Search results for: support
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6709

Search results for: support

1579 Effects of Robot-Assisted Hand Training on Upper Extremity Performance in Patients with Stroke: A Randomized Crossover Controlled, Assessor-Blinded Study

Authors: Hsin-Chieh Lee, Fen-Ling Kuo, Jui-Chi Lin

Abstract:

Background: Upper extremity functional impairment that occurs after stroke includes hemiplegia, synergy movement, muscle hypertonicity, and somatosensory impairment, which result in inefficient and inaccurate movement. Robot-assisted rehabilitation is an intensive training approach that is effective in sensorimotor and hand function recovery. However, these systems mostly focused on the proximal part of the upper limb rather than the distal part. The device used in our study was Gloreha Sinfonia, which focuses on the distal part of the upper limb and uses a dynamic support system to facilitate the whole limb function. The objective of this study was to investigate the effects of robot-assisted therapy (RT) with Gloreha device on sensorimotor, and ADLs in patients with stroke. Method: Patients with stroke (N=25) participated AB or BA (A = 12 RT sessions and B = 12 conventional therapy (CT) sessions) for 6 weeks (60 min at each session, twice a week), with 1-month break for washout period. The performance of the patients was assessed by a blinded assessor at 4 time points (pretest 1, posttest 1, pretest 2, posttest 2) which including the Fugl–Meyer Assessment-upper extremity (FMA-UE), box and block test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, a grip dynamometer for motor evaluation; Semmes–Weinstein hand monofilament and Revision of the Nottingham Sensory Assessment for sensory evaluation; and the Modified Barthel Index (MBI) for assessing the ADL ability. Result: RT group significantly improved FMA-UE proximal scores (p = 0.038), FMA-UE total scores (p = 0.046), and MBI (p = 0.030). The EDC exhibited higher efficiency during the small block grasping task in the RT group than in the CT group (p = 0.050). Conclusions: RT with the Gloreha device might lead to beneficial effects on arm motor function, ADL ability, and EDC muscle recruitment efficacy in patients with subacute to chronic stroke.

Keywords: activities of daily living, hand function, robotic rehabilitation, stroke

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1578 Microbial Effects of Iron Elution from Hematite into Seawater Mediated via Dissolved Organic Matter

Authors: Apichaya Aneksampant, Xuefei Tu, Masami Fukushima, Mitsuo Yamamoto

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The restoration of seaweed beds recovery has been developed using a fertilization technique for supplying dissolved iron to barren coastal areas. The fertilizer is composed of iron oxides as a source of iron and compost as humic substance (HS) source, which can serve as chelator of iron to stabilize the dissolved species under oxic seawater condition. However, elution mechanisms of iron from iron oxide surfaces have not sufficiently elucidated. In particular, roles of microbial activities in the elution of iron from the fertilizer are not sufficiently understood. In the present study, a fertilizer (iron oxide/compost = 1/1, v/v) was incubated in a water tank at Mashike coast, Hokkaido Japan. Microorganisms in the 6-month fertilizer were isolated and identified as Exiguobacterium oxidotolerans sp. (T-2-2). The identified bacteria were inoculated to perform iron elution test in a postgate B medium, prepared in artificial seawater. Hematite was used as a model iron oxide and anthraquinone-2,7-disolfonate (AQDS) as a model for HSs. The elution test performed in presence and absence of bacteria inoculation. ICP-AES was used to analyze total iron and a colorimetric technique using ferrozine employed for the determination of ferrous ion. During the incubation period, sample contained hematite and T-2-2 in both presence and absence of AQDS continuously showed the iron elution and reached at the highest concentration after 9 days of incubation and then slightly decrease to stabilize within 20 days. Comparison to the sample without T-2-2, trace amount of iron was observed, suggesting that iron elution to seawater can be attributed to bacterial activities. The levels of total organic carbon (TOC) in the culture solution with hematite decreased. This may be to the adsorption of organic compound, AQDS, to hematite surfaces. The decrease in UV-vis absorption of AQDS in the culture solution also support the results of TOC that AQDS was adsorbed to hematite surfaces. AQDS can enhance the iron elution, while the adsorption of organic matter suppresses the iron elution from hematite.

Keywords: anthraquinone-2, 7-disolfonate, barren ground, E.oxidotolerans sp., hematite, humic substances, iron elution

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1577 Harnessing Environmental DNA to Assess the Environmental Sustainability of Commercial Shellfish Aquaculture in the Pacific Northwest United States

Authors: James Kralj

Abstract:

Commercial shellfish aquaculture makes significant contributions to the economy and culture of the Pacific Northwest United States. The industry faces intense pressure to minimize environmental impacts as a result of Federal policies like the Magnuson-Stevens Fisheries Conservation and Management Act and the Endangered Species Act. These policies demand the protection of essential fish habitat and declare several salmon species as endangered. Consequently, numerous projects related to the protection and rehabilitation of eelgrass beds, a crucial ecosystem for countless fish species, have been proposed at both state and federal levels. Both eelgrass beds and commercial shellfish farms occupy the same physical space, and therefore understanding the effects of shellfish aquaculture on eelgrass ecosystems has become a top ecological and economic priority of both government and industry. This study evaluates the organismal communities that eelgrass and oyster aquaculture habitats support. Water samples were collected from Willapa Bay, Washington; Tillamook Bay, Oregon; Humboldt Bay, California; and Sammish Bay, Washington to compare species diversity in eelgrass beds, oyster aquaculture plots, and boundary edges between these two habitats. Diversity was assessed using a novel technique: environmental DNA (eDNA). All organisms constantly shed small pieces of DNA into their surrounding environment through the loss of skin, hair, tissues, and waste. In the marine environment, this DNA becomes suspended in the water column allowing it to be easily collected. Once extracted and sequenced, this eDNA can be used to paint a picture of all the organisms that live in a particular habitat making it a powerful technology for environmental monitoring. Industry professionals and government officials should consider these findings to better inform future policies regulating eelgrass beds and oyster aquaculture. Furthermore, the information collected in this study may be used to improve the environmental sustainability of commercial shellfish aquaculture while simultaneously enhancing its growth and profitability in the face of ever-changing political and ecological landscapes.

