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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. Other studies conducted at different institutions have conducted research on similar topics. These studies have suggested that there is a substantial alteration in the nutritional status of asthmatic and non-Asthmatic patients. 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 the 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, which were assessed by using 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: NUTRI, BMI, asthma, food

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Authors: Stojan Kravanja, Andrej Ivanič, Tomaž Žula

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This contribution focuses on structural optimization in civil engineering using mixed integer non-linear programming (MINLP). MINLP is characterized as a versatile method that can handle both continuous and discrete optimization variables simultaneously. Continuous variables are used to optimize parameters such as dimensions, stresses, masses, or costs, while discrete variables represent binary decisions to determine the presence or absence of structural elements within a structure while also calculating discrete materials and standard sections. The optimization process is divided into three main steps. First, a mechanical superstructure with a variety of different topology-, material- and dimensional alternatives. Next, a MINLP model is formulated to encapsulate the optimization problem. Finally, an optimal solution is searched in the direction of the defined objective function while respecting the structural constraints. The economic or mass objective function of the material and labor costs of a structure is subjected to the constraints known from structural analysis. These constraints include equations for the calculation of internal forces and deflections, as well as equations for the dimensioning of structural components (in accordance with the Eurocode standards). Given the complex, non-convex and highly non-linear nature of optimization problems in civil engineering, the Modified Outer-Approximation/Equality-Relaxation (OA/ER) algorithm is applied. This algorithm alternately solves subproblems of non-linear programming (NLP) and main problems of mixed-integer linear programming (MILP), in this way gradually refines the solution space up to the optimal solution. The NLP corresponds to the continuous optimization of parameters (with fixed topology, discrete materials and standard dimensions, all determined in the previous MILP), while the MILP involves a global approximation to the superstructure of alternatives, where a new topology, materials, standard dimensions are determined. The optimization of a convex problem is stopped when the MILP solution becomes better than the best NLP solution. Otherwise, it is terminated when the NLP solution can no longer be improved. While the OA/ER algorithm, like all other algorithms, does not guarantee global optimality due to the presence of non-convex functions, various modifications, including convexity tests, are implemented in OA/ER to mitigate these difficulties. The effectiveness of the proposed MINLP approach is demonstrated by its application to various structural optimization tasks, such as mass optimization of steel buildings, cost optimization of timber halls, composite floor systems, etc. Special optimization models have been developed for the optimization of these structures. The MINLP optimizations, facilitated by the user-friendly software package MIPSYN, provide insights into a mass or cost-optimal solutions, optimal structural topologies, optimal material and standard cross-section choices, confirming MINLP as a valuable method for the optimization of structures in civil engineering.

Keywords: MINLP, mixed-integer non-linear programming, optimization, structures

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Authors: Rania S. Hussein

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This research mainly focuses on examining engagement in social media brand communities. Engagement in social media has become a main focus in literature affirming that the role of social media in our daily lives is growing. (Akman and Mishra, 2017;Prado-Gascó et al., 2017). Social media has also become a key medium for brand communication and brand building relationships(Frimpong and McLean,2018;Dimitriu and Guesalaga, 2017). Engagement on social media has become a main focus of many researchers who tried to understand this concept further and draw a link between engagement and various social media activities (Cvijikj and Michahelles;2013), Andre,2015; Wang et al., 2015). According to Felix et al. (2017), the internet and social media have provided better digital resources to improve brand loyalty and customer interactions, thus leading to social media engagement within brand communities. The aim of this research is to highlight the importance of social media and why it is important to maintain engagement within social media. While the term ‘engagement’ is widely used in scholarly literature, there isn’t a common consensus about what the term exactly entails, according to Kidd, (2011). On one hand, it was seen as something that includes factors such as participation, activation, empowerment, devotion, trust, and productivity (Zhang et al, andBenyoucef, M. (2016), ). Other scholars held different viewpoints. For example, Lim et al. (2015) has chosen to break down engagement into three types: operational engagement, emotional engagement, and relational engagement. Chandler and Lusch (2015) further studied engagement as a means to measure commitment to a brand. Fernandes&Remelhe (2016) had a more technical view, measuring engagement through comments, following, subscribing, sharing, enjoying, writing, etc., in the social media context. ustomer engagement has become a research focus for understanding how consumer relationships are developed, retained, and improved within a digital context. Based on previous literature, it is evident that many customer engagement related studies are limited to the interaction between firms and consumers on social media. There is a clear gap in the literature regarding consumer-to-consumer interaction and user-generated content and its significance. While some researchers, such as Alversia et al. (2016), touched upon the importance of customer-based engagement, a gap still remains: there is no consistent and well-tested method for defining the factors that affect consumer interaction. Moreover, few scholarly research papers such as (Case, 2019; Riley, 2020;Habibi, 2014) provided to assist businesses understand their customers' interaction habits as well as the best ways to develop customer loyalty. Additionally, the majority of research on brand pages concentrated on the drivers of Consumer engagement, with just a few studies example, Lamberton, Cc(2016), Poorrezaei, (2016). (Jayasingh, 2019), looking into the implications. This study focuses on understanding the concept of engagement and its importance, specifically engagement within social media brand communities. It examines drivers as well as consequences of engagement, including brand knowledge, brand trust, entertainment, and brand page interactivity. Brand engagement is also expected to affect brand loyalty and word of the mouth.

Keywords: engagement, social media, brand communities, drivers

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Authors: Charlotte Entwistle, Ryan Boyd

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Recent developments in information retrieval techniques and natural language processing have allowed for greater exploration of psychological and social processes. Linguistic analysis methods for understanding behaviour have provided useful insights within the field of mental health. One area within mental health that has received little attention though, is borderline personality disorder (BPD). BPD is a common mental health disorder characterised by instability of interpersonal relationships, self-image and affect. It also manifests through maladaptive behaviours, such as impulsivity and self-harm. Examination of language patterns associated with BPD could allow for a greater understanding of the disorder and its links to maladaptive thoughts and behaviours. Language analysis methods could also be used in a predictive way, such as by identifying indicators of BPD or predicting maladaptive thoughts, emotions and behaviours. Additionally, associations that are uncovered between language and maladaptive thoughts and behaviours could then be applied at a more general level. This study explores linguistic characteristics of BPD, and their links to maladaptive thoughts and behaviours, through the analysis of social media data. Data were collected from a large corpus of posts from the publicly available social media platform Reddit, namely, from the ‘r/BPD’ subreddit whereby people identify as having BPD. Data were collected using the Python Reddit API Wrapper and included all users which had posted within the BPD subreddit. All posts were manually inspected to ensure that they were not posted by someone who clearly did not have BPD, such as people posting about a loved one with BPD. These users were then tracked across all other subreddits of which they had posted in and data from these subreddits were also collected. Additionally, data were collected from a random control group of Reddit users. Disorder-relevant behaviours, such as self-harming or aggression-related behaviours, outlined within Reddit posts were coded to by expert raters. All posts and comments were aggregated by user and split by subreddit. Language data were then analysed using the Linguistic Inquiry and Word Count (LIWC) 2015 software. LIWC is a text analysis program that identifies and categorises words based on linguistic and paralinguistic dimensions, psychological constructs and personal concern categories. Statistical analyses of linguistic features could then be conducted. Findings revealed distinct linguistic features associated with BPD, based on Reddit posts, which differentiated these users from a control group. Language patterns were also found to be associated with the occurrence of maladaptive thoughts and behaviours. Thus, this study demonstrates that there are indeed linguistic markers of BPD present on social media. It also implies that language could be predictive of maladaptive thoughts and behaviours associated with BPD. These findings are of importance as they suggest potential for clinical interventions to be provided based on the language of people with BPD to try to reduce the likelihood of maladaptive thoughts and behaviours occurring. For example, by social media tracking or engaging people with BPD in expressive writing therapy. Overall, this study has provided a greater understanding of the disorder and how it manifests through language and behaviour.

