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Paper Count: 10813

Search results for: urban green open space

193 Comparing Radiographic Detection of Simulated Syndesmosis Instability Using Standard 2D Fluoroscopy Versus 3D Cone-Beam Computed Tomography

Authors: Diane Ghanem, Arjun Gupta, Rohan Vijayan, Ali Uneri, Babar Shafiq

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Introduction: Ankle sprains and fractures often result in syndesmosis injuries. Unstable syndesmotic injuries result from relative motion between the distal ends of the tibia and fibula, anatomic juncture which should otherwise be rigid, and warrant operative management. Clinical and radiological evaluations of intraoperative syndesmosis stability remain a challenging task as traditional 2D fluoroscopy is limited to a uniplanar translational displacement. The purpose of this pilot cadaveric study is to compare the 2D fluoroscopy and 3D cone beam computed tomography (CBCT) stress-induced syndesmosis displacements. Methods: Three fresh-frozen lower legs underwent 2D fluoroscopy and 3D CIOS CBCT to measure syndesmosis position before dissection. Syndesmotic injury was simulated by resecting the (1) anterior inferior tibiofibular ligament (AITFL), the (2) posterior inferior tibiofibular ligament (PITFL) and the inferior transverse ligament (ITL) simultaneously, followed by the (3) interosseous membrane (IOM). Manual external rotation and Cotton stress test were performed after each of the three resections and 2D and 3D images were acquired. Relevant 2D and 3D parameters included the tibiofibular overlap (TFO), tibiofibular clear space (TCS), relative rotation of the fibula, and anterior-posterior (AP) and medial-lateral (ML) translations of the fibula relative to the tibia. Parameters were measured by two independent observers. Inter-rater reliability was assessed by intraclass correlation coefficient (ICC) to determine measurement precision. Results: Significant mismatches were found in the trends between the 2D and 3D measurements when assessing for TFO, TCS and AP translation across the different resection states. Using 3D CBCT, TFO was inversely proportional to the number of resected ligaments while TCS was directly proportional to the latter across all cadavers and ‘resection + stress’ states. Using 2D fluoroscopy, this trend was not respected under the Cotton stress test. 3D AP translation did not show a reliable trend whereas 2D AP translation of the fibula was positive under the Cotton stress test and negative under the external rotation. 3D relative rotation of the fibula, assessed using the Tang et al. ratio method and Beisemann et al. angular method, suggested slight overall internal rotation with complete resection of the ligaments, with a change < 2mm - threshold which corresponds to the commonly used buffer to account for physiologic laxity as per clinical judgment of the surgeon. Excellent agreement (>0.90) was found between the two independent observers for each of the parameters in both 2D and 3D (overall ICC 0.9968, 95% CI 0.995 - 0.999). Conclusions: The 3D CIOS CBCT appears to reliably depict the trend in TFO and TCS. This might be due to the additional detection of relevant rotational malpositions of the fibula in comparison to the standard 2D fluoroscopy which is limited to a single plane translation. A better understanding of 3D imaging may help surgeons identify the precise measurements planes needed to achieve better syndesmosis repair.

Keywords: 2D fluoroscopy, 3D computed tomography, image processing, syndesmosis injury

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192 Improving Fingerprinting-Based Localization (FPL) System Using Generative Artificial Intelligence (GAI)

Authors: Getaneh Berie Tarekegn, Li-Chia Tai

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With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a novel semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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191 High Prevalence of Asymptomatic Dengue among Healthy Adults in Southern Malaysia: A Longitudinal Prospective Study

Authors: Nowrozy Jahan, Sharifah Syed Hassan, Daniel Reidpath

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In recent decades, Malaysia has become a dengue hyper-endemic country with the co-circulation of the four-dengue virus (DENV) serotypes. The number of symptomatic dengue cases is maintaining an increasing trend since 1995 and sharply increased in 2014. The four DENV serotypes have been co-circulating since 2000, and this pattern of cyclical dominance of sub-types contributed to the development of frequent major dengue epidemics in Malaysia. Since 2012, different Malaysian state was dominated by different serotypes. The study aims to estimate the burden of asymptomatic dengue in a healthy adult population which may act as a potential source of further symptomatic dengue infection. It also aims to identify the predominant DENV serotypes which are circulating at the community level. A longitudinal prospective community-based study was conducted in the Segamat district of Johor State, southern part of Malaysia where the number of reported dengue cases has steadily increased over the last three years (2013-2015). More specifically, the study was conducted in and around of Kampung Abdullah of Sungai Segamat sub-district which was identified as a hot spot area over the period of 2013-2015. This community-based study has been conducted by Southeast Asia Community Observatory (SEACO), an ISO-certified research platform in collaboration of the Ministry of Health Malaysia and Monash University Malaysia. It was conducted from May 2015 to May 2016. In this study, 277 apparently looking healthy respondents joined who were followed up as a cohort for four times during the one-year study period. Blood was collected to detect the serological marker of dengue at each round of follow-up. Among 277, 184 respondents (66%) joined all four rounds. Half of the study respondents were at the age-group of 45-64 years, slightly more than half of the respondents (59%) were female, and the most (69%) of them were Malay; only 35% lived in urban areas. During the baseline, the study found a very high prevalence of exposure to dengue virus; 89% of the study respondents had serological evidence of previous asymptomatic dengue infection; the majority of them did not know about it as they did not develop any symptom of dengue fever; only 13% knew as they developed symptoms. At the end of the one-year study period, 19% of respondents developed recent secondary dengue infection which was also identified by the serological marker as they did not develop any symptom (asymptomatic cases). The asymptomatic dengue incidence was higher during the rainy season compared to the dry season. All four dengue serotypes were identified in the serum of the infected respondents; among them, DENV-2 was the most prominent. Further genetic analysis is going on to identify the association of HLA-B*46 and HLA-DRB1*08 with dengue resistance. This study provides evidence for the policymakers to be aware of asymptomatic dengue infection, to develop a useful tool for raising awareness about asymptomatic dengue infection among the general population, to monitor the community participation to strengthen the individual and community level dengue prevention and control measures when neither there is vaccine nor particular treatment for dengue.

Keywords: asymptomatic, dengue, health adults, prospective study

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190 Saline Aspiration Negative Intravascular Test: Mitigating Risk with Injectable Fillers

Authors: Marcelo Lopes Dias Kolling, Felipe Ferreira Laranjeira, Guilherme Augusto Hettwer, Pedro Salomão Piccinini, Marwan Masri, Carlos Oscar Uebel

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Introduction: Injectable fillers are among the most common nonsurgical cosmetic procedures, with significant growth yearly. Knowledge of rheological and mechanical characteristics of fillers, facial anatomy, and injection technique is essential for safety. Concepts such as the use of cannula versus needle, aspiration before injection, and facial danger zones have been well discussed. In case of an accidental intravascular puncture, the pressure inside the vessel may not be sufficient to push blood into the syringe due to the characteristics of the filler product; this is especially true for calcium hydroxyapatite (CaHA) or hyaluronic acid (HA) fillers with high G’. Since viscoelastic properties of normal saline are much lower than those of fillers, aspiration with saline prior to filler injection may decrease the risk of a false negative aspiration and subsequent catastrophic effects. We discuss a technique to add an additional safety step to the procedure with saline aspiration prior to injection, a ‘’reverse Seldinger’’ technique for intravascular access, which we term SANIT: Saline Aspiration Negative Intravascular Test. Objectives: To demonstrate the author’s (PSP) technique which adds an additional safety step to the process of filler injection, with both CaHA and HA, in order to decrease the risk of intravascular injection. Materials and Methods: Normal skin cleansing and topical anesthesia with prilocaine/lidocaine cream are performed; the facial subunits to be treated are marked. A 3mL Luer lock syringe is filled with 2mL of 0.9% normal saline and a 27G needle, which is turned one half rotation. When a cannula is to be used, the Luer lock syringe is attached to a 27G 4cm single hole disposable cannula. After skin puncture, the 3mL syringe is advanced with the plunger pulled back (negative pressure). Progress is made to the desired depth, all the while aspirating. Once the desired location of filler injection is reached, the syringe is exchanged for the syringe containing a filler, securely grabbing the hub of the needle and taking care to not dislodge the needle tip. Prior to this, we remove 0.1mL of filler to allow for space inside the syringe for aspiration. We again aspirate and inject retrograde. SANIT is especially useful for CaHA, since the G’ is much higher than HA, and thus reflux of blood into the syringe is less likely to occur. Results: The technique has been used safely for the past two years with no adverse events; the increase in cost is negligible (only the cost of 2mL of normal saline). Over 100 patients (over 300 syringes) have been treated with this technique. The risk of accidental intravascular puncture has been calculated to be between 1:6410 to 1:40882 syringes among expert injectors; however, the consequences of intravascular injection can be catastrophic even with board-certified physicians. Conclusions: While the risk of intravascular filler injection is low, the consequences can be disastrous. We believe that adding the SANIT technique can help further mitigate risk with no significant untoward effects and could be considered by all performing injectable fillers. Further follow-up is ongoing.

