Search results for: Katie Olson
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 36

Search results for: Katie Olson

36 Closing the Front Door of Child Protection: Rethinking Mandated Reporting

Authors: Miriam Itzkowitz, Katie Olson

Abstract:

Through an interdisciplinary and trauma-responsive lens, this article reviews the legal and social history of mandated reporting laws and family separation, examines the ethical conundrum of mandated reporting as it relates to evidence-based practice, and discusses alternatives to mandated reporting as a primary prevention strategy. Using existing and emerging data, the authors argue that mandated reporting as a universal strategy contributes to racial disproportionality in the child welfare system and that anti-racist practices should begin with an examination of our reliance on mandated reporting.

Keywords: child welfare, education, mandated reporting, racial disproportionality, trauma

Procedia PDF Downloads 292
35 Motivational Interviewing as a Framework for Coaching Physicians through ACGME Milestones

Authors: Michael Olson

Abstract:

The Accreditation Council for Graduate Medical Education (ACGME) in the U.S. has established core competencies and milestones for family physicians in residency training programs. These competencies are intended to guide preceptors as they work with physician trainees toward independent practice. This conceptual paper describes a framework for coaching trainees toward these milestones using motivational interviewing as an evidence-based approach. The main objective of applying the motivational interviewing framework to the residency training setting is to facilitate clinical behavior change that meets higher level competencies/rubric. This is a work in progress and there is no manuscript/paper prepared to date. A conceptual paper/framework will be completed by the conference deadline. This is based on a separate but related development of work we have completed and published elsewhere.

Keywords: coaching, motivational interviewing, physicians, competencies

Procedia PDF Downloads 144
34 Unsupervised Text Mining Approach to Early Warning System

Authors: Ichihan Tai, Bill Olson, Paul Blessner

Abstract:

Traditional early warning systems that alarm against crisis are generally based on structured or numerical data; therefore, a system that can make predictions based on unstructured textual data, an uncorrelated data source, is a great complement to the traditional early warning systems. The Chicago Board Options Exchange (CBOE) Volatility Index (VIX), commonly referred to as the fear index, measures the cost of insurance against market crash, and spikes in the event of crisis. In this study, news data is consumed for prediction of whether there will be a market-wide crisis by predicting the movement of the fear index, and the historical references to similar events are presented in an unsupervised manner. Topic modeling-based prediction and representation are made based on daily news data between 1990 and 2015 from The Wall Street Journal against VIX index data from CBOE.

Keywords: early warning system, knowledge management, market prediction, topic modeling.

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33 The Use of Piezocone Penetration Test Data for the Assessment of Iron Ore Tailings Liquefaction Susceptibility

Authors: Breno M. Castilho

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The Iron Ore Quadrangle, located in the state of Minas Gerais, Brazil is responsible for most of the country’s iron ore production. As a result, some of the biggest tailings dams in the country are located in this area. In recent years, several major failure events have happened in Tailings Storage Facilities (TSF) located in the Iron Ore Quadrangle. Some of these failures were found to be caused by liquefaction flowslides. This paper presents Piezocone Penetration Test (CPTu) data that was used, by applying Olson and Peterson methods, for the liquefaction susceptibility assessment of the iron ore tailings that are typically found in most TSF in the area. Piezocone data was also used to determine the steady-state strength of the tailings so as to allow for comparison with its drained strength. Results have shown great susceptibility for liquefaction to occur in the studied tailings and, more importantly, a large reduction in its strength. These results are key to understanding the failures that took place over the last few years.

Keywords: Piezocone Penetration Test CPTu, iron ore tailings, mining, liquefaction susceptibility assessment

Procedia PDF Downloads 203
32 A Topological Approach for Motion Track Discrimination

Authors: Tegan H. Emerson, Colin C. Olson, George Stantchev, Jason A. Edelberg, Michael Wilson

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Detecting small targets at range is difficult because there is not enough spatial information present in an image sub-region containing the target to use correlation-based methods to differentiate it from dynamic confusers present in the scene. Moreover, this lack of spatial information also disqualifies the use of most state-of-the-art deep learning image-based classifiers. Here, we use characteristics of target tracks extracted from video sequences as data from which to derive distinguishing topological features that help robustly differentiate targets of interest from confusers. In particular, we calculate persistent homology from time-delayed embeddings of dynamic statistics calculated from motion tracks extracted from a wide field-of-view video stream. In short, we use topological methods to extract features related to target motion dynamics that are useful for classification and disambiguation and show that small targets can be detected at range with high probability.

Keywords: motion tracks, persistence images, time-delay embedding, topological data analysis

Procedia PDF Downloads 80
31 Meta-Review of Scholarly Publications on Biosensors: A Bibliometric Study

Authors: Nasrine Olson

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With over 70,000 scholarly publications on the topic of biosensors, an overview of the field has become a challenge. To facilitate, there are currently over 700 expert-reviews of publications on biosensors and related topics. This study focuses on these review papers in order to provide a Meta-Review of the area. This paper provides a statistical analysis and overview of biosensor-related review papers. Comprehensive searches are conducted in the Web of Science, and PubMed databases and the resulting empirical material are analyzed using bibliometric methods and tools. The study finds that the biosensor-related review papers can be categorized in five related subgroups, broadly denoted by (i) properties of materials and particles, (ii) analysis and indicators, (iii) diagnostics, (iv) pollutant and analytical devices, and (v) treatment/ application. For an easy and clear access to the findings visualization of clusters and networks of connections are presented. The study includes a temporal dimension and identifies the trends over the years with an emphasis on the most recent developments. This paper provides useful insights for those who wish to form a better understanding of the research trends in the area of biosensors.

