Search results for: quality approach
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21493

Search results for: quality approach

4843 Limits of the Dot Counting Test: A Culturally Responsive Approach to Neuropsychological Evaluations and Treatment

Authors: Erin Curtis, Avraham Schwiger

Abstract:

Neuropsychological testing and evaluation is a crucial step in providing patients with effective diagnoses and treatment while in clinical care. The variety of batteries used in these evaluations can help clinicians better understand the nuanced declivities in a patient’s cognitive, behavioral, or emotional functioning, consequently equipping clinicians with the insights to make intentional choices about a patient’s care. Despite the knowledge these batteries can yield, some aspects of neuropsychological testing remain largely inaccessible to certain patient groups as a result of fundamental cultural, educational, or social differences. One such battery includes the Dot Counting Test (DCT), during which patients are required to count a series of dots on a page as rapidly and accurately as possible. As the battery progresses, the dots appear in clusters that are designed to be easily multiplied. This task evaluates a patient’s cognitive functioning, attention, and level of effort exerted on the evaluation as a whole. However, there is evidence to suggest that certain social groups, particularly Latinx groups, may perform worse on this task as a result of cultural or educational differences, not reduced cognitive functioning or effort. As such, this battery fails to account for baseline differences among patient groups, thus creating questions surrounding the accuracy, generalizability, and value of its results. Accessibility and cultural sensitivity are critical considerations in the testing and treatment of marginalized groups, yet have been largely ignored in the literature and in clinical settings to date. Implications and improvements to applications are discussed.

Keywords: culture, latino, neuropsychological assessment, neuropsychology, accessibility

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4842 Development of a Wound Dressing Material Based on Microbial Polyhydroxybutyrate Electrospun Microfibers Containing Curcumin

Authors: Ariel Vilchez, Francisca Acevedo, Rodrigo Navia

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The wound healing process can be accelerated and improved by the action of antioxidants such as curcumin (Cur) over the tissues; however, the efficacy of curcumin used through the digestive system is not enough to exploit its benefits. Electrospinning presents an alternative to carry curcumin directly to the wounds, and polyhydroxybutyrate (PHB) is proposed as the matrix to load curcumin owing to its biodegradable and biocompatible properties. PHB is among 150 types of Polyhydroxyalkanoates (PHAs) identified, it is a natural thermoplastic polyester produced by microbial fermentation obtained from microorganisms. The proposed objective is to develop electrospun bacterial PHB-based microfibers containing curcumin for possible biomedical applications. Commercial PHB was solved in Chloroform: Dimethylformamide (4:1) to a final concentration of 7% m/V. Curcumin was added to the polymeric solution at 1%, and 7% m/m regarding PHB. The electrospinning equipment (NEU-BM, China) with a rotary collector was used to obtain Cur-PHB fibers at different voltages and flow rate of the polymeric solution considering a distance of 20 cm from the needle to the collector. Scanning electron microscopy (SEM) was used to determine the diameter and morphology of the obtained fibers. Thermal stability was obtained from Thermogravimetric (TGA) analysis, and Fourier Transform Infrared Spectroscopy (FT-IR) was carried out in order to study the chemical bonds and interactions. A preliminary curcumin release to Phosphate Buffer Saline (PBS) pH = 7.4 was obtained in vitro and measured by spectrophotometry. PHB fibers presented an intact chemical composition regarding the original condition (dust) according to FTIR spectra, the diameter fluctuates between 0.761 ± 0.123 and 2.157 ± 0.882 μm, with different qualities according to their morphology. The best fibers in terms of quality and diameter resulted in sample 2 and sample 6, obtained at 0-10kV and 0.5 mL/hr, and 0-10kV and 1.5 mL/hr, respectively. The melting temperature resulted near 178 °C, according to the bibliography. The crystallinity of fibers decreases while curcumin concentration increases for the studied interval. The curcumin release reaches near 14% at 37 °C at 54h in PBS adjusted to a quasi-Fickian Diffusion. We conclude that it is possible to load curcumin in PHB to obtain continuous, homogeneous, and solvent-free microfibers by electrospinning. Between 0% and 7% of curcumin, the crystallinity of fibers decreases as the concentration of curcumin increases. Thus, curcumin enhances the flexibility of the obtained material. HPLC should be used in further analysis of curcumin release.

Keywords: antioxidant, curcumin, polyhydroxybutyrate, wound healing

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4841 Exploring Teacher Verbal Feedback on Postgraduate Students' Performances in Presentations in English

Authors: Nattawadee Sinpattanawong, Yaowaret Tharawoot

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This is an analytic and descriptive classroom-centered research, the purpose of which is to explore teacher verbal feedback on postgraduate students’ performances in presentations in English in an English for Specific Purposes (ESP) postgraduate classroom. The participants are a Thai female teacher, two Thai female postgraduate students, and two foreign male postgraduate students. The current study draws on both classroom observation and interview data. The class focused on the students’ presentations and the teacher’s providing verbal feedback on them was observed nine times with audio recording and taking notes. For the interviews, the teacher was interviewed about linkages between her verbal feedback and each student’s presentation skills in English. For the data analysis, the audio files from the observations were transcribed and analyzed both quantitatively and qualitatively. The quantitative approach addressed the frequencies and percentages of content of the teacher’s verbal feedback for each student’s performances based on eight presentation factors (content, structure, grammar, coherence, vocabulary, speaking skills, involving the audience, and self-presentation). Based on the quantitative data including the interview data, a qualitative analysis of the transcripts was made to describe the occurrences of several content of verbal feedback for each student’s presentation performances. The study’s findings may help teachers to reflect on their providing verbal feedback based on various students’ performances in presentation in English. They also help students who have similar characteristics to the students in the present study when giving a presentation in English improve their presentation performances by applying the teacher’s verbal feedback content.