Keywords: injectable fillers, safety, saline aspiration, injectable filler complications, hyaluronic acid, calcium hydroxyapatite

Procedia PDF Downloads 126
189 The Impact of Supporting Productive Struggle in Learning Mathematics: A Quasi-Experimental Study in High School Algebra Classes

Authors: Sumeyra Karatas, Veysel Karatas, Reyhan Safak, Gamze Bulut-Ozturk, Ozgul Kartal

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Productive struggle entails a student's cognitive exertion to comprehend mathematical concepts and uncover solutions not immediately apparent. The significance of productive struggle in learning mathematics is accentuated by influential educational theorists, emphasizing its necessity for learning mathematics with understanding. Consequently, supporting productive struggle in learning mathematics is recognized as a high-leverage and effective mathematics teaching practice. In this study, the investigation into the role of productive struggle in learning mathematics led to the development of a comprehensive rubric for productive struggle pedagogy through an exhaustive literature review. The rubric consists of eight primary criteria and 37 sub-criteria, providing a detailed description of teacher actions and pedagogical choices that foster students' productive struggles. These criteria encompass various pedagogical aspects, including task design, tool implementation, allowing time for struggle, posing questions, scaffolding, handling mistakes, acknowledging efforts, and facilitating discussion/feedback. Utilizing this rubric, a team of researchers and teachers designed eight 90-minute lesson plans, employing a productive struggle pedagogy, for a two-week unit on solving systems of linear equations. Simultaneously, another set of eight lesson plans on the same topic, featuring identical content and problems but employing a traditional lecture-and-practice model, was designed by the same team. The objective was to assess the impact of supporting productive struggle on students' mathematics learning, defined by the strands of mathematical proficiency. This quasi-experimental study compares the control group, which received traditional lecture- and practice instruction, with the treatment group, which experienced a productive struggle in pedagogy. Sixty-six 10th and 11th-grade students from two algebra classes, taught by the same teacher at a high school, underwent either the productive struggle pedagogy or lecture-and-practice approach over two-week eight 90-minute class sessions. To measure students' learning, an assessment was created and validated by a team of researchers and teachers. It comprised seven open-response problems assessing the strands of mathematical proficiency: procedural and conceptual understanding, strategic competence, and adaptive reasoning on the topic. The test was administered at the beginning and end of the two weeks as pre-and post-test. Students' solutions underwent scoring using an established rubric, subjected to expert validation and an inter-rater reliability process involving multiple criteria for each problem based on their steps and procedures. An analysis of covariance (ANCOVA) was conducted to examine the differences between the control group, which received traditional pedagogy, and the treatment group, exposed to the productive struggle pedagogy, on the post-test scores while controlling for the pre-test. The results indicated a significant effect of treatment on post-test scores for procedural understanding (F(2, 63) = 10.47, p < .001), strategic competence (F(2, 63) = 9.92, p < .001), adaptive reasoning (F(2, 63) = 10.69, p < .001), and conceptual understanding (F(2, 63) = 10.06, p < .001), controlling for pre-test scores. This demonstrates the positive impact of supporting productive struggle in learning mathematics. In conclusion, the results revealed the significance of the role of productive struggle in learning mathematics. The study further explored the practical application of productive struggle through the development of a comprehensive rubric describing the pedagogy of supporting productive struggle.

Keywords: effective mathematics teaching practice, high school algebra, learning mathematics, productive struggle

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188 Generative Design of Acoustical Diffuser and Absorber Elements Using Large-Scale Additive Manufacturing

Authors: Saqib Aziz, Brad Alexander, Christoph Gengnagel, Stefan Weinzierl

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This paper explores a generative design, simulation, and optimization workflow for the integration of acoustical diffuser and/or absorber geometry with embedded coupled Helmholtz-resonators for full-scale 3D printed building components. Large-scale additive manufacturing in conjunction with algorithmic CAD design tools enables a vast amount of control when creating geometry. This is advantageous regarding the increasing demands of comfort standards for indoor spaces and the use of more resourceful and sustainable construction methods and materials. The presented methodology highlights these new technological advancements and offers a multimodal and integrative design solution with the potential for an immediate application in the AEC-Industry. In principle, the methodology can be applied to a wide range of structural elements that can be manufactured by additive manufacturing processes. The current paper focuses on a case study of an application for a biaxial load-bearing beam grillage made of reinforced concrete, which allows for a variety of applications through the combination of additive prefabricated semi-finished parts and in-situ concrete supplementation. The semi-prefabricated parts or formwork bodies form the basic framework of the supporting structure and at the same time have acoustic absorption and diffusion properties that are precisely acoustically programmed for the space underneath the structure. To this end, a hybrid validation strategy is being explored using a digital and cross-platform simulation environment, verified with physical prototyping. The iterative workflow starts with the generation of a parametric design model for the acoustical geometry using the algorithmic visual scripting editor Grasshopper3D inside the building information modeling (BIM) software Revit. Various geometric attributes (i.e., bottleneck and cavity dimensions) of the resonator are parameterized and fed to a numerical optimization algorithm which can modify the geometry with the goal of increasing absorption at resonance and increasing the bandwidth of the effective absorption range. Using Rhino.Inside and LiveLink for Revit, the generative model was imported directly into the Multiphysics simulation environment COMSOL. The geometry was further modified and prepared for simulation in a semi-automated process. The incident and scattered pressure fields were simulated from which the surface normal absorption coefficients were calculated. This reciprocal process was repeated to further optimize the geometric parameters. Subsequently the numerical models were compared to a set of 3D concrete printed physical twin models, which were tested in a .25 m x .25 m impedance tube. The empirical results served to improve the starting parameter settings of the initial numerical model. The geometry resulting from the numerical optimization was finally returned to grasshopper for further implementation in an interdisciplinary study.

Keywords: acoustical design, additive manufacturing, computational design, multimodal optimization

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187 Single Pass Design of Genetic Circuits Using Absolute Binding Free Energy Measurements and Dimensionless Analysis

Authors: Iman Farasat, Howard M. Salis

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Engineered genetic circuits reprogram cellular behavior to act as living computers with applications in detecting cancer, creating self-controlling artificial tissues, and dynamically regulating metabolic pathways. Phenemenological models are often used to simulate and design genetic circuit behavior towards a desired behavior. While such models assume that each circuit component’s function is modular and independent, even small changes in a circuit (e.g. a new promoter, a change in transcription factor expression level, or even a new media) can have significant effects on the circuit’s function. Here, we use statistical thermodynamics to account for the several factors that control transcriptional regulation in bacteria, and experimentally demonstrate the model’s accuracy across 825 measurements in several genetic contexts and hosts. We then employ our first principles model to design, experimentally construct, and characterize a family of signal amplifying genetic circuits (genetic OpAmps) that expand the dynamic range of cell sensors. To develop these models, we needed a new approach to measuring the in vivo binding free energies of transcription factors (TFs), a key ingredient of statistical thermodynamic models of gene regulation. We developed a new high-throughput assay to measure RNA polymerase and TF binding free energies, requiring the construction and characterization of only a few constructs and data analysis (Figure 1A). We experimentally verified the assay on 6 TetR-homolog repressors and a CRISPR/dCas9 guide RNA. We found that our binding free energy measurements quantitatively explains why changing TF expression levels alters circuit function. Altogether, by combining these measurements with our biophysical model of translation (the RBS Calculator) as well as other measurements (Figure 1B), our model can account for changes in TF binding sites, TF expression levels, circuit copy number, host genome size, and host growth rate (Figure 1C). Model predictions correctly accounted for how these 8 factors control a promoter’s transcription rate (Figure 1D). Using the model, we developed a design framework for engineering multi-promoter genetic circuits that greatly reduces the number of degrees of freedom (8 factors per promoter) to a single dimensionless unit. We propose the Ptashne (Pt) number to encapsulate the 8 co-dependent factors that control transcriptional regulation into a single number. Therefore, a single number controls a promoter’s output rather than these 8 co-dependent factors, and designing a genetic circuit with N promoters requires specification of only N Pt numbers. We demonstrate how to design genetic circuits in Pt number space by constructing and characterizing 15 2-repressor OpAmp circuits that act as signal amplifiers when within an optimal Pt region. We experimentally show that OpAmp circuits using different TFs and TF expression levels will only amplify the dynamic range of input signals when their corresponding Pt numbers are within the optimal region. Thus, the use of the Pt number greatly simplifies the genetic circuit design, particularly important as circuits employ more TFs to perform increasingly complex functions.

Keywords: transcription factor, synthetic biology, genetic circuit, biophysical model, binding energy measurement

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186 Developing Digital Competencies in Aboriginal Students through University-College Partnerships

Authors: W. S. Barber, S. L. King

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This paper reports on a pilot project to develop a collaborative partnership between a community college in rural northern Ontario, Canada, and an urban university in the greater Toronto area in Oshawa, Canada. Partner institutions will collaborate to address learning needs of university applicants whose goals are to attain an undergraduate university BA in Educational Studies and Digital Technology degree, but who may not live in a geographical location that would facilitate this pathways process. The UOIT BA degree is attained through a 2+2 program, where students with a 2 year college diploma or equivalent can attain a four year undergraduate degree. The goals reported on the project are as: 1. Our aim is to expand the BA program to include an additional stream which includes serious educational games, simulations and virtual environments, 2. Develop fully (using both synchronous and asynchronous technologies) online learning modules for use by university applicants who otherwise are not geographically located close to a physical university site, 3. Assess the digital competencies of all students, including members of local, distance and Indigenous communities using a validated tool developed and tested by UOIT across numerous populations. This tool, the General Technical Competency Use and Scale (GTCU) will provide the collaborating institutions with data that will allow for analyzing how well students are prepared to succeed in fully online learning communities. Philosophically, the UOIT BA program is based on a fully online learning communities model (FOLC) that can be accessed from anywhere in the world through digital learning environments via audio video conferencing tools such as Adobe Connect. It also follows models of adult learning and mobile learning, and makes a university degree accessible to the increasing demographic of adult learners who may use mobile devices to learn anywhere anytime. The program is based on key principles of Problem Based Learning, allowing students to build their own understandings through the co-design of the learning environment in collaboration with the instructors and their peers. In this way, this degree allows students to personalize and individualize the learning based on their own culture, background and professional/personal experiences. Using modified flipped classroom strategies, students are able to interrogate video modules on their own time in preparation for one hour discussions occurring in video conferencing sessions. As a consequence of the program flexibility, students may continue to work full or part time. All of the partner institutions will co-develop four new modules, administer the GTCU and share data, while creating a new stream of the UOIT BA degree. This will increase accessibility for students to bridge from community colleges to university through a fully digital environment. We aim to work collaboratively with Indigenous elders, community members and distance education instructors to increase opportunities for more students to attain a university education.