Keywords: bibliometrics, biosensors, meta-review, statistical analysis, trends visualization

Procedia PDF Downloads 183
30 Pregnancy Outcomes Affected by COVID-19, Large Obstetrics and Gynecology Cohort in Southern Vietnam

Authors: Le-Quyen Nguyen, Hoang Van Bui, Ngoc Thi Tran, Binh Thanh Le, Linus Olson, Thanh Quang Le

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Objective: We compared of outcomes between infected and non-infected COVID-19 pregnant at the largest obstetrics and gynecology hospital in southern Vietnam. Materials and Methods: A retrospective study was conducted at gestational age (GA) 28-42 weeks, who terminated pregnancy and had a real-time PCR test for SARS-CoV-2 at Tu Du Hospital. Demographic, clinical, laboratory, and epidemiological data were collected from hospital electronic-medical-records. Diagnosis and screening of SARS-CoV-2 used Real-time-PCR. Results: From July to October 2021, 9,246 pregnant with GA of 28-42 weeks were delivered, including 664 infected with COVID-19 and 8,582 non-infected. The cesarean section (CS) rates of pregnant with and without COVID-19 were 47.3% and 46.0%. At GA 32-34 weeks, the rate of CS with COVID-19 was 5.07 times higher than without. The rate of postpartum hemorrhage (PPH) and the Apgar score between these two groups were similar. The mortality rate of infected pregnants was 2.26%. Conclusions: COVID-19 infection increased the CS rate in the group of preterm pregnancies from 32 to less than 34 weeks. COVID-19 did not increase the risk of complications related to adverse pregnancy outcomes such as PPH, Apgar scores, the ratio of stillbirths, deaths due to malformation, and fetal deaths in labor.

Keywords: COVID-19, SARS-CoV-2, pregnancy, outcome, vietnam

Procedia PDF Downloads 92
29 The Hauntings of Empire: Imperial Nationalism and International Relations

Authors: Katie Hudson

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A growing body of scholarship is dedicated to the concept of imperial nationalism, denoting a nostalgia for empire amongst former imperial powers and a yearning to recapture the grandeur of the imperial ‘golden age.’ Much research within this field has focused on Brexit, arguing that Britain’s imperialist identity has spawned Euroscepticism. However, the interaction between imperial nationalism and foreign policy remains underdeveloped and thus far has failed to consider cases outside of the UK. Using maximum variation sampling across post-2000 Britain, Spain and the Netherlands, this comparative analysis aims to explore the discursive invocation of empire in foreign policy framing, under which circumstances and in what ways imperial nationalism emerges. Preliminary findings demonstrate that empire is most often cited when there is a perceived threat to the sovereignty of the nation and that all cases frame foreign policy options according to their acute concerns with regaining the prestige associated with empire. This is present to a lesser extent in Spain, whose earlier period of decolonisation affected the extent to which imperialism has permeated their national psyche. This, therefore, provides an alternative lens through which we can view both Euroscepticism and international relations, conditioned by an imperial legacy.

Keywords: empire, nationalism, foreign policy, IR

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28 Palliation of Pain in Pyomyositis: A Case Series and Literature Review

Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

Procedia PDF Downloads 107
27 The Mathematics of Fractal Art: Using a Derived Cubic Method and the Julia Programming Language to Make Fractal Zoom Videos

Authors: Darsh N. Patel, Eric Olson

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Fractals can be found everywhere, whether it be the shape of a leaf or a system of blood vessels. Fractals are used to help study and understand different physical and mathematical processes; however, their artistic nature is also beautiful to simply explore. This project explores fractals generated by a cubically convergent extension to Newton's method. With this iteration as a starting point, a complex plane spanning from -2 to 2 is created with a color wheel mapped onto it. Next, the polynomial whose roots the fractal will generate from is established. From the Fundamental Theorem of Algebra, it is known that any polynomial has as many roots (counted by multiplicity) as its degree. When generating the fractals, each root will receive its own color. The complex plane can then be colored to indicate the basins of attraction that converge to each root. From a computational point of view, this project’s code identifies which points converge to which roots and then obtains fractal images. A zoom path into the fractal was implemented to easily visualize the self-similar structure. This path was obtained by selecting keyframes at different magnifications through which a path is then interpolated. Using parallel processing, many images were generated and condensed into a video. This project illustrates how practical techniques used for scientific visualization can also have an artistic side.

