Search results for: software reliability growth models
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Search results for: software reliability growth models

64 Black-Box-Optimization Approach for High Precision Multi-Axes Forward-Feed Design

Authors: Sebastian Kehne, Alexander Epple, Werner Herfs

Abstract:

A new method for optimal selection of components for multi-axes forward-feed drive systems is proposed in which the choice of motors, gear boxes and ball screw drives is optimized. Essential is here the synchronization of electrical and mechanical frequency behavior of all axes because even advanced controls (like H∞-controls) can only control a small part of the mechanical modes – namely only those of observable and controllable states whose value can be derived from the positions of extern linear length measurement systems and/or rotary encoders on the motor or gear box shafts. Further problems are the unknown processing forces like cutting forces in machine tools during normal operation which make the estimation and control via an observer even more difficult. To start with, the open source Modelica Feed Drive Library which was developed at the Laboratory for Machine Tools, and Production Engineering (WZL) is extended from one axis design to the multi axes design. It is capable to simulate the mechanical, electrical and thermal behavior of permanent magnet synchronous machines with inverters, different gear boxes and ball screw drives in a mechanical system. To keep the calculation time down analytical equations are used for field and torque producing equivalent circuit, heat dissipation and mechanical torque at the shaft. As a first step, a small machine tool with a working area of 635 x 315 x 420 mm is taken apart, and the mechanical transfer behavior is measured with an impulse hammer and acceleration sensors. With the frequency transfer functions, a mechanical finite element model is built up which is reduced with substructure coupling to a mass-damper system which models the most important modes of the axes. The model is modelled with Modelica Feed Drive Library and validated by further relative measurements between machine table and spindle holder with a piezo actor and acceleration sensors. In a next step, the choice of possible components in motor catalogues is limited by derived analytical formulas which are based on well-known metrics to gain effective power and torque of the components. The simulation in Modelica is run with different permanent magnet synchronous motors, gear boxes and ball screw drives from different suppliers. To speed up the optimization different black-box optimization methods (Surrogate-based, gradient-based and evolutionary) are tested on the case. The objective that was chosen is to minimize the integral of the deviations if a step is given on the position controls of the different axes. Small values are good measures for a high dynamic axes. In each iteration (evaluation of one set of components) the control variables are adjusted automatically to have an overshoot less than 1%. It is obtained that the order of the components in optimization problem has a deep impact on the speed of the black-box optimization. An approach to do efficient black-box optimization for multi-axes design is presented in the last part. The authors would like to thank the German Research Foundation DFG for financial support of the project “Optimierung des mechatronischen Entwurfs von mehrachsigen Antriebssystemen (HE 5386/14-1 | 6954/4-1)” (English: Optimization of the Mechatronic Design of Multi-Axes Drive Systems).

Keywords: ball screw drive design, discrete optimization, forward feed drives, gear box design, linear drives, machine tools, motor design, multi-axes design

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63 Microfluidic Plasmonic Device for the Sensitive Dual LSPR-Thermal Detection of the Cardiac Troponin Biomarker in Laminal Flow

Authors: Andreea Campu, Ilinica Muresan, Simona Cainap, Simion Astilean, Monica Focsan

Abstract:

Acute myocardial infarction (AMI) is the most severe cardiovascular disease, which has threatened human lives for decades, thus a continuous interest is directed towards the detection of cardiac biomarkers such as cardiac troponin I (cTnI) in order to predict risk and, implicitly, fulfill the early diagnosis requirements in AMI settings. Microfluidics is a major technology involved in the development of efficient sensing devices with real-time fast responses and on-site applicability. Microfluidic devices have gathered a lot of attention recently due to their advantageous features such as high sensitivity and specificity, miniaturization and portability, ease-of-use, low-cost, facile fabrication, and reduced sample manipulation. The integration of gold nanoparticles into the structure of microfluidic sensors has led to the development of highly effective detection systems, considering the unique properties of the metallic nanostructures, specifically the Localized Surface Plasmon Resonance (LSPR), which makes them highly sensitive to their microenvironment. In this scientific context, herein, we propose the implementation of a novel detection device, which successfully combines the efficiency of gold bipyramids (AuBPs) as signal transducers and thermal generators with the sample-driven advantages of the microfluidic channels into a miniaturized, portable, low-cost, specific, and sensitive test for the dual LSPR-thermographic cTnI detection. Specifically, AuBPs with longitudinal LSPR response at 830 nm were chemically synthesized using the seed-mediated growth approach and characterized in terms of optical and morphological properties. Further, the colloidal AuBPs were deposited onto pre-treated silanized glass substrates thus, a uniform nanoparticle coverage of the substrate was obtained and confirmed by extinction measurements showing a 43 nm blue-shift of the LSPR response as a consequence of the refractive index change. The as-obtained plasmonic substrate was then integrated into a microfluidic “Y”-shaped polydimethylsiloxane (PDMS) channel, fabricated using a Laser Cutter system. Both plasmonic and microfluidic elements were plasma treated in order to achieve a permanent bond. The as-developed microfluidic plasmonic chip was further coupled to an automated syringe pump system. The proposed biosensing protocol implicates the successive injection inside the microfluidic channel as follows: p-aminothiophenol and glutaraldehyde, to achieve a covalent bond between the metallic surface and cTnI antibody, anti-cTnI, as a recognition element, and target cTnI biomarker. The successful functionalization and capture of cTnI was monitored by LSPR detection thus, after each step, a red-shift of the optical response was recorded. Furthermore, as an innovative detection technique, thermal determinations were made after each injection by exposing the microfluidic plasmonic chip to 785 nm laser excitation, considering that the AuBPs exhibit high light-to-heat conversion performances. By the analysis of the thermographic images, thermal curves were obtained, showing a decrease in the thermal efficiency after the anti-cTnI-cTnI reaction was realized. Thus, we developed a microfluidic plasmonic chip able to operate as both LSPR and thermal sensor for the detection of the cardiac troponin I biomarker, leading thus to the progress of diagnostic devices.

Keywords: gold nanobipyramids, microfluidic device, localized surface plasmon resonance detection, thermographic detection

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62 Microencapsulation of Probiotic and Evaluation for Viability, Antimicrobial Property and Cytotoxic Activities of its Postbiotic Metabolites on MCF-7 Breast Cancer Cell Line

Authors: Nkechi V. Enwuru, Bullum Nkeki, Elizabeth A. Adekoya, Olumide A. Adebesin, Rebecca F. Peters, Victoria A. Aikhomu, Mendie E. U.

Abstract:

Background: Probiotics are live microbial feed supplement beneficial for host. Probiotics and their postbiotic products have been used to prevent or treat various health conditions. However, the products cell viability is often low due to harsh conditions subjected during processing, handling, storage, and gastrointestinal transit. These strongly influence probiotics’ benefits; thus, viability is essential for probiotics to produce health benefits for the host. Microencapsulation is a promising technique with considerable effects on probiotic survival. The study is aimed to formulate a microencapsulated probiotic and evaluate its viability, antimicrobial efficacy, and cytotoxic activity of its postbiotic on the MCF-7 breast cancer cell line. Method: Human and animal raw milk were sampled for lactic acid bacteria. The isolated bacteria were identified using conventional and VITEK 2 systems. The identified lactic acid bacterium was encapsulated using spray-dried and extrusion methods. The free, encapsulated, and chitosan-coated encapsulated probiotics were tested for viability in simulated-gastric intestinal (SGI) fluid and different storage conditions at refrigerated (4oC) and room (25oC) temperatures. The disintegration time and weight uniformity of the spray-dried hard gelatin capsules were tested. The antimicrobial property of free and encapsulated probiotics was tested against enteric pathogenic isolates from antiretroviral therapy (ART) treated HIV-positive patients. The postbiotic of the free cells was extracted, and its cytotoxic effect on the MCF-7 breast cancer cell line was tested through an MTT assay. Result: The Lactobacillus plantarum was isolated from animal raw milk. Zero-size hard gelatin L. plantarum capsules with granules within a size range of 0.71–1.00 mm diameter was formulated. The disintegration time ranges from 2.14±0.045 to 2.91±0.293 minutes, while the average weight is 502.1mg. Simulated gastric solution significantly affected viability of both free and microcapsules. However, the encapsulated cells were more protected and viable due to impermeability in the microcapsules. Furthermore, the viability of free cells stored at 4oC and 25oC were less than 4 log CFU/g and 6 log CFU/g respectively after 12 weeks. However, the microcapsules stored at 4oC achieved the highest viability among the free and microcapsules stored at 25oC and the free cells stored at 4oC. Encapsulated cells were released in the simulated gastric fluid, viable and effective against the enteric pathogens tested. However, chitosan-coated calcium alginate encapsulated probiotics significantly inhibited Shigella flexneri, Candida albicans, and Escherichia coli. The Postbiotic Metabolites (PM) of L. plantarum produced a cytotoxic effect on the MCF-7 breast cancer cell line. The postbiotic showed significant cytotoxic activity similar to 5FU, a standard antineoplastic agent. The inhibition concentration of 50% growth (IC50) of postbiotic metabolite K3 is low and consistent with the IC50 of the positive control (Cisplatin). Conclusions: Lactobacillus plantarum postbiotic exhibited a cytotoxic effect on the MCF-7 breast cancer cell line and could be used as combined adjuvant therapy in breast cancer management. The microencapsulation technique protects the probiotics, improving their viability and delivery to the gastrointestinal tract. Chitosan enhances antibacterial efficacy; thus, chitosan-coated microencapsulated L. plantarum probiotics could be more effective and used as a combined therapy in HIV management of opportunistic enteric infection.