Keywords: aboriginal, college, competencies, digital, universities

Procedia PDF Downloads 196
185 Major Role of Social Media in Encouraging Public Interaction with Health Awareness: A Case Study of Successful Saudi Diabetes Campaign

Authors: Budur Almutairi

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Introduction: There is an alarming increase in the number of diabetic patients in Saudi Arabia during the last twenty years. The World Health Organization (WHO) reports that the country ranks seventh in the world for the rate of diabetes. It is also estimated that around 7 million of the population are diabetic and almost around 3 million have pre-diabetes. The prevalence is more in urban area than in rural and more in women than in men and it is closely associated with the parallel rise in obesity rates. Diabetes is found to be contributing to the increasing mortality, morbidity and vascular complications and becoming a significant cause of medical complications and even death. The trends shown by the numbers are worrying as the prevalence is steadily doubling every two decades and particularly in Saudi Arabia, this could soon reach 50% in those over 50 years of age. The economic growth and prosperity have shown notable changes in the lifestyle of the people. Most importantly, along with an increased consumption of fast foods and sugar-rich carbonated soft drinks, eating habits became less healthy and the level of physical activity is decreased. The simultaneous technological advancement and the introduction of new mechanical devices like, elevators, escalators, remotes and vehicles pushed people to a situation of leading a more sedentary life. This study is attempting to evaluate the success of the campaign that introduced through popular social media in the country. Methodology: The Ministry of Health (MoH) has initiated a novel method of campaign activity to generate discussion among public about diabetes. There were mythical monsters introduced through popular social media with disguised messages about the condition of diabetes has generated widespread discussions about the disease among the general public. The characters that started appearing in social media About 600 retweets of the original post was testimonial for the success of the Twitter campaign. The second most successful form of campaign was a video that adopted a very popular approach of using Dark Comedy in which, the diabetes was represented through a twisted negative character that talks about his meticulous plans of how he is going to take the common people into his clutches. This fictional character gained more popularity when introduced into twitter and people started interacting with him raising various questions and challenging his anti-social activities. Major findings: The video generated more than 3,200,000 views ranking 9th in You Tube’s most popular video in Saudi Arabia and was shared 7000 times in a single week. Also, the hashtag got over 4,500,000impressions and over one million visits. Conclusion: Diabetes mellitus in Saudi Arabia is emerging as an epidemic of massive proportions, threatening to negate the benefits of modernization and economic revival. It is highly possible that healthy practices connected with the prevention and management of DM can easily be implemented in a manner that does not conflict with the cultural milieu of Saudi Arabia.

Keywords: campaign, diabetes, Saudi, social media

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184 A Generative Pretrained Transformer-Based Question-Answer Chatbot and Phantom-Less Quantitative Computed Tomography Bone Mineral Density Measurement System for Osteoporosis

Authors: Mian Huang, Chi Ma, Junyu Lin, William Lu

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Introduction: Bone health attracts more attention recently and an intelligent question and answer (QA) chatbot for osteoporosis is helpful for science popularization. With Generative Pretrained Transformer (GPT) technology developing, we build an osteoporosis corpus dataset and then fine-tune LLaMA, a famous open-source GPT foundation large language model(LLM), on our self-constructed osteoporosis corpus. Evaluated by clinical orthopedic experts, our fine-tuned model outperforms vanilla LLaMA on osteoporosis QA task in Chinese. Three-dimensional quantitative computed tomography (QCT) measured bone mineral density (BMD) is considered as more accurate than DXA for BMD measurement in recent years. We develop an automatic Phantom-less QCT(PL-QCT) that is more efficient for BMD measurement since no need of an external phantom for calibration. Combined with LLM on osteoporosis, our PL-QCT provides efficient and accurate BMD measurement for our chatbot users. Material and Methods: We build an osteoporosis corpus containing about 30,000 Chinese literatures whose titles are related to osteoporosis. The whole process is done automatically, including crawling literatures in .pdf format, localizing text/figure/table region by layout segmentation algorithm and recognizing text by OCR algorithm. We train our model by continuous pre-training with Low-rank Adaptation (LoRA, rank=10) technology to adapt LLaMA-7B model to osteoporosis domain, whose basic principle is to mask the next word in the text and make the model predict that word. The loss function is defined as cross-entropy between the predicted and ground-truth word. Experiment is implemented on single NVIDIA A800 GPU for 15 days. Our automatic PL-QCT BMD measurement adopt AI-associated region-of-interest (ROI) generation algorithm for localizing vertebrae-parallel cylinder in cancellous bone. Due to no phantom for BMD calibration, we calculate ROI BMD by CT-BMD of personal muscle and fat. Results & Discussion: Clinical orthopaedic experts are invited to design 5 osteoporosis questions in Chinese, evaluating performance of vanilla LLaMA and our fine-tuned model. Our model outperforms LLaMA on over 80% of these questions, understanding ‘Expert Consensus on Osteoporosis’, ‘QCT for osteoporosis diagnosis’ and ‘Effect of age on osteoporosis’. Detailed results are shown in appendix. Future work may be done by training a larger LLM on the whole orthopaedics with more high-quality domain data, or a multi-modal GPT combining and understanding X-ray and medical text for orthopaedic computer-aided-diagnosis. However, GPT model gives unexpected outputs sometimes, such as repetitive text or seemingly normal but wrong answer (called ‘hallucination’). Even though GPT give correct answers, it cannot be considered as valid clinical diagnoses instead of clinical doctors. The PL-QCT BMD system provided by Bone’s QCT(Bone’s Technology(Shenzhen) Limited) achieves 0.1448mg/cm2(spine) and 0.0002 mg/cm2(hip) mean absolute error(MAE) and linear correlation coefficient R2=0.9970(spine) and R2=0.9991(hip)(compared to QCT-Pro(Mindways)) on 155 patients in three-center clinical trial in Guangzhou, China. Conclusion: This study builds a Chinese osteoporosis corpus and develops a fine-tuned and domain-adapted LLM as well as a PL-QCT BMD measurement system. Our fine-tuned GPT model shows better capability than LLaMA model on most testing questions on osteoporosis. Combined with our PL-QCT BMD system, we are looking forward to providing science popularization and early morning screening for potential osteoporotic patients.

Keywords: GPT, phantom-less QCT, large language model, osteoporosis

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183 Carbon Nanotube-Based Catalyst Modification to Improve Proton Exchange Membrane Fuel Cell Interlayer Interactions

Authors: Ling Ai, Ziyu Zhao, Zeyu Zhou, Xiaochen Yang, Heng Zhai, Stuart Holmes

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Optimizing the catalyst layer structure is crucial for enhancing the performance of proton exchange membrane fuel cells (PEMFCs) with low Platinum (Pt) loading. Current works focused on the utilization, durability, and site activity of Pt particles on support, and performance enhancement has been achieved by loading Pt onto porous support with different morphology, such as graphene, carbon fiber, and carbon black. Some schemes have also incorporated cost considerations to achieve lower Pt loading. However, the design of the catalyst layer (CL) structure in the membrane electrode assembly (MEA) must consider the interactions between the layers. Addressing the crucial aspects of water management, low contact resistance, and the establishment of effective three-phase boundary for MEA, multi-walled carbon nanotubes (MWCNTs) are promising CL support due to their intrinsically high hydrophobicity, high axial electrical conductivity, and potential for ordered alignment. However, the drawbacks of MWCNTs, such as strong agglomeration, wall surface chemical inertness, and unopened ends, are unfavorable for Pt nanoparticle loading, which is detrimental to MEA processing and leads to inhomogeneous CL surfaces. This further deteriorates the utilization of Pt and increases the contact resistance. Robust chemical oxidation or nitrogen doping can introduce polar functional groups onto the surface of MWCNTs, facilitating the creation of open tube ends and inducing defects in tube walls. This improves dispersibility and load capacity but reduces length and conductivity. Consequently, a trade-off exists between maintaining the intrinsic properties and the degree of functionalization of MWCNTs. In this work, MWCNTs were modified based on the operational requirements of the MEA from the viewpoint of interlayer interactions, including the search for the optimal degree of oxidation, N-doping, and micro-arrangement. MWCNT were functionalized by oxidizing, N-doping, as well as micro-alignment to achieve lower contact resistance between CL and proton exchange membrane (PEM), better hydrophobicity, and enhanced performance. Furthermore, this work expects to construct a more continuously distributed three-phase boundary by aligning MWCNT to form a locally ordered structure, which is essential for the efficient utilization of Pt active sites. Different from other chemical oxidation schemes that used HNO3:H2SO4 (1:3) mixed acid to strongly oxidize MWCNT, this scheme adopted pure HNO3 to partially oxidize MWCNT at a lower reflux temperature (80 ℃) and a shorter treatment time (0 to 10 h) to preserve the morphology and intrinsic conductivity of MWCNT. The maximum power density of 979.81 mw cm-2 was achieved by Pt loading on 6h MWCNT oxidation time (Pt-MWCNT6h). This represented a 59.53% improvement over the commercial Pt/C catalyst of 614.17 (mw cm-2). In addition, due to the stronger electrical conductivity, the charge transfer resistance of Pt-MWCNT6h in the electrochemical impedance spectroscopy (EIS) test was 0.09 Ohm cm-2, which was 48.86% lower than that of Pt/C. This study will discuss the developed catalysts and their efficacy in a working fuel cell system. This research will validate the impact of low-functionalization modification of MWCNTs on the performance of PEMFC, which simplifies the preparation challenges of CL and contributing for the widespread commercial application of PEMFCs on a larger scale.