Keywords: teacher verbal feedback, presentation factors, presentation in English, presentation performances

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4840 Open Source Knowledge Management Approach to Manage and Disseminate Distributed Content in a Global Enterprise

Authors: Rahul Thakur, Onkar Chandel

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Red Hat is the world leader in providing open source software and solutions. A global enterprise, like Red Hat, has unique issues of connecting employees with content because of distributed offices, multiple teams spread across geographies, multiple languages, and different cultures. Employees, of a global company, create content that is distributed across departments, teams, regions, and countries. This makes finding the best content difficult since owners keep iterating on the existing content. When employees are unable to find the content, they end up creating it once again and in the process duplicating existing material and effort. Also, employees may not find the relevant content and spend time reviewing obsolete duplicate, or irrelevant content. On an average, a person spends 15 minutes/day in failed searches that might result in missed business opportunities, employee frustration, and substandard deliverables. Red Hat Knowledge Management Office (KMO) applied 'open source strategy' to solve the above problems. Under the Open Source Strategy, decisions are taken collectively. The strategy aims at accomplishing common goals with the help of communities. The objectives of this initiative were to save employees' time, get them authentic content, improve their content search experience, avoid duplicate content creation, provide context based search, improve analytics, improve content management workflows, automate content classification, and automate content upload. This session will describe open source strategy, its applicability in content management, challenges, recommended solutions, and outcome.

Keywords: content classification, content management, knowledge management, open source

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4839 An Adaptive Back-Propagation Network and Kalman Filter Based Multi-Sensor Fusion Method for Train Location System

Authors: Yu-ding Du, Qi-lian Bao, Nassim Bessaad, Lin Liu

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The Global Navigation Satellite System (GNSS) is regarded as an effective approach for the purpose of replacing the large amount used track-side balises in modern train localization systems. This paper describes a method based on the data fusion of a GNSS receiver sensor and an odometer sensor that can significantly improve the positioning accuracy. A digital track map is needed as another sensor to project two-dimensional GNSS position to one-dimensional along-track distance due to the fact that the train’s position can only be constrained on the track. A model trained by BP neural network is used to estimate the trend positioning error which is related to the specific location and proximate processing of the digital track map. Considering that in some conditions the satellite signal failure will lead to the increase of GNSS positioning error, a detection step for GNSS signal is applied. An adaptive weighted fusion algorithm is presented to reduce the standard deviation of train speed measurement. Finally an Extended Kalman Filter (EKF) is used for the fusion of the projected 1-D GNSS positioning data and the 1-D train speed data to get the estimate position. Experimental results suggest that the proposed method performs well, which can reduce positioning error notably.

Keywords: multi-sensor data fusion, train positioning, GNSS, odometer, digital track map, map matching, BP neural network, adaptive weighted fusion, Kalman filter

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4838 Mindfulness, Acceptance and Meaning in Life for Adults with Cancer

Authors: Fernanda F. Zimmermann, Beverley Burrell, Jennifer Jordan

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Introduction: Supportive care for people affected by cancer is recognised as a priority for research but yet there is little solid evidence of the effectiveness of psychological treatments for those with advanced cancer. The literature suggests that mindfulness-based interventions may be acceptable and beneficial for this population. This study aims to develop a mindfulness intervention to provide emotional support for advanced cancer population. The treatment package includes mindfulness meditation, developing an acceptance attitude and reflections on meaning in life. Methods: This study design is a one-group pre-post test with a mixed methods approach. Participants are recruited through public and private hospitals in Christchurch, NZ. Quantitative measures are the Acceptance and Action Questionnaire-II, Mindful Coping Scale and, the Meaning in Life Questionnaire. Qualitative semi-structured interviews enquire about emotional support before and after the diagnosis, participants’ thoughts about meaning in life, expectations and reflections on the mindfulness training. Qualitative data will be analysed using thematic analysis. Treatment consists of one to one 30 minutes session weekly for 4 weeks using a pre-recorded CD/podcast of the mindfulness training. This research is part of the presenter’s PhD study. Findings: This project is currently underway. The presenter will provide preliminary data on the acceptability of the mindfulness training package being delivered to participants along with the recruitment strategies. We anticipate that this novel treatment used as a self-management tool will reduce psychological distress and enable better coping for patients with advanced cancer.

Keywords: acceptance, cancer, meaning in life, mindfulness

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4837 Consumption of Fat Burners Leads to Acute Liver Failure: A Systematic Review protocol

Authors: Anjana Aggarwal, Sheilja Walia

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Prevalence of obesity and overweight is increasing due to sedentary lifestyles and busy schedules of people that spend less time on physical exercise. To reduce weight, people are finding easier and more convenient ways. The easiest solution is the use of dietary supplements and fat burners. These are products that decrease body weight by increasing the basal metabolic rate. Various reports have been published on the consumption of fat burners leading to heart palpitations, seizures, anxiety, depression, psychosis, bradycardia, insomnia, muscle contractions, hepatotoxicity, and even liver failure. Case reports and series are reporting that the ingredients present in the fat burners caused acute liver failure (ALF) and hepatic toxicity in many cases. Another contributing factor is the absence of regulations from the Food and Drug Administration on these products, leading to increased consumption and a higher risk of liver diseases among the population. This systematic review aims to attain a better understanding of the dietary supplements used globally to reduce weight and document the case reports/series of acute liver failure caused by the consumption of fat burners. Electronic databases like PubMed, Cochrane, Google Scholar, etc., will be systematically searched for relevant articles. Various websites of dietary products and brands that sell such supplements, Journals of Hepatology, National and international projects launched for ALF, and their reports, along with the review of grey literature, will also be done to get a better understanding of the topic. After discussing with the co-author, the selection and screening of the articles will be performed by the author. The studies will be selected based on the predefined inclusion and exclusion criteria. The case reports and case series that will be included in the final list of the studies will be assessed for methodological quality using the CARE guidelines. The results from this study will provide insights and a better understanding of fat burners. Since the supplements are easily available in the market without any restrictions on their sale, people are unaware of their adverse effects. The consumption of these supplements causes acute liver failure. Thus, this review will provide a platform for future larger studies to be conducted.