Keywords: behaviour analysis, borderline personality disorder, natural language processing, social media data

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Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer

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Model assessment, in the Bayesian context, involves evaluation of the goodness-of-fit and the comparison of several alternative candidate models for predictive accuracy and improvements. In posterior predictive checks, the data simulated under the fitted model is compared with the actual data. Predictive model accuracy is estimated using information criteria such as the Akaike information criterion (AIC), the Bayesian information criterion (BIC), the Deviance information criterion (DIC), and the Watanabe-Akaike information criterion (WAIC). The goal of an information criterion is to obtain an unbiased measure of out-of-sample prediction error. Since posterior checks use the data twice; once for model estimation and once for testing, a bias correction which penalises the model complexity is incorporated in these criteria. Cross-validation (CV) is another method used for examining out-of-sample prediction accuracy. Leave-one-out cross-validation (LOO-CV) is the most computationally expensive variant among the other CV methods, as it fits as many models as the number of observations. Importance sampling (IS), truncated importance sampling (TIS) and Pareto-smoothed importance sampling (PSIS) are generally used as approximations to the exact LOO-CV and utilise the existing MCMC results avoiding expensive computational issues. The reciprocals of the predictive densities calculated over posterior draws for each observation are treated as the raw importance weights. These are in turn used to calculate the approximate LOO-CV of the observation as a weighted average of posterior densities. In IS-LOO, the raw weights are directly used. In contrast, the larger weights are replaced by their modified truncated weights in calculating TIS-LOO and PSIS-LOO. Although, information criteria and LOO-CV are unable to reflect the goodness-of-fit in absolute sense, the differences can be used to measure the relative performance of the models of interest. However, the use of these measures is only valid under specific circumstances. This study has developed 11 models using normal, log-normal, gamma, and student’s t distributions to improve the PCR stutter prediction with forensic data. These models are comprised of four with profile-wide variances, four with locus specific variances, and three which are two-component mixture models. The mean stutter ratio in each model is modeled as a locus specific simple linear regression against a feature of the alleles under study known as the longest uninterrupted sequence (LUS). The use of AIC, BIC, DIC, and WAIC in model comparison has some practical limitations. Even though, IS-LOO, TIS-LOO, and PSIS-LOO are considered to be approximations of the exact LOO-CV, the study observed some drastic deviations in the results. However, there are some interesting relationships among the logarithms of pointwise predictive densities (lppd) calculated under WAIC and the LOO approximation methods. The estimated overall lppd is a relative measure that reflects the overall goodness-of-fit of the model. Parallel log-likelihood profiles for the models conditional on equal posterior variances in lppds were observed. This study illustrates the limitations of the information criteria in practical model comparison problems. In addition, the relationships among LOO-CV approximation methods and WAIC with their limitations are discussed. Finally, useful recommendations that may help in practical model comparisons with these methods are provided.

Keywords: cross-validation, importance sampling, information criteria, predictive accuracy

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Authors: Elaine Yee Sing Wong, Jonine Jancey, Andy H. Lee, Anthony P. James

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Singapore has a rapidly aging population, where the majority of older women aged 50 years and above, are physically inactive and have unhealthy dietary habits, placing them at ‘high risk’ of non-communicable diseases. Given the multiplicity of less than optimal dietary habits and high levels of physical inactivity among Singaporean women, it is imperative to develop appropriate lifestyle interventions at recreational centres to enhance both their physical and nutritional knowledge, as well as provide them with the opportunity to develop skills to support behaviour change. To the best of our knowledge, this proposed study is the first physical activity and nutrition cluster randomised controlled trial conducted in Singapore for older women. Findings from this study may provide insights and recommendations for policy makers and key stakeholders to create new healthy living, recreational centres with supportive environments. This 6-month community-based cluster randomised controlled trial will involve the implementation and evaluation of physical activity and nutrition program for community dwelling Singaporean women, who currently attend recreational centres to promote social leisure activities in their local neighbourhood. The intervention will include dietary education and counselling sessions, physical activity classes, and telephone contact by certified fitness instructors and qualified nutritionists. Social Cognitive Theory with Motivational Interviewing will inform the development of strategies to support health behaviour change. Sixty recreational centres located in Singapore will be randomly selected from five major geographical districts and randomly allocated to the intervention (n=30) or control (n=30) cluster. A sample of 600 (intervention n=300; control n=300) women aged 50 years and above will then be recruited from these recreational centres. The control clusters will only undergo pre and post data collection and will not receive the intervention. It is hypothesised that by the end of the intervention, the intervention group participants (n = 300) compared to the control group (n = 300), will show significant improvements in the following variables: lipid profile, body mass index, physical activity and dietary behaviour, anthropometry, mental and physical health. Data collection will be examined and compared via the Statistical Package for the Social Science version 23. Descriptive and summary statistics will be used to quantify participants’ characteristics and outcome variables. Multi-variable mixed regression analyses will be used to confirm the effects of the proposed health intervention, taking into account the repeated measures and the clustering of the observations. The research protocol was approved by the Curtin University Human Research Ethics Committee (approval number: HRE2016-0366). The study has been registered with the Australian and New Zealand Clinical Trial Registry (12617001022358).

Keywords: community based, healthy aging, intervention, nutrition, older women, physical activity

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Authors: Torsten Hermanns, You Wang, Stefan Janssen, Markus Niessen, Christoph Schoeler, Ulrich Thombansen, Wolfgang Schulz

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In long pulse laser drilling of metals, it can be demonstrated that the ablation shape approaches a so-called asymptotic shape such that it changes only slightly or not at all with further irradiation. These findings are already known from ultra short pulse (USP) ablation of dielectric and semiconducting materials. The explanation for the occurrence of an asymptotic shape in long pulse drilling of metals is identified, a model for the description of the asymptotic hole shape numerically implemented, tested and clearly confirmed by comparison with experimental data. The model assumes a robust process in that way that the characteristics of the melt flow inside the arising melt film does not change qualitatively by changing the laser or processing parameters. Only robust processes are technically controllable and thus of industrial interest. The condition for a robust process is identified by a threshold for the mass flow density of the assist gas at the hole entrance which has to be exceeded. Within a robust process regime the melt flow characteristics can be captured by only one model parameter, namely the intensity threshold. In analogy to USP ablation (where it is already known for a long time that the resulting hole shape results from a threshold for the absorbed laser fluency) it is demonstrated that in the case of robust long pulse ablation the asymptotic shape forms in that way that along the whole contour the absorbed heat flux density is equal to the intensity threshold. The intensity threshold depends on the special material and radiation properties and has to be calibrated be one reference experiment. The model is implemented in a numerical simulation which is called AsymptoticDrill and requires such a few amount of resources that it can run on common desktop PCs, laptops or even smart devices. Resulting hole shapes can be calculated within seconds what depicts a clear advantage over other simulations presented in literature in the context of industrial every day usage. Against this background the software additionally is equipped with a user-friendly GUI which allows an intuitive usage. Individual parameters can be adjusted using sliders while the simulation result appears immediately in an adjacent window. A platform independent development allow a flexible usage: the operator can use the tool to adjust the process in a very convenient manner on a tablet during the developer can execute the tool in his office in order to design new processes. Furthermore, at the best knowledge of the authors AsymptoticDrill is the first simulation which allows the import of measured real beam distributions and thus calculates the asymptotic hole shape on the basis of the real state of the specific manufacturing system. In this paper the emphasis is placed on the investigation of the effect of multiple reflections on the asymptotic hole shape which gain in importance when drilling holes with large aspect ratios.

Keywords: asymptotic hole shape, intensity threshold, long pulse laser drilling, robust process

Procedia PDF Downloads 192

Authors: S. Nishat Fatima Rizvi, Tulika Chandra, Abbas Ali Mahdi, Devisha Agarwal

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Introduction: Blood components are an unexplored area prone to numerous discoveries which influence patient’s care. Experiments at different levels will further change the present concept of blood banking. Hyperlipidemia is a condition of elevated plasma level of low-density lipoprotein (LDL) as well as decreased plasma level of high-density lipoprotein (HDL). Studies show that platelets play a vital role in the progression of atherosclerosis and thrombosis, a major cause of death worldwide. They are activated by many triggers like elevated LDL in the blood resulting in aggregation and formation of plaques. Hyperlipidemic platelets are frequently transfused to patients with various disorders. Screening the random donor platelets for hyperlipidemia and correlating the condition with other donor criteria such as lipid rich diet, oral contraceptive pills intake, weight, alcohol intake, smoking, sedentary lifestyle, family history of heart diseases will lead to further deciding the exclusion criteria for donor selection. This will help in making the patients safe as well as the donor deferral criteria more stringent to improve the quality of blood supply. Technical evaluation and assessment will enable blood bankers to supply safe blood and improve the guidelines for blood safety. Thus, we try to study the correlation between hyperlipidemic platelets with platelets parameters, weight, and specific history of the donors. Methodology: This case control study included 100 blood samples of Blood donors, out of 100 only 30 samples were found to be hyperlipidemic and were included as cases, while rest were taken as controls. Lipid Profile were measured by fully automated analyzer (TRIGL:triglycerides),(LDL-C:LDL –Cholesterol plus 2nd generation),CHOL 2: Cholesterol Gen 2), HDL C 3: HDL-Cholesterol plus 3rdgeneration)-(Cobas C311-Roche Diagnostic).And Platelets parameters were analyzed by the Sysmex KX21 automated hematology analyzer. Results: A significant correlation was found amongst hyperlipidemic level in single time donor. In which 80% donors have history of heart disease, 66.66% donors have sedentary life style, 83.3% donors were smokers, 50% donors were alcoholic, and 63.33% donors had taken lipid rich diet. Active physical activity was found amongst 40% donors. We divided donors sample in two groups based on their body weight. In group 1, hyperlipidemic samples: Platelet Parameters were 75% in normal 25% abnormal in >70Kg weight while in 50-70Kg weight 90% were normal 10% were abnormal. In-group 2, Non Hyperlipidemic samples: platelet Parameters were 95% normal and 5% abnormal in >70Kg weight, while in 50-70Kg Weight, 66.66% normal and 33.33% abnormal. Conclusion: The findings indicate that Hyperlipidemic status of donors may affect the platelet parameters and can be distinguished on history by their weight, Smoking, Alcoholic intake, Sedentary lifestyle, Active physical activity, Lipid rich diet, Oral contraceptive pills intake, and Family history of heart disease. However further studies on a large sample size will affirm this finding.

