in their enzyme activity: some GGTs are better at hydrolysis reactions but poor in transpeptidase activity, whereas many others may show opposite behaviour. GGT is known to be involved in various diseases like asthma, parkinson, arthritis, and gastric cancer. Its inhibition prior to chemotherapy treatments has been shown to sensitize tumours to the treatment. Microbial GGT is known to be a virulence factor too, important for the colonization of bacteria in host. However, all known inhibitors (mimics of its native substrate, glutamate) are highly toxic because they interfere with other enzyme pathways. However, a few successful efforts have been reported previously in designing species specific inhibitors. We aim to leverage the diversity seen in GGT family (pathogen vs. eukaryotes) for designing specific inhibitors. Thus, in the present study, we have used DIVERGE software to identify sites in GGT proteins, which are crucial for the functional and structural divergence of these proteins. Since, type II divergence sites vary in clade specific manner, so type II divergent sites were our focus of interest throughout the study. Type II divergent sites were identified for pathogen vs. eukaryotes clusters and sites were marked on clade specific representative structures HpGGT (2QM6) and HmGGT (4ZCG) of pathogen and eukaryotes clade respectively. The crucial divergent sites within 15 A radii of the binding cavity were highlighted, and in-silico mutations were performed on these sites to delineate the role of these sites on the mechanism of catalysis and protein folding. Further, the amino acid network (AAN) analysis was also performed by Cytoscape to delineate assortative mixing for cavity divergent sites which could strengthen our hypothesis. Additionally, molecular dynamics simulations were performed for wild complexes and mutant complexes close to physiological conditions (pH 7.0, 0.1 M ionic strength and 1 atm pressure) and the role of putative divergence sites and structural integrities of the homologous proteins have been analysed. The dynamics data were scrutinized in terms of RMSD, RMSF, non-native H-bonds and salt bridges. The RMSD, RMSF fluctuations of proteins complexes are compared, and the changes at protein ligand binding sites were highlighted. The outcomes of our study highlighted some crucial divergent sites which could be used for novel inhibitors designing in a species-specific manner. Since, for drug development, it is challenging to design novel drug by targeting similar protein which exists in eukaryotes, so this study could set up an initial platform to overcome this challenge and help to deduce the more effective targets for novel drug discovery.

Keywords: γ-glutamyltranspeptidase, divergence, species-specific, drug design

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245 [Keynote Talk]: Surveillance of Food Safety Compliance of Hong Kong Street Food

Authors: Mabel Y. C. Yau, Roy C. F. Lai, Hugo Y. H. Or

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This study is a pilot surveillance of hygiene compliance and food microbial safety of both licensed and mobile vendors selling Chinese ready–to-eat snack foods in Hong Kong. The study reflects similar situations in running mobile food vending business on trucks. Hong Kong is about to launch the Food Truck Pilot Scheme by the end of 2016 or early 2017. Technically, selling food on the vehicle is no different from hawking food on the street or vending food on the street. Each type of business bears similar food safety issues and cast the same impact on public health. Present findings demonstrate exemplarily situations that also apply to food trucks. 9 types of Cantonese style snacks of 32 samples in total were selected for microbial screening. A total of 16 vending sites including supermarkets, street markets, and snack stores were visited. The study finally focused on a traditional snack, the steamed rice cake with red beans called Put Chai Ko (PCK). PCK is a type of classical Cantonese pastry sold on push carts on the street. It used to be sold at room temperature and served with bamboo sticks in the old days. Some shops would have them sold steam fresh. Microbial examinations on aerobic counts, yeast, and mould, coliform, salmonella as well as Staphylococcus aureus detections were carried out. Salmonella was not detected in all samples. Since PCK does not contain ingredients of beef, poultry, eggs or dairy products, the risk of the presence of Salmonella in PCK was relatively lower although other source of contamination might be possible. Coagulase positive Staphylococcus aureus was found in 6 of the 14 samples sold at room temperature. Among these 6 samples, 3 were PCK. One of the samples was in an unacceptable range of total colony forming units higher than 105. The rest were only satisfactory. Observational evaluations were made with checklists on personal hygiene, premises hygiene, food safety control, food storage, cleaning and sanitization as well as waste disposals. The maximum score was 25 if total compliance were obtained. The highest score among vendors was 20. Three stores were below average, and two of these stores were selling PCK. Most of the non-compliances were on food processing facilities, sanitization conditions and waste disposal. In conclusion, although no food poisoning outbreaks happened during the time of the investigation, the risk of food hazard existed in these stores, especially among street vendors. Attention is needed in the traditional practice of food selling, and that food handlers might not have sufficient knowledge to properly handle food products. Variations in food qualities existed among supply chains or franchise eateries or shops. It was commonly observed that packaging and storage conditions are not properly enforced in the retails. The same situation could be reflected across the food business. It did indicate need of food safety training in the industry and loopholes in quality control among business.

Keywords: cantonese snacks, food safety, microbial, hygiene, street food

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244 Understanding Awareness, Agency and Autonomy of Mothers and Potential of Digital Technology in Expanding Maternal Health Information Access: A Survey of Mothers in Urban India

Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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243 Species Profiling of White Grub Beetles and Evaluation of Pre and Post Sown Application of Insecticides against White Grub Infesting Soybean

Authors: Ajay Kumar Pandey, Mayank Kumar

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White grub (Coleoptera: Scarabaeidae) is a major destructive pest in western Himalayan region of Uttarakhand. Beetles feed on apple, apricot, plum, walnut etc. during night while, second and third instar grubs feed on live roots of cultivated as well as non-cultivated crops. Collection and identification of scarab beetles through light trap was carried out at Crop Research Centre, Govind Ballab Pant University Pantnagar, Udham Singh Nagar (Uttarakhand) during 2018. Field trials were also conducted in 2018 to evaluate pre and post sown application of different insecticides against the white grub infesting soybean. The insecticides like Carbofuran 3 Granule (G) (750 g a.i./ha), Clothianidin 50 Water Dispersal Granule (WG) (120 g a.i./ha), Fipronil 0.3 G (50 g a.i./ha), Thiamethoxam 25 WG (80 g a.i./ha), Imidacloprid 70 WG (300 g a.i./ha), Chlorantraniliprole 0.4% G(100 g a.i./ha) and mixture of Fipronil 40% and Imidacloprid 40% WG (300 g a.i./ha) were applied at the time of sowing in pre sown experiment while same dosage of insecticides were applied in standing soybean crop during (first fortnight of July). Commutative plant mortality data were recorded after 20, 40, 60 days intervals and compared with untreated control. Total 23 species of white grub beetles recorded on the light trap and Holotrichia serrata Fabricious (Coleoptera: Melolonthinae) was found to be predominant species by recording 20.6% relative abundance out of the total light trap catch (i.e. 1316 beetles) followed by Phyllognathus sp. (14.6% relative abundance). H. rosettae and Heteronychus lioderus occupied third and fourth rank with 11.85% and 9.65% relative abundance, respectively. The emergence of beetles of predominant species started from 15th March, 2018. In April, average light trap catch was 382 white grub beetles, however, peak emergence of most of the white grub species was observed from June to July, 2018 i.e. 336 beetles in June followed by 303 beetles in the July. On the basis of the emergence pattern of white grub beetles, it may be concluded that the Peak Emergence Period (PEP) for the beetles of H. serrata was second fortnight of April for the total period of 15 days. In May, June and July relatively low population of H. serrata was observed. A decreasing trend in light trap catch was observed and went on till September during the study. No single beetle of H. serrata was observed on light trap from September onwards. The cumulative plant mortality data in both the experiments revealed that all the insecticidal treatments were significantly superior in protection-wise (6.49-16.82% cumulative plant mortality) over untreated control where highest plant mortality was 17.28 to 39.65% during study. The mixture of Fipronil 40% and Imidacloprid 40% WG applied at the rate of 300 g a.i. per ha proved to be most effective having lowest plant mortality i.e. 9.29 and 10.94% in pre and post sown crop, followed by Clothianidin 50 WG (120 g a.i. per ha) where the plant mortality was 10.57 and 11.93% in pre and post sown treatments, respectively. Both treatments were found significantly at par among each other. Production-wise, all the insecticidal treatments were found statistically superior (15.00-24.66 q per ha grain yields) over untreated control where the grain yield was 8.25 & 9.13 q per ha. Treatment Fipronil 40% + Imidacloprid 40% WG applied at the rate of 300 g a.i. per ha proved to be most effective and significantly superior over Imidacloprid 70WG applied at the rate of 300 g a.i. per ha.