Keywords: aquaculture, environmental DNA, shellfish, sustainability

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1576 Using Optical Character Recognition to Manage the Unstructured Disaster Data into Smart Disaster Management System

Authors: Dong Seop Lee, Byung Sik Kim

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In the 4th Industrial Revolution, various intelligent technologies have been developed in many fields. These artificial intelligence technologies are applied in various services, including disaster management. Disaster information management does not just support disaster work, but it is also the foundation of smart disaster management. Furthermore, it gets historical disaster information using artificial intelligence technology. Disaster information is one of important elements of entire disaster cycle. Disaster information management refers to the act of managing and processing electronic data about disaster cycle from its’ occurrence to progress, response, and plan. However, information about status control, response, recovery from natural and social disaster events, etc. is mainly managed in the structured and unstructured form of reports. Those exist as handouts or hard-copies of reports. Such unstructured form of data is often lost or destroyed due to inefficient management. It is necessary to manage unstructured data for disaster information. In this paper, the Optical Character Recognition approach is used to convert handout, hard-copies, images or reports, which is printed or generated by scanners, etc. into electronic documents. Following that, the converted disaster data is organized into the disaster code system as disaster information. Those data are stored in the disaster database system. Gathering and creating disaster information based on Optical Character Recognition for unstructured data is important element as realm of the smart disaster management. In this paper, Korean characters were improved to over 90% character recognition rate by using upgraded OCR. In the case of character recognition, the recognition rate depends on the fonts, size, and special symbols of character. We improved it through the machine learning algorithm. These converted structured data is managed in a standardized disaster information form connected with the disaster code system. The disaster code system is covered that the structured information is stored and retrieve on entire disaster cycle such as historical disaster progress, damages, response, and recovery. The expected effect of this research will be able to apply it to smart disaster management and decision making by combining artificial intelligence technologies and historical big data.

Keywords: disaster information management, unstructured data, optical character recognition, machine learning

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1575 Statistical Investigation Projects: A Way for Pre-Service Mathematics Teachers to Actively Solve a Campus Problem

Authors: Muhammet Şahal, Oğuz Köklü

Abstract:

As statistical thinking and problem-solving processes have become increasingly important, teachers need to be more rigorously prepared with statistical knowledge to teach their students effectively. This study examined preservice mathematics teachers' development of statistical investigation projects using data and exploratory data analysis tools, following a design-based research perspective and statistical investigation cycle. A total of 26 pre-service senior mathematics teachers from a public university in Turkiye participated in the study. They formed groups of 3-4 members voluntarily and worked on their statistical investigation projects for six weeks. The data sources were audio recordings of pre-service teachers' group discussions while working on their projects in class, whole-class video recordings, and each group’s weekly and final reports. As part of the study, we reviewed weekly reports, provided timely feedback specific to each group, and revised the following week's class work based on the groups’ needs and development in their project. We used content analysis to analyze groups’ audio and classroom video recordings. The participants encountered several difficulties, which included formulating a meaningful statistical question in the early phase of the investigation, securing the most suitable data collection strategy, and deciding on the data analysis method appropriate for their statistical questions. The data collection and organization processes were challenging for some groups and revealed the importance of comprehensive planning. Overall, preservice senior mathematics teachers were able to work on a statistical project that contained the formulation of a statistical question, planning, data collection, analysis, and reaching a conclusion holistically, even though they faced challenges because of their lack of experience. The study suggests that preservice senior mathematics teachers have the potential to apply statistical knowledge and techniques in a real-world context, and they could proceed with the project with the support of the researchers. We provided implications for the statistical education of teachers and future research.

Keywords: design-based study, pre-service mathematics teachers, statistical investigation projects, statistical model

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1574 Psychological Intervention for Partners Post-Stroke: A Case Study

Authors: Natasha Yasmin Felles, Gerard Riley

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Background and Aims: Relationship breakdown is typical when one partner lives with an acquired brain injury caused by issues like a stroke. Research has found that the perception of relationship satisfaction decreases following such an injury among non-injured partners. Non-injured partners also are found to experience caregiver stress/burden as they immediately have to take the role of a caregiver along with being a partner of the injured. Research has also found that the perception of a continuous relationship, i.e. the perception of the relationship to be essentially the same as it was before the injury, also changes among those caregiving partners. However, there is a lack of available intervention strategies that can help those partners with both individual and relationship difficulties. The aim of this case study was to conduct a pilot test of an intervention aimed to explore whether it is possible to support a partner to experience greater continuity within the relationship poststroke, and what benefits such a change might have. Method: A couple, where one partner experienced an acquired brain injury poststroke were provided with Integrated Behavioural Couples Therapy for 3-months. The intervention addressed goals identified as necessary by the couple and by the formulation of their individual and relationship difficulties, alongside the goal of promoting relationship continuity. Before and after measures were taken using a battery of six questionnaires to evaluate changes in perceptions of continuity, stress, and other aspects of the relationship. Results: Both quantitative and qualitative data showed that relationship continuity was improved after the therapy, as were the measures of stress and other aspects of the relationship. The stress felt by the person with the acquired brain injury also showed some evidence of improvement. Conclusion: The study found that perceptions of relationship continuity can be improved by therapy and that improving these might have a beneficial impact on the stress felt by the carer, their satisfaction with the relationship and overall levels of conflict and closeness within the relationship. The study suggested the value of further research on enhancing perceptions of continuity in the relationship after an acquired brain injury. Currently, the findings of the study have been used to develop a pilot feasibility study to collect substantive evidence on the impact of the intervention on the couples and assess its feasibility and acceptability, which will help in further developing a specific generalized relationship continuity intervention, that will be beneficial in preventing relationship breakdown in the future.