Keywords: carbon nanotubes, electrocatalyst, membrane electrode assembly, proton exchange membrane fuel cell

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182 Understanding the Role of Social Entrepreneurship in Building Mobility of a Service Transportation Models

Authors: Liam Fassam, Pouria Liravi, Jacquie Bridgman

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Introduction: The way we travel is rapidly changing, car ownership and use are declining among young people and those residents in urban areas. Also, the increasing role and popularity of sharing economy companies like Uber highlight a movement towards consuming transportation solutions as a service [Mobility of a Service]. This research looks to bridge the knowledge gap that exists between city mobility, smart cities, sharing economy and social entrepreneurship business models. Understanding of this subject is crucial for smart city design, as access to affordable transport has been identified as a contributing factor to social isolation leading to issues around health and wellbeing. Methodology: To explore the current fit vis-a-vis transportation business models and social impact this research undertook a comparative analysis between a systematic literature review and a Delphi study. The systematic literature review was undertaken to gain an appreciation of the current academic thinking on ‘social entrepreneurship and smart city mobility’. The second phase of the research initiated a Delphi study across a group of 22 participants to review future opinion on ‘how social entrepreneurship can assist city mobility sharing models?’. The Delphi delivered an initial 220 results, which once cross-checked for duplication resulted in 130. These 130 answers were sent back to participants to score importance against a 5-point LIKERT scale, enabling a top 10 listing of areas for shared user transports in society to be gleaned. One further round (4) identified no change in the coefficient of variant thus no further rounds were required. Findings: Initial results of the literature review returned 1,021 journals using the search criteria ‘social entrepreneurship and smart city mobility’. Filtering allied to ‘peer review’, ‘date’, ‘region’ and ‘Chartered associated of business school’ ranking proffered a resultant journal list of 75. Of these, 58 focused on smart city design, 9 on social enterprise in cityscapes, 6 relating to smart city network design and 3 on social impact, with no journals purporting the need for social entrepreneurship to be allied to city mobility. The future inclusion factors from the Delphi expert panel indicated that smart cities needed to include shared economy models in their strategies. Furthermore, social isolation born by costs of infrastructure needed addressing through holistic A-political social enterprise models, and a better understanding of social benefit measurement is needed. Conclusion: In investigating the collaboration between key public transportation stakeholders, a theoretical model of social enterprise transportation models that positively impact upon the smart city needs of reduced transport poverty and social isolation was formed. As such, the research has identified how a revised business model of Mobility of a Service allied to a social entrepreneurship can deliver impactful measured social benefits associated to smart city design existent research.

Keywords: social enterprise, collaborative transportation, new models of ownership, transport social impact

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181 Comparison of Nutritional Status of Asthmatic vs Non-Asthmatic Adults

Authors: Ayesha Mushtaq

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Asthma is a pulmonary disease in which blockade of the airway takes place due to inflammation as a response to certain allergens. Breathing troubles, cough, and dyspnea are one of the few symptoms. Several studies have indicated a significant effect on asthma due to changes in dietary routines. Certain food items, such as oily foods and other materials, are known to cause an increase in the symptoms of asthma. Low dietary intake of fruits and vegetables may be important in relation to asthma prevalence. The objective of this study is to assess and compare the nutritional status of asthmatic and non-asthmatic patients. The significance of this study lies in the factor that it will help nutritionists to arrange a feasible dietary routine for asthmatic patients. This research was conducted at the Pulmonology Department of the Pakistan Institute of Medical Science Islamabad. About thirty hundred thirty-four million people are affected by asthma worldwide. Pakistan is on the verge of being an uplifted urban population and asthma cases are increasingly high these days. Several studies suggest an increase in the Asthmatic patient population due to improper diet. This is a cross-sectional study aimed at assessing the nutritious standing of Asthmatic and non-asthmatic patients. This research took place at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. The research included asthmatic and non-asthmatic patients coming to the pulmonology department clinic at the Pakistan Institute of Medical Sciences (PIMS). These patients were aged between 20-60 years. A questionnaire was developed for these patients to estimate their dietary plans in these patients. The methodology included four sections. The first section was the Socio-Demographic profile, which included age, gender, monthly income and occupation. The next section was anthropometric measurements which included the weight, height and body mass index (BMI) of an individual. The next section, section three, was about the biochemical attributes, such as for biochemical profiling, pulmonary function testing (PFT) was performed. In the next section, Dietary habits were assessed by a food frequency questionnaire (FFQ) through food habits and consumption pattern was assessed. The next section life style data, in which the person's level of physical activity, sleep and smoking habits were assessed. The next section was statistical analysis. All the data obtained from the study were statistically analyzed and assessed. Most of the asthma Patients were females, with weight more than normal or even obese. Body Mass Index (BMI) was higher in asthma Patients than those in non-Asthmatic ones. When the nutritional Values were assessed, we came to know that these patients were low on certain nutrients and their diet included more junk and oily food than healthy vegetables and fruits. Beverages intake was also included in the same assessment. It is evident from this study that nutritional status has a contributory effect on asthma. So, patients on the verge of developing asthma or those who have developed asthma should focus on their diet, maintain good eating habits and take healthy diets, including fruits and vegetables rather than oily foods. Proper sleep may also contribute to the control of asthma.

Keywords: BMI, nutrition, PAL, diet

Procedia PDF Downloads 49
180 Global Service-Learning: Lessons Learned from Teacher Candidates

Authors: Miranda Lin

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This project examined the impact of a globally focused service-learning project implemented in a multicultural education course in a Midwestern university. This project facilitated critical self-reflection and build cross-cultural competence while nurturing a partnership with two schools that serve students with disabilities in Vietnam. Through a service-learning project, pre-service teachers connected via Skype with the principals/teachers at schools in Vietnam to identify and subsequently develop needed instructional materials for students with mild, moderate, and severe disabilities. Qualitative data sources include students’ intercultural competence self-reflection survey (pre-test and post-test), reflections, discussions, service project, and lesson plans. Literature Review- Global service-learning is a teaching strategy that encompasses service experiences both in the local community and abroad. Drawing on elements of global learning and international service-learning, global service-learning experiences are guided by a framework that is designed to support global learning outcomes and involve direct engagement with difference. By engaging in real-world challenges, global service-learning experiences can support the achievement of learning outcomes such as civic. Knowledge and intercultural knowledge and competence. Intercultural competence development is considered essential for cooperative and reciprocal engagement with community partners.Method- Participants (n=27*) were mostly elementary and early childhood pre-service teachers who were enrolled in a multicultural education course. All but one was female. Among the pre-service teachers, one Asian American, two Latinas, and the rest were White. Two pre-service teachers identified themselves as from the low socioeconomic families and the rest were from the middle to upper middle class.The global service-learning project was implemented in the spring of 2018. Two Vietnamese schools that served students with disabilities agreed to be the global service-learning sites. Both schools were located in an urban city.Systematic collection of data coincided with the course schedule as follows: an initial intercultural competence self-reflection survey completed in week one, guided reflections submitted in week 1, 9, and 16, written lesson plans and supporting materials for the service project submitted in week 16, and a final intercultural competence self-reflection survey completed in week 16. Significance-This global service-learning project has helped participants meet Merryfield’s goals in various degrees. They 1) learned knowledge and skills in the basics of instructional planning, 2) used a variety of instructional methods that encourage active learning, meet the different learning styles of students, and are congruent with content and educational goals, 3) gained the awareness and support of their students as individuals and as learners, 4) developed questioning techniques that build higher-level thinking skills, and 5) made progress in critically reflecting on and improving their own teaching and learning as a professional educator as a result of this project.

Keywords: global service-learning, teacher education, intercultural competence, diversity

Procedia PDF Downloads 92
179 Recrystallization Behavior and Microstructural Evolution of Nickel Base Superalloy AD730 Billet during Hot Forging at Subsolvus Temperatures

Authors: Marcos Perez, Christian Dumont, Olivier Nodin, Sebastien Nouveau

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Nickel superalloys are used to manufacture high-temperature rotary engine parts such as high-pressure disks in gas turbine engines. High strength at high operating temperatures is required due to the levels of stress and heat the disk must withstand. Therefore it is necessary parts made from materials that can maintain mechanical strength at high temperatures whilst remain comparatively low in cost. A manufacturing process referred to as the triple melt process has made the production of cast and wrought (C&W) nickel superalloys possible. This means that the balance of cost and performance at high temperature may be optimized. AD730TM is a newly developed Ni-based superalloy for turbine disk applications, with reported superior service properties around 700°C when compared to Inconel 718 and several other alloys. The cast ingot is converted into billet during either cogging process or open die forging. The semi-finished billet is then further processed into its final geometry by forging, heat treating, and machining. Conventional ingot-to-billet conversion is an expensive and complex operation, requiring a significant amount of steps to break up the coarse as-cast structure and interdendritic regions. Due to the size of conventional ingots, it is difficult to achieve a uniformly high level of strain for recrystallization, resulting in non-recrystallized regions that retain large unrecrystallized grains. Non-uniform grain distributions will also affect the ultrasonic inspectability response, which is used to find defects in the final component. The main aim is to analyze the recrystallization behavior and microstructural evolution of AD730 at subsolvus temperatures from a semi-finished product (billet) under conditions representative of both cogging and hot forging operations. Special attention to the presence of large unrecrystallized grains was paid. Double truncated cones (DTCs) were hot forged at subsolvus temperatures in hydraulic press, followed by air cooling. SEM and EBSD analysis were conducted in the as-received (billet) and the as-forged conditions. AD730 from billet alloy presents a complex microstructure characterized by a mixture of several constituents. Large unrecrystallized grains present a substructure characterized by large misorientation gradients with the formation of medium to high angle boundaries in their interior, especially close to the grain boundaries, denoting inhomogeneous strain distribution. A fine distribution of intragranular precipitates was found in their interior, playing a key role on strain distribution and subsequent recrystallization behaviour during hot forging. Continuous dynamic recrystallization (CDRX) mechanism was found to be operating in the large unrecrystallized grains, promoting the formation intragranular DRX grains and the gradual recrystallization of these grains. Evidences that hetero-epitaxial recrystallization mechanism is operating in AD730 billet material were found. Coherent γ-shells around primary γ’ precipitates were found. However, no significant contribution to the overall recrystallization during hot forging was found. By contrast, strain presents the strongest effect on the microstructural evolution of AD730, increasing the recrystallization fraction and refining the structure. Regions with low level of deformation (ε ≤ 0.6) were translated into large fractions of unrecrystallized structures (strain accumulation). The presence of undissolved secondary γ’ precipitates (pinning effect), prior to hot forging operations, could explain these results.

