Search results for: Sarah Lewis

Authors: A.H.Y. Lai, C. Teyra

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In Taiwan, there are 16 official indigenous groups, accounting for 2.3% of the total population. Like other indigenous populations worldwide, indigenous peoples in Taiwan have poorer mental health because of their history of oppression and colonisation. Amid the negative narratives, the ethnic identity of cultural minorities is their unique psychological and cultural asset. Moreover, positive socialisation is found to be related to strong ethnic identity. Based on Phinney’s theory on ethnic identity development and social support theory, this study adopted a strength-based approach conceptualising ethnic identity as the central organising principle that linked perceived social support and mental health among indigenous adults in Taiwan. Aims. Overall aim is to examine the effect of ethnic identity and social support on mental health. Specific aims were to examine : (1) the association between ethnic identity and mental health; (2) the association between perceived social support and mental health ; (3) the indirect effect of ethnic identity linking perceived social support and mental health. Methods. Participants were indigenous adults in Taiwan (n=200; mean age=29.51; Female=31%, Male=61%, Others=8%). A cross-sectional quantitative design was implemented using data collected in the year 2020. Respondent-driven sampling was used. Standardised measurements were: Ethnic Identity Scale(6-item); Social Support Questionnaire-SF(6 items); Patient Health Questionnaire(9-item); and Generalised Anxiety Disorder(7-item). Covariates were age, gender and economic satisfaction. A four-stage structural equation modelling (SEM) with robust maximin likelihood estimation was employed using Mplus8.0. Step 1: A measurement model was built and tested using confirmatory factor analysis (CFA). Step 2: Factor covariates were re-specified as direct effects in the SEM. Covariates were added. The direct effects of (1) ethnic identity and social support on depression and anxiety and (2) social support on ethnic identity were tested. The indirect effect of ethnic identity was examined with the bootstrapping technique. Results. The CFA model showed satisfactory fit statistics: x^2(df)=869.69(608), p<.05; Comparative ft index (CFI)/ Tucker-Lewis fit index (TLI)=0.95/0.94; root mean square error of approximation (RMSEA)=0.05; Standardized Root Mean Squared Residual (SRMR)=0.05. Ethnic identity is represented by two latent factors: ethnic identity-commitment and ethnic identity-exploration. Depression, anxiety and social support are single-factor latent variables. For the SEM, model fit statistics were: x^2(df)=779.26(527), p<.05; CFI/TLI=0.94/0.93; RMSEA=0.05; SRMR=0.05. Ethnic identity-commitment (b=-0.30) and social support (b=-0.33) had direct negative effects on depression, but ethnic identity-exploration did not. Ethnic identity-commitment (b=-0.43) and social support (b=-0.31) had direct negative effects on anxiety, while identity-exploration (b=0.24) demonstrated a positive effect. Social support had direct positive effects on ethnic identity-exploration (b=0.26) and ethnic identity-commitment (b=0.31). Mediation analysis demonstrated the indirect effect of ethnic identity-commitment linking social support and depression (b=0.22). Implications: Results underscore the role of social support in preventing depression via ethnic identity commitment among indigenous adults in Taiwan. Adopting the strength-based approach, mental health practitioners can mobilise indigenous peoples’ commitment to their group to promote their well-being.

Keywords: ethnic identity, indigenous population, mental health, perceived social support

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Authors: Shujon Mohammed Alazzam, Sarah Saad Alamer, Omar Hassan Kasule, Lama Suliman Aleid, Mohammad Abdulaziz Alakeel, Boshra Mosleh Alanazi, Abdullah Abdulelah Altowairqi, Yahya Ali Al-Asiri

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Background: Interventional radiology (IR) is a specialized field within radiology that diagnose and treat several conditions through a minimally invasive surgical procedure that involves the use of various radiological techniques. In the last few years, the role of IR has expanded to include a variety of organ systems which have been led to an increase in demand for these Specialties. The level of knowledge regarding IR is relatively low in general. In this study, we aimed to investigate the perceptions of interventional radiology (IR) as a specialty among medical students and medical interns in Riyadh, Saudi Arabia. Methodology: This study was a cross section. The target population is medical students in January 2023 in Riyadh city, KSA. We used the questionnaire for face-to-face interviews with voluntary participants to assess their knowledge of Interventional radiology. Permission was taken from participants to use their information. Assuring them that the data in this study was used only for scientific purposes. Results: According to the inclusion criteria, a total of 314 students participated in the study. (49%) of the participants were in the preclinical years, and (51%) were in the clinical years. The findings indicate more than half of the students think that they had good information about IR (58%), while (42%) reported that they had poor information and knowledge about IR. Only (28%) of students were planning to take an elective and radiology rotation, (and 27%) said they would consider a career in IR. (73%) of the participants who would not consider a career in IR, the highest reasons in order were due to "I do not find it interesting" (45%), then "Radiation exposure" (14%). Around half (48%) thought that an IRs must complete a residency training program in both radiology and surgery, and just (36%) of the students believe that an IRs must finish training in radiology. Our data show the procedures performed by IRs that (66%) lower limb angioplasty and stenting (58%) Cardiac angioplasty or stenting. (68%) of the students were familiar with angioplasty. When asked about the source of exposure to angioplasty, the majority (46%) were from a cardiologist, (and 16%) were from the interventional radiologist. Regarding IR career prospects, (78%) of the students believe that IRs have good career prospects. In conclusion, our findings reveal that the perception and exposure to IR among medical students and interns are generally poor. This has a direct influence on the student's decision regarding IR as a career path. Recommendations to attract medical students and promote IR as a career should be increased knowledge among medical students and future physicians through early exposure to IR, and this will promote the specialty's growth; also, involvement of the Saudi Interventional Radiology Society and Radiological Society of Saudi Arabia is essential.

Keywords: knowledge, medical students, perceptions, radiology, interventional radiology, Saudi Arabia

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Authors: Ali K. M. Al-Nasrawi, Uday A. Al-Hamdany, Sarah M. Hamylton, Brian G. Jones, Yasir M. Alyazichi

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Surface elevation dynamics have always responded to disturbance regimes. Creating Digital Elevation Models (DEMs) to detect surface dynamics has led to the development of several methods, devices and data clouds. DEMs can provide accurate and quick results with cost efficiency, in comparison to the inherited geomatics survey techniques. Nowadays, remote sensing datasets have become a primary source to create DEMs, including LiDAR point clouds with GIS analytic tools. However, these data need to be tested for error detection and correction. This paper evaluates various DEMs from different data sources over time for Apple Orchard Island, a coastal site in southeastern Australia, in order to detect surface dynamics. Subsequently, 30 chosen locations were examined in the field to test the error of the DEMs surface detection using high resolution global positioning systems (GPSs). Results show significant surface elevation changes on Apple Orchard Island. Accretion occurred on most of the island while surface elevation loss due to erosion is limited to the northern and southern parts. Concurrently, the projected differential correction and validation method aimed to identify errors in the dataset. The resultant DEMs demonstrated a small error ratio (≤ 3%) from the gathered datasets when compared with the fieldwork survey using RTK-GPS. As modern modelling approaches need to become more effective and accurate, applying several tools to create different DEMs on a multi-temporal scale would allow easy predictions in time-cost-frames with more comprehensive coverage and greater accuracy. With a DEM technique for the eco-geomorphic context, such insights about the ecosystem dynamic detection, at such a coastal intertidal system, would be valuable to assess the accuracy of the predicted eco-geomorphic risk for the conservation management sustainability. Demonstrating this framework to evaluate the historical and current anthropogenic and environmental stressors on coastal surface elevation dynamism could be profitably applied worldwide.