Keywords: fractals, cubic method, Julia programming language, basin of attraction

Procedia PDF Downloads 218
26 Construction of a Supply Chain Model Using the PREVA Method: The Case of Innovative Sargasso Recovery Projects in Ther Lesser Antilles

Authors: Maurice Bilioniere, Katie Lanneau

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Suddenly appeared in 2011, invasions of sargasso seaweeds Fluitans and Natans are a climatic hazard which causes many problems in the Caribbean. Faced with the growth and frequency of the phenomenon of massive sargasso stranding on their coasts, the French West Indies are moving towards the path of industrial recovery. In this context of innovative projects, we will analyze the necessary requirements for the management and performance of the supply chain, taking into account the observed volatility of the sargasso input. Our prospective approach will consist in studying the theoretical framework of modeling a hybrid supply chain by coupling the discreet event simulation (DES) with a valuation of the process costs according to the "activity-based costing" method (ABC). The PREVA approach (PRocess EVAluation) chosen for our modeling has the advantage of evaluating the financial flows of the logistic process using an analytical model chained with an action model for the evaluation or optimization of physical flows.

Keywords: sargasso, PREVA modeling, supply chain, ABC method, discreet event simulation (DES)

Procedia PDF Downloads 147
25 Resocializing Corporate Mindfulness and Meditation: A Relational-Sociological Account of Mindfulness Course Curricula in the Workplace

Authors: Katie Temple

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This paper investigates how corporate actors forge commensurability between Buddhist-based mindfulness techniques and day-to-day organizational life. In-depth interviews were conducted with mindfulness instructors certified through Google’s Search Inside Yourself Leadership Institute (SIYLI), an organization that designs corporate mindfulness program curricula based on their experiences guiding courses in Fortune 500 companies. Drawing from anti-essentialist sociology and interpretive data analysis, this paper describes instructors’ use of their standardized teacher guidebooks, a regulatory script all SIYLI-certified instructors must adhere to, and instructors’ reinterpretations of teaching protocols at the local level. Instructors mediate standardized rules through their embodied knowledge, perceived receptivity and effect of a given audience, and their political values. Instructors also resist standardizing practices by developing creative, under-the-radar tactics to deviate from the guidebook and assert their own spiritual autonomy. This research contributes to growing debates challenging critical and neoliberal accounts of capitalist abstraction.

Keywords: anti-essentialism, corporate culture, interpretive methods, mindfulness and meditation, relational sociology

Procedia PDF Downloads 56
24 Exploring Gender Bias in Self-Report Measures of Psychopathy

Authors: Katie Strong, Brian P. O'Connor, Jacqueline M. Kanippayoor

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To date, self-report measures of psychopathy have largely been conceptualized with a male-focused understanding of the disorder, with the presumption that psychopathy expression is uniform across genders. However, generalizing this understanding to the female population may be misleading. The objective of this research was to explore gender differences in the expression of psychopathy and to assess current self-report psychopathy measures for gender bias. It was hypothesized that some items in commonly used measures of psychopathy may show gender bias and that existing measures may not contain enough items that are relevant to the manifestation of psychopathy in women. An exploratory investigation was conducted on statistical bias in common measures of psychopathy, and novel, relevant, but previously neglected items and measures were included in a new data collection. The participant pool included a sample of 403 university students and 354 participants recruited using Amazon Mechanical Turk. Item Response Theory methods - including Differential Item Functioning - were used to assess for the item- and test- level bias across several common self-report measures of psychopathy. Analyses indicated occasional and modest levels of item-level bias, and that some additional female-relevant items merit consideration for inclusion in measures of psychopathy. These findings suggest that current self-report measures of psychopathy may be demonstrating gender-bias and warrant further examination.

Keywords: gender, measurement bias, personality, psychopathy

Procedia PDF Downloads 219
23 A Students' Ability Analysis Methods, Devices, Electronic Equipment and Storage Media Design

Authors: Dequn Teng, Tianshuo Yang, Mingrui Wang, Qiuyu Chen, Xiao Wang, Katie Atkinson

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Currently, many students are kind of at a loss in the university due to the complex environment within the campus, where every information within the campus is isolated with fewer interactions with each other. However, if the on-campus resources are gathered and combined with the artificial intelligence modelling techniques, there will be a bridge for not only students in understanding themselves, and the teachers will understand students in providing a much efficient approach in education. The objective of this paper is to provide a competency level analysis method, apparatus, electronic equipment, and storage medium. It uses a user’s target competency level analysis model from a plurality of predefined candidate competency level analysis models by obtaining a user’s promotion target parameters, promotion target parameters including at least one of the following parameters: target profession, target industry, and the target company, according to the promotion target parameters. According to the parameters, the model analyzes the user’s ability level, determines the user’s ability level, realizes the quantitative and personalized analysis of the user’s ability level, and helps the user to objectively position his ability level.