Keywords: probiotics, encapsulation, gastrointestinal conditions, antimicrobial effect, postbiotic, cytotoxicity effect

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61 Exploring Factors That May Contribute to the Underdiagnosis of Hereditary Transthyretin Amyloidosis in African American Patients

Authors: Kelsi Hagerty, Ami Rosen, Aaliyah Heyward, Nadia Ali, Emily Brown, Erin Demo, Yue Guan, Modele Ogunniyi, Brianna McDaniels, Alanna Morris, Kunal Bhatt

Abstract:

Hereditary transthyretin amyloidosis (hATTR) is a progressive, multi-systemic, and life-threatening disease caused by a disruption in the TTR protein that delivers thyroxine and retinol to the liver. This disruption causes the protein to misfold into amyloid fibrils, leading to the accumulation of the amyloid fibrils in the heart, nerves, and GI tract. Over 130 variants in the TTR gene are known to cause hATTR. The Val122Ile variant is the most common in the United States and is seen almost exclusively in people of African descent. TTR variants are inherited in an autosomal dominant fashion and have incomplete penetrance and variable expressivity. Individuals with hATTR may exhibit symptoms from as early as 30 years to as late as 80 years of age. hATTR is characterized by a wide range of clinical symptoms such as cardiomyopathy, neuropathy, carpal tunnel syndrome, and GI complications. Without treatment, hATTR leads to progressive disease and can ultimately lead to heart failure. hATTR disproportionately affects individuals of African descent; the estimated prevalence of hATTR among Black individuals in the US is 3.4%. Unfortunately, hATTR is often underdiagnosed and misdiagnosed because many symptoms of the disease overlap with other cardiac conditions. Due to the progressive nature of the disease, multi-systemic manifestations that can lead to a shortened lifespan, and the availability of free genetic testing and promising FDA-approved therapies that enhance treatability, early identification of individuals with a pathogenic hATTR variant is important, as this can significantly impact medical management for patients and their relatives. Furthermore, recent literature suggests that TTR genetic testing should be performed in all patients with suspicion of TTR-related cardiomyopathy, regardless of age, and that follow-up with genetic counseling services is recommended. Relatives of patients with hATTR benefit from genetic testing because testing can identify carriers early and allow relatives to receive regular screening and management. Despite the striking prevalence of hATTR among Black individuals, hATTR remains underdiagnosed in this patient population, and germline genetic testing for hATTR in Black individuals seems to be underrepresented, though the reasons for this have not yet been brought to light. Historically, Black patients experience a number of barriers to seeking healthcare that has been hypothesized to perpetuate the underdiagnosis of hATTR, such as lack of access and mistrust of healthcare professionals. Prior research has described a myriad of factors that shape an individual’s decision about whether to pursue presymptomatic genetic testing for a familial pathogenic variant, such as family closeness and communication, family dynamics, and a desire to inform other family members about potential health risks. This study explores these factors through 10 in-depth interviews with patients with hATTR about what factors may be contributing to the underdiagnosis of hATTR in the Black population. Participants were selected from the Emory University Amyloidosis clinic based on having a molecular diagnosis of hATTR. Interviews were recorded and transcribed verbatim, then coded using MAXQDA software. Thematic analysis was completed to draw commonalities between participants. Upon preliminary analysis, several themes have emerged. Barriers identified include i) Misdiagnosis and a prolonged diagnostic odyssey, ii) Family communication and dynamics surrounding health issues, iii) Perceptions of healthcare and one’s own health risks, and iv) The need for more intimate provider-patient relationships and communication. Overall, this study gleaned valuable insight from members of the Black community about possible factors contributing to the underdiagnosis of hATTR, as well as potential solutions to go about resolving this issue.

Keywords: cardiac amyloidosis, heart failure, TTR, genetic testing

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60 Effect of Degree of Phosphorylation on Electrospinning and In vitro Cell Behavior of Phosphorylated Polymers as Biomimetic Materials for Tissue Engineering Applications

Authors: Pallab Datta, Jyotirmoy Chatterjee, Santanu Dhara

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Over the past few years, phosphorous containing polymers have received widespread attention for applications such as high performance optical fibers, flame retardant materials, drug delivery and tissue engineering. Being pentavalent, phosphorous can exist in different chemical environments in these polymers which increase their versatility. In human biochemistry, phosphorous based compounds exert their functions both in soluble and insoluble form occurring as inorganic or as organophosphorous compounds. Specifically in case of biomacromolecules, phosphates are critical for functions of DNA, ATP, phosphoproteins, phospholipids, phosphoglycans and several coenzymes. Inspired by the role of phosphorous in functional biomacromolecules, design and synthesis of biomimetic materials are thus carried out by several authors to study macromolecular function or as substitutes in clinical tissue regeneration conditions. In addition, many regulatory signals of the body are controlled by phoshphorylation of key proteins present either in form of growth factors or matrix-bound scaffold proteins. This inspires works on synthesis of phospho-peptidomimetic amino acids for understanding key signaling pathways and this is extended to obtain molecules with potentially useful biological properties. Apart from above applications, phosphate groups bound to polymer backbones have also been demonstrated to improve function of osteoblast cells and augment performance of bone grafts. Despite the advantages of phosphate grafting, however, there is limited understanding on effect of degree of phosphorylation on macromolecular physicochemical and/or biological properties. Such investigations are necessary to effectively translate knowledge of macromolecular biochemistry into relevant clinical products since they directly influence processability of these polymers into suitable scaffold structures and control subsequent biological response. Amongst various techniques for fabrication of biomimetic scaffolds, nanofibrous scaffolds fabricated by electrospinning technique offer some special advantages in resembling the attributes of natural extracellular matrix. Understanding changes in physico-chemical properties of polymers as function of phosphorylation is therefore going to be crucial in development of nanofiber scaffolds based on phosphorylated polymers. The aim of the present work is to investigate the effect of phosphorous grafting on the electrospinning behavior of polymers with aim to obtain biomaterials for bone regeneration applications. For this purpose, phosphorylated derivatives of two polymers of widely different electrospinning behaviors were selected as starting materials. Poly(vinyl alcohol) is a conveniently electrospinnable polymer at different conditions and concentrations. On the other hand, electrospinning of chitosan backbone based polymers have been viewed as a critical challenge. The phosphorylated derivatives of these polymers were synthesized, characterized and electrospinning behavior of various solutions containing these derivatives was compared with electrospinning of pure poly (vinyl alcohol). In PVA, phosphorylation adversely impacted electrospinnability while in NMPC, higher phosphate content widened concentration range for nanofiber formation. Culture of MG-63 cells on electrospun nanofibers, revealed that degree of phosphate modification of a polymer significantly improves cell adhesion or osteoblast function of cultured cells. It is concluded that improvement of cell response parameters of nanofiber scaffolds can be attained as a function of controlled degree of phosphate grafting in polymeric biomaterials with implications for bone tissue engineering applications.

Keywords: bone regeneration, chitosan, electrospinning, phosphorylation

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59 Digital Geological Map of the Loki Crystalline Massif (The Caucasus) and Its Multi-Informative Explanatory Note

Authors: Irakli Gamkrelidze, David Shengelia, Giorgi Chichinadze, Tamara Tsutsunava, Giorgi Beridze, Tamara Tsamalashvili, Ketevan Tedliashvili, Irakli Javakhishvili

Abstract:

The Caucasus is situated between the Eurasian and Africa-Arabian plates and represents a component of the Mediterranean (Alpine-Himalayan) collision belt. The Loki crystalline massif crops out within one of the terranes of the Caucasus – Baiburt-Sevanian terrane. By the end of 2018, a digital geological map (1:50 000) of the Loki massif was compiled. The presented map is of great importance for the region since there is no large-scale geological map which reflects the present standards of the geological study of the massif up to the last time. The existing State Geological Map of the Loki massif is very outdated. A new map drown by using GIS (Geographic Information System) technology is loaded with multi-informative details that include: specified contours of geological units and separate tectonic scales, key mineral assemblages and facies of metamorphism, temperature conditions of metamorphism, ages of metamorphism events and the massif rocks, genetic-geodynamic types of magmatic rocks. Explanatory note, attached to the map includes the large specter of scientific information. It contains characterization of the geological setting, composition and petrogenetic and geodynamic models of the massif formation. To create a geological map of the Loki crystalline massif, appropriate methodologies were applied: a sampling of rocks, GIS technology-based mapping of geological units, microscopic description of the material, composition analysis of rocks, microprobe analysis of minerals and a new interpretation of obtained data. To prepare a digital version of the map the appropriated activities were held including the creation of a common database. Finally, the design was created that includes the elaboration of legend and the final visualization of the map. The results of the study presented in the explanatory note are given below. The autochthonous gneissose quartz diorites of normal alkalinity and sub-alkaline gabbro-diorites included in them belong to different phases of magmatism. They represent “igneous” granites corresponding to mixed mantle-crustal type granites. Four tectonic plates of the allochthonous metamorphic complex–Lower Gorastskali, Sapharlo–Lok-Jandari, Moshevani, and Lower Gorastskali differ from each other by structure and degree of metamorphism. The initial rocks of these plates are formed in different geodynamic conditions and during the Early Bretonian orogeny while overthrusting due to tectonic compression they form a thick tectonic sheet. The Lower Gorastskali overthrust sheet is a fragment of ophiolitic association corresponding to the Paleotethys oceanic crust. The protolith of the ophiolitic complex basites corresponds to the tholeiitic series of basalts. The Sapharlo–Lok-Jandari overthrust sheet is metapelites, metamorphosed in conditions of greenschist facies of regional metamorphism. The regional metamorphism of Moshevani overthrust sheet crystalline schists quartzites corresponds to a range from greenschist to hornfels facies. The “mélange” is built of rock fragments and blocks of above-mentioned overthrust sheets. Sub-alkaline and normal alkaline post-metamorphic granites of the Loki crystalline massif belong to “igneous” and rarely to “sialic” and “anorogenic” types of granites.