Keywords: acute liver failure, dietary supplements, fat burners, weight loss supplements

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4836 International Humanitarian Law and the Challenges of New Technologies of Warfare

Authors: Uche A. Nnawulezi

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Undoubtedly, despite all efforts made to achieve overall peace through the application of the principles of international humanitarian law, crimes against mankind which are of unprecedented concern to the whole world have remained unabated. The fall back on war as a technique for settling disputes between nations, individuals, countries and ethnic groups with accompanying toll of deaths and destruction of properties have remained a conspicuous component of human history. Indeed, to control this conduct of warfare and the dehumanization of individuals, a body of law aimed at regulating the impacts of conflicts and hostilities in the theater of war has become necessary. Thus, it is to examine the conditions in which international humanitarian law will apply and also to determine the extent of the challenges of new progressions of warfare that this study is undertaken. All through this examination, we grasped doctrinal approach wherein we used text books, journals, international materials and supposition of law specialists in the field of international humanitarian law. This paper shall examine the distinctive factors responsible for the rebelliousness to the rules of International Humanitarian Law and furthermore, shall proffer possible courses of action that will address the challenges of new technologies of warfare all over the world. Essentially, the basic proposals made in this paper if totally utilized may go far in ensuring a sufficient standard in the application of the rules of international humanitarian law as it relates to an increasingly frequent phenomenon of contemporary developments in technologies of warfare which has in recent past, made it more difficult for the most ideal application of the rules of international humanitarian law. This paper deduces that for a sustainable global peace to be achieved, the rules of International Humanitarian Law as it relates to the utilization of new technologies of warfare should be completely clung to and should be made a strict liability offense. Likewise, this paper further recommends the introduction of domestic criminal law punishment of serious contraventions of the rules of international humanitarian law.

Keywords: international, humanitarian law, new technologies, warfare

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4835 Oestrogen Replacement In Post-Oophorectomy Women

Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

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Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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4834 Self-rated Health as a Predictor of Hospitalizations in Patients with Bipolar Disorder and Major Depression: A Prospective Cohort Study of the United Kingdom Biobank

Authors: Haoyu Zhao, Qianshu Ma, Min Xie, Yunqi Huang, Yunjia Liu, Huan Song, Hongsheng Gui, Mingli Li, Qiang Wang

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Rationale: Bipolar disorder (BD) and major depressive disorder (MDD), as severe chronic illnesses that restrict patients’ psychosocial functioning and reduce their quality of life, are both categorized into mood disorders. Emerging evidence has suggested that the reliability of self-rated health (SRH) was wellvalidated and that the risk of various health outcomes, including mortality and health care costs, could be predicted by SRH. Compared with other lengthy multi-item patient-reported outcomes (PRO) measures, SRH was proven to have a comparable predictive ability to predict mortality and healthcare utilization. However, to our knowledge, no study has been conducted to assess the association between SRH and hospitalization among people with mental disorders. Therefore, our study aims to determine the association between SRH and subsequent all-cause hospitalizations in patients with BD and MDD. Methods: We conducted a prospective cohort study on people with BD or MDD in the UK from 2006 to 2010 using UK Biobank touchscreen questionnaire data and linked administrative health databases. The association between SRH and 2-year all-cause hospitalizations was assessed using proportional hazard regression after adjustment for sociodemographics, lifestyle behaviors, previous hospitalization use, the Elixhauser comorbidity index, and environmental factors. Results: A total of 29,966 participants were identified, experiencing 10,279 hospitalization events. Among the cohort, the average age was 55.88 (SD 8.01) years, 64.02% were female, and 3,029 (10.11%), 15,972 (53.30%), 8,313 (27.74%), and 2,652 (8.85%) reported excellent, good, fair, and poor SRH, respectively. Among patients reporting poor SRH, 54.19% had a hospitalization event within 2 years compared with 22.65% for those having excellent SRH. In the adjusted analysis, patients with good, fair, and poor SRH had 1.31 (95% CI 1.21-1.42), 1.82 (95% CI 1.68-1.98), and 2.45 (95% CI 2.22, 2.70) higher hazards of hospitalization, respectively, than those with excellent SRH. Conclusion: SRH was independently associated with subsequent all-cause hospitalizations in patients with BD or MDD. This large study facilitates rapid interpretation of SRH values and underscores the need for proactive SRH screening in this population, which might inform resource allocation and enhance high-risk population detection.

Keywords: severe mental illnesses, hospitalization, risk prediction, patient-reported outcomes

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4833 Impact of Clinical Pharmacist Intervention in Improving Drug Related Problems in Patients with Chronic Kidney Disease

Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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4832 Innovation and Employment in Sub-Saharan Africa: Evidence from Uganda Microdata

Authors: Milton Ayoki, Edward Bbaale

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This paper analyses the relationship between innovation and employment at firm level with the objective of understanding the contribution of the different innovation strategies in fostering employment growth in Uganda. We use National Innovation Survey (micro-data of 705 Ugandan firms) for the period 2011-2014 and follow closely Harrison et al. (2014) structured approach, and relate employment growth to process innovations and to the growth of sales separately due to innovative and unchanged products. We find positive effects of product innovation on employment at firm level, while process innovation has no discernable impact on employment. Although there is evidence to suggest displacement of labour in some cases where firms only introduce new process, this effect is compensated by growth in employment from new products, which for most firms are introduced simultaneously with new process. Results suggest that source of innovation as well as size of innovating firms or end users of innovation matter for job growth. Innovation that develops from within the firm itself (user) and involving larger firms has greater impact on employment than that developed from outside or coming from within smaller firms. In addition, innovative firms are one and half times more likely to survive in the innovation driven economy environment than those that do not innovate. These results have important implications for policymakers and stakeholders in innovation ecosystem. Supporting policies need to be correctly tailored since the impacts depend on the innovation strategy (type) and characteristics and sector of the innovative firms (small, large, industry, etc.). Policies to spur investment, particularly in innovative sectors and firms with high growth potential would have long lasting effects on job creation. JEL Classification: D24, J0, J20, L20, O30.