Keywords: artificial intelligence, model, university, education, recommendation system, evaluation, job hunting

Procedia PDF Downloads 113
22 Cyber Supply Chain Resilient: Enhancing Security through Leadership to Protect National Security

Authors: Katie Wood

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Cyber criminals are constantly on the lookout for new opportunities to exploit organisation and cause destruction. This could lead to significant cause of economic loss for organisations in the form of destruction in finances, reputation and even the overall survival of the organization. Additionally, this leads to serious consequences on national security. The threat of possible cyber attacks places further pressure on organisations to ensure they are secure, at a time where international scale cyber attacks have occurred in a range of sectors. Stakeholders are wanting confidence that their data is protected. This is only achievable if a business fosters a resilient supply chain strategy which is implemented throughout its supply chain by having a strong cyber leadership culture. This paper will discuss the essential role and need for organisations to adopt a cyber leadership culture and direction to learn about own internal processes to ensure mitigating systemic vulnerability of its supply chains. This paper outlines that to protect national security there is an urgent need for cyber awareness culture change. This is required in all organisations, regardless of their sector or size, to implementation throughout the whole supplier chain to support and protect economic prosperity to make the UK more resilient to cyber-attacks. Through businesses understanding the supply chain and risk management cycle of their own operates has to be the starting point to ensure effective cyber migration strategies.

Keywords: cyber leadership, cyber migration strategies, resilient supply chain strategy, cybersecurity

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21 Biochar Affects Compressive Strength of Portland Cement Composites: A Meta-Analysis

Authors: Zhihao Zhao, Ali El-Nagger, Johnson Kau, Chris Olson, Douglas Tomlinson, Scott X. Chang

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One strategy to reduce CO₂ emissions from cement production is to reduce the amount of Portland cement produced by replacing it with supplementary cementitious materials (SCMs). Biochar is a potential SCM that is an eco-friendly and stable porous pyrolytic material. However, the effects of biochar addition on the performances of Portland cement composites are not fully understood. This meta-analysis investigated the impact of biochar addition on the 7- and 28-day compressive strength of Portland cement composites based on 606 paired observations. Biochar feedstock type, pyrolysis conditions, pre-treatments and modifications, biochar dosage, and curing type all influenced the compressive strength of Portland cement composites. Biochars obtained from plant-based feedstocks (except rice and hardwood) improved the 28-day compressive strength of Portland cement composites by 3-13%. Biochars produced at pyrolysis temperatures higher than 450 °C, with a heating rate of around 10 °C/min, increased the 28-day compressive strength more effectively. Furthermore, the addition of biochars with small particle sizes increased the compressive strength of Portland cement composites by 2-7% compared to those without biochar addition. Biochar dosage of < 2.5% of the binder weight enhanced both compressive strengths and common curing methods maintained the effect of biochar addition. However, when mixing the cement, adding fine and coarse aggregates such as sand and gravel affects the concrete and mortar's compressive strength, diminishing the effect of biochar addition and making the biochar effect nonsignificant. We conclude that appropriate biochar addition could maintain or enhance the mechanical performance of Portland cement composites, and future research should explore the mechanisms of biochar effects on the performance of cement composites.

Keywords: biochar, Portland cement, constructure, compressive strength, meta-analysis

Procedia PDF Downloads 19
20 Development of Patient Satisfaction Questionnaire for Diabetes Management in Thailand and Lao People Democratic Republic

Authors: Phoutsathaphone Sibounheuang, Phayom Sookaneknun Olson, Chanuttha Ploylearmsang, Santiparp Sookaneknun, Chanthanom Manithip

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Patient satisfaction is an outcome that can be measured and used to improve diabetes care and management. There are limited instruments for assessing patient satisfaction covering the whole process of diabetes management. In this study, the questionnaire was developed with items pooled from a systematic review of qualitative studies of patients’ and healthcare providers’ perspectives in diabetes management. The questionnaire consists of 11 domains with 45 items. The Thai version was translated to Lao and then checked by back-translating it into Thai. We tested the questionnaire on 150 diabetes patients in Thailand and 150 in Lao People Democratic Republic (PDR). Validity was performed by factor analysis and Pearson correlation. Internal consistency reliability was estimated by calculating Cronbach’s alpha. The study was approved by the Mahasarakham University Ethics Committee, and the National Ethics Committee for Health Research, Lao PDR. The Thai and Lao versions showed the construct validity by principal component analysis. This consisted of 11 domains which account for 71.23% of the variance (Thai version) and 71.66% of the variance (Lao version) in the total patient satisfaction scores. The Kaiser-Meyer-Olkin (KMO) measures were 0.85 for the Thai version and 0.75 for the Lao version. The Bartlett tests of sphericity of both versions were significant (p < 0.001). The factor loadings of all items in both versions were > 0.40. The convergent validity of the Thai and Lao versions was 93.63% and 79.54% respectively. The discriminant validity for the Thai and Lao versions was 92.68% and 88.68% respectively. Cronbach’s alpha was 0.95 in both versions. The Patient Satisfaction Questionnaire (PSQ) in both versions had acceptable properties. This study has yielded evidence supporting the validity and reliability of both versions.