Keywords: DEMs, eco-geomorphic-dynamic processes, geospatial Information Science, remote sensing, surface elevation changes,

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Authors: Alice Carter, Lucy Dumbell, Lorna Cameron, Victoria Lewis

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The Olympic discipline of eventing is the triathlon of equestrian sport, consisting of dressage, cross-country and show jumping. Falls on the cross-country are common and can be serious even causing death to rider. Research identifies an increased risk of a fall with an increasing number of obstacles and for jumping efforts later in the course suggesting fatigue maybe a contributing factor. Advice based on anecdotal evidence suggests riders undertake strength and conditioning programs to improve their ‘core’, thus improving their ability to maintain and control their riding position. There is little empirical evidence to support this advice. Therefore, the aim of this study is to investigate truck muscle fatigue and cognitive function during a simulated jumping test. Eight adult riders participated in a riding test on a Racewood Event simulator for 10 minutes, over a continuous jumping programme. The SEMG activity of six trunk muscles were bilaterally measured at every minute, and normalised root mean squares (RMS) and median frequencies (MDF) were computed from the EMG power spectra. Visual analogue scales (VAS) measuring Fatigue and Pain levels and Cognitive Function ‘tapping’ tests were performed before and after the riding test. Average MDF values for all muscles differed significantly between each sampled minute (p = 0.017), however a consistent decrease from Minute 1 and Minute 9 was not found, suggesting the trunk muscles fatigued and then recovered as other muscle groups important in maintaining the riding position during dynamic movement compensated. Differences between the MDF and RMS of different muscles were highly significant (H=213.01, DF=5, p < 0.001), supporting previous anecdotal evidence that different trunk muscles carry out different roles of posture maintenance during riding. RMS values were not significantly different between the sampled minutes or between riders, suggesting the riding test produced a consistent and repeatable effect on the trunk muscles. MDF values differed significantly between riders (H=50.8, DF = 5, p < 0.001), suggesting individuals may experience localised muscular fatigue of the same test differently, and that other parameters of physical fitness should be investigated to provide conclusions. Lumbar muscles were shown to be important in maintaining the position, therefore physical training program should focus on these areas. No significant differences were found between pre- and post-riding test VAS Pain and Fatigue scores or cognitive function test scores, suggesting the riding test was not significantly fatiguing for participants. However, a near significant correlation was found between time of riding test and VAS Pain score (p = 0.06), suggesting somatic pain may be a limiting factor to performance. No other correlations were found between the factors of participant riding test time, VAS Pain and Fatigue, however a larger sample needs to be tested to improve statistical analysis. The findings suggest the simulator riding test was not sufficient to provoke fatigue in the riders, however foundations for future studies have been laid to enable methodologies in realistic eventing settings.

Keywords: eventing, fatigue, horse-rider, surface EMG, trunk muscles

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Authors: Sarah A. Alotaibi, Mohammed A. Almutairi, Abdullah A. Alsayari, Adibah M. Almutairi, Somaiah K. Almubayedh

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Concerns over the presence of acrylamide in food date back to 2002, when Swedish scientists stated that, in carbohydrate-rich foods, amounts of acrylamide were formed when cooked at high temperatures. Similar findings were reported by other researchers which, consequently, caused major international efforts to investigate dietary exposure and the subsequent health complications in order to properly manage this issue. Due to this issue, in this work, we aim to determine the acrylamide level in different foods (coffee, potato chips, biscuits, and baby food) commonly consumed by the Saudi population. In a total of forty-three samples, acrylamide was detected in twenty-three samples at levels of 12.3 to 2850 µg/kg. In reference to the food groups, the highest concentration of acrylamide was found in coffee samples (<12.3-2850 μg/kg), followed by potato chips (655-1310 μg/kg), then biscuits (23.5-449 μg/kg), whereas the lowest acrylamide level was observed in baby food (<14.75 – 126 μg/kg). Most coffee, biscuits and potato chips products contain high amount of acrylamide content and also the most commonly consumed product. Saudi adults had a mean exposure of acrylamide for coffee, potato, biscuit, and cereal (0.07439, 0.04794, 0.01125, 0.003371 µg/kg-b.w/day), respectively. On the other hand, exposure to acrylamide in Saudi infants and children to the same types of food was (0.1701, 0.1096, 0.02572, 0.00771 µg/kg-b.w/day), respectively. Most groups have a percentile that exceeds the tolerable daily intake (TDI) cancer value (2.6 µg/kg-b.w/day). Overall, the MOE results show that the Saudi population is at high risk of acrylamide-related disease in all food types, and there is a chance of cancer risk in all age groups (all values ˂10,000). Furthermore, it was found that in non-cancer risks, the acrylamide in all tested foods was within the safe limit (˃125), except for potato chips, in which there is a risk for diseases in the population. With potato and coffee as raw materials, additional studies were conducted to assess different factors, including temperature, cocking time, and additives affecting the acrylamide formation in fried potato and roasted coffee, by systematically varying processing temperatures and time values, a mitigation of acrylamide content was achieved when lowering the temperature and decreasing the cooking time. Furthermore, it was shown that the combination of the addition of chitosan and NaCl had a large impact on the formation.

Keywords: risk assessment, dietary exposure, MOA, acrylamide, hazard

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Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

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Authors: Suzanne L. Stewart, Sarah J. Ponton, Mikaela D. Gabriel, Roy Strebel, Xinyi Lu

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Indigenous Peoples have faced unique barriers to accessing and receiving culturally safe and appropriate mental health care while also facing daunting rates of mental health diagnoses and comorbidities. Indigenous researchers and clinicians have well established the connection of the current mental health issues in Indigenous communities as a direct result of colonization by way of intergenerational trauma throughout Canada’s colonial history. Such mental health barriers and challenges have become exacerbated during the COVID-19 pandemic. Throughout the pandemic, access to mental health, cultural, ceremonial, and community services were severely impacted and restricted; however, it is these same cultural activities and community resources that are key to supporting Indigenous mental health from a traditional and community-based perspective. This research employed a unique combination of a thorough, analytical scoping review of the existent mental health literature of Indigenous mental health in the COVID-19 pandemic, alongside narrative interviews employing an oral storytelling tradition methodology with key community informants that provide comprehensive cultural services to the Indigenous community of Toronto, as well as across Canada. These key informant interviews provided a wealth of insights into virtual transitions of Indigenous care and mental health support; intersections of historical underfunding and current financial navigation in technology infrastructure; accessibility and connection with Indigenous youth in remote locations; as well as maintaining community involvement and traditional practices in a current pandemic. Both the scoping review and narrative interviews were meticulously analyzed for overarching narrative themes to best explore the extent of the literature on Indigenous mental health and services during COVID-19; identify gaps in this literature; identify barriers and supports for the Indigenous community, and explore the intersection of community and cultural impacts to mental health. Themes of the scoping review included: Historical Context; Challenges in Culturally-Based Services; and Strengths in Culturally-Based Services. Meta themes across narrative interviews included: Virtual Transitions; Financial Support for Indigenous Services; Health Service Delivery & Wellbeing; and Culture & Community Connection. The results of this scoping review and narrative interviews provide wide application and contribution to the mental health literature, as well as recommendations for policy, service provision, autonomy in Indigenous health and wellbeing, and crucial insights into the present and enduring mental health needs of Indigenous Peoples throughout the COVID-19 pandemic.

Keywords: indigenous community services, indigenous mental health, indigenous scoping review, indigenous peoples and Covid-19

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Authors: Peter Boyes, Sarah Sharples, Paul Tennent, Gary Priestnall, Jeremy Morley

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Significant long-term investment projects can involve complex decisions. These are often described as capital projects, and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives; these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in the complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with the perception of veracity and validity of the data presented; this impacted the ability of group to reach consensus and, therefore, for decisions to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Keywords: decision making, decisions under uncertainty, real decisions, sensemaking, spatial, team decision making

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Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

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Authors: Maximiliano Guerra, Lexi Frankel, Amalia D. Ardeljan, Sarah Ghali, Diya Kohli, Omar M. Rashid.