Keywords: employment, process innovation, product innovation, Sub-Saharan Africa

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4831 Spatio-Temporal Risk Analysis of Cancer to Assessed Environmental Exposures in Coimbatore, India

Authors: Janani Selvaraj, M. Prashanthi Devi, P. B. Harathi

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Epidemiologic studies conducted over several decades have provided evidence to suggest that long-term exposure to elevated ambient levels of particulate air pollution is associated with increased mortality. Air quality risk management is significant in developing countries and it highlights the need to understand the role of ecologic covariates in the association between air pollution and mortality. Several new methods show promise in exploring the geographical distribution of disease and the identification of high risk areas using epidemiological maps. However, the addition of the temporal attribute would further give us an in depth idea of the disease burden with respect to forecasting measures. In recent years, new methods developed in the reanalysis were useful for exploring the spatial structure of the data and the impact of spatial autocorrelation on estimates of risk associated with exposure to air pollution. Based on this, our present study aims to explore the spatial and temporal distribution of the lung cancer cases in the Coimbatore district of Tamil Nadu in relation to air pollution risk areas. A spatio temporal moving average method was computed using the CrimeStat software and visualized in ArcGIS 10.1 to document the spatio temporal movement of the disease in the study region. The random walk analysis performed showed the progress of the peak cancer incidences in the intersection regions of the Coimbatore North and South taluks that include major commercial and residential regions like Gandhipuram, Peelamedu, Ganapathy, etc. Our study shows evidence that daily exposure to high air pollutant concentration zones may lead to the risk of lung cancer. The observations from the present study will be useful in delineating high risk zones of environmental exposure that contribute to the increase of cancer among daily commuters. Through our study we suggest that spatially resolved exposure models in relevant time frames will produce higher risks zones rather than solely on statistical theory about the impact of measurement error and the empirical findings.

Keywords: air pollution, cancer, spatio-temporal analysis, India

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4830 Environmental Virtue Ethics for the Anthropocene in Barbara Kingsolver’s Animal Dreams

Authors: Xu Lan, Zainor Izat Zainal

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Human intervention in Earth’s macro system has ushered in the age of the Anthropocene, prompting introspection among humans, the action agent. This epoch demands a reawakening of human conscience and inner motivation to mitigate the irreversible trend so as to shape the trajectory of the Anthropocene. Environmental virtue ethics claims that the fundamental cause of environmental crisis lies in humans themselves. Rather than focusing more on what humans should do, environmental virtue ethics seeks to specify environmental virtues to appeal to what kind of person a human should be. Renowned Pulitzer Prize-winning author Barbara Kingsolver illustrates her contentions about environmental ethics through the narrative of Codi and her sister Hallie’s environmental choices and actions in Animal Dreams (1990). This study adopts a textual analysis approach of the character traits exhibited by Codi and Hallie that are constitutive of making them environmentally virtuous, exploring how emotions and inner motivations drive actions. This paper is informed by Ronald Sandler’s (2007) virtues of sustainability, virtues of communion with nature, and virtues of environmental stewardship and activism. It aims to examine how Codi and Hallie’s character traits are built around these virtues. Furthermore, this study underscores the importance of internalizing principles and cultivating virtues for the environment and humans’ flourishing in the Anthropocene. As a tentative practice in applying environmental virtue ethics to examine environmental virtues for the Anthropocene, this study reveals Kingsolver’s endeavor of setting environmental virtue exemplars from fictional characters to inspire humans’ long-term and stable contribution to a better future.

Keywords: anthopocene, environmental ethics, environmental virtues, virtue ethics

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4829 Usage of Biosorbent Material for the Removal of Nitrate from Wastewater

Authors: M. Abouleish, R. Umer, Z. Sara

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Nitrate can cause serious environmental and human health problems. Effluent from different industries and excessive use of fertilizers have increased the level of nitrate in ground and surface water. Nitrate can convert to nitrite in the body, and as a result, can lead to Methemoglobinemia and cancer. Therefore, different organizations have set standard limits for nitrate and nitrite. The United States Environmental Protection Agency (USEPA) has set a Maximum Contaminant Level Goal (MCLG) of 10 mg N/L for nitrate and 1 mg N/L for nitrite. The removal of nitrate from water and wastewater is very important to ensure the availability of clean water. Different plant materials such as banana peel, rice hull, coconut and bamboo shells, have been studied as biosorbents for the removal of nitrates from water. The use of abundantly existing plant material as an adsorbent material and the lack of energy requirement for the adsorption process makes biosorption a sustainable approach. Therefore, in this research, the fruit of the plant was investigated for its ability to act as a biosorbent to remove the nitrate from wastewater. The effect of pH on nitrate removal was studied using both the raw and chemically activated fruit (adsorbent). Results demonstrated that the adsorbent needs to be chemically activated before usage to remove the nitrate from wastewater. pH did not have a significant effect on the adsorption process, with maximum adsorption of nitrate occurring at pH 4. SEM/EDX results demonstrated that there is no change in the surface of the adsorbent as a result of the chemical activation. Chemical activation of the adsorbent using NaOH increased the removal of nitrate by 6%; therefore, various methods of activation of the adsorbent will be investigated to increase the removal of nitrate.