Keywords: construct validity, diabetes management, patient satisfaction, questionnaire development, reliability

Procedia PDF Downloads 110
19 An Assessment of Sexual Informational Needs of Breast Cancer Patients in Radiation Oncology

Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

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Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

Procedia PDF Downloads 174
18 Depth Camera Aided Dead-Reckoning Localization of Autonomous Mobile Robots in Unstructured GNSS-Denied Environments

Authors: David L. Olson, Stephen B. H. Bruder, Adam S. Watkins, Cleon E. Davis

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In global navigation satellite systems (GNSS), denied settings such as indoor environments, autonomous mobile robots are often limited to dead-reckoning navigation techniques to determine their position, velocity, and attitude (PVA). Localization is typically accomplished by employing an inertial measurement unit (IMU), which, while precise in nature, accumulates errors rapidly and severely degrades the localization solution. Standard sensor fusion methods, such as Kalman filtering, aim to fuse precise IMU measurements with accurate aiding sensors to establish a precise and accurate solution. In indoor environments, where GNSS and no other a priori information is known about the environment, effective sensor fusion is difficult to achieve, as accurate aiding sensor choices are sparse. However, an opportunity arises by employing a depth camera in the indoor environment. A depth camera can capture point clouds of the surrounding floors and walls. Extracting attitude from these surfaces can serve as an accurate aiding source, which directly combats errors that arise due to gyroscope imperfections. This configuration for sensor fusion leads to a dramatic reduction of PVA error compared to traditional aiding sensor configurations. This paper provides the theoretical basis for the depth camera aiding sensor method, initial expectations of performance benefit via simulation, and hardware implementation, thus verifying its veracity. Hardware implementation is performed on the Quanser Qbot 2™ mobile robot, with a Vector-Nav VN-200™ IMU and Kinect™ camera from Microsoft.

Keywords: autonomous mobile robotics, dead reckoning, depth camera, inertial navigation, Kalman filtering, localization, sensor fusion

Procedia PDF Downloads 177
17 Impact of Mucormycosis Infection In Limb Salvage for Trauma Patients

Authors: Katie-Beth Webster

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Mucormycosis is a rare opportunistic fungal infection that, if left untreated, can cause large scale tissue necrosis and death. There are a number of cases of this in the literature, most commonly in the head and neck region arising from sinuses. It is also usually found in immunocompromised patient subgroups. This study reviewed a number of cases of mucormycosis in previously fit and healthy young trauma patients to assess predisposing factors for infection and adequacy of current treatment paradigms. These trauma patients likely contracted the fungal infection from the soil at the site of the incident. Despite early washout and debridement of the wounds at the scene of the injury and on arrival in hospital, both these patients contracted mucormycosis. It was suspected that inadequate early debridement of soil contaminated limbs was one of the major factors that can lead to catastrophic tissue necrosis. In both cases, this resulted in the patients having a higher level of amputation than would have initially been required based on the level of their injury. This was secondary to cutaneous and soft tissue necrosis secondary to the fungal infiltration leading to osteomyelitis and systemic sepsis. In the literature, it appears diagnosis is often protracted in this condition secondary to inadequate early treatment and long processing times for fungal cultures. If fungal cultures were sent at the time of first assessment and adequate debridements are performed aggressively early, it could lead to these critically unwell trauma patients receiving appropriate antifungal and surgical treatment earlier in their episode of care. This is likely to improve long term outcomes for these patients.

Keywords: mucormycosis, plastic surgery, osteomyelitis, trauma

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16 Opportunities for Lesbian/Gay/Bisexual/Transgender/Queer/Questioning Tourism in Vietnam

Authors: Eric D. Olson

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The lesbian/gay/bisexual/transgender/queer/questioning tourist (LGBTQ+) travels more frequently, spends more money on travel, and is more likely to travel internationally compared to their straight/heterosexual counterparts. For Vietnam, this represents a huge opportunity to increase international tourism, considering social advancements and recognition of the LGBTQ+ have greatly increased in the past few years in Vietnam. For example, Vietnam’s Health Ministry confirmed in 2022 that same-sex attraction and being transgender is not a mental health condition. A robust hospitality ecosystem of LGBTQ+ tourism suppliers already exists in Vietnam catering to LGBTQ+ tourists (e.g., Gay Hanoi Tours, VietPride). Vietnam is a safe and welcoming destination with incredible nature, cosmopolitan cities, and friendly people; however, there is a dearth of academic and industry research that has examined how LGBTQ+ international tourists perceive Vietnam as an LGBTQ+ friendly destination. To rectify this gap, this research examines Vietnam as an LGBTQ+ destination in order to provide government officials, destination marketers, and industry practitioners with insight into this increasingly visible tourist market segment. A self-administered survey instrument was administered to n=375 international LGBTQ+ tourists to examine their perceptions of Vietnam. A factor analysis found three categories of LGBTQ+ factors of visitation to Vietnam: safety and security (Eigenvalue = 4.12, variance = 32.45, α = .82); LGBTQ+ attractions (Eigenvalue = 3.65 variance = 24.23, α = .75); and friendly interactions (Eigenvalue = 3.71, variance = 10.45, α = .96). Multiple regression was used to examine LGBTQ+ visitation factors and intention to visit Vietnam, F=12.20 (2, 127), p < .001, R2 = .56. Safety and security (β = 0.42, p < .001), LGBTQ+ attractions (β = 0.61, p < .001) and friendly interactions (β = 0.42, p < .001) are predictors to visit Vietnam. Results are consistent with previous research that highlight safety/security is of utmost importance to the community when traveling. Attractions, such as LGBTQ+ tours, suppliers, and festivals can also be used as a pull factor in encouraging tourism. Implications/limitations will be discussed.