Keywords: bio efficacy, insecticide, soybean, white grub

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242 Early Biological Effects in Schoolchildren Living in an Area of Salento (Italy) with High Incidence of Chronic Respiratory Diseases: The IMP.AIR. Study

Authors: Alessandra Panico, Francesco Bagordo, Tiziana Grassi, Adele Idolo, Marcello Guido, Francesca Serio, Mattia De Giorgi, Antonella De Donno

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In the Province of Lecce (Southeastern Italy) an area with unusual high incidence of chronic respiratory diseases, including lung cancer, was recently identified. The causes of this health emergency are still not entirely clear. In order to determine the risk profile of children living in five municipalities included in this area an epidemiological-molecular study was performed in the years 2014-2016: the IMP.AIR. (Impact of air quality on health of residents in the Municipalities of Sternatia, Galatina, Cutrofiano, Sogliano Cavour and Soleto) study. 122 children aged 6-8 years attending primary school in the study area were enrolled to evaluate the frequency of micronuclei (MNs) in their buccal exfoliated cells. The samples were collected in May 2015 by rubbing the oral mucosa with a soft bristle disposable toothbrush. At the same time, a validated questionnaire was administered to parents to obtain information about health, lifestyle and eating habits of the children. In addition, information on airborne pollutants, routinely detected by the Regional Environmental Agency (ARPA Puglia) in the study area, was acquired. A multivariate analysis was performed to detect any significant association between frequency of MNs (dependent variable) and behavioral factors (independent variables). The presence of MNs was highlighted in the buccal exfoliated cells of about 42% of recruited children with a mean frequency of 0.49 MN/1000 cells, greater than in other areas of Salento. The survey on individual characteristics and lifestyles showed that one in three children was overweight and that most of them had unhealthy eating habits with frequent consumption of foods considered ‘risky’. Moreover many parents (40% of fathers and 12% of mothers) were smokers and about 20% of them admitted to smoking in the house where the children lived. Information regarding atmospheric contaminants was poor. Of the few substances routinely detected by the only one monitoring station located in the study area (PM2.5, SO2, NO2, CO, O3) only ozone showed high concentrations exceeding the limits set by the legislation for 67 times in the year 2015. The study showed that the level of early biological effect markers in children was not negligible. This critical condition could be related to some individual factors and lifestyles such as overweight, unhealthy eating habits and exposure to passive smoking. At present, no relationship with airborne pollutants can be established due to the lack of information on many substances. Therefore, it would be advisable to modify incorrect behaviors and to intensify the monitoring of airborne pollutants (e.g. including detection of PM10, heavy metals, aromatic polycyclic hydrocarbons, benzene) given the epidemiology of chronic respiratory diseases registered in this area.

Keywords: chronic respiratory diseases, environmental pollution, lifestyle, micronuclei

Procedia PDF Downloads 183
241 Microfungi on Sandy Beaches: Potential Threats for People Enjoying Lakeside Recreation

Authors: Tomasz Balabanski, Anna Biedunkiewicz

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Research on basic bacteriological and physicochemical parameters conducted by state institutions (Provincial Sanitary and Epidemiological Station and District Sanitary and Epidemiological Station) are limited to bathing waters under constant sanitary and epidemiological supervision. Unfortunately, no routine or monitoring tests are carried out for the presence of microfungi. This also applies to beach sand used for recreational purposes. The purpose of the planned own research was to determine the diversity of the mycobiota present on supervised and unsupervised sandy beaches, on the shores of lakes, of municipal baths used for recreation. The research material consisted of microfungi isolated from April to October 2019 from sandy beaches of supervised and unsupervised lakes located within the administrative boundaries of the city of Olsztyn (North-Eastern Poland, Europe). Four lakes, out of the fifteen available (Tyrsko, Kortowskie, Skanda, and Ukiel), whose bathing waters are subjected to routine bacteriological tests, were selected for testing. To compare the diversity of the mycobiota composition on the surface and below the sand mixing layer, samples were taken from two depths (10 cm and 50 cm), using a soil auger. Micro-fungi from sand samples were obtained by surface inoculation on an RBC medium from the 1st dilution (1:10). After incubation at 25°C for 96-144 h, the average number of CFU/dm³ was counted. Morphologically differing yeast colonies were passaged into Sabouraud agar slants with gentamicin and incubated again. For detailed laboratory analyses, culture methods (macro- and micro-cultures) and identification methods recommended in diagnostic mycological laboratories were used. The conducted research allowed obtaining 140 yeast isolates. The total average population ranged from 1.37 × 10⁻² CFU/dm³ before the bathing season (April 2019), 1.64 × 10⁻³ CFU/dm³ in the season (May-September 2019), and 1.60 × 10⁻² CFU/dm³ after the end of the season (October 2019). More microfungi were obtained from the surface layer of sand (100 isolates) than from the deeper layer (40 isolates). Reported microfungi may circulate seasonally between individual elements of the lake ecosystem. From the sand/soil from the catchment area beaches, they can get into bathing waters, stopping periodically on the coastal phyllosphere. The sand of the beaches and the phyllosphere are a kind of filter for the water reservoir. The presence of microfungi with various pathogenicity potential in these places is of major epidemiological importance. Therefore, full monitoring of not only recreational waters but also sandy beaches should be treated as an element of constant control by appropriate supervisory institutions, allowing recreational areas for public use so that the use of these places does not involve the risk of infection. Acknowledgment: 'Development Program of the University of Warmia and Mazury in Olsztyn', POWR.03.05.00-00-Z310/17, co-financed by the European Union under the European Social Fund from the Operational Program Knowledge Education Development. Tomasz Bałabański is a recipient of a scholarship from the Programme Interdisciplinary Doctoral Studies in Biology and Biotechnology (POWR.03.05.00-00-Z310/17), which is funded by the 'European Social Fund'.