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Introduction/Background: Haemophilus influenzae is present as a commensal organism in the nasopharynx of most healthy adults from where it can spread to cause both systemic and respiratory tract infection. Pathogenic properties of this bacterium as well as defects in host defense may result in the spread of these bacteria throughout the body. This can result in a proinflammatory state and colonization particularly in the lungs. Recent studies have failed to determine a link between H. Influenzae colonization and prostate cancer, despite previous research demonstrating the presence of proinflammatory states in preneoplastic and neoplastic prostate lesions. Given these contradictory findings, the primary goal of this study was to evaluate the correlation between H. Influenzae infection and the incidence of prostate cancer. Methods: To evaluate the incidence of Haemophilus influenzae infection and the development of prostate cancer in the future we used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. We were afforded access to this database by Holy Cross Health, Fort Lauderdale for the express purpose of academic research. Standard statistical methods were employed in this study including Pearson’s chi-square tests. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 13, 691 patients in both the control and C. difficile infected groups, respectively. The two groups were matched by age range and CCI score. In the Haemophilus influenzae infected group, the incidence of prostate cancer was 1.46%, while the incidence of the prostate cancer control group was 4.56%. The observed difference in cancer incidence was determined to be a statistically significant p-value (< 2.2x10^-16). This suggests that patients with a history of C. difficile have less risk of developing prostate cancer (OR 0.425, 95% CI: 0.382 - 0.472). Treatment bias was considered, the data was analyzed and resulted in two groups matched groups of 3,208 patients in both the infected with H. Influenzae treated group and the control who used the same medications for a different cause. Patients infected with H. Influenzae and treated had an incidence of prostate cancer of 2.49% whereas the control group incidence of prostate cancer was 4.92% with a p-value (< 2.2x10^-16) OR 0.455 CI 95% (0.526 -0.754), proving that the initial results were not due to the use of medications. Conclusion: The findings of our study reveal a statistically significant correlation between H. Influenzae infection and a decreased incidence of prostate cancer. Our findings suggest that prior infection with H. Influenzae may confer some degree of protection to patients and reduce their risk for developing prostate cancer. Future research is recommended to further characterize the potential role of Haemophilus influenzae in the pathogenesis of prostate cancer.

Keywords: Haemophilus Influenzae, incidence, prostate cancer, risk.

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Authors: K. Power, M. White, B. Dunleavey, E. Comerford, C. Doherty, N. Delanty, R. Corbridge, M. Fitzsimons

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Introduction: Providing people with access to their own healthcare information and engaging them as co-authors of their health record can promote better transparency, trust, and inclusivity in the healthcare system. With the advent of electronic health records, there is a move towards involving patients as partners in their healthcare by providing them with access to their own health data via electronic patient portals (ePortal). For example, a recently developed ePortal to the Irish National Epilepsy Electronic Patient Record (EPR) provides access to summary medical records, tools for Patient Reported Outcomes (PROM), health goal-setting and preparation for clinical appointments. Aim: To determine what people with epilepsy (their families/carers) value about the Irish epilepsy ePortal. Methods: A socio-technical process was employed recruiting 30 families of people with epilepsy who also have an intellectual disability (ID). Family members who are a care partner of the person with epilepsy (PWE) were invited to co-design, develop and implement the ePortal. Family members engaged in usability and utility testing which involved a face to face meeting to learn about the ePortal, register for a user account and evaluate its structure and content. Family members were instructed to login to the portal on at least two separate occasions following the meeting and to complete a self-report evaluation tool during this time. The evaluation tool, based on a Usability Questionnaire (Lewis, 1993), consists of a short assessment of comfort using technology, instructions for using the ePortal and some tasks to complete. Tasks included validating summary record details, assessing ePortal ease of use, evaluation of information presented. Participants were asked for suggestions on how to improve the portal and make it more applicable to PWE who also have an ID. Results: Family members responded positively to the ePortal and valued the ability to share information between clinicians and care partners; use the ePortal as a passport between different healthcare settings (e.g., primary care to hospital). In the context of elderly parents of PWE, the ePortal is valued as a tool for supporting shared care between family members. Participants welcomed the facility to log lists of questions and goals to discuss with the clinician at the next clinical appointment as a means of improving quality of care. Participants also suggested further enhancements to the ePortal such as access to clinic letters which can provide an aide memoir in terms of the careplan agreed with the clinical team. For example, through the ePortal, people could see what investigations or therapies are scheduled. Conclusion: The Epilepsy Patient Portal is accessible via a range of devices such as smartphones and tablets. ePortals have the potential to help personalise care, improve patient involvement in clinical decision making, engage them as quality and safety partners, and help clinicians be more responsive to patient needs. Acknowledgement: The epilepsy ePortal project is part of PISCES, a Lighthouse Project funded by eHealth Ireland and HSE to help build an understanding of the benefits of eHealth technologies in the Irish Healthcare System.

Keywords: electronic patient portal, electronic patient record, epilepsy, intellectual disability, usability testing

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Authors: Igor B. Sivaev

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Design of molecular machines is an extraordinary growing and very important area of research that it was recognized by awarding Sauvage, Stoddart and Feringa the Nobel Prize in Chemistry in 2016 'for the design and synthesis of molecular machines'. Based on the type of motion being performed, molecular machines can be divided into two main types: molecular motors and molecular switches. Molecular switches are molecules or supramolecular complexes having bistability, i.e., the ability to exist in two or more stable forms, among which may be reversible transitions under external influence (heating, lighting, changing the medium acidity, the action of chemicals, exposure to magnetic or electric field). Molecular switches are the main structural element of any molecular electronics devices. Therefore, the design and the study of molecules and supramolecular systems capable of performing mechanical movement is an important and urgent problem of modern chemistry. There is growing interest in molecular switches and other devices of molecular electronics based on transition metal complexes; therefore choice of suitable stable organometallic unit is of great importance. An example of such unit is bis(dicarbollide) complexes of transition metals [3,3’-M(1,2-C₂B₉H₁₁)₂]ⁿ⁻. The control on the ligand rotation in such complexes can be reached by introducing substituents which could provide stabilization of certain rotamers due to specific interactions between the ligands, on the one hand, and which can participate as Lewis bases in complex formation with external metals resulting in a change in the rotation angle of the ligands, on the other hand. A series of isomeric methyl sulfide derivatives of cobalt bis(dicarbollide) complexes containing methyl sulfide substituents at boron atoms in different positions of the pentagonal face of the dicarbollide ligands [8,8’-(MeS)₂-3,3’-Co(1,2-C₂B₉H₁₀)₂]⁻, rac-[4,4’-(MeS)₂-3,3’-Co(1,2-C₂B₉H₁₀)₂]⁻ and meso-[4,7’-(MeS)₂-3,3’-Co(1,2-C₂B₉H₁₀)₂]⁻ were synthesized by the reaction of CoCl₂ with the corresponding methyl sulfide carborane derivatives [10-MeS-7,8-C₂B₉H₁₁)₂]⁻ and [10-MeS-7,8-C₂B₉H₁₁)₂]⁻. In the case of asymmetrically substituted cobalt bis(dicarbollide) complexes the corresponding rac- and meso-isomers were successfully separated by column chromatography as the tetrabutylammonium salts. The compounds obtained were studied by the methods of ¹H, ¹³C, and ¹¹B NMR spectroscopy, single crystal X-ray diffraction, cyclic voltammetry, controlled potential coulometry and quantum chemical calculations. It was found that in the solid state, the transoid- and gauche-conformations of the 8,8’- and 4,4’-isomers are stabilized by four intramolecular CH···S(Me)B hydrogen bonds each one (2.683-2.712 Å and 2.709-2.752 Å, respectively), whereas gauche-conformation of the 4,7’-isomer is stabilized by two intramolecular CH···S hydrogen bonds (2.699-2.711 Å). The existence of the intramolecular CH·S(Me)B hydrogen bonding in solutions was supported by the 1H NMR spectroscopy. These data are in a good agreement with results of the quantum chemical calculations. The corresponding iron and nickel complexes were synthesized as well. The reaction of the methyl sulfide derivatives of cobalt bis(dicarbollide) with various labile transition metal complexes results in rupture of intramolecular hydrogen bonds and complexation of the methyl sulfide groups with external metal. This results in stabilization of other rotational conformation of cobalt bis(dicarbollide) and can be used in design of molecular switches. This work was supported by the Russian Science Foundation (16-13-10331).