Keywords: AD730 alloy, continuous dynamic recrystallization, hot forging, γ’ precipitates

Procedia PDF Downloads 175
178 Imaging Spectrum of Central Nervous System Tuberculosis on Magnetic Resonance Imaging: Correlation with Clinical and Microbiological Results

Authors: Vasundhara Arora, Anupam Jhobta, Suresh Thakur, Sanjiv Sharma

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Aims and Objectives: Intracranial tuberculosis (TB) is one of the most devastating manifestations of TB and a challenging public health issue of considerable importance and magnitude world over. This study elaborates on the imaging spectrum of neurotuberculosis on magnetic resonance imaging (MRI) in 29 clinically suspected cases from a tertiary care hospital. Materials and Methods: The prospective hospital based evaluation of MR imaging features of neuro-tuberculosis in 29 clinically suspected cases was carried out in Department of Radio-diagnosis, Indira Gandhi Medical Hospital from July 2017 to August 2018. MR Images were obtained on a 1.5 T Magnetom Avanto machine and were analyzed to identify any abnormal meningeal enhancement or parenchymal lesions. Microbiological and Biochemical CSF analysis was performed in radio-logically suspected cases and the results were compared with the imaging data. Clinical follow up of the patients started on anti-tuberculous treatment was done to evaluate the response to treatment and clinical outcome. Results: Age range of patients in the study was between 1 year to 73 years. The mean age of presentation was 11.5 years. No significant difference in the distribution of cerebral tuberculosis was noted among the two genders. Imaging findings of neuro-tuberculosis obtained were varied and non specific ranging from lepto-meningeal enhancement, cerebritis to space occupying lesions such as tuberculomas and tubercular abscesses. Complications presenting as hydrocephalus (n= 7) and infarcts (n=9) was noted in few of these patients. 29 patients showed radiological suspicion of CNS tuberculosis with meningitis alone observed in 11 cases, tuberculomas alone were observed in 4 cases, meningitis with parenchymal tuberculomas in 11 cases. Tubercular abscess and cerebritis were observed in one case each. Tuberculous arachnoiditis was noted in one patient. Gene expert positivity was obtained in 11 out of 29 radiologically suspected patients; none of the patients showed culture positivity. Meningeal form of the disease alone showed higher positivity rate of gene Xpert (n=5) followed by combination of meningeal and parenchymal forms of disease (n=4). The parenchymal manifestation of disease alone showed least positivity rates (n= 3) with gene xpert testing. All 29 patients were started on anti tubercular treatment based on radiological suspicion of the disease with clinical improvement observed in 27 treated patients. Conclusions: In our study, higher incidence of neuro- tuberculosis was noted in paediatric population with predominance of the meningeal form of the disease. Gene Xpert positivity obtained was low due to paucibacillary nature of cerebrospinal fluid (CSF) with even lower positivity of CSF samples in parenchymal form of the manifestation. MRI showed high accuracy in detecting CNS lesions in neuro-tuberculosis. Hence, it can be concluded that MRI plays a crucial role in the diagnosis because of its inherent sensitivity and specificity and is an indispensible imaging modality. It caters to the need of early diagnosis owing to poor sensitivity of microbiological tests more so in the parenchymal manifestation of the disease.

Keywords: neurotuberculosis, tubercular abscess, tuberculoma, tuberculous meningitis

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177 Carbohydrate Intake and Physical Activity Levels Modify the Association between FTO Gene Variants and Obesity and Type 2 Diabetes: First Nutrigenetics Study in an Asian Indian Population

Authors: K. S. Vimal, D. Bodhini, K. Ramya, N. Lakshmipriya, R. M. Anjana, V. Sudha, J. A. Lovegrove, V. Mohan, V. Radha

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Gene-lifestyle interaction studies have been carried out in various populations. However, to date there are no studies in an Asian Indian population. Hence, we examined whether lifestyle factors such as diet and physical activity modify the association between fat mass and obesity–associated (FTO) gene variants and obesity and type 2 diabetes (T2D) in an Asian Indian population. We studied 734 unrelated T2D and 884 normal glucose-tolerant (NGT) participants randomly selected from the Chennai Urban Rural Epidemiology Study (CURES) in Southern India. Obesity was defined according to the World Health Organization Asia Pacific Guidelines (non-obese, BMI < 25 kg/m2; obese, BMI ≥ 25 kg/m2). Six single nucleotide polymorphisms (SNPs) in the FTO gene (rs9940128, rs7193144, rs8050136, rs918031, rs1588413 and rs11076023) identified from recent genome-wide association studies for T2D were genotyped by polymerase chain reaction-restriction fragment length polymorphism and direct sequencing. Dietary assessment was carried out using a validated food frequency questionnaire and physical activity was based upon the self-report. Interaction analyses were performed by including the interaction terms in the model. A joint likelihood ratio test of the main SNP effects and the SNP-diet/physical activity interaction effects was used in the linear regression analyses to maximize statistical power. Statistical analyses were performed using STATA version 13. There was a significant interaction between FTO SNP rs8050136 and carbohydrate energy percentage (Pinteraction=0.04) on obesity, where the ‘A’ allele carriers of the SNP rs8050136 had 2.46 times higher risk of obesity than those with ‘CC’ genotype (P=3.0x10-5) among individuals in the highest tertile of carbohydrate energy percentage. Furthermore, among those who had lower levels of physical activity, the ‘A’ allele carriers of the SNP rs8050136 had 1.89 times higher risk of obesity than those with ‘CC’ genotype (P=4.0x10-5). We also found a borderline interaction between SNP rs11076023 and carbohydrate energy percentage (Pinteraction=0.08) on T2D, where the ‘A’ allele carriers in the highest tertile of carbohydrate energy percentage, had 1.57 times higher risk of T2D than those with ‘TT’ genotype (P=0.002). There was also a significant interaction between SNP rs11076023 and physical activity (Pinteraction=0.03) on T2D. No further significant interactions between SNPs and macronutrient intake or physical activity on obesity and T2D were observed. In conclusion, this is the first study to provide evidence for a gene-diet and gene-physical activity interaction on obesity and T2D in an Asian Indian population. These findings suggest that the association between FTO gene variants and obesity and T2D is influenced by carbohydrate intake and physical activity levels. Greater understanding of how FTO gene influences obesity and T2D through dietary and exercise interventions will advance the development of behavioral intervention and personalised lifestyle strategies predicted to reduce the development of metabolic diseases in ‘A’ allele carriers of both SNPs in this Asian Indian population.

Keywords: dietary intake, FTO, obesity, physical activity, type 2 diabetes, Asian Indian.

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176 Review of the Nutritional Value of Spirulina as a Potential Replacement of Fishmeal in Aquafeed

Authors: Onada Olawale Ahmed

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As the intensification of aquaculture production increases on global scale, the growing concern of fish farmers around the world is related to cost of fish production, where cost of feeding takes substantial percentage. Fishmeal (FM) is one of the most expensive ingredients, and its high dependence in aqua-feed production translates to high cost of feeding of stocked fish. However, to reach a sustainable aquaculture, new alternative protein sources including cheaper plant or animal origin proteins are needed to be introduced for stable aqua-feed production. Spirulina is a cyanobacterium that has good nutrient profile that could be useful in aquaculture. This review therefore emphasizes on the nutritional value of Spirulina as a potential replacement of FM in aqua-feed. Spirulina is a planktonic photosynthetic filamentous cyanobacterium that forms massive populations in tropical and subtropical bodies of water with high levels of carbonate and bicarbonate. Spirulina grows naturally in nutrient rich alkaline lake with water salinity ( > 30 g/l) and high pH (8.5–11.0). Its artificial production requires luminosity (photo-period 12/12, 4 luxes), temperature (30 °C), inoculum, water stirring device, dissolved solids (10–60 g/litre), pH (8.5– 10.5), good water quality, and macro and micronutrient presence (C, N, P, K, S, Mg, Na, Cl, Ca and Fe, Zn, Cu, Ni, Co, Se). Spirulina has also been reported to grow on agro-industrial waste such as sugar mill waste effluent, poultry industry waste, fertilizer factory waste, and urban waste and organic matter. Chemical composition of Spirulina indicates that it has high nutritional value due to its content of 55-70% protein, 14-19% soluble carbohydrate, high amount of polyunsaturated fatty acids (PUFAs), 1.5–2.0 percent of 5–6 percent total lipid, all the essential minerals are available in spirulina which contributes about 7 percent (average range 2.76–3.00 percent of total weight) under laboratory conditions, β-carotene, B-group vitamin, vitamin E, iron, potassium and chlorophyll are also available in spirulina. Spirulina protein has a balanced composition of amino acids with concentration of methionine, tryptophan and other amino acids almost similar to those of casein, although, this depends upon the culture media used. Positive effects of spirulina on growth, feed utilization and stress and disease resistance of cultured fish have been reported in earlier studies. Spirulina was reported to replace up to 40% of fishmeal protein in tilapia (Oreochromis mossambicus) diet and even higher replacement of fishmeal was possible in common carp (Cyprinus carpio), partial replacement of fish meal with spirulina in diets for parrot fish (Oplegnathus fasciatus) and Tilapia (Orechromis niloticus) has also been conducted. Spirulina have considerable potential for development, especially as a small-scale crop for nutritional enhancement and health improvement of fish. It is important therefore that more research needs to be conducted on its production, inclusion level in aqua-feed and its possible potential use of aquaculture.