Keywords: biosorption, nitrates, plant material, water, and wastewater treatment

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4828 Personality Traits and Physical Activity among Staff Personnel of University of Southern Mindanao

Authors: Cheeze Janito, Crisly Dawang

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It is important to determine the personality traits that exist in the workplace and the contribution of these personality traits in the staff’s daily work routines; a sedentary lifestyle is harmful to one’s health. This study reports the personality traits of the University of Southern Mindanao, Kabacan, Philippines, non-teaching staff, the physical activity involvement of the non-teaching staff, and the big five personality traits that shape the relationship of university non-teaching staff in engaging physical activities. A quantitative method approach, which comprised a three-part questionnaire, was used to collect the data. The fifty non-teaching staff complete the survey. The results revealed that among the big five personality traits, the university non-teaching staff scored higher in agreeableness as revealed, that there was a commonality among the respondents’ traits of consideration to the feelings of the co-workers in observance to not being rude and vividly display of respect to co-workers and workplace and scored least in the personality trait of neuroticism. The study also reported that the university non-teaching staff's main physical activity was house chores as a prime physical exercise in which respondents reported a physical activity frequency of once to twice a week; thus, this study reported that the respondents are less engaged in doing physical activities. Further, the relationship of personality traits and the physical activity of the non-teaching staff gained a p-value of .596 that indicates there is no significant relationship between the two variables, the personality trait and physical activities. This study recommends the tight promotion of staff in engaging in physical activity of at least one hundred fifty minutes of moderate-intensity activity each week. Added to this, the use of different platforms containing physical exercise literacy and the benefits of physical exercise for the holistic development of the university community.

Keywords: university staff, physical fitness, personality traits, physical activity

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4827 Support Vector Regression for Retrieval of Soil Moisture Using Bistatic Scatterometer Data at X-Band

Authors: Dileep Kumar Gupta, Rajendra Prasad, Pradeep Kumar, Varun Narayan Mishra, Ajeet Kumar Vishwakarma, Prashant K. Srivastava

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An approach was evaluated for the retrieval of soil moisture of bare soil surface using bistatic scatterometer data in the angular range of 200 to 700 at VV- and HH- polarization. The microwave data was acquired by specially designed X-band (10 GHz) bistatic scatterometer. The linear regression analysis was done between scattering coefficients and soil moisture content to select the suitable incidence angle for retrieval of soil moisture content. The 250 incidence angle was found more suitable. The support vector regression analysis was used to approximate the function described by the input-output relationship between the scattering coefficient and corresponding measured values of the soil moisture content. The performance of support vector regression algorithm was evaluated by comparing the observed and the estimated soil moisture content by statistical performance indices %Bias, root mean squared error (RMSE) and Nash-Sutcliffe Efficiency (NSE). The values of %Bias, root mean squared error (RMSE) and Nash-Sutcliffe Efficiency (NSE) were found 2.9451, 1.0986, and 0.9214, respectively at HH-polarization. At VV- polarization, the values of %Bias, root mean squared error (RMSE) and Nash-Sutcliffe Efficiency (NSE) were found 3.6186, 0.9373, and 0.9428, respectively.

Keywords: bistatic scatterometer, soil moisture, support vector regression, RMSE, %Bias, NSE

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4826 Muslim Husbands’ Participation in Women’s Health and Illness: A Descriptive Exploratory Study Applied to Muslim Women in Indonesia

Authors: Restuning Widiasih, Katherine Nelson, Joan Skinner

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Muslim husbands have significant roles in the family including their roles in women’s health and illness. However, studies that explore Muslim husbands’ participation in women’s health is limited. The objective of this study was to uncover Muslim husbands’ participation in women’ health and illness including cancer prevention and screening. A descriptive exploratory approach was used involving 20 Muslim women from urban and rural areas of West Java Province, Indonesia. Muslim women shared experience related to their husbands support and activities in women’s health and illness. The data from the interviews were analyzed using the Comparative Analysis for Interview (CAI). Women perceived that husbands fully supported their health by providing opportunities for activities, and reminding them about healthy food, their workloads, and family planning. Husbands actively involved when women faced health issues including sharing knowledge and experience, discussing any health problems, advising for medical check-ups, and accompanying them for treatments. The analysis also found that husbands were less active and offered less advice regarding prevention and early detection of cancer. This study highlights the significant involvement of Muslim husbands in women’s health and illness, yet a lack of support from husbands related to screening and cancer prevention. This condition could be a burden for Muslim women to participate in health programs related to cancer prevention and early detection. Health education programs to improve Muslim husbands’ understanding of women’s health is needed.

Keywords: descriptive exploratory study, Muslim husbands, Muslim women, women's health and illness

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4825 A Comparative Study on Occupational Fraud and Prosecution

Authors: Michelle Odudu

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Ghana and Nigeria are known for their high levels of Occupational Fraud in public offices. The governments of both countries have emphasised their commitment to reducing the losses caused to the state by pledging their allegiance to the counter-fraud agencies to help tackle Occupational Fraud. Yet it seems that the prosecution of such cases is ineffective as high-profile fraudsters can operate with immunity and their cases remain unprosecuted. This research project was based on in-depth examinations of 50 occupational fraud cases involving high-profile individuals in both countries. In doing so, it established the characteristics of those who were prosecuted; the extent to which prosecutions were effectively managed; the barriers to effective prosecutions; and the similarities or differences between the occurrences in both countries. The aim of the project is to examine the practice of and barriers to prosecution of large-scale occupational fraud of those in senior public positions in Ghana and Nigeria. The study drew on the experiences of stakeholders such as defence and prosecution barristers, academics, and fraud analysts via semi-structured interviews and questionnaires. 13 interviews were conducted in Ghana and in Nigeria, where respondents were recruited using a snowball approach. Questionnaires were physically distributed: 20 of the staff at EOCO and 10 to NGO staff in Ghana; 6 and 5 came back, respectively. The empirical data collected suggests that there is no lack of will on the agencies’ part to at least commence proceedings. However, various impediments hamper a successful completion of prosecution. Challenges were more evident in Nigeria, where agencies are less effective at retrieving stolen assets and changing social norms. This is further compounded by several cultural and political factors, which create limitations leaving many cases ‘still pending’.