Keywords: beach, microfungi, sand, yeasts

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240 A Genetic Identification of Candida Species Causing Intravenous Catheter-Associated Candidemia in Heart Failure Patients

Authors: Seyed Reza Aghili, Tahereh Shokohi, Shirin Sadat Hashemi Fesharaki, Mohammad Ali Boroumand, Bahar Salmanian

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Introduction: Intravenous catheter-associated fungal infection as nosocomial infection continue to be a deep problem among hospitalized patients, decreasing quality of life and adding healthcare costs. The capacity of catheters in the spread of candidemia in heart failure patients is obvious. The aim of this study was to evaluate the prevalence and genetic identification of Candida species in heart disorder patients. Material and Methods: This study was conducted in Tehran Hospital of Cardiology Center (Tehran, Iran, 2014) during 1.5 years on the patients hospitalized for at least 7 days and who had central or peripheral vein catheter. Culture of catheters, blood and skin of the location of catheter insertion were applied for detecting Candida colonies in 223 patients. Identification of Candida species was made on the basis of a combination of various phenotypic methods and confirmed by sequencing the ITS1-5.8S-ITS2 region amplified from the genomic DNA using PCR and the NCBI BLAST. Results: Of the 223 patients samples tested, we identified totally 15 Candida isolates obtained from 9 (4.04%) catheter cultures, 3 (1.35%) blood cultures and 2 (0.90%) skin cultures of the catheter insertion areas. On the base of ITS region sequencing, out of nine Candida isolates from catheter, 5(55.6%) C. albicans, 2(22.2%) C. glabrata, 1(11.1%) C. membranifiaciens and 1 (11.1%) C. tropicalis were identified. Among three Candida isolates from blood culture, C. tropicalis, C. carpophila and C. membranifiaciens were identified. Non-candida yeast isolated from one blood culture was Cryptococcus albidus. One case of C. glabrata and one case of Candida albicans were isolated from skin culture of the catheter insertion areas in patients with positive catheter culture. In these patients, ITS region of rDNA sequence showed a similarity between Candida isolated from the skin and catheter. However, the blood samples of these patients were negative for fungal growth. We report two cases of catheter-related candidemia caused by C. membranifiaciens and C. tropicalis on the base of genetic similarity of species isolated from blood and catheter which were treated successfully with intravenous fluconazole and catheter removal. In phenotypic identification methods, we could only identify C. albicans and C. tropicalis and other yeast isolates were diagnosed as Candida sp. Discussion: Although more than 200 species of Candida have been identified, only a few cause diseases in humans. There is some evidence that non-albicans infections are increasing. Many risk factors, including prior antibiotic therapy, use of a central venous catheter, surgery, and parenteral nutrition are considered to be associated with candidemia in hospitalized heart failure patients. Identifying the route of infection in candidemia is difficult. Non-albicans candida as the cause of candidemia is increasing dramatically. By using conventional method, many non-albicans isolates remain unidentified. So, using more sensitive and specific molecular genetic sequencing to clarify the aspects of epidemiology of the unknown candida species infections is essential. The positive blood and catheter cultures for candida isolates and high percentage of similarity of their ITS region of rDNA sequence in these two patients confirmed the diagnosis of intravenous catheter-associated candidemia.

Keywords: catheter-associated infections, heart failure patient, molecular genetic sequencing, ITS region of rDNA, Candidemia

Procedia PDF Downloads 304
239 Implementing a Comprehensive Emergency Care and Life Support Course in a Low- and Middle-Income Country Setting: A Survey of Learners in India

Authors: Vijayabhaskar Reddy Kandula, Peter Provost Taillac, Balasubramanya M. A., Ram Krishnan Nair, Gokul Toshnival, Vibhu Dhawan, Vijaya Karanam, Buffy Cramer

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Introduction: The lack of Emergency Care Services (ECS) is a cause of extensive and serious public health problems in low- and middle-income countries (LMIC), Many LMIC countries have ambulance services that allow timely transfer of ill patients but due to poor care during the ‘Golden Hour’ many deaths occur which are otherwise preventable. Lack of adequate training as evidenced by a study in India is a major reason for poor care during the ‘Golden Hour’. Adapting developed country models which includes staffing specialty-trained doctors in emergency care, is neither feasible nor guarantees cost-effective ECS. Methods: Based on our assessment and felt needs by first-line doctors providing emergency care in 2014, Rajiv Gandhi Health Sciences University’s JeevaRaksha Trust in partnership with the University of Utah, USA, designed, piloted and successfully implemented a 4-day Comprehensive-Emergency Care and Life Support course (C-ECLS) for allopathic doctors. 1730 doctors completed the 4-day course between June 2014 and December- 2020. Subsequently, we conducted a survey to investigate the utilization rates and usefulness of the training. 1662 were contacted but only 309 completed the survey. The respondents had the following designations: Senior faculty (33%), junior faculty (25), Resident (16%), Private-Practitioners (8%), Medical-Officer (16%) and not-working (11%). 51% were generalists (51%) and the rest were specialists (>30 specialties). Results: 97% (271/280) felt they are better doctors because of C-ECLS. 79% (244/309) reported that training helped to save life- specialists more likely than generalists (91% v/s 68%. P<0.05). 64% agreed that they were confident of managing COVID-19 symptomatic patients better because of C-ECLS. 27% (77) were neutral; 9% (24) disagreed. 66% agreed that training helps to be confident in managing COVID-19 critically ill patients. 26% (72) were neutral; 8% (23) disagreed. Frequency of use of C-ECLS skills: Hemorrhage-control (70%), Airway (67%), circulation skills (62%), Safe-transport and communication (60%), managing critically ill patients (58%), cardiac arrest (51%), Trauma (49%), poisoning/animal bites/stings (44%), neonatal-resuscitation (39%), breathing (36%), post-partum-hemorrhage and eclampsia (35%). Among those who used the skills, the majority (ranging from (88%-94%) reported that they were able to apply the skill more effectively because of ECLS training. Conclusion: JeevaRaksha’s C-ECLS is the world’s first comprehensive training. It improves the confidence of front-line doctors and enables them to provide quality care during the ‘Golden Hour’ of emergency. It also prepares doctors to manage unknown emergencies (e.g., COVID-19). C-ECLS was piloted in Morocco, and Uzbekistan and implemented countrywide in Bhutan. C-ECLS is relevant to most settings and offers a replicable model across LMIC.

Keywords: comprehensive emergency care and life support, training, capacity building, low- and middle-income countries, developing countries

Procedia PDF Downloads 39
238 The Influence of Perinatal Anxiety and Depression on Breastfeeding Behaviours: A Qualitative Systematic Review