Keywords: blood donors, hyperlipidemia, platelet, weight

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Authors: Praniil Nagaraj

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This paper proposes a method to collect homeless data using crowdsourcing and presents an approach to analyze the data, demonstrating its potential to strengthen existing and future policies aimed at promoting socio-economic equilibrium. The 2022 Annual Homeless Assessment Report (AHAR) to Congress highlighted alarming statistics, emphasizing the need for effective decision-making and budget allocation within local planning bodies known as Continuums of Care (CoC). This paper's contributions can be categorized into three main areas. Firstly, a unique method for collecting homeless data is introduced, utilizing a user-friendly smartphone app (currently available for Android). The app enables the general public to quickly record information about homeless individuals, including the number of people and details about their living conditions. The collected data, including date, time, and location, is anonymized and securely transmitted to the cloud. It is anticipated that an increasing number of users motivated to contribute to society will adopt the app, thus expanding the data collection efforts. Duplicate data is addressed through simple classification methods, and historical data is utilized to fill in missing information. The second contribution of this paper is the description of data analysis techniques applied to the collected data. By combining this new data with existing information, statistical regression analysis is employed to gain insights into various aspects, such as distinguishing between unsheltered and sheltered homeless populations, as well as examining their correlation with factors like unemployment rates, housing affordability, and labor demand. Initial data is collected in San Francisco, while pre-existing information is drawn from three cities: San Francisco, New York City, and Washington D.C., facilitating the conduction of simulations. The third contribution focuses on demonstrating the practical implications of the data processing results. The challenges faced by key stakeholders, including charitable organizations and local city governments, are taken into consideration. Two case studies are presented as examples. The first case study explores improving the efficiency of food and necessities distribution, as well as medical assistance, driven by charitable organizations. The second case study examines the correlation between micro-geographic budget expenditure by local city governments and homeless information to justify budget allocation and expenditures. The ultimate objective of this endeavor is to enable the continuous enhancement of the quality of life for the underprivileged. It is hoped that through increased crowdsourcing of data from the public, the Generosity Curve and the Need Curve will intersect, leading to a better world for all.

Keywords: crowdsourcing, homelessness, socio-economic policies, statistical regression

Procedia PDF Downloads 56

Authors: Oyvind Nordvik, Peder O. L. Heggdal, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing Loss (HL) is a condition that may affect people in all stages of life, but the prevalence increases with age, mostly because of age-related HL, generally referred to as presbyacusis. As human speech is related to relatively high frequencies, even a limited hearing loss at high frequencies may cause impaired speech intelligibility. Being diagnosed with, treated for and living with a chronic condition such as HL, must for many be a disabling and stressful condition that put ones coping resources to test. Stress is a natural part of life and most people will experience stressful events or periods. Chronic diseases, such as HL, are risk factor for distress in individuals, causing anxiety and lowered mood. How an individual cope with HL may be closely connected to the level of distress he or she is experiencing and to personality, which can be defined as those characteristics of a person that account for consistent patterns of feelings, thinking, and behavior. Thus, as to distress in life, such as illness or disease, available coping strategies may be more important than the challenge itself. The same line of arguments applies to level of experienced health-related quality of life (HRQoL). Aim: The aim of this study was to investigate the relationship between distress, HRQoL, reported hearing loss, personality and coping in patients with HL. Method: 158 adult (aged 18-78 years) patients with HL, referred for hearing aid (HA) fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals were included. First-time users had been pre-examined by an ENT-specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2, and 4 kHz) was determined for each ear. The Eysenck personality inventory, neuroticism and lie scales, the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) measuring active coping, hopelessness and helplessness, as well as distress (General Health Questionnaire (GHQ) - 12 items) and the EORTC Quality of Life Questionnaire general part were answered. In addition, we used a revised and shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) as a measure of patient-reported hearing loss. Results: Significant correlations were determined between APHAB (weak), HRQoL scores (strong), distress scores (strong) on the one side and personality and choice of coping scores on the other side. As measured by stepwise regression analyses, the distress and HRQoL scores were scored secondary to the obtained personality and coping scores. The APHAB scores were as determined by regression analyses scored secondary to PTA (best ear), level of neuroticism and lie score. Conclusion: We found that reported employed coping style, distress/HRQoL and personality are closely connected to each other in this patient group. Patient-reported HL was associated to hearing level and personality. There is need for further investigations on these questions, and how these associations may influence the clinical context.

Keywords: coping, distress, hearing loss, personality

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Authors: Kalliopi Kanaki, Michael Kalogiannakis

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Nowadays, in the digital era, the early acquisition of basic programming skills and knowledge is encouraged, as it facilitates students’ exposure to computational thinking and empowers their creativity, problem-solving skills, and cognitive development. More and more researchers and educators investigate the introduction of computational thinking in K-12 since it is expected to be a fundamental skill for everyone by the middle of the 21st century, just like reading, writing and arithmetic are at the moment. In this paper, a doctoral research in the process is presented, which investigates the infusion of computational thinking into science curriculum in early childhood education. The whole attempt aims to develop young children’s computational thinking by introducing them to the fundamental concepts of object-oriented programming in an enjoyable, yet educational framework. The backbone of the research is the digital environment PhysGramming (an abbreviation of Physical Science Programming), which provides children the opportunity to create their own digital games, turning them from passive consumers to active creators of technology. PhysGramming deploys an innovative hybrid schema of visual and text-based programming techniques, with emphasis on object-orientation. Through PhysGramming, young students are familiarized with basic object-oriented programming concepts, such as classes, objects, and attributes, while, at the same time, get a view of object-oriented programming syntax. Nevertheless, the most noteworthy feature of PhysGramming is that children create their own digital games within the context of physical science courses, in a way that provides familiarization with the basic principles of object-oriented programming and computational thinking, even though no specific reference is made to these principles. Attuned to the ethical guidelines of educational research, interventions were conducted in two classes of second grade. The interventions were designed with respect to the thematic units of the curriculum of physical science courses, as a part of the learning activities of the class. PhysGramming was integrated into the classroom, after short introductory sessions. During the interventions, 6-7 years old children worked in pairs on computers and created their own digital games (group games, matching games, and puzzles). The authors participated in these interventions as observers in order to achieve a realistic evaluation of the proposed educational framework concerning its applicability in the classroom and its educational and pedagogical perspectives. To better examine if the objectives of the research are met, the investigation was focused on six criteria; the educational value of PhysGramming, its engaging and enjoyable characteristics, its child-friendliness, its appropriateness for the purpose that is proposed, its ability to monitor the user’s progress and its individualizing features. In this paper, the functionality of PhysGramming and the philosophy of its integration in the classroom are both described in detail. Information about the implemented interventions and the results obtained is also provided. Finally, several limitations of the research conducted that deserve attention are denoted.

