Validation Sessions Research Articles

Answering, Fast and Slow: Strategy enhancement of visual understanding guided by causality

In his classic book Thinking, Fast and Slow (Daniel, 2017), Kahneman points out that human thinking can be categorized into two main modes of thinking: a system that displays intuition and emotion (i.e., System 1), and a system that is more planned and relies more on logic, defined as System 2. This idea explains both rational and irrational motivations. In this paper, we revisit visual comprehension tasks based on this idea. At the theoretical level, we focus on the relationship between intuitive thinking, prior knowledge, and environmental information, and build a causal graph between the three. Further, inspired by the constructed causal graph, an intuitive optimization strategy with clear interpretability is proposed. In the validation session, we provide conclusions consistent with the theoretical analyses through extensive experiments on public datasets based on a visual quizzing task. Excitingly, our scheme demonstrates strong competitiveness in terms of generalizability without adding new technologies.

Technology for fast-tracking high-risk head and neck cancer referrals: Co-designing with patients

BackgroundHead and Neck Cancer (HNC) is the eighth most prevalent global cancer. Timely recognition of symptoms is crucial for reducing mortality rates. The EVolution of a patiEnt-REported symptom-based risk stratification sySTem to redesign the suspected Head and Neck cancer referral pathway (EVEREST-HN) study aims to develop and evaluate a risk stratification tool using patient reported symptoms, which will be populated remotely in the community before the patient is seen by the clinician to hasten HNC diagnosis. EVEREST-HN will design a patient SYmptom iNput Clinical (SYNC) system to gather patient symptom data and calculate a risk score to aid clinicians in identifying high-risk cases. This identification potentially allows for high-risk patients to be seen sooner, thereby improving patient outcomes. MethodsThree workshop sessions were conducted involving a total of 17 unique participants, with several contributing to multiple sessions: nine in the co-design session, six in the validation session, and nine in the evaluation session. The co-design session employed online collaboration with patients’ representatives. Thematic analysis was used to identify requirements and concerns informing the development of a low-fidelity prototype. The validation session assessed whether the prototype aligned with patient expectations. In the evaluation session, participants interacted with an online prototype and provided further feedback. ResultsDuring the co-design workshop, participants emphasized the need for a concise and clear SYNC system questionnaire for reporting suspected HNC symptoms. Concerns were raised about questionnaire length, language clarity, and the inclusion of probing questions. Participants suggested concise questions using lay language, incorporating visual aids for topics like alcohol and tobacco use, and making the sexual activity question optional. Recommendations included diverse language options, hard copies for non-English speakers, and phone call options for those uncomfortable with screen-based technology. The validation workshop confirmed that the prototype reflected participants’ ideas. Feedback highlighted the need for call-back features to help those not confident with technology and the need to present symptom questions first before social background questions. Feedback from the evaluation demonstrated a commitment to efficiency, and continuous improvement. ConclusionThis study aims to develop the SYNC system to enhance efficiency of suspected HNC referrals. The workshops highlighted the importance of end-user inclusiveness in the system development life cycle, with collaboration with stakeholders and repeated feedback, providing crucial insights for ensuring the SYNC system effectively addresses the needs and concerns of patients in the context of HNC diagnosis.

Environmental Lighting towards Growth Effect Monitoring System of Plant Factory using ANN

Malaysia is currently driven to become another most developed country in the world. Among other priority sector is Food Sustainability. Along the process, our vegetable supply-demand keeps increasing by year. Compared to traditional systems, closed systems or its other name called hydroponic is getting more important for plant production, with artificial light which has many potential advantages, including better quality transplants, shorter production time and less resource use. To gain full profit from it, the quality of vegetables needs to be controlled efficiently. Climate conditions, especially temperature and light intensity, have a significant impact on vegetable growth and yield, as well as nutritional quality. Plant growth and development are influenced by a variety of environmental factors, the most important one is light intensity. Among the problems to be tackled in this research are plant growth manual observation, light intensity variation and abundance of growth-related data to be evaluated manually. Therefore, to solve these problems, the specific type of vegetable used here is lettuce. The proposed methods are, observation of plant growth conducted automatically round the clock in intervals of 15 minutes for the whole month (estimated mature period of lettuce), using images captured. At the same time, the proposed light intensity which is red & white to the ratio of 2:1 (optimum ratio recommended by previous researchers) will be used. The issue of data to be evaluated manually will be solved using Artificial Neural Network (ANN) architecture, in specific Deep Learning. Concisely, the results & analysis shows the research is successfully developed for plant growth monitoring by using artificial neural network which, reached 80% to 90% accuracy in the training and validation session that made the architecture sufficient for determining the growth of the said vegetable. This is indeed foreseen, will highly assist the farmer in better monitoring the growth rate of the plant.

How can we develop a well-supported policy plan? Towards a cocreative development of a new informal care policy plan in Flanders: process and research results.