Authors: Khulud Alhussain, Anna Gavine, Stephen Macgillivray, Sushila Chowdhry

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Background: Estimates show that by the year 2030, mental illness will account for more than half of the global economic burden, second to non-communicable diseases. Often, the perinatal period is characterised by psychological ambivalence and a mixed anxiety-depressive condition. Maternal mental disorder is associated with perinatal anxiety and depression and affects breastfeeding behaviors. Studies also indicate that maternal mental health can considerably influence a baby's health in numerous aspects and impact the newborn health due to lack of adequate breastfeeding. However, studies reporting factors associated with breastfeeding behaviors are predominantly quantitative. Therefore, it is not clear what literature is available to understand the factors affecting breastfeeding and perinatal women’s perspectives and experiences. Aim: This review aimed to explore the perceptions and experiences of women with perinatal anxiety and depression, as well as how these experiences influence their breastfeeding behaviours. Methods: A systematic literature review of qualitative studies in line with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). Four electronic databases (CINAHL, PsycINFO, Embase, and Google Scholar) were explored for relevant studies using a search strategy. The search was restricted to studies published in the English language between 2000 and 2022. Findings from the literature were screened using a pre-defined screening criterion and the quality of eligible studies was appraised using the Walsh and Downe (2006) checklist. Findings were extracted and synthesised based on Braun and Clark. The review protocol was registered on PROSPERO (Ref: CRD42022319609). Result: A total of 4947 studies were identified from the four databases. Following duplicate removal and screening 16 studies met the inclusion criteria. The studies included 87 pregnant and 302 post-partum women from 12 countries. The participants were from a variety of economic, regional, and religious backgrounds, mainly from the age of 18 to 45 years old. Three main themes were identified: Barriers to breastfeeding, breastfeeding facilitators, emotional disturbance, and breastfeeding. Seven subthemes emerged from the data: expectation versus reality, uncertainly about maternal competencies, body image and breastfeeding, lack of sufficient breastfeeding support for family and caregivers’ support, influences positive breastfeeding practices, breastfeeding education, and causes of mental strain among breastfeeding women. Breastfeeding duration is affected in women with mental health disorders, irrespective of their desire to breastfeed. Conclusion: There is significant empirical evidence that breastfeeding behaviour and perinatal mental disturbance are linked. However, there is a lack of evidence to apply the findings to Saudi women due to lack of empirical qualitative information. To improve the psychological well-being of mothers, it is crucial to explore and recognise any concerns with their mental, physical, and emotional well-being. Therefore, robust research is needed so that breastfeeding intervention researchers and policymakers can focus on specifically what needs to be done to help mentally distressed perinatal women and their new-born.

Keywords: pregnancy, perinatal period, anxiety, depression, emotional disturbance, breastfeeding

Procedia PDF Downloads 61
237 Teachers’ Language Insecurity in English as a Second Language Instruction: Developing Effective In-Service Training

Authors: Mamiko Orii

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This study reports on primary school second language teachers’ sources of language insecurity. Furthermore, it aims to develop an in-service training course to reduce anxiety and build sufficient English communication skills. Language/Linguistic insecurity refers to a lack of confidence experienced by language speakers. In particular, second language/non-native learners often experience insecurity, influencing their learning efficacy. While language learner insecurity has been well-documented, research on the insecurity of language teaching professionals is limited. Teachers’ language insecurity or anxiety in target language use may adversely affect language instruction. For example, they may avoid classroom activities requiring intensive language use. Therefore, understanding teachers’ language insecurity and providing continuing education to help teachers to improve their proficiency is vital to improve teaching quality. This study investigated Japanese primary school teachers’ language insecurity. In Japan, teachers are responsible for teaching most subjects, including English, which was recently added as compulsory. Most teachers have never been professionally trained in second language instruction during college teacher certificate preparation, leading to low confidence in English teaching. Primary source of language insecurity is a lack of confidence regarding English communication skills. Their actual use of English in classrooms remains unclear. Teachers’ classroom speech remains a neglected area requiring improvement. A more refined programme for second language teachers could be constructed if we can identify areas of need. Two questionnaires were administered to primary school teachers in Tokyo: (1) Questionnaire A: 396 teachers answered questions (using a 5-point scale) concerning classroom teaching anxiety and general English use and needs for in-service training (Summer 2021); (2) Questionnaire B: 20 teachers answered detailed questions concerning their English use (Autumn 2022). Questionnaire A’s responses showed that over 80% of teachers have significant language insecurity and anxiety, mainly when speaking English in class or teaching independently. Most teachers relied on a team-teaching partner (e.g., ALT) and avoided speaking English. Over 70% of the teachers said they would like to participate in training courses in classroom English. Questionnaire B’s results showed that teachers could use simple classroom English, such as greetings and basic instructions (e.g., stand up, repeat after me), and initiate conversation (e.g., asking questions). In contrast, teachers reported that conversations were mainly carried on in a simple question-answer style. They had difficulty continuing conversations. Responding to learners’ ‘on-the-spot’ utterances was particularly difficult. Instruction in turn-taking patterns suitable in the classroom communication context is needed. Most teachers received grammar-based instruction during their entire English education. They were predominantly exposed to displayed questions and form-focused corrective feedback. Therefore, strategies such as encouraging teachers to ask genuine questions (i.e., referential questions) and responding to students with content feedback are crucial. When learners’ utterances are incorrect or unsatisfactory, teachers should rephrase or extend (recast) them instead of offering explicit corrections. These strategies support a continuous conversational flow. These results offer benefits beyond Japan’s English as a second Language context. They will be valuable in any context where primary school teachers are underprepared but must provide English-language instruction.

Keywords: english as a second/non-native language, in-service training, primary school, teachers’ language insecurity

Procedia PDF Downloads 47
236 3D Printing of Polycaprolactone Scaffold with Multiscale Porosity Via Incorporation of Sacrificial Sucrose Particles

Authors: Mikaela Kutrolli, Noah S. Pereira, Vanessa Scanlon, Mohamadmahdi Samandari, Ali Tamayol

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Bone tissue engineering has drawn significant attention and various biomaterials have been tested. Polymers such as polycaprolactone (PCL) offer excellent biocompatibility, reasonable mechanical properties, and biodegradability. However, PCL scaffolds suffer a critical drawback: a lack of micro/mesoporosity, affecting cell attachment, tissue integration, and mineralization. It also results in a slow degradation rate. While 3D-printing has addressed the issue of macroporosity through CAD-guided fabrication, PCL scaffolds still exhibit poor smaller-scale porosity. To overcome this, we generated composites of PCL, hydroxyapatite (HA), and powdered sucrose (PS). The latter serves as a sacrificial material to generate porous particles after sucrose dissolution. Additionally, we have incorporated dexamethasone (DEX) to boost the PCL osteogenic properties. The resulting scaffolds maintain controlled macroporosity from the lattice print structure but also develop micro/mesoporosity within PCL fibers when exposed to aqueous environments. The study involved mixing PS into solvent-dissolved PCL in different weight ratios of PS to PCL (70:30, 50:50, and 30:70 wt%). The resulting composite was used for 3D printing of scaffolds at room temperature. Printability was optimized by adjusting pressure, speed, and layer height through filament collapse and fusion test. Enzymatic degradation, porogen leaching, and DEX release profiles were characterized. Physical properties were assessed using wettability, SEM, and micro-CT to quantify the porosity (percentage, pore size, and interconnectivity). Raman spectroscopy was used to verify the absence of sugar after leaching. Mechanical characteristics were evaluated via compression testing before and after porogen leaching. Bone marrow stromal cells (BMSCs) behavior in the printed scaffolds was studied by assessing viability, metabolic activity, osteo-differentiation, and mineralization. The scaffolds with a 70% sugar concentration exhibited superior printability and reached the highest porosity of 80%, but performed poorly during mechanical testing. A 50% PS concentration demonstrated a 70% porosity, with an average pore size of 25 µm, favoring cell attachment. No trace of sucrose was found in Raman after leaching the sugar for 8 hours. Water contact angle results show improved hydrophilicity as the sugar concentration increased, making the scaffolds more conductive to cell adhesion. The behavior of bone marrow stromal cells (BMSCs) showed positive viability and proliferation results with an increasing trend of mineralization and osteo-differentiation as the sucrose concentration increased. The addition of HA and DEX also promoted mineralization and osteo-differentiation in the cultures. The integration of PS as porogen at a concentration of 50%wt within PCL scaffolds presents a promising approach to address the poor cell attachment and tissue integration issues of PCL in bone tissue engineering. The method allows for the fabrication of scaffolds with tunable porosity and mechanical properties, suitable for various applications. The addition of HA and DEX further enhanced the scaffolds. Future studies will apply the scaffolds in an in-vivo model to thoroughly investigate their performance.