Keywords: acquired brain injury, couples therapy, relationship continuity, stroke

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1573 Renewable Energy and Environment: Design of a Decision Aided Tool for Sustainable Development

Authors: Mustapha Ouardouz, Mina Amharref, Abdessamed Bernoussi

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The future energy, for limited energy resources countries, goes through renewable energies (solar, wind etc.). The renewable energies constitute a major component of the energy strategy to cover a substantial part of the growing needs and contribute to environmental protection by replacing fossil fuels. Indeed, sustainable development involves the promotion of renewable energy and the preservation of the environment by the use of clean energy technologies to limit emissions of greenhouse gases and reducing the pressure exerted on the forest cover. So the impact studies, of the energy use on the environment and farm-related risks are necessary. For that, a global approach integrating all the various sectors involved in such project seems to be the best approach. In this paper we present an approach based on the multi criteria analysis and the realization of one pilot to achieve the development of an innovative geo-intelligent environmental platform. An implementation of this platform will collect, process, analyze and manage environmental data in connection with the nature of used energy in the studied region. As an application we consider a region in the north of Morocco characterized by intense agricultural and industrials activities and using diverse renewable energy. The strategic goals of this platform are; the decision support for better governance, improving the responsiveness of public and private companies connected by providing them in real time with reliable data, modeling and simulation possibilities of energy scenarios, the identification of socio-technical solutions to introduce renewable energies and estimate technical and implantable potential by socio-economic analyzes and the assessment of infrastructure for the region and the communities, the preservation and enhancement of natural resources for better citizenship governance through democratization of access to environmental information, the tool will also perform simulations integrating environmental impacts of natural disasters, particularly those linked to climate change. Indeed extreme cases such as floods, droughts and storms will be no longer rare and therefore should be integrated into such projects.

Keywords: renewable energies, decision aided tool, environment, simulation

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1572 Preliminary Experience in Multiple Green Health Hospital Construction

Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

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Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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1571 Using Indigenous Knowledge Systems in Teaching Early Literacy: A Case Study of Zambian Public Preschools

Authors: Ronald L. Kaunda

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The education system in Zambia still bears scars of colonialism in the area of policy, curriculum and implementation. This historical context resulted in the failure by the Government of the Republic of Zambia to achieve literacy goals expected among school going children. Specifically, research shows that the use of English for initial literacy and Western based teaching methods to engage learners in literacy activities at lower levels of education including preschool has exacerbated this situation. In 2014, the Government of the Republic of Zambia implemented a new curriculum that, among others things, required preschool teachers to use local and cultural materials and familiar languages for early literacy teaching from preschool to grade 4. This paper presents findings from a study that sought to establish ways in which preschool teachers use Zambian Indigenous knowledge systems and Indigenous teaching strategies to support literacy development among preschool children. The study used Indigenous research methodology for data collection and iterative feature of Constructivist Grounded Theory (CGT) in the data collection process and analysis. This study established that, as agents of education, preschool teachers represented community adult educators because of some roles which they played beyond their academic mandate. The study further found that classrooms as venues of learning were equipped with learning corners reflecting Indigenous literacy materials and Indigenous ways of learning. Additionally, the study found that learners were more responsive to literacy lessons because of the use of familiar languages and local contextualized environments that supported their own cultural ways of learning. The study recommended that if the education system in Zambia is to be fully inclusive of Indigenous knowledge systems and cultural ways of learning, the education policy and curriculum should include conscious steps on how this should be implemented at the classroom level. The study further recommended that more diverse local literacy materials and teaching aids should be produced for use in the classroom.

Keywords: agents of learning, early literacy, indigenous knowledge systems, venues of education

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1570 Application of a Synthetic DNA Reference Material for Optimisation of DNA Extraction and Purification for Molecular Identification of Medicinal Plants

Authors: Mina Kalantarzadeh, Claire Lockie-Williams, Caroline Howard

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DNA barcoding is increasingly used for identification of medicinal plants worldwide. In the last decade, a large number of DNA barcodes have been generated, and their application in species identification explored. The success of DNA barcoding process relies on the accuracy of the results from polymerase chain reaction (PCR) amplification step which could be negatively affected due to a presence of inhibitors or degraded DNA in herbal samples. An established DNA reference material can be used to support molecular characterisation protocols and prove system suitability, for fast and accurate identification of plant species. The present study describes the use of a novel reference material, the trnH-psbA British Pharmacopoeia Nucleic Acid Reference Material (trnH-psbA BPNARM), which was produced to aid in the identification of Ocimum tenuiflorum L., a widely used herb. During DNA barcoding of O. tenuiflorum, PCR amplifications of isolated DNA produced inconsistent results, suggesting an issue with either the method or DNA quality of the tested samples. The trnH-psbA BPNARM was produced and tested to check for the issues caused during PCR amplification. It was added to the plant material as control DNA before extraction and was co-extracted and amplified by PCR. PCR analyses revealed that the amplification was not as successful as expected which suggested that the amplification is affected by presence of inhibitors co-extracted from plant materials. Various potential issues were assessed during DNA extraction and optimisations were made accordingly. A DNA barcoding protocol for O. tenuiflorum was published in the British Pharmacopoeia 2016, which included the reference sequence. The trnH-psbA BPNARM accelerated degradation test which investigates the stability of the reference material over time demonstrated that it has been stable when stored at 56 °C for a year. Using this protocol and trnH-psbA reference material provides a fast and accurate method for identification of O. tenuiflorum. The optimisations of the DNA extraction using the trnH-psbA BPNARM provided a signposting method which can assist in overcoming common problems encountered when using molecular methods with medicinal plants.