Keywords: computational thinking, early childhood education, object-oriented programming, physical science courses

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Authors: Maria Cardova

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Aim and objectives: The purpose of this studywas to explore to what extent the deprivation statusinfluenced children’s physical activity, dietary behaviour, and health outcomes such as weight status. Background: The United Kingdom’s childhood obesity rates are currently ranked among the highest in Europe. North West England deals with highest rates of childhood obesity. Data from the UK Millennium Cohort Study suggested a deprivation gradient to childhood obesity in England, with obesity rates being the highest in the most deprived areas. Traditionally, it has been individual conception of health, but the contemporary stance is that health behaviours affecting obesity are influenced by a broad range of factors operating at multiple levels. According to socio-ecological model of health behaviour, differences in obesity rates and health outcomes are likely explained by differences in lifestyle behaviours including physical activity and diet behaviours. However, higher rates of obesity among deprived children are not due to physical inactivity, in fact, most socially disadvantaged children are the most physically active. Poor diet including high consumption of fast food and sugar-sweetened beverages and low consumption of fruit and vegetables was found to be the most prevalent among adolescents living in poverty. Methods: This study adopted quantitative approach. It consisted of combination of basic demographic data, anthropometry, and questionnaires. Children (N = 165, mean age = 10.04 years; 53.33% female; 46.66% male) completed survey packs during school day including KIDSCREEN, Youth Activity Profile, Beverage and Snack Questionnaire, and Child Body Image Scale questionnaires as well as had anthropometric measurements taken including Body mass index, waist circumference, weight, and height. Children’s deprivation status was based on the English Indices of Multiple Deprivation scores of the school they attended. Results: Children from more deprived areas had higher weight status, waist circumference. Deprivation status had also effect on some dimensions of the KIDSCREEN questionnaire, such as that those from more deprived areas felt less socially accepted and bullied by their peers, had worse feelings about themselves such as body image, and more difficulty with school and learning. Children from more deprived areas reported higher rates of physical activity and also differences in snack and fruit and vegetable intake than their more affluent peers. Conclusion: Results demonstrated that, children living in the most-deprived areas appear to be at greater risk of unfavourable health-related variables and behaviours and are exposed to home and neighbourhood environments that are less conducive to health-promoting behaviours compared to their peers from less deprived areas. These findings indicate that children living in highly deprived areas represent an important group for future interventions designed to promote health-behaviours that would impact on the quality of life of the child and other health variables such as weight status.

Keywords: children, dietary behaviour, health, obesity, physical Activity, weight Status

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Authors: B. Sudhakara Reddy

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In modern economy, energy is fundamental to virtually every product and service in use. It has been developed on the dependence of abundant and easy-to-transform polluting fossil fuels. On one hand, increase in population and income levels combined with increased per capita energy consumption requires energy production to keep pace with economic growth, and on the other, the impact of fossil fuel use on environmental degradation is enormous. The conflicting policy objectives of protecting the environment while increasing economic growth and employment has resulted in this paradox. Hence, it is important to decouple economic growth from environmental degeneration. Hence, the search for green energy involving affordable, low-carbon, and renewable energies has become global priority. This paper explores a transition to a sustainable energy system using the socio-economic-technical scenario method. This approach takes into account the multifaceted nature of transitions which not only require the development and use of new technologies, but also of changes in user behaviour, policy and regulation. The scenarios that are developed are: baseline business as usual (BAU) as well as green energy (GE). The baseline scenario assumes that the current trends (energy use, efficiency levels, etc.) will continue in future. India’s population is projected to grow by 23% during 2010 –2030, reaching 1.47 billion. The real GDP, as per the model, is projected to grow by 6.5% per year on average between 2010 and 2030 reaching US$5.1 trillion or $3,586 per capita (base year 2010). Due to increase in population and GDP, the primary energy demand will double in two decades reaching 1,397 MTOE in 2030 with the share of fossil fuels remaining around 80%. The increase in energy use corresponds to an increase in energy intensity (TOE/US $ of GDP) from 0.019 to 0.036. The carbon emissions are projected to increase by 2.5 times from 2010 reaching 3,440 million tonnes with per capita emissions of 2.2 tons/annum. However, the carbon intensity (tons per US$ of GDP) decreases from 0.96 to 0.67. As per GE scenario, energy use will reach 1079 MTOE by 2030, a saving of about 30% over BAU. The penetration rate of renewable energy resources will reduce the total primary energy demand by 23% under GE. The reduction in fossil fuel demand and focus on clean energy will reduce the energy intensity to 0.21 (TOE/US$ of GDP) and carbon intensity to 0.42 (ton/US$ of GDP) under the GE scenario. The study develops new ‘pathways out of poverty’ by creating more than 10 million jobs and thus raise the standard of living of low-income people. Our scenarios are, to a great extent, based on the existing technologies. The challenges to this path lie in socio-economic-political domains. However, to attain a green economy the appropriate policy package should be in place which will be critical in determining the kind of investments that will be needed and the incidence of costs and benefits. These results provide a basis for policy discussions on investments, policies and incentives to be put in place by national and local governments.

Keywords: energy, renewables, green technology, scenario

Procedia PDF Downloads 223

Authors: Nadia Obaed, Lexi Frankel, Amalia Ardeljan, Denis Nigel, Anniki Witter, Omar Rashid

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Breast cancer is the most common cancer among women, with a lifetime risk of one in eight of all women in the United States. Although breast cancer is prevalent throughout the world, the uneven distribution in incidence and mortality rates is shaped by the variation in population structure, environment, genetics and known lifestyle risk factors. Furthermore, the bacterial profile in healthy and cancerous breast tissue differs with a higher relative abundance of bacteria capable of causing DNA damage in breast cancer patients. Previous bacterial infections may change the composition of the microbiome and partially account for the environmental factors promoting breast cancer. One study found that higher amounts of Staphylococcus, Bacillus, and Enterobacteriaceae, of which Escherichia coli (E. coli) is a part, were present in breast tumor tissue. Based on E. coli’s ability to damage DNA, it is hypothesized that there is an increased risk of breast cancer associated with previous E. coli infection. Therefore, the purpose of this study was to evaluate the correlation between E. coli infection and the incidence of breast cancer. Holy Cross Health, Fort Lauderdale, provided access to the Health Insurance Portability and Accountability (HIPAA) compliant national database for the purpose of academic research. International Classification of Disease 9th and 10th Codes (ICD-9, ICD-10) was then used to conduct a retrospective analysis using data from January 2010 to December 2019. All breast cancer diagnoses and all patients infected versus not infected with E. coli that underwent typical E. coli treatment were investigated. The obtained data were matched for age, Charlson Comorbidity Score (CCI score), and antibiotic treatment. Standard statistical methods were applied to determine statistical significance and an odds ratio was used to estimate the relative risk. A total of 81286 patients were identified and analyzed from the initial query and then reduced to 31894 antibiotic-specific treated patients in both the infected and control group, respectively. The incidence of breast cancer was 2.51% and present in 2043 patients in the E. coli group compared to 5.996% and present in 4874 patients in the control group. The incidence of breast cancer was 3.84% and present in 1223 patients in the treated E. coli group compared to 6.38% and present in 2034 patients in the treated control group. The decreased incidence of breast cancer in the E. coli and treated E. coli groups was statistically significant with a p-value of 2.2x10-16 and 2.264x10-16, respectively. The odds ratio in the E. coli and treated E. coli groups was 0.784 and 0.787 with a 95% confidence interval, respectively (0.756-0.813; 0.743-0.833). The current study shows a statistically significant decrease in breast cancer incidence in association with previous Escherichia coli infection. Researching the relationship between single bacterial species is important as only up to 10% of breast cancer risk is attributable to genetics, while the contribution of environmental factors including previous infections potentially accounts for a majority of the preventable risk. Further evaluation is recommended to assess the potential and mechanism of E. coli in decreasing the risk of breast cancer.

Keywords: breast cancer, escherichia coli, incidence, infection, microbiome, risk

Procedia PDF Downloads 219

Authors: Simone Raimondi De Souza, Glaucia Maria Moraes De Oliveira, Ronir Raggio Luiz, Glorimar Rosa

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Introduction: Obesity is among the main risk factors for cardiovascular disease (CVD). Genesis is multifactorial, including genetic, hormonal and environmental factors disorders, among which inadequate feeding pattern, for which nutritional counseling strategies have proven effective. The consumption of beta-glucans (soluble fibers that reportedly promote satiety) present in oat bran can be an effective strategy for preventing and treating obesity. Other benefits have been observed with oat bran consumption, such as reduction of hypercholesterolemia and hyperglycemia, two other risk factors for CVD. Objectives: To analyze the effect of oat bran consumption associated with nutritional counseling in reducing body mass index (BMI), blood cholesterol, glucose profile, waist and neck circumference in obese individuals, and to evaluate the change in eating pattern. Methods: clinical trial, randomized, double-blind, placebo-controlled, lasting 90 days with adults of both genders, with BMI ≥30kg/m2. The study was approved by the Ethics in Research involving human beings in a public institute of cardiology, in Rio de Janeiro, Brazil. Individuals were invited to participate and accepted formally by signing the Terms of Consent. Participants were randomized into oat bran group (gOB) or placebo group (gPCB) and received, respectively: morning prepared consisting of 40g oat bran, 30g of skimmed milk powder and 1g sweetener sucralose; refined flour 40g rice, 30g of milk powder and 1g sweetener sucralose. The Ten Steps to Healthy Eating, of Brazilian Ministry of Health were used to support the nutritional counseling. Variables analyzed: gender; age; BMI, waist circumference (WC) neck circumference (NC); systolic blood pressure (SBP); diastolic blood pressure (DBP); food consumption, total cholesterol (TC), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), non-HDL cholesterol (nHDLc), triglycerides (TG), fasting glucose (FG), fasting insulin (FI) and HOMA-IR. Dietary intake was assessed by 24-hour dietary recall. The Diet Quality Index revised for the Brazilian population (IQD-R) assessed quality of feeding pattern. Statistical analyzes were performed using SPSS version 21, considering statistically significant p-value less than 0.05. Results: A total of 38 participants were included, age = 50 ± 7,6years, 63% women. 19 subjects were placed in gOB and 19 in gPCB. After intervention, statistically significant reductions were observed in the following parameters: in gOB: IQD-R, TC, LDL-c, nHDL-c, FI, SBP, DBP, BMI, WC, NC; in gPCB: IQD-R, LDL-c, SBP, DBP, BMI, WC, NC. No statistically significant differences were observed in the results between groups. Conclusion: Our results reinforce nutritional counseling as important strategy for prevention and treatment of obesity and suggest that inclusion of oat bran in daily diet can bring additional benefits controlling risk factors for CVD. More studies are needed to establish all benefits of oat bran to human health as well as the ideal daily dose for consumption.