Keywords: bone, PCL, 3D printing, tissue engineering

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235 Urban Sprawl: A Case Study of Suryapet Town in Nalgonda District of Telangana State, a Geoinformatic Approach

Authors: Ashok Kumar Lonavath, V. Sathish Kumar

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Urban sprawl is the uncontrolled and uncoordinated outgrowth of towns and cities. The process of urban sprawl can be described by change in pattern over time, like proportional increase in built-up surface to population leading to rapid urban spatial expansion. Significant economic and livelihood opportunities in the urban areas results in lack of basic amenities due to the unplanned growth The patterns, processes, dynamic causes and consequences of sprawl can be explored and designed with the help of spatial planning support system. In India context the urban area is defined as the population more than 5000, density more than 400 persons per sq. km and 75% of the population is involved in non-agricultural occupations. India’s urban population is increasing at the rate of 2.35% pa. The class I town’s population of India according to 2011 census is 18.8% that accounts for 60.4% of total unban population. Similarly in Erstwhile Andhra Pradesh it is 22.9% which accounts for 68.8% of total urban population. Suryapet town has historical recognition as ‘Gate Way of Telangana’ in the Indian State of Andhra Pradesh. The Municipality was constituted in 1952 as Grade-III, later upgraded into Grade-II in 1984 and to Grade-I in 1998. The area is 35 Sq.kms. Three major tanks located in three different directions and Musi River is flowing from a distance of 8 kms. The average ground water table is about 50m below ground. It is a fast growing town with a population of 1, 06,805 and 25,448 households. Density is 3051pp sq km, It is a Class I city as per population census. It secured the ISO 14001-2004 certificate for establishing and maintaining an environment-friendly system for solid waste disposal. It is the first municipality in the country to receive such a certificate. It won HUDCO award under environment management, award of appreciation and cash from Ministry of Housing and Poverty Elevation from Government of India and undivided Andhra Pradesh under UN Human Settlement Programme, Greentech Excellance award, Supreme Courts appreciation for solid waste management. Foreign delegates from different countries and also from various other states of India visited Suryapet municipality for study tour and training programs as part of their official visit Suryapet is located at 17°5’ North Latitude and 79°37’ East Longitude. The average elevation is 266m, annual mean temperature is 36°C and average rainfall is 821.0 mm. The people of this town are engaged in Commercial and agriculture activities hence the town has become a centre for marketing and stocking agricultural produce. It is also educational centre in this region. The present paper on urban sprawl is a theoretical framework to analyze the interaction of planning and governance on the extent of outgrowth and level of services. The GIS techniques, SOI Toposheet, satellite imageries and image analysis techniques are extensively used to explore the sprawl and measure the urban land-use. This paper concludes outlining the challenges in addressing urban sprawl while ensuring adequate level of services that planning and governance have to ensure towards achieving sustainable urbanization.

Keywords: remote sensing, GIS, urban sprawl, urbanization

Procedia PDF Downloads 199
234 Poly (3,4-Ethylenedioxythiophene) Prepared by Vapor Phase Polymerization for Stimuli-Responsive Ion-Exchange Drug Delivery

Authors: M. Naveed Yasin, Robert Brooke, Andrew Chan, Geoffrey I. N. Waterhouse, Drew Evans, Darren Svirskis, Ilva D. Rupenthal

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Poly(3,4-ethylenedioxythiophene) (PEDOT) is a robust conducting polymer (CP) exhibiting high conductivity and environmental stability. It can be synthesized by either chemical, electrochemical or vapour phase polymerization (VPP). Dexamethasone sodium phosphate (dexP) is an anionic drug molecule which has previously been loaded onto PEDOT as a dopant via electrochemical polymerisation; however this technique requires conductive surfaces from which polymerization is initiated. On the other hand, VPP produces highly organized biocompatible CP structures while polymerization can be achieved onto a range of surfaces with a relatively straight forward scale-up process. Following VPP of PEDOT, dexP can be loaded and subsequently released via ion-exchange. This study aimed at preparing and characterising both non-porous and porous VPP PEDOT structures including examining drug loading and release via ion-exchange. Porous PEDOT structures were prepared by first depositing a sacrificial polystyrene (PS) colloidal template on a substrate, heat curing this deposition and then spin coating it with the oxidant solution (iron tosylate) at 1500 rpm for 20 sec. VPP of both porous and non-porous PEDOT was achieved by exposing to monomer vapours in a vacuum oven at 40 mbar and 40 °C for 3 hrs. Non-porous structures were prepared similarly on the same substrate but without any sacrificial template. Surface morphology, compositions and behaviour were then characterized by atomic force microscopy (AFM), scanning electron microscopy (SEM), x-ray photoelectron spectroscopy (XPS) and cyclic voltammetry (CV) respectively. Drug loading was achieved by 50 CV cycles in a 0.1 M dexP aqueous solution. For drug release, each sample was exposed to 20 mL of phosphate buffer saline (PBS) placed in a water bath operating at 37 °C and 100 rpm. Film was stimulated (continuous pulse of ± 1 V at 0.5 Hz for 17 mins) while immersed into PBS. Samples were collected at 1, 2, 6, 23, 24, 26 and 27 hrs and were analysed for dexP by high performance liquid chromatography (HPLC Agilent 1200 series). AFM and SEM revealed the honey comb nature of prepared porous structures. XPS data showed the elemental composition of the dexP loaded film surface, which related well with that of PEDOT and also showed that one dexP molecule was present per almost three EDOT monomer units. The reproducible electroactive nature was shown by several cycles of reduction and oxidation via CV. Drug release revealed success in drug loading via ion-exchange, with stimulated porous and non-porous structures exhibiting a proof of concept burst release upon application of an electrical stimulus. A similar drug release pattern was observed for porous and non-porous structures without any significant statistical difference, possibly due to the thin nature of these structures. To our knowledge, this is the first report to explore the potential of VPP prepared PEDOT for stimuli-responsive drug delivery via ion-exchange. The produced porous structures were ordered and highly porous as indicated by AFM and SEM. These porous structures exhibited good electroactivity as shown by CV. Future work will investigate porous structures as nano-reservoirs to increase drug loading while sealing these structures to minimize spontaneous drug leakage.