Keywords: tourism, LGBTQ, vietnam, regression

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15 Harnessing Deep-Level Metagenomics to Explore the Three Dynamic One Health Areas: Healthcare, Domiciliary and Veterinary

Authors: Christina Killian, Katie Wall, Séamus Fanning, Guerrino Macori

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Deep-level metagenomics offers a useful technical approach to explore the three dynamic One Health axes: healthcare, domiciliary and veterinary. There is currently limited understanding of the composition of complex biofilms, natural abundance of AMR genes and gene transfer occurrence in these ecological niches. By using a newly established small-scale complex biofilm model, COMBAT has the potential to provide new information on microbial diversity, antimicrobial resistance (AMR)-encoding gene abundance, and their transfer in complex biofilms of importance to these three One Health axes. Shotgun metagenomics has been used to sample the genomes of all microbes comprising the complex communities found in each biofilm source. A comparative analysis between untreated and biocide-treated biofilms is described. The basic steps include the purification of genomic DNA, followed by library preparation, sequencing, and finally, data analysis. The use of long-read sequencing facilitates the completion of metagenome-assembled genomes (MAG). Samples were sequenced using a PromethION platform, and following quality checks, binning methods, and bespoke bioinformatics pipelines, we describe the recovery of individual MAGs to identify mobile gene elements (MGE) and the corresponding AMR genotypes that map to these structures. High-throughput sequencing strategies have been deployed to characterize these communities. Accurately defining the profiles of these niches is an essential step towards elucidating the impact of the microbiota on each niche biofilm environment and their evolution.

Keywords: COMBAT, biofilm, metagenomics, high-throughput sequencing

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14 The Organizational Structure, Development Features, and Metadiscoursal Elements in the Expository Writing of College Freshman Students

Authors: Lota Largavista

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This study entitled, ‘The Organizational Structure, Development Features, and Metadiscoursal Elements in the Expository Writing of Freshman College Writers’ aimed to examine essays written by college students. It seeks to examine the organizational structure and development features of the essays and describe their defining characteristics, the linguistic elements at both macrostructural and microstructural discourse levels and the types of textual and interpersonal metadiscourse markers that are employed in order to negotiate meanings with their prospective readers. The different frameworks used to analyze the essays include Toulmin’s ( 1984) model for argument structure, Olson’s ( 2003) three-part essay structure; Halliday and Matthiesen (2004) in Herriman (2011) notions of thematic structure, Danes (1974) thematic progression or method of development, Halliday’s (2004) concept of grammatical and lexical cohesion ;Hyland’s (2005) metadiscourse strategies; and Chung and Nation’s( 2003) four-step scale for technical vocabulary. This descriptive study analyzes qualitatively and quantitatively how freshman students generally express their written compositions. Coding of units is done to determine what linguistic features are present in the essays. Findings revealed that students’ expository essays observe a three-part structure having all three moves, the Introduction, the Body and the Conclusion. Stance assertion, stance support, and emerging moves/strategies are found to be employed in the essays. Students have more marked themes on the essays and also prefer constant theme progression as their method of development. The analysis of salient linguistic elements reveals frequently used cohesive devices and metadiscoursal strategies. Based on the findings, an instructional learning plan is being proposed. This plan is characterized by a genre approach that focuses on expository and linguistic conventions.

Keywords: metadiscourse, organization, theme progression, structure

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13 Incorporation of Growth Factors onto Hydrogels via Peptide Mediated Binding for Development of Vascular Networks

Authors: Katie Kilgour, Brendan Turner, Carly Catella, Michael Daniele, Stefano Menegatti

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In vivo, the extracellular matrix (ECM) provides biochemical and mechanical properties that are instructional to resident cells to form complex tissues with characteristics to develop and support vascular networks. In vitro, the development of vascular networks can be guided by biochemical patterning of substrates via spatial distribution and display of peptides and growth factors to prompt cell adhesion, differentiation, and proliferation. We have developed a technique utilizing peptide ligands that specifically bind vascular endothelial growth factor (VEGF), erythropoietin (EPO), or angiopoietin-1 (ANG1) to spatiotemporally distribute growth factors to cells. This allows for the controlled release of each growth factor, ultimately enhancing the formation of a vascular network. Our engineered tissue constructs (ETCs) are fabricated out of gelatin methacryloyl (GelMA), which is an ideal substrate for tailored stiffness and bio-functionality, and covalently patterned with growth factor specific peptides. These peptides mimic growth factor receptors, facilitating the non-covalent binding of the growth factors to the ETC, allowing for facile uptake by the cells. We have demonstrated in the absence of cells the binding affinity of VEGF, EPO, and ANG1 to their respective peptides and the ability for each to be patterned onto a GelMA substrate. The ability to organize growth factors on an ETC provides different functionality to develop organized vascular networks. Our results demonstrated a method to incorporate biochemical cues into ETCs that enable spatial and temporal control of growth factors. Future efforts will investigate the cellular response by evaluating gene expression, quantifying angiogenic activity, and measuring the speed of growth factor consumption.