Keywords: molecular switches, NMR spectroscopy, single crystal X-ray diffraction, transition metal bis(dicarbollide) complexes, quantum chemical calculations

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Authors: Sarah E. Nelson, Casey Weiner, Alexander Sigmon, Jun Hua, Haris I. Sair, Jose I. Suarez, Robert D. Stevens

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Graph-theoretical information from structural connectomes indicated significant connectivity changes and improved acute prognostication in a Random Forest (RF) model in aneurysmal subarachnoid hemorrhage (aSAH), which can lead to significant morbidity and mortality and has traditionally been fraught by poor methods to predict outcome. This study’s hypothesis was that structural connectivity changes occur in canonical brain networks of acute aSAH patients, and that these changes are associated with functional outcome at six months. In a prospective cohort of patients admitted to a single institution for management of acute aSAH, patients underwent diffusion tensor imaging (DTI) as part of a multimodal MRI scan. A weighted undirected structural connectome was created of each patient’s images using Constant Solid Angle (CSA) tractography, with 176 regions of interest (ROIs) defined by the Johns Hopkins Eve atlas. ROIs were sorted into four networks: Default Mode Network, Executive Control Network, Salience Network, and Whole Brain. The resulting nodes and edges were characterized using graph-theoretic features, including Node Strength (NS), Betweenness Centrality (BC), Network Degree (ND), and Connectedness (C). Clinical (including demographics and World Federation of Neurologic Surgeons scale) and graph features were used separately and in combination to train RF and Logistic Regression classifiers to predict two outcomes: dichotomized modified Rankin Score (mRS) at discharge and at six months after discharge (favorable outcome mRS 0-2, unfavorable outcome mRS 3-6). A total of 56 aSAH patients underwent DTI a median (IQR) of 7 (IQR=8.5) days after admission. The best performing model (RF) combining clinical and DTI graph features had a mean Area Under the Receiver Operator Characteristic Curve (AUROC) of 0.88 ± 0.00 and Area Under the Precision Recall Curve (AUPRC) of 0.95 ± 0.00 over 500 trials. The combined model performed better than the clinical model alone (AUROC 0.81 ± 0.01, AUPRC 0.91 ± 0.00). The highest-ranked graph features for prediction were NS, BC, and ND. These results indicate reorganization of the connectome early after aSAH. The performance of clinical prognostic models was increased significantly by the inclusion of DTI-derived graph connectivity metrics. This methodology could significantly improve prognostication of aSAH.

Keywords: connectomics, diffusion tensor imaging, graph theory, machine learning, subarachnoid hemorrhage

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Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

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Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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Authors: Dennis Kreutzer, Sarah Müller-Abdelrazeq, Ingrid Isenhardt

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Resource scarcity, energy transition and the planned climate neutrality pose enormous challenges for manufacturing companies. In order to achieve these goals and a holistic sustainable development, the European Union has listed the circular economy as part of the Circular Economy Action Plan. In addition to a reduction in resource consumption, reduced emissions of greenhouse gases and a reduced volume of waste, the principles of the circular economy also offer enormous economic potential for companies, such as the generation of new circular business models. However, many manufacturing companies, especially small and medium-sized enterprises, do not have the necessary capacity to plan their transformation. They need support and strategies on the path to circular transformation, because this change affects not only production but also the entire company. Maturity models offer an approach, as they enable companies to determine the current status of their transformation processes. In addition, companies can use the models to identify transformation strategies and thus promote the transformation process. While maturity models are established in other areas, e.g. IT or project management, only a few circular economy maturity models can be found in the scientific literature. The aim of this paper is to analyse the identified maturity models of the circular economy through a systematic literature review (SLR) and, besides other aspects, to check their completeness as well as their quality. Since the terms "maturity model" and "readiness model" are often used to assess the transformation process, this paper considers both types of models to provide a more comprehensive result. For this purpose, circular economy maturity models at the company (micro) level were identified from the literature, compared, and analysed with regard to their theoretical and methodological structure. A specific focus was placed, on the one hand, on the analysis of the business units considered in the respective models and, on the other hand, on the underlying metrics and indicators in order to determine the individual maturity level of the entire company. The results of the literature review show, for instance, a significant difference in the holism of their assessment framework. Only a few models include the entire company with supporting areas outside the value-creating core process, e.g. strategy and vision. Additionally, there are large differences in the number and type of indicators as well as their metrics. For example, most models often use subjective indicators and very few objective indicators in their surveys. It was also found that there are rarely well-founded thresholds between the levels. Based on the generated results, concrete ideas and proposals for a research agenda in the field of circular economy maturity models are made.

Keywords: maturity model, circular economy, transformation, metric, assessment

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Authors: Lewis J. Woollin, Robert I. Davidson, Paul Watson, Philip J. Hyde

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Introduction: In-vitro testing of arthroplasty materials is of paramount importance when ensuring that they can withstand the performance requirements encountered in-vivo. One common machine used for in-vitro testing is a pin-on-plate tribometer, an early stage screening device that generates data on the wear characteristics of arthroplasty bearing materials. These devices test vertically loaded rotating cylindrical pins acting against reciprocating plates, representing the bearing surfaces. In this study, a pin-on-plate machine has been developed that provides several improvements over current technology, thereby progressing arthroplasty bearing research. Historically, pin-on-plate tribometers have been used to investigate the performance of arthroplasty bearing materials under conditions commonly encountered during a standard gait cycle; nominal operating pressures of 2-6 MPa and an operating frequency of 1 Hz are typical. There has been increased interest in using pin-on-plate machines to test more representative in-vivo conditions, due to the drive to test 'beyond compliance', as well as their testing speed and economic advantages over hip simulators. Current pin-on-plate machines do not accommodate the increased performance requirements associated with more extreme kinematic conditions, therefore a next-generation pin-on-plate tribometer has been developed to bridge the gap between current technology and future research requirements. Methodology: The design was driven by several physiologically relevant requirements. Firstly, an increased loading capacity was essential to replicate the peak pressures that occur in the natural hip joint during running and chair-rising, as well as increasing the understanding of wear rates in obese patients. Secondly, the introduction of mid-cycle load variation was of paramount importance, as this allows for an approximation of the loads present in a gait cycle to be applied and to test the fatigue properties of materials. Finally, the rig must be validated against previous-generation pin-on-plate and arthroplasty wear data. Results: The resulting machine is a twelve station device that is split into three sets of four stations, providing an increased testing capacity compared to most current pin-on-plate tribometers. The loading of the pins is generated using a pneumatic system, which can produce contact pressures of up to 201 MPa on a 3.2 mm² round pin face. This greatly exceeds currently achievable contact pressures in literature and opens new research avenues such as testing rim wear of mal-positioned hip implants. Additionally, the contact pressure of each set can be changed independently of the others, allowing multiple loading conditions to be tested simultaneously. Using pneumatics also allows the applied pressure to be switched ON/OFF mid-cycle, another feature not currently reported elsewhere, which allows for investigation into intermittent loading and material fatigue. The device is currently undergoing a series of validation tests using Ultra-High-Molecular-Weight-Polyethylene pins and 316L Stainless Steel Plates (polished to a Ra < 0.05 µm). The operating pressures will be between 2-6 MPa, operating at 1 Hz, allowing for validation of the machine against results reported previously in the literature. The successful production of this next-generation pin-on-plate tribometer will, following its validation, unlock multiple previously unavailable research avenues.

Keywords: arthroplasty, mechanical design, pin-on-plate, total joint replacement, wear testing

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Authors: Sarah Alamolhoda, Kevin J. Smith, Xiaotao Bi, Naoko Ellis

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For millennials, biomass has been the most important source of fuel used to produce energy. Energy derived from biomass is renewable by re-growth of biomass. Various technologies are used to convert biomass to potential renewable products including combustion, gasification, pyrolysis and fermentation. Gasification is the incomplete combustion of biomass in a controlled environment that results in valuable products such as syngas, biooil and biochar. Syngas is a combustible gas consisting of hydrogen (H₂), carbon monoxide (CO), carbon dioxide (CO₂), and traces of methane (CH₄) and nitrogen (N₂). Cleaned syngas can be used as a turbine fuel to generate electricity, raw material for hydrogen and synthetic natural gas production, or as the anode gas of solid oxide fuel cells. In this work, syngas as a product of woody biomass gasification in British Columbia, Canada, was introduced to two consecutive fixed bed reactors to perform a catalytic water gas shift reaction followed by a catalytic methanation reaction. The water gas shift reaction is a well-established industrial process and used to increase the hydrogen content of the syngas before the methanation process. Catalysts were used in the process since both reactions are reversible exothermic, and thermodynamically preferred at lower temperatures while kinetically favored at elevated temperatures. The water gas shift reactor and the methanation reactor were packed with Cu-based catalyst and Ni-based catalyst, respectively. Simulated syngas with different percentages of CO, H₂, CH₄, and CO₂ were fed to the reactors to investigate the effect of operating conditions in the unit. The water gas shift reaction experiments were done in the temperature of 150 ˚C to 200 ˚C, and the pressure of 550 kPa to 830 kPa. Similarly, methanation experiments were run in the temperature of 300 ˚C to 400 ˚C, and the pressure of 2340 kPa to 3450 kPa. The Methanation reaction reached 98% of CO conversion at 340 ˚C and 3450 kPa, in which more than half of CO was converted to CH₄. Increasing the reaction temperature caused reduction in the CO conversion and increase in the CH₄ selectivity. The process was designed to be renewable and release low greenhouse gas emissions. Syngas is a clean burning fuel, however by going through water gas shift reaction, toxic CO was removed, and hydrogen as a green fuel was produced. Moreover, in the methanation process, the syngas energy was transformed to a fuel with higher energy density (per volume) leading to reduction in the amount of required fuel that flows through the equipment and improvement in the process efficiency. Natural gas is about 3.5 times more efficient (energy/ volume) than hydrogen and easier to store and transport. When modification of existing infrastructure is not practical, the partial conversion of renewable hydrogen to natural gas (with up to 15% hydrogen content), the efficiency would be preserved while greenhouse gas emission footprint is eliminated.