Keywords: PEDOT for ion-exchange drug delivery, stimuli-responsive drug delivery, template based porous PEDOT structures, vapour phase polymerization of PEDOT

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233 Mineralized Nanoparticles as a Contrast Agent for Ultrasound and Magnetic Resonance Imaging

Authors: Jae Won Lee, Kyung Hyun Min, Hong Jae Lee, Sang Cheon Lee

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To date, imaging techniques have attracted much attention in medicine because the detection of diseases at an early stage provides greater opportunities for successful treatment. Consequently, over the past few decades, diverse imaging modalities including magnetic resonance (MR), positron emission tomography, computed tomography, and ultrasound (US) have been developed and applied widely in the field of clinical diagnosis. However, each of the above-mentioned imaging modalities possesses unique strengths and intrinsic weaknesses, which limit their abilities to provide accurate information. Therefore, multimodal imaging systems may be a solution that can provide improved diagnostic performance. Among the current medical imaging modalities, US is a widely available real-time imaging modality. It has many advantages including safety, low cost and easy access for patients. However, its low spatial resolution precludes accurate discrimination of diseased region such as cancer sites. In contrast, MR has no tissue-penetrating limit and can provide images possessing exquisite soft tissue contrast and high spatial resolution. However, it cannot offer real-time images and needs a comparatively long imaging time. The characteristics of these imaging modalities may be considered complementary, and the modalities have been frequently combined for the clinical diagnostic process. Biominerals such as calcium carbonate (CaCO3) and calcium phosphate (CaP) exhibit pH-dependent dissolution behavior. They demonstrate pH-controlled drug release due to the dissolution of minerals in acidic pH conditions. In particular, the application of this mineralization technique to a US contrast agent has been reported recently. The CaCO3 mineral reacts with acids and decomposes to generate calcium dioxide (CO2) gas in an acidic environment. These gas-generating mineralized nanoparticles generated CO2 bubbles in the acidic environment of the tumor, thereby allowing for strong echogenic US imaging of tumor tissues. On the basis of this previous work, it was hypothesized that the loading of MR contrast agents into the CaCO3 mineralized nanoparticles may be a novel strategy in designing a contrast agent for dual imaging. Herein, CaCO3 mineralized nanoparticles that were capable of generating CO2 bubbles to trigger the release of entrapped MR contrast agents in response to tumoral acidic pH were developed for the purposes of US and MR dual-modality imaging of tumors. Gd2O3 nanoparticles were selected as an MR contrast agent. A key strategy employed in this study was to prepare Gd2O3 nanoparticle-loaded mineralized nanoparticles (Gd2O3-MNPs) using block copolymer-templated CaCO3 mineralization in the presence of calcium cations (Ca2+), carbonate anions (CO32-) and positively charged Gd2O3 nanoparticles. The CaCO3 core was considered suitable because it may effectively shield Gd2O3 nanoparticles from water molecules in the blood (pH 7.4) before decomposing to generate CO2 gas, triggering the release of Gd2O3 nanoparticles in tumor tissues (pH 6.4~7.4). The kinetics of CaCO3 dissolution and CO2 generation from the Gd2O3-MNPs were examined as a function of pH and pH-dependent in vitro magnetic relaxation; additionally, the echogenic properties were estimated to demonstrate the potential of the particles for the tumor-specific US and MR imaging.

Keywords: calcium carbonate, mineralization, ultrasound imaging, magnetic resonance imaging

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232 Blood Thicker Than Water: A Case Report on Familial Ovarian Cancer

Authors: Joanna Marie A. Paulino-Morente, Vaneza Valentina L. Penolio, Grace Sabado

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Ovarian cancer is extremely hard to diagnose in its early stages, and those afflicted at the time of diagnosis are typically asymptomatic and in the late stages of the disease, with metastasis to other organs. Ovarian cancers often occur sporadically, with only 5% associated with hereditary mutations. Mutations in the BRCA1 and BRCA2 tumor suppressor genes have been found to be responsible for the majority of hereditary ovarian cancers. One type of ovarian tumor is Malignant Mixed Mullerian Tumor (MMMT), which is a very rare and aggressive type, accounting for only 1% of all ovarian cancers. Reported is a case of a 43-year-old G3P3 (3003), who came into our institution due to a 2-month history of difficulty of breathing. Family history reveals that her eldest and younger sisters both died of ovarian malignancy, with her younger sister having a histopathology report of endometrioid ovarian carcinoma, left ovary stage IIIb. She still has 2 asymptomatic sisters. Physical examination pointed to pleural effusion of right lung, and presence of bilateral ovarian new growth, which had a Sassone score of 13. Admitting Diagnosis was G3P3 (3003), Ovarian New Growth, bilateral, Malignant; Pleural effusion secondary to malignancy. BRCA was requested to establish a hereditary mutation; however, the patient had no funds. Once the patient was stabilized, TAHBSO with surgical staging was performed. Intraoperatively, the pelvic cavity was occupied by firm, irregularly shaped ovaries, with a colorectal metastasis. Microscopic sections from both ovaries and the colorectal metastasis had pleomorphic tumor cells lined by cuboidal to columnar epithelium exhibiting glandular complexity, displaying nuclear atypia and increased nuclear-cytoplasmic ratio, which are infiltrating the stroma, consistent with the features of Malignant Mixed Mullerian Tumor, since MMMT is composed histologically of malignant epithelial and sarcomatous elements. In conclusion, discussed is the clinic-pathological feature of a patient with primary ovarian Malignant Mixed Mullerian Tumor, a rare malignancy comprising only 1% of all ovarian neoplasms. Also, by understanding the hereditary ovarian cancer syndromes and its relation to this patient, it cannot be overemphasized that a comprehensive family history is really fundamental for early diagnosis. The familial association of the disease, given that the patient has two sisters who were diagnosed with an advanced stage of ovarian cancer and succumbed to the disease at a much earlier age than what is reported in the general population, points to a possible hereditary syndrome which occurs in only 5% of ovarian neoplasms. In a low-resource setting, being in a third world country, the following will be recommended for monitoring and/or screening women who are at high risk for developing ovarian cancer, such as the remaining sisters of the patient: 1) Physical examination focusing on the breast, abdomen, and rectal area every 6 months. 2) Transvaginal sonography every 6 months. 3) Mammography annually. 4) CA125 for postmenopausal women. 5) Genetic testing for BRCA1 and BRCA2 will be reserved for those who are financially capable.

Keywords: BRCA, hereditary breast-ovarian cancer syndrome, malignant mixed mullerian tumor, ovarian cancer

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231 Barriers and Facilitators of Physical Activity among Adults and Older Adults from Black and Minority Ethnic Groups in the UK: A Meta-Ethnographic Study

Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell

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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.

Keywords: BME, UK, meta-ethnographic, adults

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230 Local Governance Systems for Value Chains' Promotion: A Chance for Rural Development in Tunisia