Keywords: degradation, DNA extraction, nucleic acid reference material, trnH-psbA

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1569 Subject Teachers’ Perception of the Changing Role of Language in the Curriculum of Secondary Education

Authors: Moldir Makenova

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Alongside the implementation of trilingual education in schools, the Ministry of Education and Science of the Republic of Kazakhstan innovated the school curriculum in 2013 to include a Content and Language Integrated Learning (CLIL) approach. In this regard, some transition issues have arisen, such as unprepared teachers, a need for more awareness of the CLIL approach, and teaching resources. Some teachers view it as a challenge due to its combination of both content and language. This often creates anxiety among teachers who are knowledgeable about their subject areas in Kazakh or Russian but are deficient in delivering the subject’s content in English. Thus, with this new teaching approach, teachers encounter to choose the role of language and answer how language works in the CLIL classroom. This study aimed to explore how teachers experience the changing role of language in the curriculum and to find out what challenges teachers face related to CLIL implementation and how their language proficiency influences their teaching practices. A qualitative comparative case study was conducted in an X Lyceum and a mainstream school piloting CLIL. Data collection procedures were conducted via semi-structured interviews, classroom observations, and document analysis. Eight content teachers were chosen from these two schools as the target group of this study. Subject teachers, rather than language teachers, were chosen as the target group to grasp how the language-related issues in the new curriculum are interpreted by educators who do not necessarily identify themselves as language experts at the outset. The findings showed that mainstream teachers prioritize content over language because, as content teachers, the knowledge of content is more essential for them rather than the language. In contrast, most X Lyceum teachers balance language and content and additionally showed their preferences to support the ‘English language only' policy among 10-11 graders. Moreover, due to the low-level English proficiency, mainstream teachers did highlight the necessity of CLIL training and further collaboration with language teachers. This study will be beneficial for teachers and policy-makers to enable them to solve the issues mentioned above related to the implementation of CLIL. Larger-scale research conducted in the future would further inform its successful deployment country-wide.

Keywords: role of language, trilingual education, updated curriculum, teacher practices

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1568 The Impact of WhatsApp Groups as Supportive Technology in Teaching

Authors: Pinn Tsin Isabel Yee

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With the advent of internet technologies, students are increasingly turning toward social media and cross-platform messaging apps such as WhatsApp, Line, and WeChat to support their teaching and learning processes. Although each messaging app has varying features, WhatsApp remains one of the most popular cross-platform apps that allow for fast, simple, secure messaging and free calls anytime, anywhere. With a plethora of advantages, students could easily assimilate WhatsApp as a supportive technology in their learning process. There could be peer to peer learning, and a teacher will be able to share knowledge digitally via the creation of WhatsApp groups. Content analysis techniques were utilized to analyze data collected by closed-ended question forms. Studies demonstrated that 98.8% of college students (n=80) from the Monash University foundation year agreed that the employment of WhatsApp groups was helpful as a learning tool. Approximately 71.3% disagreed that notifications and alerts from the WhatsApp group were disruptions in their studies. Students commented that they could silence the notifications and hence, it would not disturb their flow of thoughts. In fact, an overwhelming majority of students (95.0%) found it enjoyable to participate in WhatsApp groups for educational purposes. It was a common perception that some students felt pressured to post a reply in such groups, but data analysis showed that 72.5% of students did not feel pressured to comment or reply. It was good that 93.8% of students felt satisfactory if their posts were not responded to speedily, but was eventually attended to. Generally, 97.5% of students found it useful if their teachers provided their handphone numbers to be added to a WhatsApp group. If a teacher posts an explanation or a mathematical working in the group, all students would be able to view the post together, as opposed to individual students asking their teacher a similar question. On whether students preferred using Facebook as a learning tool, there was a 50-50 divide in the replies from the respondents as 51.3% of students liked WhatsApp, while 48.8% preferred Facebook as a supportive technology in teaching and learning. Taken altogether, the utilization of WhatsApp groups as a supportive technology in teaching and learning should be implemented in all classes to continuously engage our generation Y students in the ever-changing digital landscape.-

Keywords: education, learning, messaging app, technology, WhatsApp groups

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1567 From Reform to Revolt: Bashar al-Assad and the Arab Tribes in Syria

Authors: Haian Dukhan

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The death of Hafez al-Assad and the ascension of his son, Bashar, to rule brought an end to the state-society dynamics that his father worked on for decades. Hafez al-Assad built an authoritarian state that rests on patronage networks that connected his regime to the society. During Bashar’s reign, these patronage relationships have been affected by the policies of privatization and liberalization. Privatization and liberalisation of the economy have created new economic and social players that transformed the populist nature of the authoritarian regime into a regime that is connected mainly with bourgeoisie and the upper class neglecting the rural tribal constituency that was a vital part of Hafez al-Assad’s authoritarian state. Drawing on different data gathered through interviews as well as written literature, this paper will explore the policies that Bashar al-Assad carried out towards the Arab tribes in the period extended from 2000 until 2010. The paper starts by outlining how Bashar al-Assad narrowed the coalition of his rule to depend mainly on his family, the city merchants excluding the lower and middle strata in the periphery. It will then trace the disintegration of the social contract between the regime and the Arab tribe as a result of the latter’s failure to deliver adequate development services in their regions. Losing the support of the tribes undermined the stability of the regime resulting in different clashes between the tribes themselves, the tribes and the Kurds, the tribes and the druze (a sect of Islam situated in Southern Syria), which will be investigated in detail in this paper. In similar policies adopted by his father who used the tribes as leverage against the Islamists and the Kurds, Bashar al-Assad’s regime encouragement of Syrian tribal youth to join the Iraqi insurgency against the Americans will be explored in detail. The regime’s tolerance of Iran missionary activities in the tribal regions and its accommodation of Islamists group’s activities in those regions have erased the regime’s secular foundation. This paper will argue that Bashar al-Assad’s policies towards the Arab tribes have chipped away the regime’s ideological pillars and threatened the longer-term cohesion of its social base which paved the way for the uprising to start in the tribal regions.