Keywords: oat bran, cardiovascular disease, nutritional counseling, obesity

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Authors: Nisha Sharma, Mili Kaur, Ashutosh Halder, Seema Kaushal, Manoj Kumar, Manish Jain

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Purpose: To investigate microRNAs (miRNA) as an epigenomic etiological factor in idiopathic non-obstructive azoospermia (NOA). In order to achieve the same, an association was seen between occupational exposure to radiation, thermal, and chemical factors and idiopathic cases of non-obstructive azoospermia, and later, testicular differential miRNA expression profiling was done in exposure group NOA cases. Method: It is a prospective study in which 200 apparent idiopathic male factor infertility cases, who have been advised to undergo testicular fine needle aspiration (FNA) evaluation, are recruited. A detailed occupational history was taken to understand the possible type of exposure due to the nature and duration of work. A total of 26 patients were excluded upon XY-FISH and Yq microdeletion tests due to the presence of genetic causes of infertility, 6 hypospermatogeneis (HS), six Sertoli cell-only syndrome (SCOS), and six normospermatogeneis patients testicular FNA samples were used for RNA isolation followed by small RNA sequencing and nCounter miRNA expression analysis. Differential miRNA expression profile of HS and SCOS patients was done. A web-based tool, miRNet, was used to predict the interacting compounds or chemicals using the shortlisted miRNAs with high fold change. The major limitation encountered in this study was the insufficient quantity of testicular FNA sample used for total RNA isolation, which resulted in a low yield and RNA integrity number (RIN) value. Therefore, the number of RNA samples admissible for differential miRNA expression analysis was very small in comparison to the total number of patients recruited. Results: Differential expression analysis revealed 69 down-regulated and 40 up-regulated miRNAs in HS and 66 down-regulated and 33 up-regulated miRNAs in SCOS in comparison to normospermatogenesis controls. The miRNA interaction analysis using the miRNet tool showed that the differential expression profiles of HS and SCOS patients were associated with arsenic trioxide, bisphenol-A, calcium sulphate, lithium, and cadmium. These compounds are reproductive toxins and might be responsible for miRNA-mediated epigenetic deregulation leading to NOA. The association between occupational risk factor exposure and the non-exposure group of NOA patients was not statistically significant, with ꭓ2 (3, N= 178) = 6.70, p= 0.082. The association between individual exposure groups (radiation, thermal, and chemical) and various sub-types of NOA is also not significant, with ꭓ2 (9, N= 178) = 15.06, p= 0.089. Functional analysis of HS and SCOS patients' miRNA profiles revealed some important miR-family members in terms of male fertility. The miR-181 family plays a role in the differentiation of spermatogonia and spermatocytes, as well as the transcriptional regulation of haploid germ cells. The miR-34 family is expressed in spermatocytes and round spermatids and is involved in the regulation of SSCs differentiation. Conclusion: The reproductive toxins might adopt the miRNA-mediated mechanism of disease development in idiopathic cases of NOA. Chemical compound induced; miRNA-mediated epigenetic deregulation can give a future perspective on the etiopathogenesis of the disease.

Keywords: microRNA, non-obstructive azoospermia (NOA), occupational exposure, hypospermatogenesis (HS), Sertoli cell only syndrome (SCOS)

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Authors: Shayma Mohammed, Adel Trabelsi

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Radiopharmacy is the art of preparing high-quality, radioactive, medicinal products for use in diagnosis and therapy. Radiopharmaceuticals unlike normal medicines, this dual aspect (radioactive, medical) makes their management highly critical. One of the most convincing applications of modern technologies is the ability to delegate the execution of repetitive tasks to programming scripts. Automation has found its way to the most skilled jobs, to improve the company's overall performance by allowing human workers to focus on more important tasks than document filling. This project aims to contribute to implement a comprehensive system to insure rigorous management of radiopharmaceuticals through the use of a platform that links the Nuclear Medicine Service Management System to the Nuclear Radio-pharmacy Management System in accordance with the recommendations of World Health Organization (WHO) and International Atomic Energy Agency (IAEA). In this project we attempt to build a web application that targets radiopharmacies, the platform is built atop the inherently compatible web stack which allows it to work in virtually any environment. Different technologies are used in this project (PHP, Symfony, MySQL Workbench, Bootstrap, Angular 7, Visual Studio Code and TypeScript). The operating principle of the platform is mainly based on two parts: Radiopharmaceutical Backoffice for the Radiopharmacian, who is responsible for the realization of radiopharmaceutical preparations and their delivery and Medical Backoffice for the Doctor, who holds the authorization for the possession and use of radionuclides and he/she is responsible for ordering radioactive products. The application consists of sven modules: Production, Quality Control/Quality Assurance, Release, General Management, References, Transport and Stock Management. It allows 8 classes of users: The Production Manager (PM), Quality Control Manager (QCM), Stock Manager (SM), General Manager (GM), Client (Doctor), Parking and Transport Manager (PTM), Qualified Person (QP) and Technical and Production Staff. Digital platform bringing together all players involved in the use of radiopharmaceuticals and integrating the stages of preparation, production and distribution, Web technologies, in particular, promise to offer all the benefits of automation while requiring no more than a web browser to act as a user client, which is a strength because the web stack is by nature multi-platform. This platform will provide a traceability system for radiopharmaceuticals products to ensure the safety and radioprotection of actors and of patients. The new integrated platform is an alternative to write all the boilerplate paperwork manually, which is a tedious and error-prone task. It would minimize manual human manipulation, which has proven to be the main source of error in nuclear medicine. A codified electronic transfer of information from radiopharmaceutical preparation to delivery will further reduce the risk of maladministration.

Keywords: automated system, management, radiopharmacy, technical papers

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Mauro Callejas-Cuervo, Andrea C. Alarcon-Aldana, Andres F. Ruiz-Olaya, Juan C. Alvarez

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Motion capture (MC) is the construction of a precise and accurate digital representation of a real motion. Systems have been used in the last years in a wide range of applications, from films special effects and animation, interactive entertainment, medicine, to high competitive sport where a maximum performance and low injury risk during training and competition is seeking. This paper presents an inertial and magnetic sensor based technological platform, intended for particular amplitude monitoring and telerehabilitation processes considering an efficient cost/technical considerations compromise. Our platform particularities offer high social impact possibilities by making telerehabilitation accessible to large population sectors in marginal socio-economic sector, especially in underdeveloped countries that in opposition to developed countries specialist are scarce, and high technology is not available or inexistent. This platform integrates high-resolution low-cost inertial and magnetic sensors with adequate user interfaces and communication protocols to perform a web or other communication networks available diagnosis service. The amplitude information is generated by sensors then transferred to a computing device with adequate interfaces to make it accessible to inexperienced personnel, providing a high social value. Amplitude measurements of the platform virtual system presented a good fit to its respective reference system. Analyzing the robotic arm results (estimation error RMSE 1=2.12° and estimation error RMSE 2=2.28°), it can be observed that during arm motion in any sense, the estimation error is negligible; in fact, error appears only during sense inversion what can easily be explained by the nature of inertial sensors and its relation to acceleration. Inertial sensors present a time constant delay which acts as a first order filter attenuating signals at large acceleration values as is the case for a change of sense in motion. It can be seen a damped response of platform virtual in other images where error analysis show that at maximum amplitude an underestimation of amplitude is present whereas at minimum amplitude estimations an overestimation of amplitude is observed. This work presents and describes the platform virtual as a motion capture system suitable for telerehabilitation with the cost - quality and precision - accessibility relations optimized. These particular characteristics achieved by efficiently using the state of the art of accessible generic technology in sensors and hardware, and adequate software for capture, transmission analysis and visualization, provides the capacity to offer good telerehabilitation services, reaching large more or less marginal populations where technologies and specialists are not available but accessible with basic communication networks.