Keywords: comparative, prosecution, punishment, international, whitecollar, fraud

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4824 Efficient Human Motion Detection Feature Set by Using Local Phase Quantization Method

Authors: Arwa Alzughaibi

Abstract:

Human Motion detection is a challenging task due to a number of factors including variable appearance, posture and a wide range of illumination conditions and background. So, the first need of such a model is a reliable feature set that can discriminate between a human and a non-human form with a fair amount of confidence even under difficult conditions. By having richer representations, the classification task becomes easier and improved results can be achieved. The Aim of this paper is to investigate the reliable and accurate human motion detection models that are able to detect the human motions accurately under varying illumination levels and backgrounds. Different sets of features are tried and tested including Histogram of Oriented Gradients (HOG), Deformable Parts Model (DPM), Local Decorrelated Channel Feature (LDCF) and Aggregate Channel Feature (ACF). However, we propose an efficient and reliable human motion detection approach by combining Histogram of oriented gradients (HOG) and local phase quantization (LPQ) as the feature set, and implementing search pruning algorithm based on optical flow to reduce the number of false positive. Experimental results show the effectiveness of combining local phase quantization descriptor and the histogram of gradient to perform perfectly well for a large range of illumination conditions and backgrounds than the state-of-the-art human detectors. Areaunder th ROC Curve (AUC) of the proposed method achieved 0.781 for UCF dataset and 0.826 for CDW dataset which indicates that it performs comparably better than HOG, DPM, LDCF and ACF methods.

Keywords: human motion detection, histograms of oriented gradient, local phase quantization, local phase quantization

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4823 History of Textiles and Fashion: Gender Symbolism in the Context of Colour

Authors: Damayanthie Eluwawalage

Abstract:

Historically, the color-coded attire demarcated differences, for example, differences in social position and differences in gender, etc. Distinctive colors are worn by different classes in medieval England. By the twentieth-century Western society, certain colors were firmly associated with the specific gender; as pink for girls, and blue for boys. The color-coded gender phenomenon was a novelty at the turn of the twentieth-century and became widely practiced after World War II. Prior to that era, there were no distinctions or differences in the dress of younger children, in relation to their gender. In the nineteenth century, pink suits were highly acceptable for gentlemen’s attire. Frenchmen in the eighteenth-century wore colors with an infinite range of hues like pink, plum, white, cream, blue, yellow, puce and sea green. Nineteenth-century European male austerity, primarily caused by the usage of sombre colors such as black, white and grey, has been described as an element for dignity, control and morality. In the nineteenth century, there were many color-associated distinctions, as certain colors were reserved for the unmarried, the single or the aged. Two luminous colors in one dress was ‘vulgar’ and yellow was generally regarded as unladylike. Yellow was the color utilised for most correctional attire. Orange was prohibited for the unmarried. Fashionable dressing in the nineteenth century was more gender-differentiated than in previous centuries. Masculine austerity, emphasized a shift in class relations. As a result of that shift, male attire became more uniform, homogeneous and integrated (amongst the classes), than its traditional hierarchal approach.

Keywords: textiles, fashion, gender symbolism, color

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4822 Human Trafficking the Kosovar Perspective of Fighting the Phenomena through Police and Civil Society Cooperation

Authors: Samedin Mehmeti

Abstract:

The rationale behind this study is considering combating and preventing the phenomenon of trafficking in human beings from a multidisciplinary perspective that involves many layers of the society. Trafficking in human beings is an abhorrent phenomenon highly affecting negatively the victims and their families in both human and material aspect, sometimes causing irreversible damages. The longer term effects of this phenomenon, in countries with a weak economic development and extremely young and dynamic population, such as Kosovo, without proper measures to prevented and control can cause tremendous damages in the society. Given the fact that a complete eradication of this phenomenon is almost impossible, efforts should be concentrated at least on the prevention and controlling aspects. Treating trafficking in human beings based on traditional police tactics, methods and proceedings cannot bring satisfactory results. There is no doubt that a multi-disciplinary approach is an irreplaceable requirement, in other words, a combination of authentic and functional proactive and reactive methods, techniques and tactics. Obviously, police must exercise its role in preventing and combating trafficking in human beings, a role sanctioned by the law, however, police role and contribution cannot by any means considered complete if all segments of the society are not included in these efforts. Naturally, civil society should have an important share in these collaborative and interactive efforts especially in preventive activities such as: awareness on trafficking risks and damages, proactive engagement in drafting appropriate legislation and strategies, law enforcement monitoring and direct or indirect involvement in protective and supporting activities which benefit the victims of trafficking etc.