Keywords: aquaculture, spirulina, fish nutrition, fish feed

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175 Metal Contents in Bird Feathers (Columba livia) from Mt Etna Volcano: Volcanic Plume Contribution and Biological Fractionation

Authors: Edda E. Falcone, Cinzia Federico, Sergio Bellomo, Lorenzo Brusca, Manfredi Longo, Walter D’Alessandro

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Although trace metals are an essential element for living beings, they can become toxic at high concentrations. Their potential toxicity is related not only to the total content in the environment but mostly upon their bioavailability. Volcanoes are important natural metal emitters and they can deeply affect the quality of air, water and soils, as well as the human health. Trace metals tend to accumulate in the tissues of living organisms, depending on the metal contents in food, air and water and on the exposure time. Birds are considered as bioindicators of interest, because their feathers directly reflects the metals uptake from the blood. Birds are exposed to the atmospheric pollution through the contact with rainfall, dust, and aerosol, and they accumulate metals over the whole life cycle. We report on the first data combining the rainfall metal content in three different areas of Mt Etna, variably fumigated by the volcanic plume, and the metal contents in the feathers of pigeons, collected in the same areas. Rainfall samples were collected from three rain gauges placed at different elevation on the Eastern flank of the volcano, the most exposed to airborne plume, filtered, treated with HNO₃ Suprapur-grade and analyzed for Fe, Cr, Co, Ni, Se, Zn, Cu, Sr, Ba, Cd and As by ICP-MS technique, and major ions by ion chromatography. Feathers were collected from single individuals, in the same areas where the rain gauges were installed. Additionally, some samples were collected in an urban area, poorly interested by the volcanic plume. The samples were rinsed in MilliQ water and acetone, dried at 50°C until constant weight and digested in a mixture of 2:1 HNO₃ (65%) - H₂O₂ (30%) Suprapur-grade for 25-50 mg of sample, in a bath at near-to-boiling temperature. The solutions were diluted up to 20 ml prior to be analyzed by ICP-MS. The rainfall samples most contaminated by the plume were collected at close distance from the summit craters (less than 6 km), and show lower pH values and higher concentrations for all analyzed metals relative to those from the sites at lower elevation. Analyzed samples are enriched in both metals directly emitted by the volcanic plume and transported by acidic gases (SO₂, HCl, HF), and metals leached from the airborne volcanic ash. Feathers show different patterns in the different sites related to the exposure to natural or anthropogenic pollutants. They show abundance ratios similar to rainfall for lithophile elements (Ba, Sr), whereas are enriched in Zn and Se, known for their antioxidant properties, probably as adaptive response to oxidative stress induced by toxic metal exposure. The pigeons revealed a clear heterogeneity of metal uptake in the different parts of the volcano, as an effect of volcanic plume impact. Additionally, some physiological processes can modify the fate of some metals after uptake and this offer some insights for translational studies.

Keywords: bioindicators, environmental pollution, feathers, trace metals, volcanic plume

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174 Characterization of Agroforestry Systems in Burkina Faso Using an Earth Observation Data Cube

Authors: Dan Kanmegne

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Africa will become the most populated continent by the end of the century, with around 4 billion inhabitants. Food security and climate changes will become continental issues since agricultural practices depend on climate but also contribute to global emissions and land degradation. Agroforestry has been identified as a cost-efficient and reliable strategy to address these two issues. It is defined as the integrated management of trees and crops/animals in the same land unit. Agroforestry provides benefits in terms of goods (fruits, medicine, wood, etc.) and services (windbreaks, fertility, etc.), and is acknowledged to have a great potential for carbon sequestration; therefore it can be integrated into reduction mechanisms of carbon emissions. Particularly in sub-Saharan Africa, the constraint stands in the lack of information about both areas under agroforestry and the characterization (composition, structure, and management) of each agroforestry system at the country level. This study describes and quantifies “what is where?”, earliest to the quantification of carbon stock in different systems. Remote sensing (RS) is the most efficient approach to map such a dynamic technology as agroforestry since it gives relatively adequate and consistent information over a large area at nearly no cost. RS data fulfill the good practice guidelines of the Intergovernmental Panel On Climate Change (IPCC) that is to be used in carbon estimation. Satellite data are getting more and more accessible, and the archives are growing exponentially. To retrieve useful information to support decision-making out of this large amount of data, satellite data needs to be organized so to ensure fast processing, quick accessibility, and ease of use. A new solution is a data cube, which can be understood as a multi-dimensional stack (space, time, data type) of spatially aligned pixels and used for efficient access and analysis. A data cube for Burkina Faso has been set up from the cooperation project between the international service provider WASCAL and Germany, which provides an accessible exploitation architecture of multi-temporal satellite data. The aim of this study is to map and characterize agroforestry systems using the Burkina Faso earth observation data cube. The approach in its initial stage is based on an unsupervised image classification of a normalized difference vegetation index (NDVI) time series from 2010 to 2018, to stratify the country based on the vegetation. Fifteen strata were identified, and four samples per location were randomly assigned to define the sampling units. For safety reasons, the northern part will not be part of the fieldwork. A total of 52 locations will be visited by the end of the dry season in February-March 2020. The field campaigns will consist of identifying and describing different agroforestry systems and qualitative interviews. A multi-temporal supervised image classification will be done with a random forest algorithm, and the field data will be used for both training the algorithm and accuracy assessment. The expected outputs are (i) map(s) of agroforestry dynamics, (ii) characteristics of different systems (main species, management, area, etc.); (iii) assessment report of Burkina Faso data cube.

Keywords: agroforestry systems, Burkina Faso, earth observation data cube, multi-temporal image classification

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173 Forests, the Sanctuaries to Specialist and Rare Wild Native Bees at the Foothills of Western Himalayas

Authors: Preeti Virkar, V. P. Uniyal, Vinod Kumar Bhatt

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With 50% decline in managed honey bee hives in the continents of Europe and America, farmers and landscape managers are turning to native wild bees for their essential ecosystem services of pollination. Wild bees population are too under danger due to the rapid land use changes from anthropogenic activities. With an escalating population reaching 9.0 billion by 2050, human-induced land use changes are predicted to further deteriorate the habitats of numerous species by the turn of this century. The status of bees are uncertain, especially in the tropical regions of the world, which also questions the crisis of global pollinator decline and their essential services to wild and managed flora. Our investigation collectively compares wild native bee diversity and their status in forests and agroecosystems in Doon Valley landscape, situated at the foothills of Himalayan ranges, Uttarakhand, India. We seek to ask whether (1) natural habitat are refuge to richer and rarer bees communities than the agroecosystems, (2) Are agroecosystems closer to natural habitats similar to them than agroecosystems farther away; hence support richer bee communities and hence, (3) Do polyculture farms support richer bee communities than monoculture. The data was collected using observation and pantrap sampling form February to May, 2012 to 2014. We recorded 43 species of bees in Doon Valley. They belonged to 5 families; Megachilidae, Apidae, Andrenidae, Halictidae and Collitidae. A multinomial model approach was used to classify the bees into 2 habitats, in which forests demonstrated to support greater number of specialist (26%, n= 11) species than agroecosystems (7%, n= 3). The valley had many species categorized as the rare (58%, n= 25) and very few generalists (9%, n=4). A linear regression model run on our data demonstrated higher bee diversity in agro-ecosystems in close proximity to forests (H’ for < 200 m = 1.60) compared to those further away (H’ for > 600 m = 0.56) (R2=0.782, SE=0.148, p value=0.004). Organic agriculture supported significantly greater species richness in comparison to conventional farms (Mann-Whitney U test, n1 = 33, n2 = 35; P = 0.001). Forests ecosystems are refuge to rare specialist groups and support bee communities in nearby agroecosystems. The findings of our investigation demonstrate the importance of natural habitats as a potential refuge for rare native wild bee pollinators. Polyculture in the valley behaves similar to natural habitats and supports diverse bee communities in comparison to conventional monocultures. Our study suggests that the farming communities adopt diverse organic agriculture systems to attract wild pollinators beneficial for better crop production. Forests are sanctuaries for bees to nest, forage, and breed. Therefore, our outcome also suggests landscape managers not only preserve protected areas but also enhance the floral diversity in semi-natural and urban areas.

Keywords: native bees, pollinators, polyculture, agroecosystem, natural habitat, diversity, monoculture, specialists, generalists

Procedia PDF Downloads 180
172 Isolation and Identification of Low-Temperature Tolerant-Yeast Strains from Apple with Biocontrol Activity

Authors: Lachin Mikjtarnejad, Mohsen Farzaneh

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Various microbes, such as fungi and bacteria species, are naturally found in the fruit microbiota, and some of them act as a pathogen and result in fruit rot. Among non-pathogenic microbes, yeasts (single-celled microorganisms belonging to the fungi kingdom) can colonize fruit tissues and interact with them without causing any damage to them. Although yeasts are part of the plant microbiota, there is little information about their interactions with plants in comparison with bacteria and filamentous fungi. According to several existing studies, some yeasts can colonize different plant species and have the biological control ability to suppress some of the plant pathogens. It means those specific yeast-colonized plants are more resistant to some plant pathogens. The major objective of the present investigation is to isolate yeast strains from apple fruit and screen their ability to control Penicillium expansum, the causal agent of blue mold of fruits. In the present study, psychrotrophic and epiphytic yeasts were isolated from apple fruits that were stored at low temperatures (0–1°C). Totally, 42 yeast isolates were obtained and identified by molecular analysis based on genomic sequences of the D1/D2 and ITS1/ITS4 regions of their rDNA. All isolated yeasts were primarily screened by' in vitro dual culture assay against P. expansum by measuring the fungus' relative growth inhibition after 10 days of incubation. The results showed that the mycelial growth of P. expansum was reduced between 41–53% when challenged by promising yeast strains. The isolates with the strongest antagonistic activity belonged to Metschnikowia pulcherrima A13, Rhodotorula mucilaginosa A41, Leucosporidium Scottii A26, Aureobasidium pullulans A19, Pichia guilliermondii A32, Cryptococcus flavescents A25, and Pichia kluyveri A40. The results of seven superior isolates to inhibit blue mold decay on fruit showed that isolates A. pullulans A19, L. scottii A26, and Pi. guilliermondii A32 could significantly reduce the fruit rot and decay with 26 mm, 22 mm and 20 mm zone diameter, respectively, compared to the control sample with 43 mm. Our results show Pi. guilliermondii strain A13 was the most effective yeast isolates in inhibiting P. expansum on apple fruits. In addition, various biological control mechanisms of promising biological isolates against blue mold have been evaluated to date, including competition for nutrients and space, production of volatile metabolites, reduction of spore germination, production of siderophores and production of extracellular lytic enzymes such as chitinase and β-1,3-glucanase. However, the competition for nutrients and the ability to inhibit P. expansum spore growth have been introduced as the prevailing mechanisms among them. Accordingly, in our study, isolates A13, A41, A40, A25, A32, A19 and A26 inhibited the germination of P. expansum, whereas isolates A13 and A19 were the strongest inhibitors of P. expansum mycelia growth, causing 89.13% and 81.75 % reduction in the mycelial surface, respectively. All the promising isolates produced chitinase and β-1,3-glucanase after 3, 5 and 7 days of cultivation. Finally, based on our findings, we are proposing that, Pi. guilliermondiias as an effective biocontrol agent and alternative to chemical fungicides to control the blue mold of apple fruit.