Authors: Neil Fourati

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Collaboration between public and private stakeholders for agricultural development are today lacking in Tunisia. The last dictatorship witnessed by the country has deteriorated the necessary trust between the state and small farmers for the realization of development projects, in particular in the interior, disadvantaged regions of the country. These regions, where the youth unemployment rate is above 30%, have been the heart of the uprising that preceded the revolution. The transitional period that the country is going through since 2011 is an opportunity for the emergence of new governance systems in the context of the decentralization. The latter is recognized in the 2nd Tunisian Republic constitution as the basis of regional management. Civil society participation to the decision-making process is considered as a mean to identify measures that are more coherent with local populations’ needs. The development of agriculture and food value chains in rural areas is relevant within the framework of the implementation of new decisions systems that require public-private collaborations. These new systems can lead to actions in favor of improving living conditions of rural populations. The diverisification of activities around agriculture can be a solution for job creation and local value creation. The project for the promotion of sustainable agriculture and rural development in Tunisia has designed and implemented a multi-stakeholder dialogue process for the development of local value chains platforms in disadvantaged areas of the country. The platforms gather public and private organizations ; as well civil society organizations ; that intervene in a locality in relation to the production transformation or product’s commercialization. The role of these platforms is to formulate realize and evaluate collaborative actions or projects for the promotion of the concerned product and territory. The dialogue process steps allow to create the necessary collaboration conditions in order to promote viable collectivities, dynamic economies and healthy environments. Effectively, the dialogue process steps allow to identify the local leaders. These leaders recognize the development constraints and opportunities. They deal with key and gathering subjects around the collaborative projects or actions. They take common decisions in order to create effective coalitions for the implementation of common actions. The plateforms realize quick success so as to build trust. The project has supported the formulation of 22 collaborative projects. Seven priority collaborative projects have been realized. Each collaborative project includes 3 parts : the signature of the collaboration conventions between public and private organizations, investment in the relevant material in order to increase productivity and the quality of local and products and finally management and technical training in favour of producers’ organizations for the promotion of local products. The implementation of this process has enabled to enhance the capacities of collaboration between local actors : producers, traders, processors and support structures from public sector and civil society. It also allowed to improve the efficiency and relevance of actions and measures for agriculture and rural development programs. Thus, the process for the development of local value chain platform is a basis for sustainable development of agriculture.

Keywords: governance, public private collaboration, rural development, value chains

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229 Modeling the Demand for the Healthcare Services Using Data Analysis Techniques

Authors: Elizaveta S. Prokofyeva, Svetlana V. Maltseva, Roman D. Zaitsev

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Rapidly evolving modern data analysis technologies in healthcare play a large role in understanding the operation of the system and its characteristics. Nowadays, one of the key tasks in urban healthcare is to optimize the resource allocation. Thus, the application of data analysis in medical institutions to solve optimization problems determines the significance of this study. The purpose of this research was to establish the dependence between the indicators of the effectiveness of the medical institution and its resources. Hospital discharges by diagnosis; hospital days of in-patients and in-patient average length of stay were selected as the performance indicators and the demand of the medical facility. The hospital beds by type of care, medical technology (magnetic resonance tomography, gamma cameras, angiographic complexes and lithotripters) and physicians characterized the resource provision of medical institutions for the developed models. The data source for the research was an open database of the statistical service Eurostat. The choice of the source is due to the fact that the databases contain complete and open information necessary for research tasks in the field of public health. In addition, the statistical database has a user-friendly interface that allows you to quickly build analytical reports. The study provides information on 28 European for the period from 2007 to 2016. For all countries included in the study, with the most accurate and complete data for the period under review, predictive models were developed based on historical panel data. An attempt to improve the quality and the interpretation of the models was made by cluster analysis of the investigated set of countries. The main idea was to assess the similarity of the joint behavior of the variables throughout the time period under consideration to identify groups of similar countries and to construct the separate regression models for them. Therefore, the original time series were used as the objects of clustering. The hierarchical agglomerate algorithm k-medoids was used. The sampled objects were used as the centers of the clusters obtained, since determining the centroid when working with time series involves additional difficulties. The number of clusters used the silhouette coefficient. After the cluster analysis it was possible to significantly improve the predictive power of the models: for example, in the one of the clusters, MAPE error was only 0,82%, which makes it possible to conclude that this forecast is highly reliable in the short term. The obtained predicted values of the developed models have a relatively low level of error and can be used to make decisions on the resource provision of the hospital by medical personnel. The research displays the strong dependencies between the demand for the medical services and the modern medical equipment variable, which highlights the importance of the technological component for the successful development of the medical facility. Currently, data analysis has a huge potential, which allows to significantly improving health services. Medical institutions that are the first to introduce these technologies will certainly have a competitive advantage.

Keywords: data analysis, demand modeling, healthcare, medical facilities

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228 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education

Authors: Lauren G. Coggins

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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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227 Non-Invasive Evaluation of Patients After Percutaneous Coronary Revascularization. The Role of Cardiac Imaging

Authors: Abdou Elhendy

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Numerous study have shown the efficacy of the percutaneous intervention (PCI) and coronary stenting in improving left ventricular function and relieving exertional angina. Furthermore, PCI remains the main line of therapy in acute myocardial infarction. Improvement of procedural techniques and new devices have resulted in an increased number of PCI in those with difficult and extensive lesions, multivessel disease as well as total occlusion. Immediate and late outcome may be compromised by acute thrombosis or the development of fibro-intimal hyperplasia. In addition, progression of coronary artery disease proximal or distal to the stent as well as in non-stented arteries is not uncommon. As a result, complications can occur, such as acute myocardial infarction, worsened heart failure or recurrence of angina. In a stent, restenosis can occur without symptoms or with atypical complaints rendering the clinical diagnosis difficult. Routine invasive angiography is not appropriate as a follow up tool due to associated risk and cost and the limited functional assessment. Exercise and pharmacologic stress testing are increasingly used to evaluate the myocardial function, perfusion and adequacy of revascularization. Information obtained by these techniques provide important clues regarding presence and severity of compromise in myocardial blood flow. Stress echocardiography can be performed in conjunction with exercise or dobutamine infusion. The diagnostic accuracy has been moderate, but the results provide excellent prognostic stratification. Adding myocardial contrast agents can improve imaging quality and allows assessment of both function and perfusion. Stress radionuclide myocardial perfusion imaging is an alternative to evaluate these patients. The extent and severity of wall motion and perfusion abnormalities observed during exercise or pharmacologic stress are predictors of survival and risk of cardiac events. According to current guidelines, stress echocardiography and radionuclide imaging are considered to have appropriate indication among patients after PCI who have cardiac symptoms and those who underwent incomplete revascularization. Stress testing is not recommended in asymptomatic patients, particularly early after revascularization, Coronary CT angiography is increasingly used and provides high sensitive for the diagnosis of coronary artery stenosis. Average sensitivity and specificity for the diagnosis of in stent stenosis in pooled data are 79% and 81%, respectively. Limitations include blooming artifacts and low feasibility in patients with small stents or thick struts. Anatomical and functional cardiac imaging modalities are corner stone for the assessment of patients after PCI and provide salient diagnostic and prognostic information. Current imaging techniques cans serve as gate keeper for coronary angiography, thus limiting the risk of invasive procedures to those who are likely to benefit from subsequent revascularization. The determination of which modality to apply requires careful identification of merits and limitation of each technique as well as the unique characteristic of each individual patient.