Keywords: growth factor, hydrogel, peptide, angiogenesis, vascular, patterning

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12 Cooling With Phase-Change-Material in Vietnam: Outcomes at 18 Months

Authors: Hang T. T. Tran, Ha T. Le, Hanh T. P. Tran, Hung V. Cao, Giang T. H. Nguyen, Dien M. Tran, Tobias Alfvén, Linus Olson

Abstract:

Background: Hypoxic Ischemic Encephalopathy is one of the major causes of neonatal death and those who survive with severe encephalopathy are more likely to develop adverse long-term outcomes such as neurocognitive impairment and cerebral palsy, which is a huge burden, especially in low-middle income countries. It is important to have a long-term follow-up for early detection and promote early intervention for these groups of high-risk infants. Aim: To determine the neurological outcome of cooling infants at 18 months and identify an optimized neurological examination scale for Hypoxic Ischemic Encephalopathy infants in Vietnam. Method: Descriptive study of neurodevelopmental outcomes at 18 months of HIE infants who underwent therapeutic hypothermia treatment in Vietnam. All survived cooling infants were assessed at discharge and at 6, 12, and 18 months by a pediatric physical therapist and a neurologist using two assessment tools: Ages and Stages Questionnaires and the Hammersmith Infant Neurological Examination scale to detect impairments and promote early intervention for those who require it. Results: During a 3-year period, a total of 130 neonates with moderate to severe HIE underwent therapeutic hypothermia treatment using Phase change material mattress (65% moderate, 35% severe – Sarnat). 43 (33%) died during hospitalization and infancy; among survivors, 69 (79%) completed 3 follow-ups at 18 months. At 18 months, 25 had cerebral palsy, 11 had mild delayed neurodevelopment. At each time-point, infants with a normal/mildly delayed neurodevelopment had significantly higher Ages and Stages Questionnaires and Hammersmith Infant Neurological Examination scores (p<0.05) than those with cerebral palsy. Conclusion: The study showed that the Ages and Stages Questionnaires and Hammersmith Infant Neurological Examination is a helpful tool in the process of early diagnosis of infants at low and high neurological risk and identifying those infants needing specific rehabilitation programme.

Keywords: encephalopathy, phase-change-material, neurodevelopment, cerebral palsy

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11 Arginase Enzyme Activity in Human Serum as a Marker of Cognitive Function: The Role of Inositol in Combination with Arginine Silicate

Authors: Katie Emerson, Sara Perez-Ojalvo, Jim Komorowski, Danielle Greenberg

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The purpose of this study was to evaluate arginase activity levels in response to combinations of an inositol-stabilized arginine silicate (ASI; Nitrosigine®), L-arginine, and Inositol. Arginine acts as a vasodilator that promotes increased blood flow resulting in enhanced delivery of oxygen and nutrients to the brain and other tissues. ASI alone has been shown to improve performance on cognitive tasks. Arginase, found in human serum, catalyzes the conversion of arginine to ornithine and urea, completing the last step in the urea cycle. Decreasing arginase levels maintains arginine and results in increased nitric oxide production. This study aimed to determine the most effective combination of ASI, L-arginine and inositol for minimizing arginase levels and therefore maximize ASI’s effect on cognition. Serum was taken from untreated healthy donors by separation from clotted factors. Arginase activity of serum in the presence or absence of test products was determined (QuantiChrom™, DARG-100, Bioassay Systems, Hayward CA). The remaining ultra-filtrated serum units were harvested and used as the source for the arginase enzyme. ASI alone or combined with varied levels of Inositol were tested as follows: ASI + inositol at 0.25 g, 0.5 g, 0.75 g, or 1.00 g. L-arginine was also tested as a positive control. All tests elicited changes in arginase activity demonstrating the efficacy of the method used. Adding L-arginine to serum from untreated subjects, with or without inositol only had a mild effect. Adding inositol at all levels reduced arginase activity. Adding 0.5 g to the standardized amount of ASI led to the lowest amount of arginase activity as compared to the 0.25g 0.75g or 1.00g doses of inositol or to L-arginine alone. The outcome of this study demonstrates an interaction of the pairing of inositol with ASI on the activity of the enzyme arginase. We found that neither the maximum nor minimum amount of inositol tested in this study led to maximal arginase inhibition. Since the inhibition of arginase activity is desirable for product formulations looking to maintain arginine levels, the most effective amount of inositol was deemed preferred. Subsequent studies suggest this moderate level of inositol in combination with ASI leads to cognitive improvements including reaction time, executive function, and concentration.