Keywords: Syria, tribes, uprising, regime

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1566 Knowledge, Perceptions, and Barriers of Preconception Care among Healthcare Workers in Nigeria

Authors: Taiwo Hassanat Bawa-Muhammad, Opeoluwa Hope Adegoke

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Introduction: This study aims to examine the knowledge and perceptions of preconception care among healthcare workers in Nigeria, recognizing its crucial role in ensuring safe pregnancies. Despite its significance, awareness of preconception care remains low in the country. The study seeks to assess the understanding of preconception services and identify the barriers that hinder their efficacy. Methods: Through semi-structured interviews, 129 healthcare workers across six states in Nigeria were interviewed between January and March 2023. The interviews explored the healthcare workers' knowledge of preconception care practices, the socio-cultural influences shaping decision-making, and the challenges that limit accessibility and utilization of preconception care services. Results: The findings reveal a limited knowledge of preconception care among healthcare workers, primarily due to inadequate information dissemination within the healthcare system. Additionally, cultural beliefs significantly influence perceptions surrounding preconception care. Furthermore, financial constraints, distance to healthcare facilities, and poor health infrastructure disproportionately restrict access to preconception services, particularly for vulnerable populations. The study also highlights insufficient skills and outdated training among healthcare workers regarding preconception guidance, primarily attributed to limited opportunities for professional development. Discussion: To improve preconception care in Nigeria, comprehensive education programs must be implemented, taking into account the societal influences that shape perceptions and behaviors. These programs should aim to dispel myths and promote evidence-based practices. Additionally, training healthcare workers and integrating preconception care services into primary care settings, with support from religious and community leaders, can help overcome barriers to access. Strategies should prioritize affordability while emphasizing the broader benefits of preconception care beyond fertility concerns alone. Lastly, widespread literacy campaigns utilizing trusted channels are crucial for effectively disseminating information and promoting the adoption of preconception practices in Nigeria.

Keywords: preconception care, knowledge, healthcare workers, Nigeria, barriers, education, training

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1565 Three Issues for Integrating Artificial Intelligence into Legal Reasoning

Authors: Fausto Morais

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Artificial intelligence has been widely used in law. Programs are able to classify suits, to identify decision-making patterns, to predict outcomes, and to formalize legal arguments as well. In Brazil, the artificial intelligence victor has been classifying cases to supreme court’s standards. When those programs act doing those tasks, they simulate some kind of legal decision and legal arguments, raising doubts about how artificial intelligence can be integrated into legal reasoning. Taking this into account, the following three issues are identified; the problem of hypernormatization, the argument of legal anthropocentrism, and the artificial legal principles. Hypernormatization can be seen in the Brazilian legal context in the Supreme Court’s usage of the Victor program. This program generated efficiency and consistency. On the other hand, there is a feasible risk of over standardizing factual and normative legal features. Then legal clerks and programmers should work together to develop an adequate way to model legal language into computational code. If this is possible, intelligent programs may enact legal decisions in easy cases automatically cases, and, in this picture, the legal anthropocentrism argument takes place. Such an argument argues that just humans beings should enact legal decisions. This is so because human beings have a conscience, free will, and self unity. In spite of that, it is possible to argue against the anthropocentrism argument and to show how intelligent programs may work overcoming human beings' problems like misleading cognition, emotions, and lack of memory. In this way, intelligent machines could be able to pass legal decisions automatically by classification, as Victor in Brazil does, because they are binding by legal patterns and should not deviate from them. Notwithstanding, artificial intelligent programs can be helpful beyond easy cases. In hard cases, they are able to identify legal standards and legal arguments by using machine learning. For that, a dataset of legal decisions regarding a particular matter must be available, which is a reality in Brazilian Judiciary. Doing such procedure, artificial intelligent programs can support a human decision in hard cases, providing legal standards and arguments based on empirical evidence. Those legal features claim an argumentative weight in legal reasoning and should serve as references for judges when they must decide to maintain or overcome a legal standard.

Keywords: artificial intelligence, artificial legal principles, hypernormatization, legal anthropocentrism argument, legal reasoning

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1564 The Revival of Cultural Heritage through Social Space Upliftment: Case Study of the Walled City of Ajmer, India

Authors: Vaishali Sharma

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The research is an attempt to hunt a scientific and objective method to transform Ajmer's traditional walled city into a living cultural heritage space, exploring urban management methods to elevate local economy and social space in relation to specific cultural-based initiatives. Ajmer is among the oldest and religiously diverse settlements in Rajasthan, that has seen superimposed developments through the eras. With numerous agencies operating towards the development of the town core of Ajmer, it becomes essential to structure development changes in tune with the transformations and the existing heritage. The study was radio-controlled by the subsequent analysis question: What is the way to overcome the genetic social and economic stress inside the communities and revive public life? In order to create necessary interventions at the neighbourhood level, fifteen neighbourhoods were identified. Each of those was analyzed relatively on three major dimensions: Heritage, Social and Local Economy. Each dimension was further broken down into multiple sub-aspects for an overall and exhaustive understanding. The average median values of the responses were used to develop a color-coded matrix to represent the scores in an exceedingly structured quantified manner, moreover, linking it to the spatial structure. Respondent perceptions on numerous dimensions were additionally recorded, so that the proposals are inclusive in nature. The goals are targeted at Ajmer's traditional walled towns, which will make it easier for the community to regulate the rapid transformations and commercialization occurring within the space. The study recommends the necessity for accrued support in methods and policies from the non-public sector, businesses as well as local stakeholders. An expansion, revitalization and maintenance of the major business and heritage corridors, for an increased local and visitor experience, can produce an impetus for promotion of the intangible heritage, to spur the local economic processes, conservation of heritage precincts and upward development.