Keywords: coronary artery disease, stress testing, cardiac imaging, restenosis

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226 Estimating Poverty Levels from Satellite Imagery: A Comparison of Human Readers and an Artificial Intelligence Model

Authors: Ola Hall, Ibrahim Wahab, Thorsteinn Rognvaldsson, Mattias Ohlsson

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The subfield of poverty and welfare estimation that applies machine learning tools and methods on satellite imagery is a nascent but rapidly growing one. This is in part driven by the sustainable development goal, whose overarching principle is that no region is left behind. Among other things, this requires that welfare levels can be accurately and rapidly estimated at different spatial scales and resolutions. Conventional tools of household surveys and interviews do not suffice in this regard. While they are useful for gaining a longitudinal understanding of the welfare levels of populations, they do not offer adequate spatial coverage for the accuracy that is needed, nor are their implementation sufficiently swift to gain an accurate insight into people and places. It is this void that satellite imagery fills. Previously, this was near-impossible to implement due to the sheer volume of data that needed processing. Recent advances in machine learning, especially the deep learning subtype, such as deep neural networks, have made this a rapidly growing area of scholarship. Despite their unprecedented levels of performance, such models lack transparency and explainability and thus have seen limited downstream applications as humans generally are apprehensive of techniques that are not inherently interpretable and trustworthy. While several studies have demonstrated the superhuman performance of AI models, none has directly compared the performance of such models and human readers in the domain of poverty studies. In the present study, we directly compare the performance of human readers and a DL model using different resolutions of satellite imagery to estimate the welfare levels of demographic and health survey clusters in Tanzania, using the wealth quintile ratings from the same survey as the ground truth data. The cluster-level imagery covers all 608 cluster locations, of which 428 were classified as rural. The imagery for the human readers was sourced from the Google Maps Platform at an ultra-high resolution of 0.6m per pixel at zoom level 18, while that of the machine learning model was sourced from the comparatively lower resolution Sentinel-2 10m per pixel data for the same cluster locations. Rank correlation coefficients of between 0.31 and 0.32 achieved by the human readers were much lower when compared to those attained by the machine learning model – 0.69-0.79. This superhuman performance by the model is even more significant given that it was trained on the relatively lower 10-meter resolution satellite data while the human readers estimated welfare levels from the higher 0.6m spatial resolution data from which key markers of poverty and slums – roofing and road quality – are discernible. It is important to note, however, that the human readers did not receive any training before ratings, and had this been done, their performance might have improved. The stellar performance of the model also comes with the inevitable shortfall relating to limited transparency and explainability. The findings have significant implications for attaining the objective of the current frontier of deep learning models in this domain of scholarship – eXplainable Artificial Intelligence through a collaborative rather than a comparative framework.

Keywords: poverty prediction, satellite imagery, human readers, machine learning, Tanzania

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225 Modeling the Impact of Time Pressure on Activity-Travel Rescheduling Heuristics

Authors: Jingsi Li, Neil S. Ferguson

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Time pressure could have an influence on the productivity, quality of decision making, and the efficiency of problem-solving. This has been mostly stemmed from cognitive research or psychological literature. However, a salient scarce discussion has been held for transport adjacent fields. It is conceivable that in many activity-travel contexts, time pressure is a potentially important factor since an excessive amount of decision time may incur the risk of late arrival to the next activity. The activity-travel rescheduling behavior is commonly explained by costs and benefits of factors such as activity engagements, personal intentions, social requirements, etc. This paper hypothesizes that an additional factor of perceived time pressure could affect travelers’ rescheduling behavior, thus leading to an impact on travel demand management. Time pressure may arise from different ways and is assumed here to be essentially incurred due to travelers planning their schedules without an expectation of unforeseen elements, e.g., transport disruption. In addition to a linear-additive utility-maximization model, the less computationally compensatory heuristic models are considered as an alternative to simulate travelers’ responses. The paper will contribute to travel behavior modeling research by investigating the following questions: how to measure the time pressure properly in an activity-travel day plan context? How do travelers reschedule their plans to cope with the time pressure? How would the importance of the activity affect travelers’ rescheduling behavior? What will the behavioral model be identified to describe the process of making activity-travel rescheduling decisions? How do these identified coping strategies affect the transport network? In this paper, a Mixed Heuristic Model (MHM) is employed to identify the presence of different choice heuristics through a latent class approach. The data about travelers’ activity-travel rescheduling behavior is collected via a web-based interactive survey where a fictitious scenario is created comprising multiple uncertain events on the activity or travel. The experiments are conducted in order to gain a real picture of activity-travel reschedule, considering the factor of time pressure. The identified behavioral models are then integrated into a multi-agent transport simulation model to investigate the effect of the rescheduling strategy on the transport network. The results show that an increased proportion of travelers use simpler, non-compensatory choice strategies instead of compensatory methods to cope with time pressure. Specifically, satisfying - one of the heuristic decision-making strategies - is adopted commonly since travelers tend to abandon the less important activities and keep the important ones. Furthermore, the importance of the activity is found to increase the weight of negative information when making trip-related decisions, especially route choices. When incorporating the identified non-compensatory decision-making heuristic models into the agent-based transport model, the simulation results imply that neglecting the effect of perceived time pressure may result in an inaccurate forecast of choice probability and overestimate the affectability to the policy changes.

Keywords: activity-travel rescheduling, decision making under uncertainty, mixed heuristic model, perceived time pressure, travel demand management

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224 We Are the Earth That Defends Itself: An Exploration of Discursive Practices of Les Soulèvements De La Terre

Authors: Sophie Del Fa, Loup Ducol

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This presentation will focus on the discursive practices of Les Soulèvements de la Terre (hereafter SdlT), a French environmentalist group mobilized against agribusiness. More specifically, we will use, as a case study, the violently repressed demonstration that took place in Sainte-Soline on March 25, 2023 (see after for details). The SdlT embodies the renewal of anti-capitalist and environmentalist struggles that began with Occupy Wall Street in 2009 and in France with the Nuit debout in 2016 and the yellow vests movement from 2019 to 2020. These struggles have three things in common: they are self-organized without official leaders, they rely mainly on occupations to reappropriate public places (squares, roundabouts, natural territories) and they are anti-capitalist. The SdlT was created in 2021 by activists coming from the Zone-to-Defend of Notre-Dame-des-Landes, a victorious 10 yearlong occupation movement against an airport near Nantes, France (from 2009 to 2018). The SdlT is not labeled as a formal association, nor as a constituted group, but as an anti-capitalist network of local struggles at the crossroads of ecology and social issues. Indeed, although they target agro-industry, land grabbing, soil artificialization and ecology without transition, the SdlT considers ecological and social questions as interdependent. Moreover, they have an encompassing vision of ecology that they consider as a concern for the living as a whole by erasing the division between Nature and Culture. Their radicality is structured around three main elements: federative and decentralized dimensions, the rhetoric of living alliances and militant creatives strategies. The objective of this reflexion is to understand how these three dimensions are articulated through the SdlT’s discursive practices. To explore these elements, we take as a case study one specific event: the demonstration against the ‘basins’ held in Sainte-Soline on March 25, 2023, on the construction site of new water storage infrastructure for agricultural irrigation in western France. This event represents a turning point for the SdlT. Indeed, the protest was violently repressed: 5000 grenades were fired by the police, hundreds of people were injured, and one person was still in a coma at the time of writing these lines. Moreover, following Saint-Soline’s events, the Minister of Interior Affairs, Gérald Darmin, threatened to dissolve the SdlT, thus adding fuel to the fire in an already tense social climate (with the ongoing strikes against the pensions reform). We anchor our reflexion on three types of data: 1) our own experiences (inspired by ethnography) of the Sainte-Soline demonstration; 2) the collection of more than 500 000 Tweets with the #SainteSoline hashtag and 3) a press review of texts and articles published after Sainte-Soline’s demonstration. The exploration of these data from a turning point in the history of the SdlT will allow us to analyze how the three dimensions highlighted earlier (federative and decentralized dimensions, rhetoric of living alliances and creatives militant strategies) are materialized through the discursive practices surrounding the Sainte-Soline event. This will allow us to shed light on how a new contemporary movement implements contemporary environmental struggles.

Keywords: discursive practices, Sainte-Soline, Ecology, radical ecology

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