Keywords: arginine, inositol, arginase, cognitive benefits

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10 A Joinpoint Regression Analysis of Trends in Tuberculosis Notifications in Two Urban Regions in Namibia

Authors: Anna M. N. Shifotoka, Richard Walker, Katie Haighton, Richard McNally

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An analysis of trends in Case Notification Rates (CNR) can be used to monitor the impact of Tuberculosis (TB) control interventions over time in order to inform the implementation of current and future TB interventions. A retrospective analysis of trends in TB CNR for two urban regions in Namibia, namely Khomas and Erongo regions, was conducted. TB case notification data were obtained from annual TB reports of the national TB programme, Ministry of Health and Social Services, covering the period from 1997 to 2015. Joinpoint regression was used to analyse trends in CNR for different types of TB groups. A trend was considered to be statistically significant when a p-value was less than 0.05. During the period under review, the crude CNR for all forms of TB declined from 808 to 400 per 100 000 population in Khomas, and from 1051 to 611 per 100 000 population in Erongo. In both regions, significant change points in trends were observed for all types of TB groups examined. In Khomas region, the trend for new smear positive pulmonary TB increased significantly by an annual rate of 4.1% (95% Confidence Interval (CI): 0.3% to 8.2%) during the period 1997 to 2004, and thereafter declined significantly by -6.2% (95%CI: -7.7% to -4.3%) per year until 2015. Similarly, the trend for smear negative pulmonary TB increased significantly by 23.7% (95%CI: 9.7 to 39.5) per year from 1997 to 2004 and thereafter declined significantly by an annual change of -26.4% (95%CI: -33.1% to -19.8%). The trend for all forms of TB CNR in Khomas region increased significantly by 8.1% (95%CI: 3.7 to 12.7) per year from 1997 to 2004 and thereafter declined significantly a rate of -8.7% (95%CI: -10.6 to -6.8). In Erongo region, the trend for smear positive pulmonary TB increased at a rate of 1.2% (95%CI: -1.2% to 3.6%) annually during the earlier years (1997 to 2008), and thereafter declined significantly by -9.3% (95%CI: -13.3% to -5.0%) per year from 2008 to 2015. Also in Erongo, the trend for all forms of TB CNR increased significantly by an annual rate of 4.0% (95%CI: 1.4% to 6.6%) during the years between 1997 to 2006 and thereafter declined significantly by -10.4% (95%CI: -12.7% to -8.0%) per year during 2006 to 2015. The trend for extra-pulmonary TB CNR declined but did not reach statistical significance in both regions. In conclusion, CNRs declined for all types of TB examined in both regions. Further research is needed to study trends for other TB dimensions such as treatment outcomes and notification of drug resistant TB cases.

Keywords: epidemiology, Namibia, temporal trends, tuberculosis

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9 Is the Addition of Computed Tomography with Angiography Superior to a Non-Contrast Neuroimaging Only Strategy for Patients with Suspected Stroke or Transient Ischemic Attack Presenting to the Emergency Department?

Authors: Alisha M. Ebrahim, Bijoy K. Menon, Eddy Lang, Shelagh B. Coutts, Katie Lin

Abstract:

Introduction: Frontline emergency physicians require clear and evidence-based approaches to guide neuroimaging investigations for patients presenting with suspected acute stroke or transient ischemic attack (TIA). Various forms of computed tomography (CT) are currently available for initial investigation, including non-contrast CT (NCCT), CT angiography head and neck (CTA), and CT perfusion (CTP). However, there is uncertainty around optimal imaging choice for cost-effectiveness, particularly for minor or resolved neurological symptoms. In addition to the cost of CTA and CTP testing, there is also a concern for increased incidental findings, which may contribute to the burden of overdiagnosis. Methods: In this cross-sectional observational study, analysis was conducted on 586 anonymized triage and diagnostic imaging (DI) reports for neuroimaging orders completed on patients presenting to adult emergency departments (EDs) with a suspected stroke or TIA from January-December 2019. The primary outcome of interest is the diagnostic yield of NCCT+CTA compared to NCCT alone for patients presenting to urban academic EDs with Canadian Emergency Department Information System (CEDIS) complaints of “symptoms of stroke” (specifically acute stroke and TIA indications). DI reports were coded into 4 pre-specified categories (endorsed by a panel of stroke experts): no abnormalities, clinically significant findings (requiring immediate or follow-up clinical action), incidental findings (not meeting prespecified criteria for clinical significance), and both significant and incidental findings. Standard descriptive statistics were performed. A two-sided p-value <0.05 was considered significant. Results: 75% of patients received NCCT+CTA imaging, 21% received NCCT alone, and 4% received NCCT+CTA+CTP. The diagnostic yield of NCCT+CTA imaging for prespecified clinically significant findings was 24%, compared to only 9% in those who received NCCT alone. The proportion of incidental findings was 30% in the NCCT only group and 32% in the NCCT+CTA group. CTP did not significantly increase the yield of significant or incidental findings. Conclusion: In this cohort of patients presenting with suspected stroke or TIA, an NCCT+CTA neuroimaging strategy had a higher diagnostic yield for clinically significant findings than NCCT alone without significantly increasing the number of incidental findings identified.

Keywords: stroke, diagnostic yield, neuroimaging, emergency department, CT

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8 A Dimensional Approach to Family Involvement in Forensic Mental Health Settings - Prevention of the Systemic Replication of Abuse, Need for Accepted Falsehoods and Family Guilt and Shame

Authors: Katie E. Jennings

Abstract:

The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.

Keywords: family dynamics, forensic, mental disorder, positive psychology

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7 Surgical School Project: Implementation Educational Plan for Adolescents Awaiting Bariatric Surgery

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

Abstract:

Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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