Keywords: digital geological map, 1:50 000 scale, crystalline massif, the caucasus

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58 Obesity and Lifestyle of Students in Roumanian Southeastern Region

Authors: Mariana Stuparu-Cretu, Doina-Carina Voinescu, Rodica-Mihaela Dinica, Daniela Borda, Camelia Vizireanu, Gabriela Iordachescu, Camelia Busila

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Obesity is involved in the etiology or acceleration of progression of important non-communicable diseases, such as: metabolic, cardiovascular, rheumatological, oncological and depression. It is a need to prevent the obesity occurrence, like a key link in disease management. From this point of view, the best approach is to early educate youngsters upon the need for a healthy nutrition lifestyle associated with constant physical activities. The objective of the study was to assess correlations between weight condition, physical activities and food preferences of students from South East Romania. Questionnaires were applied on high school students in Galati: 1006 girls and 880 boys, aged between 14 and 19 years (being approved by Local School Inspectorate and the Ethics Committee of the 'Dunarea de Jos' University of Galati). The collected answers have been statistically processed by using the multivariate regression method (PLS2) by Unscramble X program (Camo, Norway). Multiple variables such as age group, body mass index, nutritional habits and physical activities were separately analysed, depending on gender and general mathematical models were proposed to explain the obesity trend at an early age. The study results show that overweight and obesity are present in less than a fifth of the adolescents who were surveyed. With a very small variation and a strong correlation of over 86% for 99% of the cases, a general preference for sweet foods, nocturnal eating associated with computer work and a reduced period of physical activity is noticed for girls. In addition, the overweight girls consume sweet juices and alcohol, although a percentage of them also practice the gym. There is also a percentage of the normoponderal girls that consume high caloric foods which predispose this group to turn into overweight cases in time. Within the studied group, statistics for the boys show a positive correlation of almost 87% for over 96% of cases. They prefer high calories foods, fast food, and sweet juices, and perform medium physical activities. Both overweight and underweight boys are more sedentary. Over 15% of girls and over a quarter of boys consume alcohol. All these bad eating habits seem to increase with age, for both sexes. To conclude, obesity and overweight assessed in adolescents in S-E Romania reveal nonsignificant percentage differences between boys and girls. However, young people in this area of the country are sedentary in general; a significant percentage prefers sweets / sweet juices / fast-food and practice computer nourishing. The authors consider that at this age, it is very useful to adapt nutritional education by new methods of food processing and market supply. This would require an early understanding of the difference among foods and nutrients and the benefits of physical activities integrated into the healthy current lifestyle, as a measure for preventing and managing non-communicable chronic diseases related to nutritional errors and sedentarism. Acknowledgment— This study has been partial founded by the Francophone University Agency, Project Réseau régional dans le domaine de la santé, la nutrition et la sécurité alimentaire (SaIN), no.21899/ 06.09.2017.

Keywords: adolescents, body mass index, nutritional habits, obesity, physical activity

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57 A Case Study Report on Acoustic Impact Assessment and Mitigation of the Hyprob Research Plant

Authors: D. Bianco, A. Sollazzo, M. Barbarino, G. Elia, A. Smoraldi, N. Favaloro

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The activities, described in the present paper, have been conducted in the framework of the HYPROB-New Program, carried out by the Italian Aerospace Research Centre (CIRA) promoted and funded by the Italian Ministry of University and Research (MIUR) in order to improve the National background on rocket engine systems for space applications. The Program has the strategic objective to improve National system and technology capabilities in the field of liquid rocket engines (LRE) for future Space Propulsion Systems applications, with specific regard to LOX/LCH4 technology. The main purpose of the HYPROB program is to design and build a Propulsion Test Facility (HIMP) allowing test activities on Liquid Thrusters. The development of skills in liquid rocket propulsion can only pass through extensive test campaign. Following its mission, CIRA has planned the development of new testing facilities and infrastructures for space propulsion characterized by adequate sizes and instrumentation. The IMP test cell is devoted to testing articles representative of small combustion chambers, fed with oxygen and methane, both in liquid and gaseous phase. This article describes the activities that have been carried out for the evaluation of the acoustic impact, and its consequent mitigation. The impact of the simulated acoustic disturbance has been evaluated, first, using an approximated method based on experimental data by Baumann and Coney, included in “Noise and Vibration Control Engineering” edited by Vér and Beranek. This methodology, used to evaluate the free-field radiation of jet in ideal acoustical medium, analyzes in details the jet noise and assumes sources acting at the same time. It considers as principal radiation sources the jet mixing noise, caused by the turbulent mixing of jet gas and the ambient medium. Empirical models, allowing a direct calculation of the Sound Pressure Level, are commonly used for rocket noise simulation. The model named after K. Eldred is probably one of the most exploited in this area. In this paper, an improvement of the Eldred Standard model has been used for a detailed investigation of the acoustical impact of the Hyprob facility. This new formulation contains an explicit expression for the acoustic pressure of each equivalent noise source, in terms of amplitude and phase, allowing the investigation of the sources correlation effects and their propagation through wave equations. In order to enhance the evaluation of the facility acoustic impact, including an assessment of the mitigation strategies to be set in place, a more advanced simulation campaign has been conducted using both an in-house code for noise propagation and scattering, and a commercial code for industrial noise environmental impact, CadnaA. The noise prediction obtained with the revised Eldred-based model has then been used for formulating an empirical/BEM (Boundary Element Method) hybrid approach allowing the evaluation of the barrier mitigation effect, at the design. This approach has been compared with the analogous empirical/ray-acoustics approach, implemented within CadnaA using a customized definition of sources and directivity factor. The resulting impact evaluation study is reported here, along with the design-level barrier optimization for noise mitigation.

Keywords: acoustic impact, industrial noise, mitigation, rocket noise

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56 Targeting Matrix Metalloprotease-9 to Reduce Coronary Artery Manifestations of Kawasaki’s Disease

Authors: Mohammadjavad Sotoudeheian, Navid Farahmandian

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Kawasaki disease (KD) is the primary cause of acquired pediatric heart disease as an acute vasculitis. In children with prolonged fever, rash, and inflammation of the mucosa KD must be considered as a clinical diagnosis. There is a persuasive suggestion of immune-mediated damage as the pathophysiologic cascade of KD. For example, the invasion of cytotoxic T-cells supports a viral etiology and the inflammasome of the innate immune system is a critical component in the vasculitis formation in KD. Animal models of KD propose the cytokine profiles, such as increased IL-1 and GM-CSF, which cause vascular damage. CRP and IFN-γ elevated expression and the upregulation of IL-6, and IL-10 production are also described in previous studies. Untreated KD is a critical risk factor for coronary artery diseases and myocardial infarction. Vascular damage may encompass amplified T-cell activity. SMAD3 is an essential molecule in down-regulating T-cells and increasing expression of FoxP3. It has a critical effect in the differentiation of regulatory T-cells. The discrepancy of regulatory T-cells and pro-inflammatory Th17 has been studied in acute coronary syndrome during KD. However in the coronary artery damaged lymphocytes and IgA plasma cells are seen at the lesion locations, the major immune cells in the coronary lesions are monocytes/macrophages and neutrophils. These cells secrete TNF-α, and activates matrix metalloprotease (MMP)-9, reducing the integrity of vessels and prompting patients to arise aneurysm. MMPs can break down the components of the extracellular matrix and assist immune cell movement. IVIG as an effective form of treatment clarified the role of the immune system, which may target pathogenic antigens and regulate cytokine production. Several reports have revealed that in the coronary arteries, high expression of MMP-9 in monocyte/macrophage results in pathologic cascades. Curcumin is a potent antioxidant and anti-inflammatory molecule. Curcumin decreases the production of reactive oxygen and nitrogen species and inhibits transcription factors like AP-1 and NF-κB. Curcumin also contains the characteristics of inhibitory effects on MMPs, especially MMP-9. The upregulation of MMP-9 is an important cellular response. Curcumin treatment caused a reverse effect and down-regulates MMP-9 gene expression which may fund the anti-inflammatory effect. Curcumin inhibits MMP-9 expression via PKC and AMPK-dependent pathways in Human monocytes cells. Elevated expression and activity of MMP-9 are correlated with advanced vascular lesions. AMPK controls lipid metabolism and oxidation, and protein synthesis. AMPK is also necessary for the MMP-9 activity and THP-1 cell adhesion to endothelial cells. Curcumin was shown to inhibit the activation of AMPKα. Compound C (AMPK inhibitor) inhibits MMP-9 expression level. Therefore, through inactivating AMPKs and PKC, curcumin decreases the MMP-9 level, which results in inhibiting monocyte/macrophage differentiation. Compound C also suppress the phosphorylation of three major classes of MAP kinase signaling, suggesting that curcumin may suppress MMP-9 level by inactivation of MAPK pathways. MAPK cascades are activated to induce the expression of MMP-9. Curcumin inhibits MAPKs phosphorylation, which contributes to the down-regulation of MMP-9. This study demonstrated that the potential inhibitory properties of curcumin over MMP-9 lead to a therapeutic strategy to reduce the risk of coronary artery involvement during KD.

Keywords: MMP-9, coronary artery aneurysm, Kawasaki’s disease, curcumin, AMPK, immune system, NF-κB, MAPK

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55 Parallel Opportunity for Water Conservation and Habitat Formation on Regulated Streams through Formation of Thermal Stratification in River Pools

Authors: Todd H. Buxton, Yong G. Lai

Abstract:

Temperature management in regulated rivers can involve significant expenditures of water to meet the cold-water requirements of species in summer. For this purpose, flows released from Lewiston Dam on the Trinity River in Northern California are 12.7 cms with temperatures around 11oC in July through September to provide adult spring Chinook cold water to hold in deep pools and mature until spawning in fall. The releases are more than double the flow and 10oC colder temperatures than the natural conditions before the dam was built. The high, cold releases provide springers the habitat they require but may suppress the stream food base and limit future populations of salmon by reducing the juvenile fish size and survival to adults via the positive relationship between the two. Field and modeling research was undertaken to explore whether lowering summer releases from Lewiston Dam may promote thermal stratification in river pools so that both the cold-water needs of adult salmon and warmer water requirements of other organisms in the stream biome may be met. For this investigation, a three-dimensional (3D) computational fluid dynamics (CFD) model was developed and validated with field measurements in two deep pools on the Trinity River. Modeling and field observations were then used to identify the flows and temperatures that may form and maintain thermal stratification under different meteorologic conditions. Under low flows, a pool was found to be well mixed and thermally homogenous until temperatures began to stratify shortly after sunrise. Stratification then strengthened through the day until shading from trees and mountains cooled the inlet flow and decayed the thermal gradient, which collapsed shortly before sunset and returned the pool to a well-mixed state. This diurnal process of stratification formation and destruction was closely predicted by the 3D CFD model. Both the model and field observations indicate that thermal stratification maintained the coldest temperatures of the day at ≥2m depth in a pool and provided water that was around 8oC warmer in the upper 2m of the pool. Results further indicate that the stratified pool under low flows provided almost the same daily average temperatures as when flows were an order of magnitude higher and stratification was prevented, indicating significant water savings may be realized in regulated streams while also providing a diversity in water temperatures the ecosystem requires. With confidence in the 3D CFD model, the model is now being applied to a dozen pools in the Trinity River to understand how pool bathymetry influences thermal stratification under variable flows and diurnal temperature variations. This knowledge will be used to expand the results to 52 pools in a 64 km reach below Lewiston Dam that meet the depth criteria (≥2 m) for spring Chinook holding. From this, rating curves will be developed to relate discharge to the volume of pool habitat that provides springers the temperature (<15.6oC daily average), velocity (0.15 to 0.4 m/s) and depths that accommodate the escapement target for spring Chinook (6,000 adults) under maximum fish densities measured in other streams (3.1 m3/fish) during the holding time of year (May through August). Flow releases that meet these goals will be evaluated for water savings relative to the current flow regime and their influence on indicator species, including the Foothill Yellow-Legged Frog, and aspects of the stream biome that support salmon populations, including macroinvertebrate production and juvenile Chinook growth rates.