In Belgium, there is a growing awareness about the importance of informal carers to cover persons' care and support needs. In the last decades several efforts were made in order to support informal carers, reduce levels of burden and enhance quality of life. In 2016, Flanders launched the Flemish informal care policy plan 2016-2020, which was created to valorise and support informal carers in the Dutch speaking part of Belgium and in Brussels. This policy plan came to an end and an evaluation of its implementation was necessary to outline future policy priorities and actions.
 The evaluation methodology used insights from the analytic hierarchy process and was characterised by a participatory approach. Stakeholders from different stakeholder groups (i.e., informal carers, informal care organisations, organisations for persons with care and support needs and their relatives, professional care organisations, policy makers and researchers) were involved in all steps of the research process. In collaboration with the researchers, stakeholders generated knowledge, which formed the basis for the next steps of the research process. Focus groups were held with each stakeholder group, which aimed to explore the goals of a successful Flemish informal care policy. Six goals were identified by the participants, each containing around eight preconditions to achieve the identified goal. The generated input was used in an online questionnaire to evaluate the Flemish informal care policy plan 2016-2020 and define priorities for a new informal care policy plan. 
 The online questionnaire gathered data of 1,045 respondents from different stakeholder groups. Although the results show that the identified needs and priorities in the Flemish informal care policy plan 2016-2020 are still prominent, there is a discrepancy between the perspective of informal carers and the perspective of health and social care professionals. Most informal carers indicate that the various priorities of a successful informal care policy were not present in the implementation of the Flemish informal care plan 2016-2020, which was not the case for health and social care professionals. Regarding the new Flemish informal care policy plan, two objectives were prioritised by most participants in the different participant profiles: ‘recognising and acknowledging informal carers’ and 'supporting informal carers'. The selected goals for a new informal care policy plan as well as the selected preconditions within these goals show that the provision of care and support should be perceived as a process rather than a product. Furthermore, informal care should be approached as a matter that goes beyond care and wellbeing.
 Following the evaluation study, a participatory trajectory was initiated to outline future policy priorities and actions for a new informal care policy plan. Therefore, interviews with experts and policymakers were conducted, cocreation workshops with informal care organisations were held and a validation session with broader stakeholders was conducted.
 The evaluation study and participatory trajectory offered interesting insights for the creation of a sense of ownership in policy making and facilitated content development and implementation of a new informal care policy plan, taking various stakeholder perspectives into account.

The LIBRA NeuroLimb: Hybrid Real-Time Control and Mechatronic Design for Affordable Prosthetics in Developing Regions.

Globally, 2.5% of upper limb amputations are transhumeral, and both mechanical and electronic prosthetics are being developed for individuals with this condition. Mechanics often require compensatory movements that can lead to awkward gestures. Electronic types are mainly controlled by superficial electromyography (sEMG). However, in proximal amputations, the residual limb is utilized less frequently in daily activities. Muscle shortening increases with time and results in weakened sEMG readings. Therefore, sEMG-controlled models exhibit a low success rate in executing gestures. The LIBRA NeuroLimb prosthesis is introduced to address this problem. It features three active and four passive degrees of freedom (DOF), offers up to 8 h of operation, and employs a hybrid control system that combines sEMG and electroencephalography (EEG) signal classification. The sEMG and EEG classification models achieve up to 99% and 76% accuracy, respectively, enabling precise real-time control. The prosthesis can perform a grip within as little as 0.3 s, exerting up to 21.26 N of pinch force. Training and validation sessions were conducted with two volunteers. Assessed with the "AM-ULA" test, scores of 222 and 144 demonstrated the prosthesis's potential to improve the user's ability to perform daily activities. Future work will prioritize enhancing the mechanical strength, increasing active DOF, and refining real-world usability.

Development and Validation of a Photonumeric Scale to Assess Marionette Lines.

A validated scale is needed for objective and reproducible comparisons of marionette lines before and after treatment in clinical studies. To describe the development and validation of a 5-point photonumeric marionette lines scale. The scale was developed to include an assessment guide, verbal descriptors, and real and morphed subject images for each scale grade. Intrarater and interrater reliability was evaluated in initial scale validation (web-based review) ( N = 51 ) and live-subject validation ( N = 75 ) studies, each completed during 2 sessions. In the initial scale validation study, intrarater agreement for 2 physician raters was near perfect (weighted kappa = 0.92 and 0.94). Interrater agreement was excellent during sessions 1 and 2 (intraclass correlation coefficients of 0.94 and 0.95, respectively). In the live-subject validation study, intrarater agreement for 3 physician raters showed a strong correlation (mean weighted kappa = 0.77). Interrater agreement was high during live-subject validation sessions 1 and 2 (intraclass correlation coefficients = 0.89 for both sessions). This new marionette lines scale is a validated and reliable scale for physician rating of marionette line severity.