Keywords: yeast, yeast enzymes, biocontrol, post harvest diseases

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171 National Digital Soil Mapping Initiatives in Europe: A Review and Some Examples

Authors: Dominique Arrouays, Songchao Chen, Anne C. Richer-De-Forges

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Soils are at the crossing of many issues such as food and water security, sustainable energy, climate change mitigation and adaptation, biodiversity protection, human health and well-being. They deliver many ecosystem services that are essential to life on Earth. Therefore, there is a growing demand for soil information on a national and global scale. Unfortunately, many countries do not have detailed soil maps, and, when existing, these maps are generally based on more or less complex and often non-harmonized soil classifications. An estimate of their uncertainty is also often missing. Thus, there are not easy to understand and often not properly used by end-users. Therefore, there is an urgent need to provide end-users with spatially exhaustive grids of essential soil properties, together with an estimate of their uncertainty. One way to achieve this is digital soil mapping (DSM). The concept of DSM relies on the hypothesis that soils and their properties are not randomly distributed, but that they depend on the main soil-forming factors that are climate, organisms, relief, parent material, time (age), and position in space. All these forming factors can be approximated using several exhaustive spatial products such as climatic grids, remote sensing products or vegetation maps, digital elevation models, geological or lithological maps, spatial coordinates of soil information, etc. Thus, DSM generally relies on models calibrated with existing observed soil data (point observations or maps) and so-called “ancillary co-variates” that come from other available spatial products. Then the model is generalized on grids where soil parameters are unknown in order to predict them, and the prediction performances are validated using various methods. With the growing demand for soil information at a national and global scale and the increase of available spatial co-variates national and continental DSM initiatives are continuously increasing. This short review illustrates the main national and continental advances in Europe, the diversity of the approaches and the databases that are used, the validation techniques and the main scientific and other issues. Examples from several countries illustrate the variety of products that were delivered during the last ten years. The scientific production on this topic is continuously increasing and new models and approaches are developed at an incredible speed. Most of the digital soil mapping (DSM) products rely mainly on machine learning (ML) prediction models and/or the use or pedotransfer functions (PTF) in which calibration data come from soil analyses performed in labs or for existing conventional maps. However, some scientific issues remain to be solved and also political and legal ones related, for instance, to data sharing and to different laws in different countries. Other issues related to communication to end-users and education, especially on the use of uncertainty. Overall, the progress is very important and the willingness of institutes and countries to join their efforts is increasing. Harmonization issues are still remaining, mainly due to differences in classifications or in laboratory standards between countries. However numerous initiatives are ongoing at the EU level and also at the global level. All these progress are scientifically stimulating and also promissing to provide tools to improve and monitor soil quality in countries, EU and at the global level.

Keywords: digital soil mapping, global soil mapping, national and European initiatives, global soil mapping products, mini-review

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170 Stuck Spaces as Moments of Learning: Uncovering Threshold Concepts in Teacher Candidate Experiences of Teaching in Inclusive Classrooms

Authors: Joy Chadwick

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There is no doubt that classrooms of today are more complex and diverse than ever before. Preparing teacher candidates to meet these challenges is essential to ensure the retention of teachers within the profession and to ensure that graduates begin their teaching careers with the knowledge and understanding of how to effectively meet the diversity of students they will encounter. Creating inclusive classrooms requires teachers to have a repertoire of effective instructional skills and strategies. Teachers must also have the mindset to embrace diversity and value the uniqueness of individual students in their care. This qualitative study analyzed teacher candidates' experiences as they completed a fourteen-week teaching practicum while simultaneously completing a university course focused on inclusive pedagogy. The research investigated the challenges and successes teacher candidates had in navigating the translation of theory related to inclusive pedagogy into their teaching practice. Applying threshold concept theory as a framework, the research explored the troublesome concepts, liminal spaces, and transformative experiences as connected to inclusive practices. Threshold concept theory suggests that within all disciplinary fields, there exists particular threshold concepts that serve as gateways or portals into previously inaccessible ways of thinking and practicing. It is in these liminal spaces that conceptual shifts in thinking and understanding and deep learning can occur. The threshold concept framework provided a lens to examine teacher candidate struggles and successes with the inclusive education course content and the application of this content to their practicum experiences. A qualitative research approach was used, which included analyzing twenty-nine course reflective journals and six follow up one-to-one semi structured interviews. The journals and interview transcripts were coded and themed using NVivo software. Threshold concept theory was then applied to the data to uncover the liminal or stuck spaces of learning and the ways in which the teacher candidates navigated those challenging places of teaching. The research also sought to uncover potential transformative shifts in teacher candidate understanding as connected to teaching in an inclusive classroom. The findings suggested that teacher candidates experienced difficulties when they did not feel they had the knowledge, skill, or time to meet the needs of the students in the way they envisioned they should. To navigate the frustration of this thwarted vision, they relied on present and previous course content and experiences, collaborative work with other teacher candidates and their mentor teachers, and a proactive approach to planning for students. Transformational shifts were most evident in their ability to reframe their perceptions of children from a deficit or disability lens to a strength-based belief in the potential of students. It was evident that through their course work and practicum experiences, their beliefs regarding struggling students shifted as they saw the value of embracing neurodiversity, the importance of relationships, and planning for and teaching through a strength-based approach. Research findings have implications for teacher education programs and for understanding threshold concepts theory as connected to practice-based learning experiences.

Keywords: inclusion, inclusive education, liminal space, teacher education, threshold concepts, troublesome knowledge

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169 Knowledge Based Software Model for the Management and Treatment of Malaria Patients: A Case of Kalisizo General Hospital

Authors: Mbonigaba Swale

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Malaria is an infection or disease caused by parasites (Plasmodium Falciparum — causes severe Malaria, plasmodium Vivax, Plasmodium Ovale, and Plasmodium Malariae), transmitted by bites of infected anopheles (female) mosquitoes to humans. These vectors comprise of two types in Africa, particularly in Uganda, i.e. anopheles fenestus and Anopheles gambaie (‘example Anopheles arabiensis,,); feeds on man inside the house mainly at dusk, mid-night and dawn and rests indoors and makes them effective transmitters (vectors) of the disease. People in both urban and rural areas have consistently become prone to repetitive attacks of malaria, causing a lot of deaths and significantly increasing the poverty levels of the rural poor. Malaria is a national problem; it causes a lot of maternal pre-natal and antenatal disorders, anemia in pregnant mothers, low birth weights for the newly born, convulsions and epilepsy among the infants. Cumulatively, it kills about one million children every year in sub-Saharan Africa. It has been estimated to account for 25-35% of all outpatient visits, 20-45% of acute hospital admissions and 15-35% of hospital deaths. Uganda is the leading victim country, for which Rakai and Masaka districts are the most affected. So, it is not clear whether these abhorrent situations and episodes of recurrences and failure to cure from the disease are a result of poor diagnosis, prescription and dosing, treatment habits and compliance of the patients to the drugs or the ethical domain of the stake holders in relation to the main stream methodology of malaria management. The research is aimed at offering an alternative approach to manage and deal absolutely with problem by using a knowledge based software model of Artificial Intelligence (Al) that is capable of performing common-sense and cognitive reasoning so as to take decisions like the human brain would do to provide instantaneous expert solutions so as to avoid speculative simulation of the problem during differential diagnosis in the most accurate and literal inferential aspect. This system will assist physicians in many kinds of medical diagnosis, prescribing treatments and doses, and in monitoring patient responses, basing on the body weight and age group of the patient, it will be able to provide instantaneous and timely information options, alternative ways and approaches to influence decision making during case analysis. The computerized system approach, a new model in Uganda termed as “Software Aided Treatment” (SAT) will try to change the moral and ethical approach and influence conduct so as to improve the skills, experience and values (social and ethical) in the administration and management of the disease and drugs (combination therapy and generics) by both the patient and the health worker.

Keywords: knowledge based software, management, treatment, diagnosis

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168 Child Sexual Abuse Prevention: Evaluation of the Program “Sharing Mouth to Mouth: My Body, Nobody Can Touch It”

Authors: Faride Peña, Teresita Castillo, Concepción Campo

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Sexual violence, and particularly child sexual abuse, is a serious problem all over the world, México included. Given its importance, there are several preventive and care programs done by the government and the civil society all over the country but most of them are developed in urban areas even though these problems are especially serious in rural areas. Yucatán, a state in southern México, occupies one of the first places in child sexual abuse. Considering the above, the University Unit of Clinical Research and Victimological Attention (UNIVICT) of the Autonomous University of Yucatan, designed, implemented and is currently evaluating the program named “Sharing Mouth to Mouth: My Body, Nobody Can Touch It”, a program to prevent child sexual abuse in rural communities of Yucatán, México. Its aim was to develop skills for the detection of risk situations, providing protection strategies and mechanisms for prevention through culturally relevant psycho-educative strategies to increase personal resources in children, in collaboration with parents, teachers, police and municipal authorities. The diagnosis identified that a particularly vulnerable population were children between 4 and 10 years. The program run during 2015 in primary schools in the municipality whose inhabitants are mostly Mayan. The aim of this paper is to present its evaluation in terms of its effectiveness and efficiency. This evaluation included documental analysis of the work done in the field, psycho-educational and recreational activities with children, evaluation of knowledge by participating children and interviews with parents and teachers. The results show high efficiency in fulfilling the tasks and achieving primary objectives. The efficiency shows satisfactory results but also opportunity areas that can be resolved with minor adjustments to the program. The results also show the importance of including culturally relevant strategies and activities otherwise it minimizes possible achievements. Another highlight is the importance of participatory action research in preventive approaches to child sexual abuse since by becoming aware of the importance of the subject people participate more actively; in addition to design culturally appropriate strategies and measures so that the proposal may not be distant to the people. Discussion emphasizes the methodological implications of prevention programs (convenience of using participatory action research (PAR), importance of monitoring and mediation during implementation, developing detection skills tools in creative ways using psycho-educational interactive techniques and working assessment issued by the participants themselves). As well, it is important to consider the holistic character this type of program should have, in terms of incorporating social and culturally relevant characteristics, according to the community individuality and uniqueness, consider type of communication to be used and children’ language skills considering that there should be variations strongly linked to a specific cultural context.