Keywords: 3D CFD modeling, flow regulation, thermal stratification, chinook salmon, foothill yellow-legged frogs, water managment

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54 Quasi-Photon Monte Carlo on Radiative Heat Transfer: An Importance Sampling and Learning Approach

Authors: Utkarsh A. Mishra, Ankit Bansal

Abstract:

At high temperature, radiative heat transfer is the dominant mode of heat transfer. It is governed by various phenomena such as photon emission, absorption, and scattering. The solution of the governing integrodifferential equation of radiative transfer is a complex process, more when the effect of participating medium and wavelength properties are taken into consideration. Although a generic formulation of such radiative transport problem can be modeled for a wide variety of problems with non-gray, non-diffusive surfaces, there is always a trade-off between simplicity and accuracy of the problem. Recently, solutions of complicated mathematical problems with statistical methods based on randomization of naturally occurring phenomena have gained significant importance. Photon bundles with discrete energy can be replicated with random numbers describing the emission, absorption, and scattering processes. Photon Monte Carlo (PMC) is a simple, yet powerful technique, to solve radiative transfer problems in complicated geometries with arbitrary participating medium. The method, on the one hand, increases the accuracy of estimation, and on the other hand, increases the computational cost. The participating media -generally a gas, such as CO₂, CO, and H₂O- present complex emission and absorption spectra. To model the emission/absorption accurately with random numbers requires a weighted sampling as different sections of the spectrum carries different importance. Importance sampling (IS) was implemented to sample random photon of arbitrary wavelength, and the sampled data provided unbiased training of MC estimators for better results. A better replacement to uniform random numbers is using deterministic, quasi-random sequences. Halton, Sobol, and Faure Low-Discrepancy Sequences are used in this study. They possess better space-filling performance than the uniform random number generator and gives rise to a low variance, stable Quasi-Monte Carlo (QMC) estimators with faster convergence. An optimal supervised learning scheme was further considered to reduce the computation costs of the PMC simulation. A one-dimensional plane-parallel slab problem with participating media was formulated. The history of some randomly sampled photon bundles is recorded to train an Artificial Neural Network (ANN), back-propagation model. The flux was calculated using the standard quasi PMC and was considered to be the training target. Results obtained with the proposed model for the one-dimensional problem are compared with the exact analytical and PMC model with the Line by Line (LBL) spectral model. The approximate variance obtained was around 3.14%. Results were analyzed with respect to time and the total flux in both cases. A significant reduction in variance as well a faster rate of convergence was observed in the case of the QMC method over the standard PMC method. However, the results obtained with the ANN method resulted in greater variance (around 25-28%) as compared to the other cases. There is a great scope of machine learning models to help in further reduction of computation cost once trained successfully. Multiple ways of selecting the input data as well as various architectures will be tried such that the concerned environment can be fully addressed to the ANN model. Better results can be achieved in this unexplored domain.

Keywords: radiative heat transfer, Monte Carlo Method, pseudo-random numbers, low discrepancy sequences, artificial neural networks

Procedia PDF Downloads 187
53 Smart Laboratory for Clean Rivers in India - An Indo-Danish Collaboration

Authors: Nikhilesh Singh, Shishir Gaur, Anitha K. Sharma

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Climate change and anthropogenic stress have severely affected ecosystems all over the globe. Indian rivers are under immense pressure, facing challenges like pollution, encroachment, extreme fluctuation in the flow regime, local ignorance and lack of coordination between stakeholders. To counter all these issues a holistic river rejuvenation plan is needed that tests, innovates and implements sustainable solutions in the river space for sustainable river management. Smart Laboratory for Clean Rivers (SLCR) an Indo-Danish collaboration project, provides a living lab setup that brings all the stakeholders (government agencies, academic and industrial partners and locals) together to engage, learn, co-creating and experiment for a clean and sustainable river that last for ages. Just like every mega project requires piloting, SLCR has opted for a small catchment of the Varuna River, located in the Middle Ganga Basin in India. Considering the integrated approach of river rejuvenation, SLCR embraces various techniques and upgrades for rejuvenation. Likely, maintaining flow in the channel in the lean period, Managed Aquifer Recharge (MAR) is a proven technology. In SLCR, Floa-TEM high-resolution lithological data is used in MAR models to have better decision-making for MAR structures nearby of the river to enhance the river aquifer exchanges. Furthermore, the concerns of quality in the river are a big issue. A city like Varanasi which is located in the last stretch of the river, generates almost 260 MLD of domestic waste in the catchment. The existing STP system is working at full efficiency. Instead of installing a new STP for the future, SLCR is upgrading those STPs with an IoT-based system that optimizes according to the nutrient load and energy consumption. SLCR also advocate nature-based solutions like a reed bed for the drains having less flow. In search of micropollutants, SLCR uses fingerprint analysis involves employing advanced techniques like chromatography and mass spectrometry to create unique chemical profiles. However, rejuvenation attempts cannot be possible without involving the entire catchment. A holistic water management plan that includes storm management, water harvesting structure to efficiently manage the flow of water in the catchment and installation of several buffer zones to restrict pollutants entering into the river. Similarly, carbon (emission and sequestration) is also an important parameter for the catchment. By adopting eco-friendly practices, a ripple effect positively influences the catchment's water dynamics and aids in the revival of river systems. SLCR has adopted 4 villages to make them carbon-neutral and water-positive. Moreover, for the 24×7 monitoring of the river and the catchment, robust IoT devices are going to be installed to observe, river and groundwater quality, groundwater level, river discharge and carbon emission in the catchment and ultimately provide fuel for the data analytics. In its completion, SLCR will provide a river restoration manual, which will strategise the detailed plan and way of implementation for stakeholders. Lastly, the entire process is planned in such a way that will be managed by local administrations and stakeholders equipped with capacity-building activity. This holistic approach makes SLCR unique in the field of river rejuvenation.

Keywords: sustainable management, holistic approach, living lab, integrated river management

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52 Developing a Cloud Intelligence-Based Energy Management Architecture Facilitated with Embedded Edge Analytics for Energy Conservation in Demand-Side Management

Authors: Yu-Hsiu Lin, Wen-Chun Lin, Yen-Chang Cheng, Chia-Ju Yeh, Yu-Chuan Chen, Tai-You Li

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Demand-Side Management (DSM) has the potential to reduce electricity costs and carbon emission, which are associated with electricity used in the modern society. A home Energy Management System (EMS) commonly used by residential consumers in a down-stream sector of a smart grid to monitor, control, and optimize energy efficiency to domestic appliances is a system of computer-aided functionalities as an energy audit for residential DSM. Implementing fault detection and classification to domestic appliances monitored, controlled, and optimized is one of the most important steps to realize preventive maintenance, such as residential air conditioning and heating preventative maintenance in residential/industrial DSM. In this study, a cloud intelligence-based green EMS that comes up with an Internet of Things (IoT) technology stack for residential DSM is developed. In the EMS, Arduino MEGA Ethernet communication-based smart sockets that module a Real Time Clock chip to keep track of current time as timestamps via Network Time Protocol are designed and implemented for readings of load phenomena reflecting on voltage and current signals sensed. Also, a Network-Attached Storage providing data access to a heterogeneous group of IoT clients via Hypertext Transfer Protocol (HTTP) methods is configured to data stores of parsed sensor readings. Lastly, a desktop computer with a WAMP software bundle (the Microsoft® Windows operating system, Apache HTTP Server, MySQL relational database management system, and PHP programming language) serves as a data science analytics engine for dynamic Web APP/REpresentational State Transfer-ful web service of the residential DSM having globally-Advanced Internet of Artificial Intelligence (AI)/Computational Intelligence. Where, an abstract computing machine, Java Virtual Machine, enables the desktop computer to run Java programs, and a mash-up of Java, R language, and Python is well-suited and -configured for AI in this study. Having the ability of sending real-time push notifications to IoT clients, the desktop computer implements Google-maintained Firebase Cloud Messaging to engage IoT clients across Android/iOS devices and provide mobile notification service to residential/industrial DSM. In this study, in order to realize edge intelligence that edge devices avoiding network latency and much-needed connectivity of Internet connections for Internet of Services can support secure access to data stores and provide immediate analytical and real-time actionable insights at the edge of the network, we upgrade the designed and implemented smart sockets to be embedded AI Arduino ones (called embedded AIduino). With the realization of edge analytics by the proposed embedded AIduino for data analytics, an Arduino Ethernet shield WizNet W5100 having a micro SD card connector is conducted and used. The SD library is included for reading parsed data from and writing parsed data to an SD card. And, an Artificial Neural Network library, ArduinoANN, for Arduino MEGA is imported and used for locally-embedded AI implementation. The embedded AIduino in this study can be developed for further applications in manufacturing industry energy management and sustainable energy management, wherein in sustainable energy management rotating machinery diagnostics works to identify energy loss from gross misalignment and unbalance of rotating machines in power plants as an example.