Keywords: cultural heritage, economic revitalization, neighbourhoods in walled cities, social space, tangible and intangible heritage

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1563 Empirical Analysis of the Effect of Cloud Movement in a Basic Off-Grid Photovoltaic System: Case Study Using Transient Response of DC-DC Converters

Authors: Asowata Osamede, Christo Pienaar, Johan Bekker

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Mismatch in electrical energy (power) or outage from commercial providers, in general, does not promote development to the public and private sector, these basically limit the development of industries. The necessity for a well-structured photovoltaic (PV) system is of importance for an efficient and cost-effective monitoring system. The major renewable energy potential on earth is provided from solar radiation and solar photovoltaics (PV) are considered a promising technological solution to support the global transformation to a low-carbon economy and reduction on the dependence on fossil fuels. Solar arrays which consist of various PV module should be operated at the maximum power point in order to reduce the overall cost of the system. So power regulation and conditioning circuits should be incorporated in the set-up of a PV system. Power regulation circuits used in PV systems include maximum power point trackers, DC-DC converters and solar chargers. Inappropriate choice of power conditioning device in a basic off-grid PV system can attribute to power loss, hence the need for a right choice of power conditioning device to be coupled with the system of the essence. This paper presents the design and implementation of a power conditioning devices in order to improve the overall yield from the availability of solar energy and the system’s total efficiency. The power conditioning devices taken into consideration in the project includes the Buck and Boost DC-DC converters as well as solar chargers with MPPT. A logging interface circuit (LIC) is designed and employed into the system. The LIC is designed on a printed circuit board. It basically has DC current signalling sensors, specifically the LTS 6-NP. The LIC is consequently required to program the voltages in the system (these include the PV voltage and the power conditioning device voltage). The voltage is structured in such a way that it can be accommodated by the data logger. Preliminary results which include availability of power as well as power loss in the system and efficiency will be presented and this would be used to draw the final conclusion.

Keywords: tilt and orientation angles, solar chargers, PV panels, storage devices, direct solar radiation

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1562 Experience of Continuous Ambulatory Peritoneal Dialysis in Remote Area of Southeast Bangladesh

Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

Abstract:

Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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1561 Students’ Perception of Careers in Shared Services Industry

Authors: Oksana Koval, Stephen Nabareseh

Abstract:

Talent attraction is identified as a top priority between 2015 – 2020 for Shared Service Centers (SSCs) based on an industry-wide studies. Due to market dynamics and the structure of labour force, shared service industries in Eastern and Central Europe strive for qualified graduates with appropriate and unique skills to occupy such job places. The inbuilt interest and course prescriptions undertaken by prospective job seekers determine whether SSCs will eventually admit such professionals. This paper assesses students’ overall perception of careers in the shared services industry and further diagnosis gender impact and influence on the job preferences among students. Questionnaires were distributed among students in the Czech Republic universities using an online mode. Respondents vary by study year, gender, age, course of study, and work preferences. A total of 1283 student responses has been analyzed using Stata data analytics software. It was discovered that over 70% of respondents who are aware of SSCs are quite ignorant of the job opportunities offered by the centers. While majority of respondents are interested in support positions (e.g. procurement specialist, planning specialist, human resource specialist, process improvement specialist and payroll specialist, etc.), around a third of respondents (32.8 percent) will decline a job offer from SSCs. The analysis also revealed that males are more likely than females to seek careers in international companies, hence, tend to be more favorable towards shared service jobs. Females, however, have stronger preferences towards marketing and PR jobs. The research results provide insights into the job aspirations of students interviewed. The findings provide a huge resource for recruitment agencies and shared service industries to renew and redirect their search for talents into SSCs. Based on the fact that great portion of respondents are planning to start their career within 6-12 months, the research provides important highlights for the talent attraction and recruitment strategies in the industry and provides a curriculum direction in academia.

Keywords: Czech Republic labour market, gender, talent attraction, shared service centers, students

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1560 Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Tunisia: Risk and Protective Factor

Authors: Ahmed Sami Hammami, Mohamed Jellazi

Abstract:

Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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1559 EcoLife and Greed Index Measurement: An Alternative Tool to Promote Sustainable Communities and Eco-Justice

Authors: Louk Aourelien Andrianos, Edward Dommen, Athena Peralta

Abstract:

Greed, as epitomized by overconsumption of natural resources, is at the root of ecological destruction and unsustainability of modern societies. Presently economies rely on unrestricted structural greed which fuels unlimited economic growth, overconsumption, and individualistic competitive behavior. Structural greed undermines the life support system on earth and threatens ecological integrity, social justice and peace. The World Council of Churches (WCC) has developed a program on ecological and economic justice (EEJ) with the aim to promote an economy of life where the economy is embedded in society and society in ecology. This paper aims at analyzing and assessing the economy of life (EcoLife) by offering an empirical tool to measure and monitor the root causes and effects of unsustainability resulting from human greed on global, national, institutional and individual levels. This holistic approach is based on the integrity of ecology and economy in a society founded on justice. The paper will discuss critical questions such as ‘what is an economy of life’ and ‘how to measure and control it from the effect of greed’. A model called GLIMS, which stands for Greed Lines and Indices Measurement System is used to clarify the concept of greed and help measuring the economy of life index by fuzzy logic reasoning. The inputs of the model are from statistical indicators of natural resources consumption, financial realities, economic performance, social welfare and ethical and political facts. The outputs are concrete measures of three primary indices of ecological, economic and socio-political greed (ECOL-GI, ECON-GI, SOCI-GI) and one overall multidimensional economy of life index (EcoLife-I). EcoLife measurement aims to build awareness of an economy life and to address the effects of greed in systemic and structural aspects. It is a tool for ethical diagnosis and policy making.