Keywords: civil society, cooperation, police, human trafficking

Procedia PDF Downloads 357
4821 Ultra-Fast Growth of ZnO Nanorods from Aqueous Solution: Technology and Applications

Authors: Bartlomiej S. Witkowski, Lukasz Wachnicki, Sylwia Gieraltowska, Rafal Pietruszka, Marek Godlewski

Abstract:

Zinc oxide is extensively studied II-VI semiconductor with a direct energy gap of about 3.37 eV at room temperature and high transparency in visible light spectral region. Due to these properties, ZnO is an attractive material for applications in photovoltaic, electronic and optoelectronic devices. ZnO nanorods, due to a well-developed surface, have potential of applications in sensor technology and photovoltaics. In this work we present a new inexpensive method of the ultra-fast growth of ZnO nanorods from the aqueous solution. This environment friendly and fully reproducible method allows growth of nanorods in few minutes time on various substrates, without any catalyst or complexing agent. Growth temperature does not exceed 50ºC and growth can be performed at atmospheric pressure. The method is characterized by simplicity and allows regulation of size of the ZnO nanorods in a large extent. Moreover the method is also very safe, it requires organic, non-toxic and low-price precursors. The growth can be performed on almost any type of substrate through the homo-nucleation as well as hetero-nucleation. Moreover, received nanorods are characterized by a very high quality - they are monocrystalline as confirmed by XRD and transmission electron microscopy. Importantly oxygen vacancies are not found in the photoluminescence measurements. First results for obtained by us ZnO nanorods in sensor applications are very promising. Resistance UV sensor, based on ZnO nanorods grown on a quartz substrates shows high sensitivity of 20 mW/m2 (2 μW/cm2) for point contacts, especially that the results are obtained for the nanorods array, not for a single nanorod. UV light (below 400 nm of wavelength) generates electron-hole pairs, which results in a removal from the surfaces of the water vapor and hydroxyl groups. This reduces the depletion layer in nanorods, and thus lowers the resistance of the structure. The so-obtained sensor works at room temperature and does not need the annealing to reset to initial state. Details of the technology and the first sensors results will be presented. The obtained ZnO nanorods are also applied in simple-architecture photovoltaic cells (efficiency over 12%) in conjunction with low-price Si substrates and high-sensitive photoresistors. Details informations about technology and applications will be presented.

Keywords: hydrothermal method, photoresistor, photovoltaic cells, ZnO nanorods

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4820 Direct Cost of Anesthesia in Traumatic Patients with Massive Bleeding: A Prospective Micro-Costing Study

Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

Abstract:

Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

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4819 Event Driven Dynamic Clustering and Data Aggregation in Wireless Sensor Network

Authors: Ashok V. Sutagundar, Sunilkumar S. Manvi

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Energy, delay and bandwidth are the prime issues of wireless sensor network (WSN). Energy usage optimization and efficient bandwidth utilization are important issues in WSN. Event triggered data aggregation facilitates such optimal tasks for event affected area in WSN. Reliable delivery of the critical information to sink node is also a major challenge of WSN. To tackle these issues, we propose an event driven dynamic clustering and data aggregation scheme for WSN that enhances the life time of the network by minimizing redundant data transmission. The proposed scheme operates as follows: (1) Whenever the event is triggered, event triggered node selects the cluster head. (2) Cluster head gathers data from sensor nodes within the cluster. (3) Cluster head node identifies and classifies the events out of the collected data using Bayesian classifier. (4) Aggregation of data is done using statistical method. (5) Cluster head discovers the paths to the sink node using residual energy, path distance and bandwidth. (6) If the aggregated data is critical, cluster head sends the aggregated data over the multipath for reliable data communication. (7) Otherwise aggregated data is transmitted towards sink node over the single path which is having the more bandwidth and residual energy. The performance of the scheme is validated for various WSN scenarios to evaluate the effectiveness of the proposed approach in terms of aggregation time, cluster formation time and energy consumed for aggregation.

Keywords: wireless sensor network, dynamic clustering, data aggregation, wireless communication

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4818 Adaptable Buildings for More Sustainable Housing: Energy Life Cycle Analysis

Authors: Rafael Santos Fischer, Aloísio Leoni Schmid, Amanda Dalla-Bonna

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The life cycle analysis and the energy life cycle analysis are useful design support tools when sustainability becomes imperative. The final phase of buildings life cycle is probably the least known, on which less knowledge is available. In the Brazilian building industry, the lifespan of a building design rarely is treated as a definite design parameter. There is rather a common sense attitude to take any building demands as permanent, and to take for granted that buildings solutions are durable and solid. Housing, being a permanent issue in any society, presents a real challenge to the choice of a design lifespan. In Brazilian history, there was a contrast of the native solutions of collective, non-durable houses built by several nomadic tribes, and the stone and masonry buildings introduced by the sedentary Portuguese conquerors. Durable buildings are commonly associated with welfare. However, social dynamics makes traditional families of both parents and children be just one of several possible arrangements. In addition, a more liberal attitude towards family leads to an increase in the number of people living in alternative arrangements. Japan is an example of country where houses have been made intentionally ephemeral since the half of 20th century. The present article presents the development of a flexible housing design solution on the basis of the Design Science Research approach. A comparison in terms of energy life cycle shows how flexibility and dematerialization may point at a feasible future for housing policies in Brazil.

Keywords: adaptability, adaptable building, embodied energy, life cyclce analysis, social housing

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4817 Management of Fitness-For-Duty for Human Error Prevention in Nuclear Power Plants

Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee

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For the past several decades, not a few researchers have warned that even a trivial human error may result in unexpected accidents, especially in Nuclear Power Plants. To prevent accidents in Nuclear Power Plants, it is quite indispensable to make any factors under the effective control that may raise the possibility of human errors for accident prevention. This study aimed to develop a risk management program, especially in the sense that guaranteeing Fitness-for-Duty (FFD) of human beings working in Nuclear Power Plants. Throughout a literal survey, it was found that work stress and fatigue are major psychophysical factors requiring sophisticated management. A set of major management factors related to work stress and fatigue was through repetitive literal surveys and classified into several categories. To maintain the fitness of human workers, a 4-level – individual worker, team, staff within plants, and external professional - approach was adopted for FFD management program. Moreover, the program was arranged to envelop the whole employment cycle from selection and screening of workers, job allocation, and job rotation. Also, a managerial care program was introduced for employee assistance based on the concept of Employee Assistance Program (EAP). The developed program was reviewed with repetition by ex-operators in nuclear power plants, and assessed in the affirmative. As a whole, responses implied additional treatment to guarantee high performance of human workers not only in normal operations but also in emergency situations. Consequently, the program is under administrative modification for practical application.