Keywords: renewable natural gas, methane, hydrogen, gasification, syngas, catalysis, fuel

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Authors: Helen Nelly Naiga, Jane Frances Zalwango, Saudah N. Kizito, Brian Agaba, Brenda N Simbwa, Maria Goretti Zalwango, Richard Migisha, Benon Kwesiga, Daniel Kadobera, Alex Ario Riolexus, Sarah Paige, Julie R. Harris

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Background: Traditional community beliefs and practices can facilitate the spread of Ebola virus during outbreaks. On September 20, 2022, Uganda declared a Sudan Virus Disease (SVD) outbreak after a case was confirmed in Mubende District. During September–November 2022, the outbreak spread to eight additional districts. We investigated the role of community beliefs and practices in the spread of SUDV in Uganda in 2022. Methods: A qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. We conducted nine focus group discussions (FGDs) and six key informant interviews (KIIs). FGDs included SVD survivors, household members of SVD patients, traditional healers, religious leaders, and community leaders. Key informants included community, political, and religious leaders, traditional healers, and health workers. We asked about community beliefs and practices to understand if and how they contributed to the spread of SUDV. Interviews were recorded, translated, transcribed, and analyzed thematically. Results: Frequently-reported themes included beliefs that the community deaths, later found to be due to SVD, were the result of witchcraft or poisoning. Key informants reported that SVD patients frequently first consulted traditional healers or spiritual leaders before seeking formal healthcare, and noted that traditional healers treated patients with signs and symptoms of SVD without protective measures. Additional themes included religious leaders conducting laying-on-of-hands prayers for SVD patients and symptomatic contacts, SVD patients and their symptomatic contacts hiding in friends’ homes, and exhumation of SVD patients originally buried in safe and dignified burials, to enable traditional burials. Conclusion: Multiple community beliefs and practices likely promoted SVD outbreak spread during the 2022 outbreak in Uganda. Engaging traditional and spiritual healers early during similar outbreaks through risk communication and community engagement efforts could facilitate outbreak control. Targeted community messaging, including clear biological explanations for clusters of deaths and information on the dangers of exhuming bodies of SVD patients, could similarly facilitate improved control in future outbreaks in Uganda.

Keywords: Ebola, Sudan virus, outbreak, beliefs, traditional

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Authors: Sarah Crawford, Gerry Lesley

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This research is a pre-clinical assessment of anti-cancer effects of novel non-steroidal diethyl stilbestrol-like estrogen analogs in estrogen-receptor positive/ progesterone-receptor positive human breast cancer microtumors of MCF 7 cell line. Tamoxifen analog formulation (Tam A1) was used as a single agent or in combination with therapeutic concentrations of 4-hydroxytamoxifen, currently used as a long-term treatment for the prevention of breast cancer recurrence in women with estrogen receptor positive/ progesterone receptor positive malignancies. At concentrations ranging from 30-50 microM, Tam A1 induced microtumor disaggregation and cell death. Incremental cytotoxic effects correlated with increasing concentrations of Tam A1. Live tumor microscopy showed that microtumos displayed diffuse borders and substrate-attached cells were rounded-up and poorly adherent. A complete cytotoxic effect was observed using 40-50 microM Tam A1 with time course kinetics similar to 4-hydroxytamoxifen. Combined treatment with TamA1 (30-50 microM) and 4-hydroxytamoxifen (10-15 microM) induced a highly cytotoxic, synergistic combined treatment response that was more rapid and complete than using 4-hydroxytamoxifen as a single agent therapeutic. Microtumors completely dispersed or formed necrotic foci indicating a highly cytotoxic combined treatment response. Moreover, breast cancer microtumors treated with both 4-hydroxytamoxifen and Tam A1 displayed lower levels of long-term post-treatment regrowth, a critical parameter of primary drug resistance, than observed for 4-hydroxytamoxifen when used as a single agent therapeutic. Tumor regrowth at 6 weeks post-treatment with either single agent 4-hydroxy tamoxifen, Tam A1 or a combined treatment was assessed for the development of drug resistance. Breast cancer cells treated with both 4-hydroxytamoxifen and Tam A1 displayed significantly lower levels of post-treatment regrowth, indicative of decreased drug resistance, than observed for either single treatment modality. The preclinical data suggest that combined treatment involving the use of tamoxifen analogs may be a novel clinical approach for long-term maintenance therapy in patients with estrogen-receptor positive/progesterone-receptor positive breast cancer receiving hormonal therapy to prevent disease recurrence. Detailed data on time-course, IC50 and tumor regrowth assays post- treatment as well as a proposed mechanism of action to account for observed synergistic drug effects will be presented.

Keywords: 4-hydroxytamoxifen, tamoxifen analog, drug-resistance, microtumors

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Authors: Morteza Ahmadifar, Sarah Bahari Derakhshan

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Leakage is one of the most important problems that water distribution networks face which first reason is high-pressure existence. There are many approaches to control this excess pressure, which using pressure reducing valves (PRVs) or reducing pipe diameter are ones. On the other hand, Pumps are using electricity or fossil fuels to supply needed pressure in distribution networks but excess pressure are made in some branches due to topology problems and water networks’ variables, therefore using pressure valves will be inevitable. Although using PRVs is inevitable but it leads to waste electricity or fuels used by pumps because PRVs just waste excess hydraulic pressure to lower it. Pumps working in reverse or Pumps as Turbine (called PAT in this article) are easily available and also effective sources of reducing the equipment cost in small hydropower plants. Urban areas of developing countries are facing increasing in area and maybe water scarcity in near future. These cities need wider water networks which make it hard to predict, control and have a better operation in the urban water cycle. Using more energy and therefore more pollution, slower repairing services, more user dissatisfaction and more leakage are these networks’ serious problems. Therefore, more effective systems are needed to monitor and act in these complicated networks than what is used now. In this article a new approach is proposed and evaluated: Using PAT to produce enough energy for remote valves and sensors in the water network. These sensors can be used to determine the discharge, pressure, water quality and other important network characteristics. With the help of remote valves pipeline discharge can be controlled so Instead of wasting excess hydraulic pressure which may be destructive in some cases, obtaining extra pressure from pipeline and producing clean electricity used by remote instruments is this articles’ goal. Furthermore, due to increasing the area of network there is unwanted high pressure in some critical points which is not destructive but lowering the pressure results to longer lifetime for pipeline networks without users’ dissatisfaction. This strategy proposed in this article, leads to use PAT widely for pressure containment and producing energy needed for remote valves and sensors like what happens in supervisory control and data acquisition (SCADA) systems which make it easy for us to monitor, receive data from urban water cycle and make any needed changes in discharge and pressure of pipelines easily and remotely. This is a clean project of energy production without significant environmental impacts and can be used in urban drinking water networks, without any problem for consumers which leads to a stable and dynamic network which lowers leakage and pollution.