Keywords: inertial sensors, joint amplitude measurement, MEMS, telerehabilitation

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Authors: Zoltán Höhling, Sarah-Lu Oberschelp, Niklas Gilsdorf, Michael Wirsching, Andrea Kuhnert

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A majority of medical students at the University of Freiburg reported stress-related psychosomatic symptoms which are often associated with their studies. International research supports these findings, as medical students worldwide seem to be at special risk for mental health problems. In some countries and institutions, psychologically based interventions that assist medical students in coping with their stressors have been implemented. It turned out that anonymity is an important aspect here. Many students fear a potential damage of reputation when being associated with mental health problems, which may be due to a high level of competitiveness in classes. Therefore, we launched an online-platform where medical students could anonymously seek help and exchange their experiences with fellow students and experts. Medical students of all semesters have access to it through the university’s learning management system (called “ILIAS”). The informative part of the platform consists of exemplary videos showing medical students (actors) who act out scenes that demonstrate the antecedents of stress-related psychosomatic disorders. These videos are linked to different expert comments, describing the exhibited symptoms in an understandable and normalizing way. The (inter-)active part of the platform consists of self-help tools (such as meditation exercises or general tips for stress-coping) and an anonymous interactive forum where students can describe their stress-related problems and seek guidance from experts and/or share their experiences with fellow students. Besides creating an immediate proposal to help affected students, we expect that competitiveness between students might be diminished and bondage improved through mutual support between them. In the initial phase after the platform’s launch, it was accessed by a considerable number of medical students. On a closer look it appeared that platform sections like general information on psychosomatic-symptoms and self-treatment tools were accessed far more often than the online-forum during the first months after the platform launch. Although initial acceptance of the platform was relatively high, students showed a rather passive way of using our platform. While user statistics showed a clear demand for information on stress-related psychosomatic symptoms and its possible remedies, active engagement in the interactive online-forum was rare. We are currently advertising the platform intensively and trying to point out the assured anonymity of the platform and its interactive forum. Our plans, to assure students their anonymity through the use of an e-learning facility and promote active engagement in the online forum, did not (yet) turn out as expected. The reasons behind this may be manifold and based on either e-learning related issues or issues related to students’ individual needs. Students might, for example, question the assured anonymity due to a lack of trust in the technological functioning university’s learning management system. However, one may also conclude that reluctance to discuss stress-related psychosomatic symptoms with peer medical students may not be solely based on anonymity concerns, but could be rooted in more complex issues such as general mistrust between students.

Keywords: e-tutoring, stress-coping, student support, online forum

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Authors: Justin Byrne, Jose Ramon Cobo

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The growing importance of cross- or intercultural competencies (used here interchangeably) for the business and management professionals is now a commonplace in both academic and professional literature. This reflects two parallel developments. On the one hand, it is a consequence of the increased attention paid to a whole range of 'soft skills', now seen as fundamental in both individuals' and corporate success. On the other hand, and more specifically, the increasing demand for interculturally competent professionals is a corollary of ongoing processes of globalization, which multiply and intensify encounters between individuals and companies from different cultural backgrounds. Business schools have, for some decades, responded to the needs of the job market and their own students by providing students with training in intercultural skills, as they are encouraged to do so by the major accreditation agencies on both sides of the Atlantic. Adapting Early and Ang's (2003) formulation of Cultural Intelligence (CQ), this paper aims to help fill the lagunae in the current literature on intercultural training in three main ways. First, it offers an in-depth analysis of the CQ of a little studied group: contemporary Millenial and 'Generation Z' Business School students. The level of analysis distinguishes between the four different dimensions of CQ, cognition, metacognition, motivation and behaviour, and thereby provides a detailed picture of the strengths and weaknesses in CQ of the group as a whole, as well as of different sub-groups and profiles of students. Secondly, by crossing these individual-level findings with respondents' socio-cultural and educational data, this paper also proposes and tests hypotheses regarding the relative impact and importance of four possible antecedents of intercultural skills identified in the literature: prior international experience; intercultural training, foreign language proficiency, and experience of cultural diversity in habitual country of residence. Third, we use this analysis to suggest data-based intercultural training priorities for today's management students. These conclusions are based on the statistical analysis of individual responses of some 300 Bachelor or Masters students in a major European Business School provided to two on-line surveys: Ang, Van Dyne, et al's (2007) standard 20-question self-reporting CQ Scale, and an original questionnaire designed by the authors to collate information on respondent's socio-demographic and educational profile relevant to our four hypotheses and explanatory variables. The data from both instruments was crossed in both descriptive statistical analysis and regression analysis. This research shows that there is no statistically significant and positive relationship between the four antecedents analyzed and overall CQ level. The exception in this respect is the statistically significant correlation between international experience, and the cognitive dimension of CQ. In contrast, the results show that the combination of international experience and foreign language skills acting together, does have a strong overall impact on CQ levels. These results suggest that selecting and/or training students with strong foreign language skills and providing them with international experience (through multinational programmes, academic exchanges or international internships) constitutes one effective way of training culturally intelligent managers of tomorrow.

Keywords: business school, cultural intelligence, millennial, training

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Authors: Sanjay Ranade

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Traditional film theory assumes the cinema audience in a darkened room where cinema is projected on to a white screen, and the audience suspends their sense of reality. Shifts in audiences due to changes in cultural tastes or trends have been studied for decades. In the past two decades, however, the audience, especially the youth, has shifted to digital media for the consumption of cinema. As a result, not only are audiences watching cinema on different devices, they are also consuming cinema in places and ways never imagined before. Public transport often crowded to the brim with a lot of ambient content, and a variety of workplaces have become sites for cinema viewing. Cinema is watched piecemeal and at different times of the day. Audiences use devices such as mobile phones and tablets to watch cinema. The cinema viewing experience is getting redesigned by the user. The emerging design allows the spectator to not only consume images and narratives but also produce, reproduce, and manipulate existing images and narratives, thereby participating in the process and influencing it. Spectatorship studies stress on the importance of subjectivity when dealing with the structure of the film text and the cultural and psychological implications in the engagement between the spectator and the film text. Indian cinema has been booming and contributing to global movie production significantly. In 2005 film production was 1000 films a year and doubled to 2000 by 2016. Digital technology helped push this growth in 2012. Film studies in India have had a decided Euro-American bias. The studies have chiefly analysed the content for ideological leanings or myth or as reflections of society, societal changes, or articulation of identity or presented retrospectives of directors, actors, music directors, etc. The one factor relegated to the background has been the spectator. If they have been addressed, they are treated as a collective of class or gender. India has a performative tradition going back several centuries. How Indians receive cinema is an important aspect to study with respect to film studies. This exploratory and descriptive study looked at 162 young media students studying cinema at the undergraduate and postgraduate levels. The students, speaking as many as 20 languages amongst them, were drawn from across the country’s media schools. The study looked at nine film societies registered with the Federation of Film Societies of India. A structured questionnaire was made and distributed online through media teachers for the students. The film societies were approached through the regional office of the FFSI in Mumbai. Lastly, group discussions were held in Mumbai with students and teachers of media. A group consisted of between five and twelve student participants, along with one or two teachers. All the respondents looked at themselves as spectators and shared their experiences of spectators of cinema, providing a very rich insight into Indian conditions of viewing cinema and challenges for cinema ahead.

Keywords: audience, digital, film studies, reception, reception spectatorship

Procedia PDF Downloads 109

Authors: Evgenia Papathanasiou, Georgios Kokkotis, Georgios Axiaris, Theodoros Argyropoulos, Nikos Viazis, Olga Giouleme, Konstantinos Gkoumas, Αnthia Gatopoulou, Αggelos Theodoulou, Georgios Theocharis, Αngeliki Theodoropoulou, Μaria Κalogirou, Pantelis Karatzas, Κonstantinos Κatsanos, Theodora Kafetzi, Κonstantinos Κarmiris, Αnastasia Κourikou, Ιoannis E Κoutroubakis, Christos Liatsos, Gerassimos J. Mantzaris, Νicoletta Μathou, Georgia Bellou, George Michalopoulos Αikaterini Μantaka, Penelope Nikolaou, Μichael Oikonomou, Dimitrios Polymeros, George Papatheodoridis, Εvdoxia Stergiou, Κonstantinos Soufleris, Εpameinondas Skouloudis, Μaria Tzouvala, Georgia Tsiolakidou, Εftychia Tsironi, Styliani Tsafaraki, Kalliopi Foteinogiannopoulou, Konstantina Chalakatevaki, Αngeliki Christidou, Dimitrios K. Christodoulou, Giorgos Bamias, Spyridon Michopoulos, Εvanthia Zampeli