Keywords: fitness-for-duty (FFD), human error, work stress, fatigue, Employee-Assistance-Program (EAP)

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4816 Society and Cinema in Iran

Authors: Seyedeh Rozhano Azimi Hashemi

Abstract:

There is no doubt that ‘Art’ is a social phenomena and cinema is the most social kind of art. Hence, it’s clear that we can analyze the relation’s of cinema and art from different aspects. In this paper sociological cinema will be investigated which, is a subdivision of sociological art. This term will be discussed by two main approaches. One of these approaches is focused on the effects of cinema on the society, which is known as “Effects Theory” and the second one, which is dealing with the reflection of social issues in cinema is called ” Reflection Theory”. "Reflect theory" approach, unlike "Effects theory" is considering movies as documents, in which social life is reflected, and by analyzing them, the changes and tendencies of a society are understood. Criticizing these approaches to cinema and society doesn’t mean that they are not real. Conversely, it proves the fact that for better understanding of cinema and society’s relation, more complicated models are required, which should consider two aspects. First, they should be bilinear and they should provide a dynamic and active relation between cinema and society, as for the current concept social life and cinema have bi-linear effects on each other, and that’s how they fit in a dialectic and dynamic process. Second, it should pay attention to the role of inductor elements such as small social institutions, marketing, advertisements, cultural pattern, art’s genres and popular cinema in society. In the current study, image of middle class in cinema of Iran and changing the role of women in cinema and society which were two bold issue that cinema and society faced since 1979 revolution till 80s are analyzed. Films as an artwork on one hand, are reflections of social changes and with their effects on the society on the other hand, are trying to speed up the trends of these changes. Cinema by the illustration of changes in ideologies and approaches in exaggerated ways and through it’s normalizing functions, is preparing the audiences and public opinions for the acceptance of these changes. Consequently, audience takes effect from this process, which is a bi-linear and interactive process.

Keywords: Iranian Cinema, Cinema and Society, Middle Class, Woman’s Role

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4815 Pharmacogenetics of Uridine Diphosphate Glucuronosyltransferase (UGT1A9) Genetic Polymorphism on Sodium Valproate Pharmacokinetics in Epilepsy

Authors: Murali Munisamy, Gauthaman Karunakaran, Mubarak Al-Gahtany, Vivekanandhan Subbiah, M. Manjari Tripati

Abstract:

Background: Sodium valproate is a widely prescribed broad-spectrum anti-epileptic drug. It shows high inter-individual variability in pharmacokinetics and pharmacodynamics and has a narrow therapeutic range. We evaluated the effects of polymorphic uridine diphosphate glucuronosyltransferase (UGT1A9) metabolizing enzyme on the pharmacokinetics of sodium valproate in the patients with epilepsy who showed toxicity to therapy. Methods: Genotype analysis of the patients was made with polymerase chain–restriction fragment length polymorphism (RFLP) with sequencing. Plasma drug concentrations were measured with reversed phase high-performance liquid chromatography (HPLC) and concentration–time data were analyzed by using a non-compartmental approach. Results: The results of this study suggested a significant genotypic as well as allelic association with valproic acid toxicity for UGT1A9 polymorphic enzymes. The elimination half-life (t 1/2=40.2 h) of valproic acid was longer and the clearance rate (CL=937 ml/h) was lower in the poor metabolizers group of UGT1A9 polymorphism who showed toxicity than in the intermediate metabolizers group (t1/2=35.5 h, CL=1042 ml/h) or the extensive metabolizers group (t1/2=26. h, CL=1,302 ml/h). Conclusion: Our findings suggest that the UGT1A9 genetic polymorphism plays a significant role in the steady state concentration of sodium valproate, and it thereby has an impact on the toxicity of the sodium valproate used in the patients with epilepsy.

Keywords: UGT1A9, sodium valporate, pharmacogenetics, polymorphism

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4814 A Precision Medicine Approach to Sickle Cell Disease by Targeting the Adhesion Interactome

Authors: Anthara Vivek, Manisha Shukla, Mahesh Narayan, Prakash Narayan

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Sickle cell disease disproportionately affects sub-Saharan Africa and certain tribal populaces in India and has consequently drawn little intertest from Pharma. In sickle cell patients, adhesion of erythrocytes or reticulocytes to one another and the vessel wall results in painful ischemic episodes with few, if any, effective treatments for vaso-occlusive crises. Identification of disease-associated adhesion markers on erythrocytes or reticulocytes might inform the use of more effective therapies against vaso-occlusive crises. Increased expression of one or more of bcam, itga4, cd44, cd47, rap1a, vcam1, or icam4 has been reported in sickle cell subjects. Using the miRNet ontology knowledgebase, peripheral blood interactomes were generated by seeding various combinations of the afore-referenced mRNA. These interactomes yielded an array of miR targets. As examples, targeting hsa-miR-155-5p can potentially neutralize the rap1a-bcam-cd44-itga4-vcam1 erythrocyte/reticulocyte adhesion interactome whereas targeting hsa-miRs-103a-3p or 107 can potentially neutralize adhesion in cells overexpressing icam4-cd47-bcam-itga4-cd36. AM3380 (MIRacle™) is an off-the shelf hsa-miR-155-5p agomiR that can potentially neutralize the rap1a-bcam-cd44-itga4-vcam1 signaling axis. Phlebotomy coupled with transcriptomics represents a potentially feasible and effective precision medicine strategy to mitigate vaso-occlusive crises in sickle cell patients.

Keywords: adhesion, interactome, precision, medicine

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