Keywords: clean energies, pump as turbine, remote control, urban water distribution network

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Authors: Lewis Mehl-Madrona, Barbara Mainguy, Patrick McFarlane

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Introduction: There are many risk factors for attempting suicide, including young age, “minority stress,” which would include Transgender and Gender Diverse orientations (TGD). The rate of TGD youths for suicide attempts is 3 times higher than heterosexual cis-gender youth. Half of TGD youth have seriously contemplated taking their own lives; of those, about half attempted suicide; and 18% of the TGD teenagers reported suicidal thoughts linked to their gender identity. Native American TGD have a six times higher suicide attempt rate. Conventional mental health has not generally helped these individuals. Stigma and discrimination contribute to healthcare disparities. Storytelling plays a crucial role in the development of human culture and individual identities. Sharing narrative artwork, creative writing, and personal stories allow people to build trust and to share their vulnerabilities. This helps people become aware of themselves in relation to others and gain a sense of comfort that their stories are similar; they may also be transformed in the process. Art provides a means to reach people who are otherwise difficult to engage in services. Methods: TGD individuals are recruited through a snowballing procedure. Following a life story interview, participants complete a scale of gender dysphoria, identification with conventional masculinity, patient-reported anxiety, and depression measure, and a quality-of-life scale. The interview completes the Columbia Suicide Scale. Following this, an artist and a therapist works with the participant to create a story related to their gender identity using the six-part story method. This story is then rendered to an artists’ book, which combines narrative with art (drawings, collage, computer images, etc.) and can take the form of a graphic novella, a zine, or a comic book. The pages can range from plain to ornate, as can the covers. Participants describe their process of making the books as the work unfolds and then participate in an exit interview at the completion of their book, remarking on what has changed for them and how the process affected them. Results: Preliminary results show high levels of suicidal thoughts among this population, as expected. Participants participate enthusiastically in the life story interview process and in the construction of a story related to gender identity. They enthusiastically participate in the studio process of putting their story into the form of a graphic novel, zine, or comic book. Participants reported feeling more comfortable with their TGD identity after the process and more able to resist negative judgments of family members and society. Suicidal thoughts diminish, and participants reported improved emotional wellbeing. Quantitative analysis of questionnaire data is underway Conclusions: A process in which narrative therapy is combined with art therapy shows promise for attracting and helping TGD individuals to reduce their risk for suicide without the stigma of going for mental health treatment. This process can be done outside of conventional mental health settings, on college and University campuses. This can provide an exciting alternative pathway for minority stressed and stigmatized individuals to engage in reflective, psychotherapeutic work without the trappings of psychotherapy or mental health treatment.

Keywords: minority stress, narrative process, artists' books, life story interview

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Authors: Jo Parsons, Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton

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The problem: Vaccinations are routinely offered to pregnant women in the UK for influenza (flu), pertussis (whooping cough), and COVID-19, yet the uptake of these vaccinations in pregnancy remains low. Pregnant women are at increased risk of hospitalisation, morbidity, and mortality from these preventable illnesses, which can also expose their unborn babies to an increased risk of serious complications, including in utero death. This research aims to explore how pregnant women feel about vaccinations offered during pregnancy (flu, whooping cough, and COVID-19), particularly following the COVID-19 pandemic. It also aims to examine factors influencing women’s decisions about vaccinations during pregnancy and how they feel about their health and vulnerabilities to illness arising from the COVID-19 pandemic. The approach: This is a qualitative study involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Pregnant women were recruited via participating hospitals and community groups. Midwives were recruited via participating hospitals and midwife-specific social media groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented will focus on data from pregnant women. Pregnant women reported a wide range of views and vaccination behaviour, and identified several factors influencing their decision whether to accept vaccinations or not. These included internal factors (comprised of beliefs about susceptibility to illness, perceptions of immunity, fear, and feelings of responsibility), other influences (including visibility of illness and external influences such as healthcare professional recommendations), vaccination-related factors (comprised of beliefs about effectiveness and safety of vaccinations, availability and accessibility of vaccinations and preferences for alternative forms of protection to vaccination) and COVID-19 specific factors (including COVID-19 vaccinations and COVID-19 specific influences). Implications: Findings identified some of the factors that affect pregnant women’s decisions when deciding to have a vaccination or not and how these decisions have been influenced by COVID-19. Findings highlight areas where healthcare professional advice needs to focus, such as the provision of information about the increased vulnerability to illnesses during pregnancy and consideration of opportunistic vaccination at hospital appointments to maximise uptake of vaccinations during pregnancy. Findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, COVID-19

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Authors: A.Cifarelli, L. Boggioni, F. Bertini, L. Magon, M. Pitalieri, S. Losio

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Nowadays, the growing environmental awareness and the dwindling of fossil resources stimulate the polyurethane (PU) industry towards renewable polymers with low carbon footprint to replace the feed stocks from petroleum sources. The main challenge in this field consists in replacing high-performance products from fossil-fuel with novel synthetic polymers derived from 'green monomers'. The bio-polyols from plant oils have attracted significant industrial interest and major attention in scientific research due to their availability and biodegradability. Triglycerides rich in unsaturated fatty acids, such as soybean oil (SBO) and linseed oil (ELO), are particularly interesting because their structures and functionalities are tunable by chemical modification in order to obtain polymeric materials with expected final properties. Unfortunately, their use is still limited for processing or performance problems because a high functionality, as well as OH number of the polyols will result in an increase in cross-linking densities of the resulting PUs. The main aim of this study is to evaluate soy and linseed-based polyols as precursors to prepare prepolymers for the production of polyurethane foams (PUFs) or waterborne-polyurethanes (WPU) used as coatings. An effective reaction route is employed for its simplicity and economic impact. Indeed, bio-polyols were synthesized by a two-step method: epoxidation of the double bonds in vegetable oils and solvent-free ring-opening reaction of the oxirane with organic acids. No organic solvents have been used. Acids with different moieties (aliphatic or aromatics) and different length of hydrocarbon backbones can be used to customize polyols with different functionalities. The ring-opening reaction requires a fine tuning of the experimental conditions (time, temperature, molar ratio of carboxylic acid and epoxy group) to control the acidity value of end-product as well as the amount of residual starting materials. Besides, a Lewis base catalyst is used to favor the ring opening reaction of internal epoxy groups of the epoxidized oil and minimize the formation of cross-linked structures in order to achieve less viscous and more processable polyols with narrower polydispersity indices (molecular weight lower than 2000 g/mol⁻¹). The functionality of optimized polyols is tuned from 2 to 4 per molecule. The obtained polyols are characterized by means of GPC, NMR (¹H, ¹³C) and FT-IR spectroscopy to evaluate molecular masses, molecular mass distributions, microstructures and linkage pathways. Several polyurethane foams have been prepared by prepolymer method blending conventional synthetic polyols with new bio-polyols from soybean and linseed oils without using organic solvents. The compatibility of such bio-polyols with commercial polyols and diisocyanates is demonstrated. The influence of the bio-polyols on the foam morphology (cellular structure, interconnectivity), density, mechanical and thermal properties has been studied. Moreover, bio-based WPUs have been synthesized by well-established processing technology. In this synthesis, a portion of commercial polyols is substituted by the new bio-polyols and the properties of the coatings on leather substrates have been evaluated to determine coating hardness, abrasion resistance, impact resistance, gloss, chemical resistance, flammability, durability, and adhesive strength.