Keywords: demand-side management, edge intelligence, energy management system, fault detection and classification

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51 A Risk-Based Comprehensive Framework for the Assessment of the Security of Multi-Modal Transport Systems

Authors: Mireille Elhajj, Washington Ochieng, Deeph Chana

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The challenges of the rapid growth in the demand for transport has traditionally been seen within the context of the problems of congestion, air quality, climate change, safety, and affordability. However, there are increasing threats including those related to crime such as cyber-attacks that threaten the security of the transport of people and goods. To the best of the authors’ knowledge, this paper presents for the first time, a comprehensive framework for the assessment of the current and future security issues of multi-modal transport systems. The approach or method proposed is based on a structured framework starting with a detailed specification of the transport asset map (transport system architecture), followed by the identification of vulnerabilities. The asset map and vulnerabilities are used to identify the various approaches for exploitation of the vulnerabilities, leading to the creation of a set of threat scenarios. The threat scenarios are then transformed into risks and their categories, and include insights for their mitigation. The consideration of the mitigation space is holistic and includes the formulation of appropriate policies and tactics and/or technical interventions. The quality of the framework is ensured through a structured and logical process that identifies the stakeholders, reviews the relevant documents including policies and identifies gaps, incorporates targeted surveys to augment the reviews, and uses subject matter experts for validation. The approach to categorising security risks is an extension of the current methods that are typically employed. Specifically, the partitioning of risks into either physical or cyber categories is too limited for developing mitigation policies and tactics/interventions for transport systems where an interplay between physical and cyber processes is very often the norm. This interplay is rapidly taking on increasing significance for security as the emergence of cyber-physical technologies, are shaping the future of all transport modes. Examples include: Connected Autonomous Vehicles (CAVs) in road transport; the European Rail Traffic Management System (ERTMS) in rail transport; Automatic Identification System (AIS) in maritime transport; advanced Communications, Navigation and Surveillance (CNS) technologies in air transport; and the Internet of Things (IoT). The framework adopts a risk categorisation scheme that considers risks as falling within the following threat→impact relationships: Physical→Physical, Cyber→Cyber, Cyber→Physical, and Physical→Cyber). Thus the framework enables a more complete risk picture to be developed for today’s transport systems and, more importantly, is readily extendable to account for emerging trends in the sector that will define future transport systems. The framework facilitates the audit and retro-fitting of mitigations in current transport operations and the analysis of security management options for the next generation of Transport enabling strategic aspirations such as systems with security-by-design and co-design of safety and security to be achieved. An initial application of the framework to transport systems has shown that intra-modal consideration of security measures is sub-optimal and that a holistic and multi-modal approach that also addresses the intersections/transition points of such networks is required as their vulnerability is high. This is in-line with traveler-centric transport service provision, widely accepted as the future of mobility services. In summary, a risk-based framework is proposed for use by the stakeholders to comprehensively and holistically assess the security of transport systems. It requires a detailed understanding of the transport architecture to enable a detailed vulnerabilities analysis to be undertaken, creates threat scenarios and transforms them into risks which form the basis for the formulation of interventions.

Keywords: mitigations, risk, transport, security, vulnerabilities

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50 Unknown Groundwater Pollution Source Characterization in Contaminated Mine Sites Using Optimal Monitoring Network Design

Authors: H. K. Esfahani, B. Datta

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Groundwater is one of the most important natural resources in many parts of the world; however it is widely polluted due to human activities. Currently, effective and reliable groundwater management and remediation strategies are obtained using characterization of groundwater pollution sources, where the measured data in monitoring locations are utilized to estimate the unknown pollutant source location and magnitude. However, accurately identifying characteristics of contaminant sources is a challenging task due to uncertainties in terms of predicting source flux injection, hydro-geological and geo-chemical parameters, and the concentration field measurement. Reactive transport of chemical species in contaminated groundwater systems, especially with multiple species, is a complex and highly non-linear geochemical process. Although sufficient concentration measurement data is essential to accurately identify sources characteristics, available data are often sparse and limited in quantity. Therefore, this inverse problem-solving method for characterizing unknown groundwater pollution sources is often considered ill-posed, complex and non- unique. Different methods have been utilized to identify pollution sources; however, the linked simulation-optimization approach is one effective method to obtain acceptable results under uncertainties in complex real life scenarios. With this approach, the numerical flow and contaminant transport simulation models are externally linked to an optimization algorithm, with the objective of minimizing the difference between measured concentration and estimated pollutant concentration at observation locations. Concentration measurement data are very important to accurately estimate pollution source properties; therefore, optimal design of the monitoring network is essential to gather adequate measured data at desired times and locations. Due to budget and physical restrictions, an efficient and effective approach for groundwater pollutant source characterization is to design an optimal monitoring network, especially when only inadequate and arbitrary concentration measurement data are initially available. In this approach, preliminary concentration observation data are utilized for preliminary source location, magnitude and duration of source activity identification, and these results are utilized for monitoring network design. Further, feedback information from the monitoring network is used as inputs for sequential monitoring network design, to improve the identification of unknown source characteristics. To design an effective monitoring network of observation wells, optimization and interpolation techniques are used. A simulation model should be utilized to accurately describe the aquifer properties in terms of hydro-geochemical parameters and boundary conditions. However, the simulation of the transport processes becomes complex when the pollutants are chemically reactive. Three dimensional transient flow and reactive contaminant transport process is considered. The proposed methodology uses HYDROGEOCHEM 5.0 (HGCH) as the simulation model for flow and transport processes with chemically multiple reactive species. Adaptive Simulated Annealing (ASA) is used as optimization algorithm in linked simulation-optimization methodology to identify the unknown source characteristics. Therefore, the aim of the present study is to develop a methodology to optimally design an effective monitoring network for pollution source characterization with reactive species in polluted aquifers. The performance of the developed methodology will be evaluated for an illustrative polluted aquifer sites, for example an abandoned mine site in Queensland, Australia.

Keywords: monitoring network design, source characterization, chemical reactive transport process, contaminated mine site

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49 Microbes at Work: An Assessment on the Use of Microbial Inoculants in Reforestation and Rehabilitation of the Forest Ancestral Land of Magbukun Aytas of Morong, Bataan, Philippines

Authors: Harold M. Carag, April Charmaine D. Camacho, Girlie Nora A. Abrigo, Florencia G. Palis, Ma. Larissa Lelu P. Gata

Abstract:

A technology impact assessment on the use of microbial inoculants in the reforestation and rehabilitation of forest ancestral lands of the Magbukün Aytas in Morong, Bataan was conducted. This two-year rainforestation technology aimed to determine the optimum condition for the improvement of seedling survival rate in the nursery and in the field to hasten the process of forest regeneration of Magbukün Ayta’s ancestral land. A combination of qualitative methods (key informant interviews, focus groups and participant observation), participated by the farmers who were directly involved in the project, community men and women, the council of elders and the project staff, was employed to complete this impact assessment. The recorded data were transcribed, and the accounts were broadly categorized on the following aspects: social (gender, institutional, anthropological), economic and environmental. The Australian Center for International Agricultural Research (ACIAR) framework was primarily used for the impact analysis while the Harvard Analytical Framework was specifically used for the gender impact analysis. Through this technology, a wildling nursery with more than one thousand seedlings was successfully established and served as a good area for the healthy growth of seedlings that would be planted in the forest. Results showed that this technology affected positively and negatively the various gender roles present in the community although household work remained to be the women’s responsibility. The technology introduced directly added up to the workload done by the men and women (preparing and applying fertilizer, making pots etc.) but this, in turn, provided ways to increase their sources of livelihood. The gender roles that were already present were further strengthened after the project and men remained to be in control. The technology or project in turn also benefited from the already present roles since they no longer have to assign things to them, the execution of the various roles was smoothly executed. In the anthropological aspect, their assigned task to manage the nursery was an easy responsibility because of their deep connection to the environment and their fear and beliefs on ‘engkato’ and ‘anito’ was helpful in guarding the forest. As the cultural value of these trees increases, their mindset of safeguarding the forest also heightens. Meanwhile, the welfare of the whole tribe is the ultimate determinant of the swift entry of projects. The past institutions brought ephemeral reliefs on the subsistence of the Magbukün Aytas. These were good ‘conditioning’ factors for the adoption of the technology of the project. As an attempt to turn away from the dependent of harmful chemical, the project’s way of introducing organic inputs was slowly gaining popularity in the community. Economically, the project was able to provide additional income to the farmers. However, the slow mode of payment dismayed other farmers and abandoned their roles. Lastly, major environmental effects weren’t that much observed after the application of the technology. The minor effects concentrated more on the improved conditions of the soil and water in the community. Because of the introduced technology, soil conditions became more favorable specifically for the species that were planted. The organic fertilizers used were in turn not harmful for the residents living in Sitio Kanawan. There were no human diseases caused by the technology. The conservation of the biodiversity of the forest is clearly the most evident long-term result of the project.

Keywords: ancestral lands, impact assessment, microbial inculants, reforestation

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48 Case Study Hyperbaric Oxygen Therapy for Idiopathic Sudden Sensorineural Hearing Loss

Authors: Magdy I. A. Alshourbagi

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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.

Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)

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47 Impacts of School-Wide Positive Behavioral Interventions and Supports on Student Academics, Behavior and Mental Health

Authors: Catherine Bradshaw

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Educators often report difficulty managing behavior problems and other mental health concerns that students display at school. These concerns also interfere with the learning process and can create distraction for teachers and other students. As such, schools play an important role in both preventing and intervening with students who experience these types of challenges. A number of models have been proposed to serve as a framework for delivering prevention and early intervention services in schools. One such model is called Positive Behavioral Interventions and Supports (PBIS), which has been scaled-up to over 26,000 schools in the U.S. and many other countries worldwide. PBIS aims to improve a range of student outcomes through early detection of and intervention related to behavioral and mental health symptoms. PBIS blends and applies social learning, behavioral, and organizational theories to prevent disruptive behavior and enhance the school’s organizational health. PBIS focuses on creating and sustaining tier 1 (universal), tier 2 (selective), and tier 3 (individual) systems of support. Most schools using PBIS have focused on the core elements of the tier 1 supports, which includes the following critical features. The formation of a PBIS team within the school to lead implementation. Identification and training of a behavioral support ‘coach’, who serves as a on-site technical assistance provider. Many of the individuals identified to serve as a PBIS coach are also trained as a school psychologist or guidance counselor; coaches typically have prior PBIS experience and are trained to conduct functional behavioral assessments. The PBIS team also identifies a set of three to five positive behavioral expectations that are implemented for all students and by all staff school-wide (e.g., ‘be respectful, responsible, and ready to learn’); these expectations are posted in all settings across the school, including in the classroom, cafeteria, playground etc. All school staff define and teach the school-wide behavioral expectations to all students and review them regularly. Finally, PBIS schools develop or adopt a school-wide system to reward or reinforce students who demonstrate those 3-5 positive behavioral expectations. Staff and administrators create an agreed upon system for responding to behavioral violations that include definitions about what constitutes a classroom-managed vs. an office-managed discipline problem. Finally, a formal system is developed to collect, analyze, and use disciplinary data (e.g., office discipline referrals) to inform decision-making. This presentation provides a brief overview of PBIS and reports findings from a series of four U.S. based longitudinal randomized controlled trials (RCTs) documenting the impacts of PBIS on school climate, discipline problems, bullying, and academic achievement. The four RCTs include 80 elementary, 40 middle, and 58 high schools and results indicate a broad range of impacts on multiple student and school-wide outcomes. The session will highlight lessons learned regarding PBIS implementation and scale-up. We also review the ways in which PBIS can help educators and school leaders engage in data-based decision-making and share data with other decision-makers and stakeholders (e.g., students, parents, community members), with the overarching goal of increasing use of evidence-based programs in schools.