Keywords: greed line, sustainability indicators, fuzzy logic, eco-justice, World Council of Churches (WCC)

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1558 The Role of Parental Stress and Emotion Regulation in Responding to Children’s Expression of Negative Emotion

Authors: Lizel Bertie, Kim Johnston

Abstract:

Parental emotion regulation plays a central role in the socialisation of emotion, especially when teaching young children to cope with negative emotions. Despite evidence which shows non-supportive parental responses to children’s expression of negative emotions has implications for the social and emotional development of the child, few studies have investigated risk factors which impact parental emotion socialisation processes. The current study aimed to explore the extent to which parental stress contributes to both difficulties in parental emotion regulation and non-supportive parental responses to children’s expression of negative emotions. In addition, the study examined whether parental use of expressive suppression as an emotion regulation strategy facilitates the influence of parental stress on non-supportive responses by testing the relations in a mediation model. A sample of 140 Australian adults, who identified as parents with children aged 5 to 10 years, completed an online questionnaire. The measures explored recent symptoms of depression, anxiety, and stress, the use of expressive suppression as an emotion regulation strategy, and hypothetical parental responses to scenarios related to children’s expression of negative emotions. A mediated regression indicated that parents who reported higher levels of stress also reported higher levels of expressive suppression as an emotion regulation strategy and increased use of non-supportive responses in relation to young children’s expression of negative emotions. These findings suggest that parents who experience heightened symptoms of stress are more likely to both suppress their emotions in parent-child interaction and engage in non-supportive responses. Furthermore, higher use of expressive suppression strongly predicted the use of non-supportive responses, despite the presence of parental stress. Contrary to expectation, no indirect effect of stress on non-supportive responses was observed via expressive suppression. The findings from the study suggest that parental stress may become a more salient manifestation of psychological distress in a sub-clinical population of parents while contributing to impaired parental responses. As such, the study offers support for targeting overarching factors such as difficulties in parental emotion regulation and stress management, not only as an intervention for parental psychological distress, but also the detection and prevention of maladaptive parenting practices.

Keywords: emotion regulation, emotion socialisation, expressive suppression, non-supportive responses, parental stress

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1557 Applying the Eye Tracking Technique for the Evaluation of Oculomotor System in Patients Survived after Cerebellar Tumors

Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

Abstract:

Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

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1556 Clinical Evidence of the Efficacy of ArtiCovid (Artemisia Annua Extract) on Covid-19 Patients in DRC

Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

Abstract:

The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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1555 Effectiveness of Research Promotion Organizations in Higher Education and Research (ESR)

Authors: Jonas Sanon

Abstract:

The valorization of research is becoming a transversal instrument linking different sectors (academic, public and industrial). The practice of valorization seems to impact innovation techniques within companies where, there is often the implementation of industrial conventions of training through research (CIFRE), continuous training programs for employees, collaborations and partnerships around joint research and R&D laboratories focused on the needs of companies to improve or develop more efficient innovations. Furthermore, many public initiatives to support innovation and technology transfer have been developed at the international, European and national levels, with significant budget allocations. Thus, in the context of this work, we tried to analyze the way in which research transfer structures are evaluated within the Saclay ecosystem. In fact, the University-Paris-Saclay is one of the best French universities; it is made up of 10 university components, more than 275 laboratories and is in partnership with the largest French research centers This work mainly focused on how evaluations affected research transfer structures, how evaluations were conducted, and what the managers of research transfer structures thought about assessments. Thus, with the aid of the conducted interviews, it appears that the evaluations do not have a significant impact on the qualitative aspect of research and innovation, but is rather present a directive aspect to allow the structures to benefit or not from the financial resources to develop certain research work, sometimes directed and influenced by the market, some researchers might try to accentuate their research and experimentation work on themes that are not necessarily their areas of interest, but just to comply with the calls for proposed thematic projects. The field studies also outline the primary indicators used to assess the effectiveness of valorization structures as "the number of start-ups generated, the license agreements signed, the structure's patent portfolio, and the innovations of items developed from public research.". Finally, after mapping the actors, it became clear that the ecosystem of the University of Paris-Saclay benefits from a richness allowing it to better value its research in relation to the three categories of actors it has (internal, external and transversal), united and linked by a relationship of proximity of sharing and endowed with a real opportunity to innovate openly.

Keywords: research valorization, technology transfer, innovation, evaluation, impacts and performances, innovation policy

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1554 Genotyping and Phylogeny of Phaeomoniella Genus Associated with Grapevine Trunk Diseases in Algeria

Authors: A. Berraf-Tebbal, Z. Bouznad, , A.J.L. Phillips

Abstract:

Phaeomoniella is a fungus genus in the mitosporic ascomycota which includes Phaeomoniella chlamydospora specie associated with two declining diseases on grapevine (Vitis vinifera) namely Petri disease and esca. Recent studies have shown that several Phaeomoniella species also cause disease on many other woody crops, such as forest trees and woody ornamentals. Two new species, Phaeomoniella zymoides and Phaeomoniella pinifoliorum H.B. Lee, J.Y. Park, R.C. Summerbell et H.S. Jung, were isolated from the needle surface of Pinus densiflora Sieb. et Zucc. in Korea. The identification of species in Phaeomoniella genus can be a difficult task if based solely on morphological and cultural characters. In this respect, the application of molecular methods, particularly PCR-based techniques, may provide an important contribution. MSP-PCR (microsatellite primed-PCR) fingerprinting has proven useful in the molecular typing of fungal strains. The high discriminatory potential of this method is particularly useful when dealing with closely related or cryptic species. In the present study, the application of PCR fingerprinting was performed using the micro satellite primer M13 for the purpose of species identification and strain typing of 84 Phaeomoniella -like isolates collected from grapevines with typical symptoms of dieback. The bands produced by MSP-PCR profiles divided the strains into 3 clusters and 5 singletons with a reproducibility level of 80%. Representative isolates from each group and, when possible, isolates from Eutypa dieback and esca symptoms were selected for sequencing of the ITS region. The ITS sequences for the 16 isolates selected from the MSP-PCR profiles were combined and aligned with sequences of 18 isolates retrieved from GenBank, representing a selection of all known Phaeomoniella species. DNA sequences were compared with those available in GenBank using Neighbor-joining (NJ) and Maximum-parsimony (MP) analyses. The phylogenetic trees of the ITS region revealed that the Phaeomoniella isolates clustered with Phaeomoniella chlamydospora reference sequences with a bootstrap support of 100 %. The complexity of the pathosystems vine-trunk diseases shows clearly the need to identify unambiguously the fungal component in order to allow a better understanding of the etiology of these diseases and justify the establishment of control strategies against these fungal agents.