Keywords: bio-polyols, polyurethane foams, solvent free synthesis, waterborne-polyurethanes

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Authors: Sarah F. M. Pilati, Carolina S. Flausino, Guilherme F. Hoffmeister, Davi R. Tames, Telmo J. Mezadri

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The effects that may be related to narghile smoking in the tissues of the oral cavity, trachea and lung and associated inflammation has been the question raised lately. The objective of this study was to identify histopathological changes and the presence of inflammation through the exposure of mice to narghile smoking through a whole-body study. The animals were divided in 4 groups with 5 animals in each group, being: one control group, one with 7 days of exposure, 15 days and the last one with 30 days. The animals were exposed to the conventional hookah smoke from Mizo brand with 0.5% percentage of unwashed tobacco and the EcOco brand coconut fiber having a dimension of 2cm × 2cm. The duration of the session was 30 minutes / day per 7, 15 and 30 days. The tobacco smoke concentration at which test animals were exposed was 35 ml every two seconds while the remaining 58 seconds were pure air. Afterward, the mice were sacrificed and submitted to histological evaluation through slices. It was found in the tongue of the 7-day group the presence in epithelium areas with acanthosis, hyperkeratosis and epithelial projections. In-depth, more intense inflammation was observed. All alteration processes increased significantly as the days of exposure increased. In trachea, with the 7-day group, there was a decrease in thickening of the pseudostratified epithelium and a slight decrease in lashes, giving rise to the metaplasia process, a process that was established in the 31-day sampling when the epithelium became stratified. In the conjunctive tissue, it was observed the presence of defense cells and formation of new vessels, evidencing the chronic inflammatory process, which decreased in the course of the samples due to the deposition of collagen fibers as seen in the 15 and 31 days groups. Among the structures of the lung, the study focused on the bronchioles and alveoli. From the 7-day group, intra-alveolar septum thickness increased, alveolar space decreased, inflammatory infiltrate with mononuclear and defense cells and new vessels formation were observed, increasing the number of red blood cells in the region. The results showed that with the passing of the days a progressive increase of the signs of changes in the region was observed, a factor that shows that narghile smoking stimulates alterations mainly in the alveoli (place where gas exchanges occur that should not present alterations) calling attention to the harmful and aggressive effect of narghile smoking. These data also highlighted the harmful effect of smoking, since the presence of acanthosis, hyperkeratosis, epithelial projections and inflammation evidences the cellular alteration process for the tongue tissue protection. Also, the narghile smoking stimulates both epithelial and inflammatory changes in the trachea, in addition to a process of metaplasia, a factor that reinforces the harmful effect and the carcinogenic potential of the narghile smoking.

Keywords: metaplasia, inflammation, pathological constriction, hyperkeratosis

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Authors: Sarah J. C. Slabbert

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The uptake of research as part of the diffusion or adoption of innovation by practitioners, whether individuals or organisations, has been a popular topic in agricultural development studies for many decades. In the classical, linear model of innovation theory, the innovation originates from an expert source such as a state-supported research organisation or academic institution. The changing context of agriculture led to the development of the agricultural innovation systems model, which recognizes innovation as a complex interaction between individuals and organisations, which include private industry and collective action organisations. In terms of this model, an innovation can be developed and adopted without any input or intervention from a state or parastatal research organisation. This evolution in the diffusion of agricultural innovation has put forward new challenges for state or parastatal research organisations, which have to demonstrate the impact of their research to the legislature or a regulatory authority: Unless the organisation and the research it produces cross the knowledge paths of the intended audience, there will be no awareness, no uptake and certainly no impact. It is therefore critical for such a research organisation to base its communication strategy on a thorough understanding of the knowledge needs, information sources and knowledge networks of the intended target audience. In 2016, the South African Water Research Commission (WRC) commissioned a study to investigate the knowledge needs, information sources and knowledge networks of Water User Associations and commercial irrigators with the aim of improving uptake of its research on efficient water use in irrigation. The first phase of the study comprised face-to-face interviews with the CEOs and Board Chairs of four Water User Associations along the Orange River in South Africa, and 36 commercial irrigation farmers from the same four irrigation schemes. Intermediaries who act as knowledge conduits to the Water User Associations and the irrigators were identified and 20 of them were subsequently interviewed telephonically. The study found that irrigators interact regularly with grower organisations such as SATI (South African Table Grape Industry) and SAPPA (South African Pecan Nut Association) and that they perceive these organisations as credible, trustworthy and reliable, within their limitations. State and parastatal research institutions, on the other hand, are associated with a range of negative attributes. As a result, the awareness of, and interest in, the WRC and its research on water use efficiency in irrigated agriculture are low. The findings suggest that a communication strategy that involves collaboration with these grower organisations would empower the WRC to participate much more efficiently and with greater impact in agricultural innovation networks. The paper will elaborate on the findings and discuss partnering frameworks and opportunities to manage perceptions and uptake.

Keywords: agricultural innovation systems, communication strategy, diffusion of innovation, irrigated agriculture, knowledge paths, research organisations, target audiences, water use efficiency

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Authors: Sarah Maiter

Abstract:

Heightened globalization, migration, displacement of citizens, and refugee needs is putting increasing demand for approaches to social services for diverse populations that responds to families to ensure the safety and protection of vulnerable members while providing supports and services. Along with this social works re-focus on socially just approaches to practice increasingly asks social workers to consider the challenging circumstances of families when providing services rather than a focus on individual shortcomings alone. Child protection workers then struggle to ensure safety of children while assessing the needs of families. This assessment can prove to be difficult when providing services to immigrant, refugee, and racially diverse families as understanding of and familiarity with these families is often limited. Furthermore, child protection intervention in western countries is state mandated having legal authority when intervening in the lives of families where child protection concerns have been identified. Within this context, racialized immigrant and refugee families are at risk of misunderstandings that can result in interventions that are overly intrusive, unhelpful, and harsh. Research shows disproportionality and overrepresentation of racial and ethnic minorities, and immigrant families in the child protection system. Reasons noted include: a) possibilities of racial bias in reporting and substantiating abuse, b) struggles on the part of workers when working with families from diverse ethno-racial backgrounds and who are immigrants and may have limited proficiency in the national language of the country, c) interventions during crisis and differential ongoing services for these families, d) diverse contexts of these families that poses additional challenges for families and children, and e) possible differential definitions of child maltreatment. While cultural and ethnic diversity in child rearing approaches have been cited as contributors to child protection concerns, this approach should be viewed cautiously as it can result in stereotyping and generalizing that then results in inappropriate assessment and intervention. However, poverty and the lack of social supports, both well-known contributors to child protection concerns, also impact these families disproportionately. Child protection systems, therefore, need to continue to examine policy and practice approaches with these families that ensures safety of children while balancing the needs of families. This presentation provides data from several research studies that examined definitions of child maltreatment among a sample of racialized immigrant families, experiences of a sample of immigrant families with the child protection system, concerns of a sample of child protection workers in the provision of services to these families, and struggles of families in the transitions to their new country. These studies, along with others provide insights into areas of consideration for practice that can contribute to safety for children while ensuring just and equitable responses that have greater potential for keeping families together rather than premature apprehension and removal of children to state care.

Keywords: child protection, child welfare services, immigrant families, racial and ethnic diversity

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Authors: Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton, Jo Parsons

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The problem: Women in the UK are offered influenza (flu), pertussis (whooping cough) and COVID-19 vaccinations during their pregnancy but uptake of all three vaccines is below the desired rate. These vaccines are offered during pregnancy as pregnant women are at an increased risk of hospitalisation, morbidity, and mortality from these illnesses. Exposure to these diseases during pregnancy can also have a negative impact on the unborn baby with an increased risk of serious complications both while in utero and following birth. The research aims to explore perceptions about the vaccinations offered in pregnancy both from the perspectives of pregnant women and midwives. To determine factors that influence pregnant women’s decisions about whether or not to accept the vaccines following the Covid-19 pandemic and to explore midwives’ experiences of recommending and delivering vaccines. The approach: This research follows a qualitative design involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy, and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Midwives were recruited via participating hospitals and midwife specific social media groups. Pregnant women were recruited via participating hospitals and community groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented here will focus on data from midwives. Topics identified included three key themes for midwives. These were 1) Delivery of vaccinations which includes the convenience of offering vaccinations while attending standard antenatal appointments and practical barriers faced in delivering these vaccinations at hospital. 2) Messages and guidance included the importance of up-to-date informational needs for midwives to deliver vaccines and that uncertainty and conflicting messages about the COVID-19 vaccine during pregnancy were a barrier to delivery. 3) Recommendations to have vaccines look at all aspects of recommendations such as how recommendations are communicated, the contents of the recommendation, the importance of the vaccine and the impact of those recommendations on whether women accept the vaccine. Implications: Findings highlight the importance for midwives to receive clear and consistent information so they can feel confident in relaying this information while recommending and delivering vaccines to pregnant women. Emphasising why vaccines are important when recommending vaccinations to pregnant women in addition to standard information on the availability and timing will add to the strength and impact of that recommendation in helping women to make informed decisions about accepting vaccines. The findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, Covid-19, midwives

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Authors: Tom S. Owens, Tom A. Calverley, Benjamin S. Stacey, Christopher J. Marley, George Rose, Lewis Fall, Gareth L. Jones, Priscilla Williams, John P. R. Williams, Martin Steggall, Damian M. Bailey