Keywords: positive behavioral interventions and supports, mental health, randomized trials, school-based prevention

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46 Determination of Aquifer Geometry Using Geophysical Methods: A Case Study from Sidi Bouzid Basin, Central Tunisia

Authors: Dhekra Khazri, Hakim Gabtni

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Because of Sidi Bouzid water table overexploitation, this study aims at integrating geophysical methods to determinate aquifers geometry assessing their geological situation and geophysical characteristics. However in highly tectonic zones controlled by Atlassic structural features with NE-SW major directions (central Tunisia), Bouguer gravimetric responses of some areas can be as much dominated by the regional structural tendency, as being non-identified or either defectively interpreted such as the case of Sidi Bouzid basin. This issue required a residual gravity anomaly elaboration isolating the Sidi Bouzid basin gravity response ranging between -8 and -14 mGal and crucial for its aquifers geometry characterization. Several gravity techniques helped constructing the Sidi Bouzid basin's residual gravity anomaly, such as Upwards continuation compared to polynomial regression trends and power spectrum analysis detecting deep basement sources at (3km), intermediate (2km) and shallow sources (1km). A 3D Euler Deconvolution was also performed detecting deepest accidents trending NE-SW, N-S and E-W with depth values reaching 5500 m and delineating the main outcropping structures of the study area. Further gravity treatments highlighted the subsurface geometry and structural features of Sidi Bouzid basin over Horizontal and vertical gradient, and also filters based on them such as Tilt angle and Source Edge detector locating rooted edges or peaks from potential field data detecting a new E-W lineament compartmentalizing the Sidi Bouzid gutter into two unequally residual anomaly and subsiding domains. This subsurface morphology is also detected by the used 2D seismic reflection sections defining the Sidi Bouzid basin as a deep gutter within a tectonic set of negative flower structures, and collapsed and tilted blocks. Furthermore, these structural features were confirmed by forward gravity modeling process over several modeled residual gravity profiles crossing the main area. Sidi Bouzid basin (central Tunisia) is also of a big interest cause of the unknown total thickness and the undefined substratum of its siliciclastic Tertiary package, and its aquifers unbounded structural subsurface features and deep accidents. The Combination of geological, hydrogeological and geophysical methods is then of an ultimate need. Therefore, a geophysical methods integration based on gravity survey supporting available seismic data through forward gravity modeling, enhanced lateral and vertical extent definition of the basin's complex sedimentary fill via 3D gravity models, improved depth estimation by a depth to basement modeling approach, and provided 3D isochronous seismic mapping visualization of the basin's Tertiary complex refining its geostructural schema. A subsurface basin geomorphology mapping, over an ultimate matching between the basin's residual gravity map and the calculated theoretical signature map, was also displayed over the modeled residual gravity profiles. An ultimate multidisciplinary geophysical study of the Sidi Bouzid basin aquifers can be accomplished via an aeromagnetic survey and a 4D Microgravity reservoir monitoring offering temporal tracking of the target aquifer's subsurface fluid dynamics enhancing and rationalizing future groundwater exploitation in this arid area of central Tunisia.

Keywords: aquifer geometry, geophysics, 3D gravity modeling, improved depths, source edge detector

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45 Anajaa-Visual Substitution System: A Navigation Assistive Device for the Visually Impaired

Authors: Juan Pablo Botero Torres, Alba Avila, Luis Felipe Giraldo

Abstract:

Independent navigation and mobility through unknown spaces pose a challenge for the autonomy of visually impaired people (VIP), who have relied on the use of traditional assistive tools like the white cane and trained dogs. However, emerging visually assistive technologies (VAT) have proposed several human-machine interfaces (HMIs) that could improve VIP’s ability for self-guidance. Hereby, we introduce the design and implementation of a visually assistive device, Anajaa – Visual Substitution System (AVSS). This system integrates ultrasonic sensors with custom electronics, and computer vision models (convolutional neural networks), in order to achieve a robust system that acquires information of the surrounding space and transmits it to the user in an intuitive and efficient manner. AVSS consists of two modules: the sensing and the actuation module, which are fitted to a chest mount and belt that communicate via Bluetooth. The sensing module was designed for the acquisition and processing of proximity signals provided by an array of ultrasonic sensors. The distribution of these within the chest mount allows an accurate representation of the surrounding space, discretized in three different levels of proximity, ranging from 0 to 6 meters. Additionally, this module is fitted with an RGB-D camera used to detect potentially threatening obstacles, like staircases, using a convolutional neural network specifically trained for this purpose. Posteriorly, the depth data is used to estimate the distance between the stairs and the user. The information gathered from this module is then sent to the actuation module that creates an HMI, by the means of a 3x2 array of vibration motors that make up the tactile display and allow the system to deliver haptic feedback. The actuation module uses vibrational messages (tactones); changing both in amplitude and frequency to deliver different awareness levels according to the proximity of the obstacle. This enables the system to deliver an intuitive interface. Both modules were tested under lab conditions, and the HMI was additionally tested with a focal group of VIP. The lab testing was conducted in order to establish the processing speed of the computer vision algorithms. This experimentation determined that the model can process 0.59 frames per second (FPS); this is considered as an adequate processing speed taking into account that the walking speed of VIP is 1.439 m/s. In order to test the HMI, we conducted a focal group composed of two females and two males between the ages of 35-65 years. The subject selection was aided by the Colombian Cooperative of Work and Services for the Sightless (COOTRASIN). We analyzed the learning process of the haptic messages throughout five experimentation sessions using two metrics: message discrimination and localization success. These correspond to the ability of the subjects to recognize different tactones and locate them within the tactile display. Both were calculated as the mean across all subjects. Results show that the focal group achieved message discrimination of 70% and a localization success of 80%, demonstrating how the proposed HMI leads to the appropriation and understanding of the feedback messages, enabling the user’s awareness of its surrounding space.

Keywords: computer vision on embedded systems, electronic trave aids, human-machine interface, haptic feedback, visual assistive technologies, vision substitution systems

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44 Nonlinear Homogenized Continuum Approach for Determining Peak Horizontal Floor Acceleration of Old Masonry Buildings

Authors: Andreas Rudisch, Ralf Lampert, Andreas Kolbitsch

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It is a well-known fact among the engineering community that earthquakes with comparatively low magnitudes can cause serious damage to nonstructural components (NSCs) of buildings, even when the supporting structure performs relatively well. Past research works focused mainly on NSCs of nuclear power plants and industrial plants. Particular attention should also be given to architectural façade elements of old masonry buildings (e.g. ornamental figures, balustrades, vases), which are very vulnerable under seismic excitation. Large numbers of these historical nonstructural components (HiNSCs) can be found in highly frequented historical city centers and in the event of failure, they pose a significant danger to persons. In order to estimate the vulnerability of acceleration sensitive HiNSCs, the peak horizontal floor acceleration (PHFA) is used. The PHFA depends on the dynamic characteristics of the building, the ground excitation, and induced nonlinearities. Consequently, the PHFA can not be generalized as a simple function of height. In the present research work, an extensive case study was conducted to investigate the influence of induced nonlinearity on the PHFA for old masonry buildings. Probabilistic nonlinear FE time-history analyses considering three different hazard levels were performed. A set of eighteen synthetically generated ground motions was used as input to the structure models. An elastoplastic macro-model (multiPlas) for nonlinear homogenized continuum FE-calculation was calibrated to multiple scales and applied, taking specific failure mechanisms of masonry into account. The macro-model was calibrated according to the results of specific laboratory and cyclic in situ shear tests. The nonlinear macro-model is based on the concept of multi-surface rate-independent plasticity. Material damage or crack formation are detected by reducing the initial strength after failure due to shear or tensile stress. As a result, shear forces can only be transmitted to a limited extent by friction when the cracking begins. The tensile strength is reduced to zero. The first goal of the calibration was the consistency of the load-displacement curves between experiment and simulation. The calibrated macro-model matches well with regard to the initial stiffness and the maximum horizontal load. Another goal was the correct reproduction of the observed crack image and the plastic strain activities. Again the macro-model proved to work well in this case and shows very good correlation. The results of the case study show that there is significant scatter in the absolute distribution of the PHFA between the applied ground excitations. An absolute distribution along the normalized building height was determined in the framework of probability theory. It can be observed that the extent of nonlinear behavior varies for the three hazard levels. Due to the detailed scope of the present research work, a robust comparison with code-recommendations and simplified PHFA distributions are possible. The chosen methodology offers a chance to determine the distribution of PHFA along the building height of old masonry structures. This permits a proper hazard assessment of HiNSCs under seismic loads.

Keywords: nonlinear macro-model, nonstructural components, time-history analysis, unreinforced masonry

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43 Full Characterization of Heterogeneous Antibody Samples under Denaturing and Native Conditions on a Hybrid Quadrupole-Orbitrap Mass Spectrometer

Authors: Rowan Moore, Kai Scheffler, Eugen Damoc, Jennifer Sutton, Aaron Bailey, Stephane Houel, Simon Cubbon, Jonathan Josephs

Abstract:

Purpose: MS analysis of monoclonal antibodies (mAbs) at the protein and peptide levels is critical during development and production of biopharmaceuticals. The compositions of current generation therapeutic proteins are often complex due to various modifications which may affect efficacy. Intact proteins analyzed by MS are detected in higher charge states that also provide more complexity in mass spectra. Protein analysis in native or native-like conditions with zero or minimal organic solvent and neutral or weakly acidic pH decreases charge state value resulting in mAb detection at higher m/z ranges with more spatial resolution. Methods: Three commercially available mAbs were used for all experiments. Intact proteins were desalted online using size exclusion chromatography (SEC) or reversed phase chromatography coupled on-line with a mass spectrometer. For streamlined use of the LC- MS platform we used a single SEC column and alternately selected specific mobile phases to perform separations in either denaturing or native-like conditions: buffer A (20 % ACN, 0.1 % FA) with Buffer B (100 mM ammonium acetate). For peptide analysis mAbs were proteolytically digested with and without prior reduction and alkylation. The mass spectrometer used for all experiments was a commercially available Thermo Scientific™ hybrid Quadrupole-Orbitrap™ mass spectrometer, equipped with the new BioPharma option which includes a new High Mass Range (HMR) mode that allows for improved high mass transmission and mass detection up to 8000 m/z. Results: We have analyzed the profiles of three mAbs under reducing and native conditions by direct infusion with offline desalting and with on-line desalting via size exclusion and reversed phase type columns. The presence of high salt under denaturing conditions was found to influence the observed charge state envelope and impact mass accuracy after spectral deconvolution. The significantly lower charge states observed under native conditions improves the spatial resolution of protein signals and has significant benefits for the analysis of antibody mixtures, e.g. lysine variants, degradants or sequence variants. This type of analysis requires the detection of masses beyond the standard mass range ranging up to 6000 m/z requiring the extended capabilities available in the new HMR mode. We have compared each antibody sample that was analyzed individually with mixtures in various relative concentrations. For this type of analysis, we observed that apparent native structures persist and ESI is benefited by the addition of low amounts of acetonitrile and formic acid in combination with the ammonium acetate-buffered mobile phase. For analyses on the peptide level we analyzed reduced/alkylated, and non-reduced proteolytic digests of the individual antibodies separated via reversed phase chromatography aiming to retrieve as much information as possible regarding sequence coverage, disulfide bridges, post-translational modifications such as various glycans, sequence variants, and their relative quantification. All data acquired were submitted to a single software package for analysis aiming to obtain a complete picture of the molecules analyzed. Here we demonstrate the capabilities of the mass spectrometer to fully characterize homogeneous and heterogeneous therapeutic proteins on one single platform. Conclusion: Full characterization of heterogeneous intact protein mixtures by improved mass separation on a quadrupole-Orbitrap™ mass spectrometer with extended capabilities has been demonstrated.

Keywords: disulfide bond analysis, intact analysis, native analysis, mass spectrometry, monoclonal antibodies, peptide mapping, post-translational modifications, sequence variants, size exclusion chromatography, therapeutic protein analysis, UHPLC

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42 Phenotype and Psychometric Characterization of Phelan-Mcdermid Syndrome Patients

Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

Abstract:

Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

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41 Development Programmes Requirements for Managing and Supporting the Ever-Dynamic Job Roles of Middle Managers in Higher Education Institutions: The Espousal Demanded from Human Resources Department; Case Studies of a New University in United Kingdom

Authors: Mohamed Sameer Mughal, Andrew D. Ross, Damian J. Fearon

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Background: The fast-paced changing landscape of UK Higher Education Institution (HEIs) is poised by changes and challenges affecting Middle Managers (MM) in their job roles. MM contribute to the success of HEIs by balancing the equilibrium and pass organization strategies from senior staff towards operationalization directives to junior staff. However, this study showcased from the data analyzed during the semi structured interviews; MM job role is becoming more complex due to changes and challenges creating colossal pressures and workloads in day-to-day working. Current development programmes provisions by Human Resources (HR) departments in such HEIs are not feasible, applicable, and matching the true essence and requirements of MM who suggest that programmes offered by HR are too generic to suit their precise needs and require tailor made espousal to work effectively in their pertinent job roles. Methodologies: This study aims to capture demands of MM Development Needs (DN) by means of a conceptual model as conclusive part of the research that is divided into 2 phases. Phase 1 initiated by carrying out 2 pilot interviews with a retired Emeritus status professor and HR programmes development coordinator. Key themes from the pilot and literature review subsidized into formulation of 22 set of questions (Kvale and Brinkmann) in form of interviewing questionnaire during qualitative data collection. Data strategy and collection consisted of purposeful sampling of 12 semi structured interviews (n=12) lasting approximately an hour for all participants. The MM interviewed were at faculty and departmental levels which included; deans (n=2), head of departments (n=4), subject leaders (n=2), and lastly programme leaders (n=4). Participants recruitment was carried out via emails and snowballing technique. The interviews data was transcribed (verbatim) and managed using Computer Assisted Qualitative Data Analysis using Nvivo ver.11 software. Data was meticulously analyzed using Miles and Huberman inductive approach of positivistic style grounded theory, whereby key themes and categories emerged from the rich data collected. The data was precisely coded and classified into case studies (Robert Yin); with a main case study, sub cases (4 classes of MM) and embedded cases (12 individual MMs). Major Findings: An interim conceptual model emerged from analyzing the data with main concepts that included; key performance indicators (KPI’s), HEI effectiveness and outlook, practices, processes and procedures, support mechanisms, student events, rules, regulations and policies, career progression, reporting/accountability, changes and challenges, and lastly skills and attributes. Conclusion: Dynamic elements affecting MM includes; increase in government pressures, student numbers, irrelevant development programmes, bureaucratic structures, transparency and accountability, organization policies, skills sets… can only be confronted by employing structured development programmes originated by HR that are not provided generically. Future Work: Stage 2 (Quantitative method) of the study plans to validate the interim conceptual model externally through fully completed online survey questionnaire (Bram Oppenheim) from external HEIs (n=150). The total sample targeted is 1500 MM. Author contribution focuses on enhancing management theory and narrow the gap between by HR and MM development programme provision.

Keywords: development needs (DN), higher education institutions (HEIs), human resources (HR), middle managers (MM)

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40 TeleEmergency Medicine: Transforming Acute Care through Virtual Technology

Authors: Ashley L. Freeman, Jessica D. Watkins

Abstract:

TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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39 A Spatial Repetitive Controller Applied to an Aeroelastic Model for Wind Turbines

Authors: Riccardo Fratini, Riccardo Santini, Jacopo Serafini, Massimo Gennaretti, Stefano Panzieri

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This paper presents a nonlinear differential model, for a three-bladed horizontal axis wind turbine (HAWT) suited for control applications. It is based on a 8-dofs, lumped parameters structural dynamics coupled with a quasi-steady sectional aerodynamics. In particular, using the Euler-Lagrange Equation (Energetic Variation approach), the authors derive, and successively validate, such model. For the derivation of the aerodynamic model, the Greenbergs theory, an extension of the theory proposed by Theodorsen to the case of thin airfoils undergoing pulsating flows, is used. Specifically, in this work, the authors restricted that theory under the hypothesis of low perturbation reduced frequency k, which causes the lift deficiency function C(k) to be real and equal to 1. Furthermore, the expressions of the aerodynamic loads are obtained using the quasi-steady strip theory (Hodges and Ormiston), as a function of the chordwise and normal components of relative velocity between flow and airfoil Ut, Up, their derivatives, and section angular velocity ε˙. For the validation of the proposed model, the authors carried out open and closed-loop simulations of a 5 MW HAWT, characterized by radius R =61.5 m and by mean chord c = 3 m, with a nominal angular velocity Ωn = 1.266rad/sec. The first analysis performed is the steady state solution, where a uniform wind Vw = 11.4 m/s is considered and a collective pitch angle θ = 0.88◦ is imposed. During this step, the authors noticed that the proposed model is intrinsically periodic due to the effect of the wind and of the gravitational force. In order to reject this periodic trend in the model dynamics, the authors propose a collective repetitive control algorithm coupled with a PD controller. In particular, when the reference command to be tracked and/or the disturbance to be rejected are periodic signals with a fixed period, the repetitive control strategies can be applied due to their high precision, simple implementation and little performance dependency on system parameters. The functional scheme of a repetitive controller is quite simple and, given a periodic reference command, is composed of a control block Crc(s) usually added to an existing feedback control system. The control block contains and a free time-delay system eτs in a positive feedback loop, and a low-pass filter q(s). It should be noticed that, while the time delay term reduces the stability margin, on the other hand the low pass filter is added to ensure stability. It is worth noting that, in this work, the authors propose a phase shifting for the controller and the delay system has been modified as e^(−(T−γk)), where T is the period of the signal and γk is a phase shifting of k samples of the same periodic signal. It should be noticed that, the phase shifting technique is particularly useful in non-minimum phase systems, such as flexible structures. In fact, using the phase shifting, the iterative algorithm could reach the convergence also at high frequencies. Notice that, in our case study, the shifting of k samples depends both on the rotor angular velocity Ω and on the rotor azimuth angle Ψ: we refer to this controller as a spatial repetitive controller. The collective repetitive controller has also been coupled with a C(s) = PD(s), in order to dampen oscillations of the blades. The performance of the spatial repetitive controller is compared with an industrial PI controller. In particular, starting from wind speed velocity Vw = 11.4 m/s the controller is asked to maintain the nominal angular velocity Ωn = 1.266rad/s after an instantaneous increase of wind speed (Vw = 15 m/s). Then, a purely periodic external disturbance is introduced in order to stress the capabilities of the repetitive controller. The results of the simulations show that, contrary to a simple PI controller, the spatial repetitive-PD controller has the capability to reject both external disturbances and periodic trend in the model dynamics. Finally, the nominal value of the angular velocity is reached, in accordance with results obtained with commercial software for a turbine of the same type.

Keywords: wind turbines, aeroelasticity, repetitive control, periodic systems

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38 Increasing Student Engagement through Culturally-Responsive Classroom Management

Authors: Catherine P. Bradshaw, Elise T. Pas, Katrina J. Debnam, Jessika H. Bottiani, Michael Rosenberg

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Worldwide, ethnically and culturally diverse students are at increased risk for school failure, discipline problems, and dropout. Despite decades of concern about this issue of disparities in education and other fields (e.g., 'school to prison pipeline'), there has been limited empirical examination of models that can actually reduce these gaps in schools. Moreover, few studies have examined the effectiveness of in-service teacher interventions and supports specifically designed to reduce discipline disparities and improve student engagement. This session provides an overview of the evidence-based Double Check model which serves as a framework for teachers to use culturally-responsive strategies to engage ethnically and culturally diverse students in the classroom and reduce discipline problems. Specifically, Double Check is a school-based prevention program which includes three core components: (a) enhancements to the school-wide Positive Behavioral Interventions and Supports (PBIS) tier-1 level of support; (b) five one-hour professional development training sessions, each of which addresses five domains of cultural competence (i.e., connection to the curriculum, authentic relationships, reflective thinking, effective communication, and sensitivity to students’ culture); and (c) coaching of classroom teachers using an adapted version of the Classroom Check-Up, which intends to increase teachers’ use of effective classroom management and culturally-responsive strategies using research-based motivational interviewing and data-informed problem-solving approaches. This paper presents findings from a randomized controlled trial (RCT) testing the impact of Double Check, on office discipline referrals (disaggregated by race) and independently observed and self-reported culturally-responsive practices and classroom behavior management. The RCT included 12 elementary and middle schools; 159 classroom teachers were randomized either to receive coaching or serve as comparisons. Specifically, multilevel analyses indicated that teacher self-reported culturally responsive behavior management improved over the course of the school year for teachers who received the coaching and professional development. However, the average annual office discipline referrals issued to black students were reduced among teachers who were randomly assigned to receive coaching relative to comparison teachers. Similarly, observations conducted by trained external raters indicated significantly more teacher proactive behavior management and anticipation of student problems, higher student compliance, less student non-compliance, and less socially disruptive behaviors in classrooms led by coached teachers than classrooms led teachers randomly assigned to the non-coached condition. These findings indicated promising effects of the Double Check model on a range of teacher and student outcomes, including disproportionality in office discipline referrals among Black students. These results also suggest that the Double Check model is one of only a few systematic approaches to promoting culturally-responsive behavior management which has been rigorously tested and shown to be associated with improvements in either student or staff outcomes indicated significant reductions in discipline problems and improvements in behavior management. Implications of these findings are considered within the broader context of globalization and demographic shifts, and their impacts on schools. These issues are particularly timely, given growing concerns about immigration policies in the U.S. and abroad.