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Background: Inflammatory bowel disease (IBD) commonly affects female patients of reproductive age, making the interaction between fertility, pregnancy and IBD an important issue in disease management. The effect of disease activity on the outcome of pregnancy and its impact on neonatal growth is a field of intense research. Close follow-up of pregnant IBD patients by a multidisciplinary team improves maternal and neonatal outcomes. Aim – Methods: Α national retrospective study of pregnancies in women with IBD between 2010-2020 was carried out in 22 IBD reference centers in Greece. Patient characteristics such as disease profile, type of treatment, and disease activity during gestation were analyzed in correlation to the method of delivery, pregnancy outcomes, as well as breastfeeding and offspring health. Results: Two-hundred and twenty-three pregnancies in 175 IBD patients were registered in the study. 122 with Crohn’s disease (CD). Median age during diagnosis was 25.6 years (12-44), with median disease duration of 7.4 years (0-23). One-hundred and twenty-nine patients (58%) were recorded during their first pregnancy. Early pregnancy termination was reported by 48 patients (22%). Pregnancy as a result of in vitro fertilization (IVF) occurred in 15 cases (6.7%). At the beginning of gestation, 165 patients (74%) were under treatment: 48 with anti-TNF agents (29%), 43 with azathioprine (26%), 101 with 5-aminosalicylic acid formulations (61%) and 12 with steroids (7%). We recorded 49 cases of IBD flares (22%) during pregnancy. Two-thirds of them (n=30) were in remission at the onset of the pregnancy. Almost half of them (n=22) required corticosteroid treatment. Patients with ulcerative colitis (UC) were in greater risk of disease flare during pregnancy (p<0.001). All but 3 pregnancies (99.1%) resulted in uncomplicated delivery. In 147 cases (67.1%), cesarean delivery was performed. Two late fetal deaths (0.9%) were reported, both in patients with continuously active disease since the beginning of pregnancy. After delivery, 75 patients (34%) presented with a disease flare, which was associated with active disease at the beginning of pregnancy (p <0.001). Conclusion: The majority of female, Greek IBD patients, had a favorable pregnancy outcome. Active inflammation during gestation and UC diagnosis were associated with a negative impact on pregnancy outcomes. The results of this study are in favor of the continuation of IBD treatment during pregnancy.

Keywords: pregnancy, ulcerative colitis, Crohn disease, flare

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Authors: Patrick Cormier, Cesar Meylan, Matt Jensen, Dana Agar-Newman, Chloe Werle, Ming-Chang Tsai, Marc Klimstra

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Sprint-derived horizontal force-velocity-power (FVP) profiles can be developed with adequate validity and reliability with satellite (GPS/GNSS) systems. However, FVP metrics are sensitive to small nuances in data processing procedures such that minor differences in defining the onset and end of the sprint could result in different FVP metric outcomes. Furthermore, in team-sports, there is a requirement for rapid analysis and feedback of results from multiple athletes, therefore developing standardized and automated methods to improve the speed, efficiency and reliability of this process are warranted. Thus, the purpose of this study was to compare different methods of sprint end detection on the development of FVP profiles from 10Hz GPS/GNSS data through goodness-of-fit and intertrial reliability statistics. Seventeen national team female soccer players participated in the FVP protocol which consisted of 2x40m maximal sprints performed towards the end of a soccer specific warm-up in a training session (1020 hPa, wind = 0, temperature = 30°C) on an open grass field. Each player wore a 10Hz Catapult system unit (Vector S7, Catapult Innovations) inserted in a vest in a pouch between the scapulae. All data were analyzed following common procedures. Variables computed and assessed were the model parameters, estimated maximal sprint speed (MSS) and the acceleration constant τ, in addition to horizontal relative force (F₀), velocity at zero (V₀), and relative mechanical power (Pmax). The onset of the sprints was standardized with an acceleration threshold of 0.1 m/s². The sprint end detection methods were: 1. Time when peak velocity (MSS) was achieved (zero acceleration), 2. Time after peak velocity drops by -0.4 m/s, 3. Time after peak velocity drops by -0.6 m/s, and 4. When the integrated distance from the GPS/GNSS signal achieves 40-m. Goodness-of-fit of each sprint end detection method was determined using the residual sum of squares (RSS) to demonstrate the error of the FVP modeling with the sprint data from the GPS/GNSS system. Inter-trial reliability (from 2 trials) was assessed utilizing intraclass correlation coefficients (ICC). For goodness-of-fit results, the end detection technique that used the time when peak velocity was achieved (zero acceleration) had the lowest RSS values, followed by -0.4 and -0.6 velocity decay, and 40-m end had the highest RSS values. For intertrial reliability, the end of sprint detection techniques that were defined as the time at (method 1) or shortly after (method 2 and 3) when MSS was achieved had very large to near perfect ICC and the time at the 40 m integrated distance (method 4) had large to very large ICCs. Peak velocity was reached at 29.52 ± 4.02-m. Therefore, sport scientists should implement end of sprint detection either when peak velocity is determined or shortly after to improve goodness of fit to achieve reliable between trial FVP profile metrics. Although, more robust processing and modeling procedures should be developed in future research to improve sprint model fitting. This protocol was seamlessly integrated into the usual training which shows promise for sprint monitoring in the field with this technology.

Keywords: automated, biomechanics, team-sports, sprint

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Authors: Elisa Boatti, Ulisse Stefanelli, Alessandro Reali, Ferdinando Auricchio

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Thanks to their unusual properties, shape memory alloys (SMAs) are good candidates for advanced applications in a wide range of engineering fields, such as automotive, robotics, civil, biomedical, aerospace. In the last decades, the ever-growing interest for such materials has boosted several research studies aimed at modeling their complex nonlinear behavior in an effective and robust way. Since the constitutive response of SMAs is strongly thermomechanically coupled, the investigation of the non-isothermal evolution of the material must be taken into consideration. The present study considers an existing three-dimensional phenomenological model for SMAs, able to reproduce the main SMA properties while maintaining a simple user-friendly structure, and proposes a variational reformulation of the full non-isothermal version of the model. While the considered model has been thoroughly assessed in an isothermal setting, the proposed formulation allows to take into account the full nonisothermal problem. In particular, the reformulation is inspired to the GENERIC (General Equations for Non-Equilibrium Reversible-Irreversible Coupling) formalism, and is based on a generalized gradient flow of the total entropy, related to thermal and mechanical variables. Such phrasing of the model is new and allows for a discussion of the model from both a theoretical and a numerical point of view. Moreover, it directly implies the dissipativity of the flow. A semi-implicit time-discrete scheme is also presented for the fully coupled thermomechanical system, and is proven unconditionally stable and convergent. The correspondent algorithm is then implemented, under a space-homogeneous temperature field assumption, and tested under different conditions. The core of the algorithm is composed of a mechanical subproblem and a thermal subproblem. The iterative scheme is solved by a generalized Newton method. Numerous uniaxial and biaxial tests are reported to assess the performance of the model and algorithm, including variable imposed strain, strain rate, heat exchange properties, and external temperature. In particular, the heat exchange with the environment is the only source of rate-dependency in the model. The reported curves clearly display the interdependence between phase transformation strain and material temperature. The full thermomechanical coupling allows to reproduce the exothermic and endothermic effects during respectively forward and backward phase transformation. The numerical tests have thus demonstrated that the model can appropriately reproduce the coupled SMA behavior in different loading conditions and rates. Moreover, the algorithm has proved effective and robust. Further developments are being considered, such as the extension of the formulation to the finite-strain setting and the study of the boundary value problem.

Keywords: generalized gradient flow, GENERIC formalism, shape memory alloys, thermomechanical coupling

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Authors: Anna Costanza Russo, Daniele Landi, Michele Germani

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Nowadays, the European Ecodesign Directive has emerged as a new approach to integrate environmental concerns into the product design and related processes. Ecodesign aims to minimize environmental impacts throughout the product life cycle, without compromising performances and costs. In addition, the recent Ecodesign Directives require products which are increasingly eco-friendly and eco-efficient, preserving high-performances. It is very important for producers measuring performances, for electric cooking ranges, hobs, ovens, and grills for household use, and a low power consumption of appliances represents a powerful selling point, also in terms of ecodesign requirements. The Ecodesign Directive provides a clear framework about the sustainable design of products and it has been extended in 2009 to all energy-related products, or products with an impact on energy consumption during the use. The European Regulation establishes measures of ecodesign of ovens, hobs, and kitchen hoods, and domestic use and energy efficiency of a product has a significant environmental aspect in the use phase which is the most impactful in the life cycle. It is important that the product parameters and performances are not affected by ecodesign requirements from a user’s point of view, and the benefits of reducing energy consumption in the use phase should offset the possible environmental impact in the production stage. Accurate measurements of cooking appliance performance are essential to help the industry to produce more energy efficient appliances. The development of ecodriven products requires ecoinnovation and ecodesign tools to support the sustainability improvement. The ecodesign tools should be practical and focused on specific ecoobjectives in order to be largely diffused. The main scope of this paper is the development, implementation, and testing of an innovative tool, which could be an improvement for the sustainable design of induction hobs. In particular, a prototypical software tool is developed in order to simulate the energy performances of the induction hobs. The tool is focused on a multiphysics model which is able to simulate the energy performances and the efficiency of induction hobs starting from the design data. The multiphysics model is composed by an electromagnetic simulation and a thermal simulation. The electromagnetic simulation is able to calculate the eddy current induced in the pot, which leads to the Joule heating of material. The thermal simulation is able to measure the energy consumption during the operational phase. The Joule heating caused from the eddy currents is the output of electromagnetic simulation and the input of thermal ones. The aims of the paper are the development of integrated tools and methodologies of virtual prototyping in the context of the ecodesign. This tool could be a revolutionary instrument in the field of industrial engineering and it gives consideration to the environmental aspects of product design and focus on the ecodesign of energy-related products, in order to achieve a reduced environmental impact.