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Introduction and aims: Sports-related concussion (SRC) represents a significant and growing public health concern in rugby union, yet remains one of the least understood injuries facing the health community today. Alongside increasing SRC incidence rates, there is concern that prior recurrent concussion may contribute to long-term neurologic sequelae in later-life. This may be due to an accelerated decline in cerebral perfusion, a major risk factor for neurocognitive decline and neurodegeneration, though the underlying mechanisms remain to be established. The present study hypothesised that recurrent concussion in current professional rugby union players would result in elevated systemic oxidative-nitrosative stress, reflected by a free radical-mediated reduction in nitric oxide (NO) bioavailability and impaired cerebrovascular and cognitive function. Methodology: A longitudinal study design was adopted across the 2017-2018 rugby union season. Ethical approval was obtained from the University of South Wales Ethics Committee. Data collection is ongoing, and therefore the current report documents result from the pre-season and first half of the in-season data collection. Participants were initially divided into two subgroups; 23 professional rugby union players (aged 26 ± 5 years) and 22 non-concussed controls (27 ± 8 years). Pre-season measurements were performed for cerebrovascular function (Doppler ultrasound of middle cerebral artery velocity (MCAv) in response to hypocapnia/normocapnia/hypercapnia), cephalic venous concentrations of the ascorbate radical (A•-, electron paramagnetic resonance spectroscopy), NO (ozone-based chemiluminescence) and cognition (neuropsychometric tests). Notational analysis was performed to assess contact in the rugby group throughout each competitive game. Results: 1001 tackles and 62 injuries, including three concussions were observed across the first half of the season. However, no associations were apparent between number of tackles and any injury type (P > 0.05). The rugby group expressed greater oxidative stress as indicated by increased A•- (P < 0.05 vs. control) and a subsequent decrease in NO bioavailability (P < 0.05 vs. control). The rugby group performed worse in the Ray Auditory Verbal Learning Test B (RAVLT-B, learning, and memory) and the Grooved Pegboard test using both the dominant and non-dominant hands (visuomotor coordination, P < 0.05 vs. control). There were no between-group differences in cerebral perfusion at baseline (MCAv: 54 ± 13 vs. 59 ± 12, P > 0.05). Likewise, no between-group differences in CVRCO2Hypo (2.58 ± 1.01 vs. 2.58 ± 0.75, P > 0.05) or CVRCO2Hyper (2.69 ± 1.07 vs. 3.35 ± 1.28, P > 0.05) were observed. Conclusion: The present study identified that the rugby union players are characterized by impaired cognitive function subsequent to elevated systemic-oxidative-nitrosative stress. However, this appears to be independent of any functional impairment in cerebrovascular function. Given the potential long-term trajectory towards accelerated cognitive decline in populations exposed to SRC, prophylaxis to increase NO bioavailability warrants consideration.

Keywords: cognition, concussion, mild traumatic brain injury, rugby

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Authors: Sarah Pfoser, Lisa-Maria Putz, Thomas Berger

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In the EU, the transport sector accounts for roughly one fourth of the total greenhouse gas emissions. In fact, the transport sector is one of the main contributors of greenhouse gas emissions. Climate protection targets aim to reduce the negative effects of greenhouse gas emissions (e.g. climate change, global warming) worldwide. Achieving a modal shift to foster environmentally friendly modes of transport such as rail and inland waterways is an important strategy to fulfill the climate protection targets. The present paper goes beyond these conventional transport modes and reflects upon currently emerging high-performance transport modes that yield the potential of complementing future transport systems in an efficient way. It will be defined which properties describe high-performance transport modes, which types of technology are included and what is their potential to contribute to a sustainable future transport network. The first step of this paper is to compile state-of-the-art information about high-performance transport modes to find out which technologies are currently emerging. A multidimensional impact analysis will be conducted afterwards to evaluate which of the technologies is most promising. This analysis will be performed from a spatial, social, economic and environmental perspective. Frequently used instruments such as cost-benefit analysis and SWOT analysis will be applied for the multidimensional assessment. The estimations for the analysis will be derived based on desktop research and discussions in an interdisciplinary team of researchers. For the purpose of this work, high-performance transport modes are characterized as transport modes with very fast and very high throughput connections that could act as efficient extension to the existing transport network. The recently proposed hyperloop system represents a potential high-performance transport mode which might be an innovative supplement for the current transport networks. The idea of hyperloops is that persons and freight are shipped in a tube at more than airline speed. Another innovative technology consists in drones for freight transport. Amazon already tests drones for their parcel shipments, they aim for delivery times of 30 minutes. Drones can, therefore, be considered as high-performance transport modes as well. The Trans-European Transport Networks program (TEN-T) addresses the expansion of transport grids in Europe and also includes high speed rail connections to better connect important European cities. These services should increase competitiveness of rail and are intended to replace aviation, which is known to be a polluting transport mode. In this sense, the integration of high-performance transport modes as described above facilitates the objectives of the TEN-T program. The results of the multidimensional impact analysis will reveal potential future effects of the integration of high-performance modes into transport networks. Building on that, a recommendation on the following (research) steps can be given which are necessary to ensure the most efficient implementation and integration processes.

Keywords: drones, future transport networks, high performance transport modes, hyperloops, impact analysis

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Authors: Martin Grootveld, Benita Percival, Sarah Moumtaz, Kerry L. Grootveld

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Objectives/Hypotheses: The adverse health effect potential of dietary lipid oxidation products (LOPs) has evoked much clinical interest. Therefore, we employed a ¹H NMR-linked Principal Component Regression (PCR) chemometrics modelling strategy to explore relationships between data matrices comprising (1) aldehydic LOP concentrations generated in culinary oils/fats when exposed to laboratory-simulated shallow frying practices, and (2) the prior saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acid (PUFA) contents of such frying media (FM), together with their heating time-points at a standard frying temperature (180 ^oC). Methods: Corn, sunflower, extra virgin olive, rapeseed, linseed, canola, coconut and MUFA-rich algae frying oils, together with butter and lard, were heated according to laboratory-simulated shallow-frying episodes at 180 ^oC, and FM samples were collected at time-points of 0, 5, 10, 20, 30, 60, and 90 min. (n = 6 replicates per sample). Aldehydes were determined by ¹H NMR analysis (Bruker AV 400 MHz spectrometer). The first (dependent output variable) PCR data matrix comprised aldehyde concentration scores vectors (PC1* and PC2*), whilst the second (predictor) one incorporated those from the fatty acid content/heating time variables (PC1-PC4) and their first-order interactions. Results: Structurally complex trans,trans- and cis,trans-alka-2,4-dienals, 4,5-epxy-trans-2-alkenals and 4-hydroxy-/4-hydroperoxy-trans-2-alkenals (group I aldehydes predominantly arising from PUFA peroxidation) strongly and positively loaded on PC1*, whereas n-alkanals and trans-2-alkenals (group II aldehydes derived from both MUFA and PUFA hydroperoxides) strongly and positively loaded on PC2*. PCR analysis of these scores vectors (SVs) demonstrated that PCs 1 (positively-loaded linoleoylglycerols and [linoleoylglycerol]:[SFA] content ratio), 2 (positively-loaded oleoylglycerols and negatively-loaded SFAs), 3 (positively-loaded linolenoylglycerols and [PUFA]:[SFA] content ratios), and 4 (exclusively orthogonal sampling time-points) all powerfully contributed to aldehydic PC1* SVs (p 10^-3 to < 10^-9), as did all PC1-3 x PC4 interaction ones (p 10^-5 to < 10^-9). PC2* was also markedly dependent on all the above PC SVs (PC2 > PC1 and PC3), and the interactions of PC1 and PC2 with PC4 (p < 10^-9 in each case), but not the PC3 x PC4 contribution. Conclusions: NMR-linked PCR analysis is a valuable strategy for (1) modelling the generation of aldehydic LOPs in heated cooking oils and other FM, and (2) tracking their unsaturated fatty acid (UFA) triacylglycerol sources therein.

Keywords: frying oils, lipid oxidation products, frying episodes, chemometrics, principal component regression, NMR Analysis, cytotoxic/genotoxic aldehydes

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