Keywords: Genotyping, MSP-PCR, ITS, phylogeny, trunk diseases

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1553 Evaluation of a Staffing to Workload Tool in a Multispecialty Clinic Setting

Authors: Kristin Thooft

Abstract:

— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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1552 An Overview of Suicidality in American Indians and Alaska Natives

Authors: Christopher S. Perez, Kendal C. Boyd

Abstract:

global suicide rates have decreased in recent decades, rates in the United States have increased by 35.2 percent since 1999.American Indians and Alaska Natives (AI/AN) have the highest rates of suicide in the U.S., with approximately 22 suicides per 100,000 people as of 2019. AI/AN have experienced significant historical trauma resulting in disproportionate rates of substance abuse and mental disorders. This literature review aimed to identify the demographic and clinical risk and protective factors for American Indians and Alaska Natives and provide an overview of suicidality in this population. The literature reflected varying definitions of suicidality depending on region, with some AI/AN tribesconceptualizing suicide through a spiritual framework, while others defined suicide in the biomedical sense. Furthermore, AI/AN adults and adolescents experienced higher rates of suicidal ideation when compared to other racial groups. Religious preference, sexual orientation, prior suicidal behavior, psychiatric admission, history of abuse, substance abuse, family history of mental illness, family history of substance abuse, family history of suicidal behaviors, domestic violence, and trauma were discussed as factors related to suicidality. Recommendations included increasing access to and utilization of mental health and medical services, culturally adapting suicide prevention programs to AI/AN communities, increasing support for LGBTQ+ AI/AN, providing opportunities that reinforce ethnic identity, and post-hospitalization follow-up care. The following databases were utilized to obtain peer-reviewed articles for this literature review: Complementary Index, Academic Search Premier, Science Direct, PsycInfo, Social Sciences Citation Index, PsycArticles, PubMed, EbscoHost, and PsycBooks. Articles that examined Native populations outside of the United States did not cite a primary source and/or were published before 1990 were excluded.

Keywords: alaska native, american indian, protective factors, risk factors, suicidality, suicide

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1551 Nose Macroneedling Tie Suture Hidden Technique

Authors: Mohamed Ghoz, Hala Alsabeh

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Context: Macroscopic Nose Macroneedling (MNM) is a new non-surgical procedure for lifting and tightening the nose. It is a tissue-non-invasive technique that uses a needle to create micro-injuries in the skin. These injuries stimulate the production of collagen and elastin, which results in the tightening and lifting of the skin. Research Aim: The research aim of this study was to investigate the efficacy and safety of MNM for the treatment of nasal deformities. Methodology A total of 100 patients with nasal deformities were included in this study. The patients were randomly assigned to either the MNM group or the control group. The MNM group received a single treatment of MNM, while the control group received no treatment. The patients were evaluated at baseline, 6 months, and 12 months after treatment. Findings: The results of this study showed that MNM was effective in improving the appearance of the nose in patients with nasal deformities. At 6 months after treatment, the patients in the MNM group had significantly improved nasal tip projection, nasal bridge height, and nasal width compared to the patients in the control group. The improvements in nasal appearance were maintained at 12 months after treatment. Theoretical Importance: The findings of this study provide support for the use of MNM as a safe and effective treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities. Data Collection: Data was collected from the patients using a variety of methods, including clinical assessments, photographic assessments, and patient-reported outcome measures. Analysis Procedures: The data was analyzed using a variety of statistical methods, including descriptive statistics, inferential statistics, and meta-analysis. Question Addressed: The research question addressed in this study was whether MNM is an effective and safe treatment for nasal deformities. Conclusion: The findings of this study suggest that MNM is an effective and safe treatment for nasal deformities. MNM is a non-surgical procedure that is associated with minimal downtime and no risk of scarring. This makes it an attractive option for patients who are looking for a minimally invasive treatment for their nasal deformities.

Keywords: nose, surgery, tie, suture

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1550 Observation of a Phase Transition in Adsorbed Hydrogen at 101 Kelvin

Authors: Raina J. Olsen, Andrew K. Gillespie, John W. Taylor, Cristian I. Contescu, Peter Pfeifer, James R. Morris

Abstract:

While adsorbent surfaces such as graphite are known to increase the melting temperature of solid H2, this effect is normally rather small, increasing to 20 Kelvin (K) relative to 14 K in the bulk. An as-yet unidentified phase transition has been observed in a system of H2 adsorbed in a porous, locally graphitic, Saran carbon with sub-nanometer sized pores at temperatures (74-101 K) and pressures ( > 76 bar) well above the critical point of bulk H2 using hydrogen adsorption and neutron scattering experiments. Adsorption data shows a discontinuous pressure jump in the kinetics at 76 bar after nearly an hour of equilibration time, which is identified as an exothermic phase transition. This discontinuity is observed in the 87 K isotherm, but not the 77 K isotherm. At higher pressures, the measured isotherms show greater excess adsorption at 87 K than 77 K. Inelastic neutron scattering measurements also show a striking phase transition, with the amount of high angle scattering (corresponding to large momentum transfer/ large effective mass) increasing by up to a factor of 5 in the novel phase. During the course of the neutron scattering experiment, three of these reversible spectral phase transitions were observed to occur in response to only changes in sample temperature. The novel phase was observed by neutron scattering only at high H2 pressure (123 bar and 187 bar) and temperatures between 74-101 K in the sample of interest, but not at low pressure (30 bar), or in a control activated carbon at 186 bar of H2 pressure. Based on several of the more unusual observations, such as the slow equilibration and the presence of both an upper and lower temperature bound, a reasonable hypothesis is that this phase forms only in the presence of a high concentration of ortho-H2 (nuclear spin S=1). The increase in adsorption with temperature, temperatures which cross the lower temperature bound observed by neutron scattering, indicates that this novel phase is denser. Structural characterization data on the adsorbent shows that it may support a commensurate solid phase denser than those known to exist on graphite at much lower temperatures. Whatever this phase is eventually proven to be, these results show that surfaces can have a more striking effect on hydrogen phases than previously thought.

Keywords: adsorbed phases, hydrogen, neutron scattering, nuclear spin

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