Keywords: child sexual abuse, evaluation, PAR, prevention

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167 Exploring 3-D Virtual Art Spaces: Engaging Student Communities Through Feedback and Exhibitions

Authors: Zena Tredinnick-Kirby, Anna Divinsky, Brendan Berthold, Nicole Cingolani

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Faculty members from The Pennsylvania State University, Zena Tredinnick-Kirby, Ph.D., and Anna Divinsky are at the forefront of an innovative educational approach to improve access in asynchronous online art courses. Their pioneering work weaves virtual reality (VR) technologies to construct a more equitable educational experience for students by transforming their learning and engagement. The significance of their study lies in the need to bridge the digital divide in online art courses, making them more inclusive and interactive for all distance learners. In an era where conventional classroom settings are no longer the sole means of instruction, Tredinnick-Kirby and Divinsky harness the power of instructional technologies to break down geographical barriers by incorporating an interactive VR experience that facilitates community building within an online environment transcending physical constraints. The methodology adopted by Tredinnick-Kirby, and Divinsky is centered around integrating 3D virtual spaces into their art courses. Spatial.io, a virtual world platform, enables students to develop digital avatars and engage in virtual art museums through a free browser-based program or an Oculus headset, where they can interact with other visitors and critique each other’s artwork. The goal is not only to provide students with an engaging and immersive learning experience but also to nourish them with a more profound understanding of the language of art criticism and technology. Furthermore, the study aims to cultivate critical thinking skills among students and foster a collaborative spirit. By leveraging cutting-edge VR technology, students are encouraged to explore the possibilities of their field, experimenting with innovative tools and techniques. This approach not only enriches their learning experience but also prepares them for a dynamic and ever-evolving art landscape in technology and education. One of the fundamental objectives of Tredinnick-Kirby and Divinsky is to remodel how feedback is derived through peer-to-peer art critique. Through the inclusion of 3D virtual spaces into the curriculum, students now have the opportunity to install their final artwork in a virtual gallery space and incorporate peer feedback, enabling students to exhibit their work opening the doors to a collaborative and interactive process. Students can provide constructive suggestions, engage in discussions, and integrate peer commentary into developing their ideas and praxis. This approach not only accelerates the learning process but also promotes a sense of community and growth. In summary, the study conducted by the Penn State faculty members Zena Tredinnick-Kirby, and Anna Divinsky represents innovative use of technology in their courses. By incorporating 3D virtual spaces, they are enriching the learners' experience. Through this inventive pedagogical technique, they nurture critical thinking, collaboration, and the practical application of cutting-edge technology in art. This research holds great promise for the future of online art education, transforming it into a dynamic, inclusive, and interactive experience that transcends the confines of distance learning.

Keywords: Art, community building, distance learning, virtual reality

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166 An Alternative to Problem-Based Learning in a Post-Graduate Healthcare Professional Programme

Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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165 Correlates of Comprehensive HIV/AIDS Knowledge and Acceptance Attitude Towards People Living with HIV/AIDS: A Cross-Sectional Study among Unmarried Young Women in Uganda

Authors: Tesfaldet Mekonnen Estifanos, Chen Hui, Afewerki Weldezgi

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Background: Youth in general and young females in particular, remain at the center of the HIV/AIDS epidemic. Sexual risk-taking among young unmarried women is relatively high and are the most vulnerable and highly exposed to HIV/AIDS. Improvements in the status of HIV/AIDS knowledge and acceptance attitude towards people living with HIV (PLWHIV) plays a great role in averting the incidence of HIV/AIDS. Thus, the aim of the study was to explore the level and correlates of HIV/AIDS knowledge and accepting attitude toward PLWHIV. Methods: A cross-sectional study was conducted using data from the Uganda Demographic Health Survey 2016 (UDHS-2016). National level representative household surveys using a multistage cluster probability sampling method, face to face interviews with standard questionnaires were performed. Unmarried women aged 15-24 years with a sample size of 2019 were selected from the total sample of 8674 women aged 15-49 years and were analyzed using SPSS version 23. Independent variables such as age, religion, educational level, residence, and wealth index were included. Two binary outcome variables (comprehensive HIV/AIDS knowledge and acceptance attitude toward PLWHIV) were utilized. We used the chi-square test as well as multivariate regression analysis to explore correlations of explanatory variables with the outcome variables. The results were reported by odds ratios (OR) with 95% confidence interval (95% CI), taking a p-value less than 0.05 as significant. Results: Almost all (99.3%) of the unmarried women aged 15-24 years were aware of HIV/AIDS, but only 51.2% had adequate comprehensive knowledge on HIV/AIDS. Only 69.4% knew both methods: using a condom every time had sex, and having only one faithful uninfected partner can prevent HIV/AIDS transmission. About 66.6% of the unmarried women reject at least two common local misconceptions about HIV/AIDS. Moreover, an alarmingly few (20.3%) of the respondents had a positive acceptance attitude to PLWHIV. On multivariate analysis, age (20-24 years), living in urban, being educated and wealthier, were predictors of having adequate comprehensive HIV/AIDS knowledge. On the other hand, research participants with adequate comprehensive knowledge about HIV/AIDS were highly likely (OR, 1.94 95% CI, 1.52-2.46) to have a positive acceptance attitude to PLWHIV than those with inadequate knowledge. Respondents with no education, Muslim, and Pentecostal religion were emerged less likely to have a positive acceptance attitude to PLWHIV. Conclusion: This study found out the highly accepted level of awareness, but the knowledge and positive acceptance attitude are not encouraging. Thus, expanding access to comprehensive sexuality and strengthening educational campaigns on HIV/AIDS in communities, health facilities, and schools is needed with a greater focus on disadvantaged women having low educational level, poor socioeconomic status, and those residing in rural areas. Sexual risk behaviors among the most affected people - young women have also a role in the spread of HIV/AIDS. Hence, further research assessing the significant contributing factors for sexual risk-taking might have a positive impact on the fight against HIV/AIDS.

Keywords: acceptance attitude, HIV/AIDS, knowledge, unmarried women

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164 Flood Analysis of Domestic Rooftop Rainwater Harvesting in Low Lying Flood Plain Areas at Gomti Nagar In Rain-Dominated Monsoon Climates

Authors: Rajkumar Ghosh

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Rapid urbanization, rising population, changing lifestyles and in-migration, Lucknow is groundwater over-exploited area, with an abstract rate of 1968 m3/day/km2 in Gomti Nagar. The groundwater situation in Gomti Nagar is deteriorating day-by-day. According to the work, the calculated annual water deficiency in Gomti Nagar area will be 28061 Million Litre (ML) in 2022. Within 30 yrs., the water deficiency will be 735570 ML (till 2051). The calculated groundwater recharge in Gomti Nagar was 10813 ML/y (in 2022). The annual groundwater abstraction from Gomti Nagar area was 35332 ML/yr. (in 2022). Bye-laws (≥ 300 sq.m) existing RTRWHs can recharge 17.71 ML/yr. in Gomti Nagar area. The existing RTRWHs are contributing 0.07% for recharging groundwater table. In Gomti Nagar, the water level is dropping at a rate of 1.0 metre per year, and the depth of the water table is less than 30 metre below ground level (mbgl). Natural groundwater recharge is affected by the geomorphological conditions of the surrounding area. Gomti Nagar is located on the erosional terrace (Te) and depositional terrace (d) of the Gomti River. The flood plain in Lucknow city is less active due to the embankments on the both sides of the Gomti River. The alluvium is composed of clay sandy up to a depth of 30m, and the alignment of the Gomti River reveals the presence of sandy soil at shallow depths. Aquifer depth 120 metre. Recharge as in Gomti Nagar (it may vary) 0 – 150 metre. Infiltration rates in alluvial floodplains range from 0.8 to 74 cm/hr. Geologically and Geomorphologically support rapid percolation of rainwater through alluvium in Gomti Nagar, Lucknow city, Uttar Pradesh. Over-exploitation of groundwater causes natural hazards viz. land subsidence, development of cracks on roads and buildings, development of vacuum and compactness of soil/clay which leads towards land subsidence, devastating effects on natural stream flow. Gomti River already transitioning phase from ‘effluent’ to ‘influent’, and saline intrusion in Aquifer –II (among Five aquifers in Lucknow city). A 250 m long crack developed in 2007 due to groundwater depletion in Dullu Khera and Vader Khera village of Kakori, Uttar Pradesh. The groundwater table of Lucknow is declining and water table imbalance occurs due to 17 times less recharge than groundwater exploitation. Uttar Pradesh along with four states have extracted 49% of groundwater in the entire country. In Gomti Nagar area, 27305 no of houses are present and available build up area 3.8 sq. km (60% of plot area) based on Lucknow Development Authority (LDA) Master plan 2031. If RTRWHs would install in all the houses, then 12% harvested rainwater contribute to the water table in Gomti Nagar area. Till 2051, Gomti Nagar area will harvest 91110 ML of rainwater. There are minimalistic chances that any incidence of flood can occur due to RTRWH. Thus, it can conclud that RTRWH is not related to flood happening in urban areas viz. Gomti Nagar.

Keywords: RTRWH, aquifer, groundwater table, rainwater, infiltration

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