Keywords: ecodesign, energy efficiency, induction hobs, virtual prototyping

Procedia PDF Downloads 236

Authors: Eleni Maistrou, D. Kosmopoulos, Carolina Moretti, Amalia Konidi, Katerina Boulougoura

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InterArch is an ongoing research project that has been running since September 2020. It aims to propose the design of a site-based digital application for archaeological sites and outdoor guided tours, supporting virtual and augmented reality technology. The research project is co‐financed by the European Union and Greek national funds, through the Operational Program Competitiveness, Entrepreneurship, and Innovation, under the call RESEARCH - CREATE – INNOVATE (project code: Τ2ΕΔΚ-01659). It involves mutual collaboration between academic and cultural institutions and the contribution of an IT applications development company. The research will be completed by July 2023 and will run as a pilot project for the city of Ancient Messene, a place of outstanding natural beauty in the west of Peloponnese, which is considered one of the most important archaeological sites in Greece. The applied research project integrates an interactive approach to the natural environment, aiming at a manifold sensory experience. It combines the physical space of the archaeological site with the digital space of archaeological and cultural data while at the same time, it embraces storytelling processes by engaging an interdisciplinary approach that familiarizes the user with multiple semantic interpretations. The mingling of the real-world environment with its digital and cultural components by using augmented reality techniques could potentially transform the visit on-site into an immersive multimodal sensory experience. To this purpose, an extensive spatial analysis along with a detailed evaluation of the existing digital and non-digital archives is proposed in our project, intending to correlate natural landscape morphology (including archaeological material remains and environmental characteristics) with the extensive historical records and cultural digital data. On-site research was carried out, during which visitors’ itineraries were monitored and tracked throughout the archaeological visit using GPS locators. The results provide our project with useful insight concerning the way visitors engage and interact with their surroundings, depending on the sequence of their itineraries and the duration of stay at each location. InterArch aims to propose the design of a site-based digital application for archaeological sites and outdoor guided tours, supporting virtual and augmented reality technology. Extensive spatial analysis, along with a detailed evaluation of the existing digital and non-digital archives, is used in our project, intending to correlate natural landscape morphology with the extensive historical records and cultural digital data. The results of the on-site research provide our project with useful insight concerning the way visitors engage and interact with their surroundings, depending on the sequence of their itineraries and the duration of stay at each location.

Keywords: archaeological site, digital space, semantic interpretations, cultural heritage

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Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen

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Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.

Keywords: ehealth, one health, risk communication, stakeholder, zoonosis

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Authors: Daniel Rowe, Christopher R. Vogel, Richard H. J. Willden

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The University of Oxford’s recirculating water flume is a combined wave and current test tank with a 1 m depth, 1.1 m width, and 10 m long working section, and is capable of flow speeds up to 1 ms−1 . This study documents the hydrodynamic characteristics of the facility in preparation for experimental testing of horizontal axis tidal stream turbine models. The turbine to be tested has a rotor diameter of 0.6 m and is a modified version of one of two model-scale turbines tested in previous experimental campaigns. An Acoustic Doppler Velocimeter (ADV) was used to measure the flow at high temporal resolution at various locations throughout the flume, enabling the spatial uniformity and turbulence flow parameters to be investigated. The mean velocity profiles exhibited high levels of spatial uniformity at the design speed of the flume, 0.6 ms−1 , with variations in the three-dimensional velocity components on the order of ±1% at the 95% confidence level, along with a modest streamwise acceleration through the measurement domain, a target 5 m working section of the flume. A high degree of uniformity was also apparent for the turbulence intensity, with values ranging between 1-2% across the intended swept area of the turbine rotor. The integral scales of turbulence exhibited a far higher degree of variation throughout the water column, particularly in the streamwise and vertical scales. This behaviour is believed to be due to the high signal noise content leading to decorrelation in the sampling records. To achieve more realistic levels of vertical velocity shear in the flume, a simple procedure to practically generate target vertical shear profiles in open-channel flows is described. Here, the authors arranged a series of non-uniformly spaced parallel bars placed across the width of the flume and normal to the onset flow. By adjusting the resistance grading across the height of the working section, the downstream profiles could be modified accordingly, characterised by changes in the velocity profile power law exponent, 1/n. Considering the significant temporal variation in a tidal channel, the choice of the exponent denominator, n = 6 and n = 9, effectively provides an achievable range around the much-cited value of n = 7 observed at many tidal sites. The resulting flow profiles, which we intend to use in future turbine tests, have been characterised in detail. The results indicate non-uniform vertical shear across the survey area and reveal substantial corner flows, arising from the differential shear between the target vertical and cross-stream shear profiles throughout the measurement domain. In vertically sheared flow, the rotor-equivalent turbulence intensity ranges between 3.0-3.8% throughout the measurement domain for both bar arrangements, while the streamwise integral length scale grows from a characteristic dimension on the order of the bar width, similar to the flow downstream of a turbulence-generating grid. The experimental tests are well-defined and repeatable and serve as a reference for other researchers who wish to undertake similar investigations.

Keywords: acoustic doppler Velocimeter, experimental hydrodynamics, open-channel flow, shear profiles, tidal stream turbines

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the bacteriological profile and antibiotic resistance of the isolates and to find out the potential risk factors for infection with multidrug-resistant organisms. Diabetic foot ulcer is a major medical, social, economic problem and a leading cause of morbidity and mortality, especially in the developing countries like India. 25 percent of all diabetic patients develop a foot ulcer at some point in their lives which is highly susceptible to infections and that spreads rapidly, leading to overwhelming tissue destruction and subsequent amputation. Infection with multidrug resistant organisms (MDRO) may increase the cost of management and may cause additional morbidity and mortality. Proper management of these infections requires appropriate antibiotic selection based on culture and antimicrobial susceptibility testing. Early diagnosis of microbial infections is aimed to institute the appropriate antibacterial therapy initiative to avoid further complications. A total of 200 Type 2 Diabetic Mellitus patients with infection were admitted at GD Hospital and Diabetes Institute, Kolkata. 60 of them who developed ulcer during the year 2013 were included in this study. A detailed clinical history and physical examination were carried out for every subject. Specimens for microbiological studies were obtained from ulcer region. Gram-negative bacilli were tested for extended spectrum Beta-lactamase (ESBL) production by double disc diffusion method. Staphylococcal isolates were tested for susceptibility to oxacillin by screen agar method and disc diffusion. Potential risk factors for MDRO-positive samples were explored. Gram-negative aerobes were most frequently isolated, followed by gram-positive aerobes. Males were predominant in the study and majority of the patients were in the age group of 41-60 years. The presence of neuropathy was observed in 80% cases followed by peripheral vascular disease (73%). Proteus spp. (22) was the most common pathogen isolated, followed by E.coli (17). Staphylococcus aureus was predominant amongst the gram-positive isolates. S.aureus showed a high rate of resistance to antibiotic tested (63.6%). Other gram-positive isolates were found to be highly resistant to erythromycin, tetracycline and ciprofloxacin, 40% each. All isolates were found to be sensitive to Vancomycin and Linezolid. ESBL production was noted in Proteus spp and E.coli. Approximately 70 % of the patients were positive for MDRO. MDRO-infected patients had poor glycemic control (HbA1c 11± 2). Infection with MDROs is common in diabetic foot ulcers and is associated with risk factors like inadequate glycemic control, the presence of neuropathy, osteomyelitis, ulcer size and increased the requirement for surgical treatment. There is a need for continuous surveillance of resistant bacteria to provide the basis for empirical therapy and reduce the risk of complications.

Keywords: diabetic foot ulcer, bacterial infection, multidrug-resistant organism, extended spectrum beta-lactamase

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