Keywords: ethnically and culturally diverse students, student engagement, school-based prevention, academic achievement

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37 Working at the Interface of Health and Criminal Justice: An Interpretative Phenomenological Analysis Exploration of the Experiences of Liaison and Diversion Nurses – Emerging Findings

Authors: Sithandazile Masuku

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Introduction: Public health approaches to offender mental health are driven by international policies and frameworks in response to the disproportionately large representation of people with mental health problems within the offender pathway compared to the general population. Public health service innovations include mental health courts in the US, restorative models in Singapore and, liaison and diversion services in Australia, the UK, and some other European countries. Mental health nurses are at the forefront of offender health service innovations. In the U.K. context, police custody has been identified as an early point within the offender pathway where nurses can improve outcomes by offering assessments and share information with criminal justice partners. This scope of nursing practice has introduced challenges related to skills and support required for nurses working at the interface of health and the criminal justice system. Parallel literature exploring experiences of nurses working in forensic settings suggests the presence of compassion fatigue, burnout and vicarious trauma that may impede risk harm to the nurses in these settings. Published research explores mainly service-level outcomes including monitoring of figures indicative of a reduction in offending behavior. There is minimal research exploring the experiences of liaison and diversion nurses who are situated away from a supportive clinical environment and engaged in complex autonomous decision-making. Aim: This paper will share qualitative findings (in progress) from a PhD study that aims to explore the experiences of liaison and diversion nurses in one service in the U.K. Methodology: This is a qualitative interview study conducted using an Interpretative Phenomenological Analysis to gain an in-depth analysis of lived experiences. Methods: A purposive sampling technique was used to recruit n=8 mental health nurses registered with the UK professional body, Nursing and Midwifery Council, from one UK Liaison and Diversion service. All participants were interviewed online via video call using semi-structured interview topic guide. Data were recorded and transcribed verbatim. Data were analysed using the seven steps of the Interpretative Phenomenological Analysis data analysis method. Emerging Findings Analysis to date has identified pertinent themes: • Difficulties of meaning-making for nurses because of the complexity of their boundary spanning role. • Emotional burden experienced in a highly emotive and fast-changing environment. • Stress and difficulties with role identity impacting on individual nurses’ ability to be resilient. • Challenges to wellbeing related to a sense of isolation when making complex decisions. Conclusion Emerging findings have highlighted the lived experiences of nurses working in liaison and diversion as challenging. The nature of the custody environment has an impact on role identity and decision making. Nurses left feeling isolated and unsupported are less resilient and may go on to experience compassion fatigue. The findings from this study thus far point to a need to connect nurses working in these boundary spanning roles with a supportive infrastructure where the complexity of their role is acknowledged, and they can be connected with a health agenda. In doing this, the nurses would be protected from harm and the likelihood of sustained positive outcomes for service users is optimised.

Keywords: liaison and diversion, nurse experiences, offender health, staff wellbeing

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36 Renewable Energy Utilization for Future Sustainability: An Approach to Roof-Mounted Photovoltaic Array Systems and Domestic Rooftop Rainwater Harvesting System Implementation in a Himachal Pradesh, India

Authors: Rajkumar Ghosh, Ananya Mukhopadhyay

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This scientific paper presents a thorough investigation into the integration of roof-mounted photovoltaic (PV) array systems and home rooftop rainwater collection systems in a remote community in Himachal Pradesh, India, with the goal of optimum utilization of natural resources for attaining sustainable living conditions by 2030. The study looks into the technical feasibility, environmental benefits, and socioeconomic impacts of this integrated method, emphasizing its ability to handle energy and water concerns in remote rural regions. This comprehensive method not only provides a sustainable source of electricity but also ensures a steady supply of clean water, promoting resilience and improving the quality of life for the village's residents. This research highlights the potential of such integrated systems in supporting sustainable conditions in rural areas through a combination of technical feasibility studies, economic analysis, and community interaction. There would be 20690 villages and 1.48 million homes (23.79% annual growth rate) in Himachal Pradesh if all residential buildings in the state had roof-mounted photovoltaic arrays to capture solar energy for power generation. The energy produced is utilized to power homes, lessening dependency on traditional fossil fuels. The same residential buildings housed domestic rooftop rainwater collection systems. Rainwater runoff from rooftops is collected and stored in tanks for use in a number of residential purposes, such as drinking, cooking, and irrigation. The gathered rainfall enhances the region's limited groundwater resources, easing the strain on local wells and aquifers. Although Himachal Pradesh of India is a Power state, the PV arrays have reduced the reliance of village on grid power and diesel generators by providing a steady source of electricity. Rooftop rainwater gathering has not only increased residential water supply but it has also lessened the burden on local groundwater resources. This helps to replenish groundwater and offers a more sustainable water supply for the town. The neighbourhood has saved money by utilizing renewable energy and rainwater gathering. Furthermore, lower fossil fuel consumption reduces greenhouse gas emissions, which helps to mitigate the effects of climate change. The integrated strategy of installing grid connected rooftop photovoltaic arrays and home rooftop rainwater collecting systems in Himachal Pradesh rural community demonstrates a feasible model for sustainable development. According to “Swaran Jayanti Energy Policy of Himachal Pradesh”, Himachal Pradesh is planned 10 GW from rooftop mode from Solar Power. Government of India provides 40% subsidy on solar panel of 1-3 kw and subsidy of Rs 6,000 per kw per year to encourage domestic consumers of Himachal Pradesh. This effort solves energy and water concerns, improves economic well-being, and helps to conserve the environment. Such integrated systems can serve as a model for sustainable development in rural areas not only in Himachal Pradesh, but also in other parts of the world where resource scarcity is a major concern. Long-term performance and scalability of such integrated systems should be the focus of future study. Efforts should also be made to duplicate this approach in other rural areas and examine its socioeconomic and environmental implications over time.

Keywords: renewable energy, photovoltaic arrays, rainwater harvesting, sustainability, rural development, Himachal Pradesh, India

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35 Impact of Simulated Brain Interstitial Fluid Flow on the Chemokine CXC-Chemokine-Ligand-12 Release From an Alginate-Based Hydrogel

Authors: Wiam El Kheir, Anais Dumais, Maude Beaudoin, Bernard Marcos, Nick Virgilio, Benoit Paquette, Nathalie Faucheux, Marc-Antoine Lauzon

Abstract:

The high infiltrative pattern of glioblastoma multiforme cells (GBM) is the main cause responsible for the actual standard treatments failure. The tumor high heterogeneity, the interstitial fluid flow (IFF) and chemokines guides GBM cells migration in the brain parenchyma resulting in tumor recurrence. Drug delivery systems emerged as an alternative approach to develop effective treatments for the disease. Some recent studies have proposed to harness the effect CXC-lchemokine-ligand-12 to direct and control the cancer cell migration through delivery system. However, the dynamics of the brain environment on the delivery system remains poorly understood. Nanoparticles (NPs) and hydrogels are known as good carriers for the encapsulation of different agents and control their release. We studied the release of CXCL12 (free or loaded into NPs) from an alginate-based hydrogel under static and indirect perfusion (IP) conditions. Under static conditions, the main phenomena driving CXCL12 release from the hydrogel was diffusion with the presence of strong interactions between the positively charged CXCL12 and the negatively charge alginate. CXCL12 release profiles were independent from the initial mass loadings. Afterwards, we demonstrated that the release could tuned by loading CXCL12 into Alginate/Chitosan-Nanoparticles (Alg/Chit-NPs) and embedded them into alginate-hydrogel. The initial burst release was substantially attenuated and the overall cumulative release percentages of 21%, 16% and 7% were observed for initial mass loadings of 0.07, 0.13 and 0.26 µg, respectively, suggesting stronger electrostatic interactions. Results were mathematically modeled based on Fick’s second law of diffusion framework developed previously to estimate the effective diffusion coefficient (Deff) and the mass transfer coefficient. Embedding the CXCL12 into NPs decreased the Deff an order of magnitude, which was coherent with experimental data. Thereafter, we developed an in-vitro 3D model that takes into consideration the convective contribution of the brain IFF to study CXCL12 release in an in-vitro microenvironment that mimics as faithfully as possible the human brain. From is unique design, the model also allowed us to understand the effect of IP on CXCL12 release in respect to time and space. Four flow rates (0.5, 3, 6.5 and 10 µL/min) which may increase CXCL12 release in-vivo depending on the tumor location were assessed. Under IP, cumulative percentages varying between 4.5-7.3%, 23-58.5%, 77.8-92.5% and 89.2-95.9% were released for the three initial mass loadings of 0.08, 0.16 and 0.33 µg, respectively. As the flow rate increase, IP culture conditions resulted in a higher release of CXCL12 compared to static conditions as the convection contribution became the main driving mass transport phenomena. Further, depending on the flow rate, IP had a direct impact on CXCL12 distribution within the simulated brain tissue, which illustrates the importance of developing such 3D in-vitro models to assess the efficiency of a delivery system targeting the brain. In future work, using this very model, we aim to understand the impact of the different phenomenon occurring on GBM cell behaviors in response to the resulting chemokine gradient subjected to various flow while allowing them to express their invasive characteristics in an in-vitro microenvironment that mimics the in-vivo brain parenchyma.

Keywords: 3D culture system, chemokines gradient, glioblastoma multiforme, kinetic release, mathematical modeling

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