Development and Validation of a Digital Photographic Atlas of Argentine Foods

Introduction. Before the Second National Health and Nutrition Survey in Argentina, it was necessary to create a digital visual tool to help participants in the quantification of intake. This study describes the development of a Digital Photographic Atlas of Argentinean Foods (AFDAA) and evaluates its accuracy in visually estimating the amounts of foods consumed in Argentina. Methods. A total of 292 photographs of food/dishes were taken in standardized conditions and classified into 103 series according to food group. Thirty series were selected for validation. Adults ≥ 18 years of age were invited to participate in three validation sessions that were conducted at “blinded” between 2016 and 2018. During each session, the participant´s ability to visually relate a real amount of food presented on a plate to an amount depicted in a photograph series was assessed. The difference between the participant’s perception of the weight of foods/dishes in photographs and the real weight was expressed as a percentage. The average percentage difference was estimated, and 95% confidence intervals were used. When ≥ 50% of the differences were outside the ±30% range, the set of pictures was removed from the final version. Results. This free-to-use digital Atlas is a valuable tool that can be employed in future dietary surveys to quantify the consumption of foods similar to those depicted in the images. Conclusion. The degree of BMI tends to increase the level of sleepiness. Funding: This research received financial support from UNICEF and the Universidad Nacional de La Matanza (Grant C2SAL012).

Trapped in housing insecurity: Socioecological barriers to housing access experienced by intimate partner violence survivors from marginalized communities.

Homelessness and intimate partner violence (IPV)do not impact all communities equally. Survivors from marginalized communities-that is communities that have been historically and structurally excluded from social, economic, and political resources-face additional challenges weathering IPV and housing crises. Understanding the housing experiences of marginalized survivors is necessary to achieve housing equity for all survivors. Community-based participatory research methods were utilized to convene 14 listening sessions (7 primary/7 validation) with Black and Latinx IPV survivors with intersectional identities (n = 92). Listening sessions were held in community-based locations including a church, health clinic, social service agency, and private residence. The last five validation sessions were conducted virtually on Zoom due to COVID pandemic protocols. All listening sessions were digitally recorded and transcribed verbatim. Latinx population listening sessions were conducted in Spanish and were implemented and translated with attention to linguistic justice principles. The research team used a modified constructivist grounded theory approach for data analysis.Four overarching themes (and seven subthemes) related to survivors' housing experiences emerged: (1) safety and healing challenges, including living in unhealthy physical environments, not being safe in their homes, and contending with community violence, sexual exploitation threats, and eviction fears; (2) formal service fragmentation/bureaucracy that hampered access to housing resource information and resources; (3) resource scarcity associated with limited affordable housing stock; and (4) systemic oppression resulting from discriminatory treatment and gentrification. Comprehensive multileveled approaches are needed to disrupt the cycle of housing insecurity for IPV survivors from marginalized communities.

You Look like You’ll Buy It! Purchase Intent Prediction Based on Facially Detected Emotions in Social Media Campaigns for Food Products

Understanding the online behavior and purchase intent of online consumers in social media can bring significant benefits to the ecommerce business and consumer research community. Despite the tight links between consumer emotions and purchase decisions, previous studies focused primarily on predicting purchase intent through web analytics and sales historical data. Here, the use of facially expressed emotions is suggested to infer the purchase intent of online consumers while watching social media video campaigns for food products (yogurt and nut butters). A FaceReader OnlineTM multi-stage experiment was set, collecting data from 154 valid sessions of 74 participants. A set of different classification models was deployed, and the performance evaluation metrics were compared. The models included Neural Networks (NNs), Logistic Regression (LR), Decision Trees (DTs), Random Forest (RF,) and Support Vector Machine (SVM). The NNs proved highly accurate (90–91%) in predicting the consumers’ intention to buy or try the product, while RF showed promising results (75%). The expressions of sadness and surprise indicated the highest levels of relative importance in RF and DTs correspondingly. Despite the low activation scores in arousal, micro expressions of emotions proved to be sufficient input in predicting purchase intent based on instances of facially decoded emotions.

Degradation Mode Knowledge Transfer Method for LFP Batteries

Lithium-ion (Li-ion) batteries are widely utilized as energy storage units owing to their high energy density and safety. However, when battery degradation occurs, Li-ion batteries deteriorate and become untrustworthy. Accurate diagnosis and identification of the degradation modes (DMs) constitute a critical task for systems employing Li-ion batteries. Current diagnosis methods are usually postanalysis and cannot be directly employed for diagnosing the batteries that are in operation. This study proposes a ResNet-50-based diagnosis model for DMs, which can quantify the contribution of three DMs for the synthetic datasets. Because the real and synthetic datasets are independent and identically distributed, it is difficult to apply this model to the real datasets. To bridge the gap, this article proposes a deep domain adaptation method to minimize the classification loss and domain adaptation loss between the source domain (synthetic) and the target domain (real), such that the degradation knowledge learned from the synthetic batteries can be transferred to the real batteries. The model’s input, structure, and parameters are optimized through simulation tests to improve the diagnosis accuracy. A validation session is designed to verify the classification accuracy of unlabeled DMs of the lithium iron phosphate (LFP) battery. The results show that the proposed method can effectively transfer the knowledge of degradations from synthetic batteries to real-world LFP batteries to diagnose and identify DMs of LFP batteries with relatively high classification accuracy.

Feasibility and reliability of telephone‐based cognitive assessment in middle‐aged and older adults in the Wisconsin Alzheimer’s Disease Research Center

AbstractBackgroundUse of telephone‐based cognitive assessments became more widespread during the COVID‐19 pandemic. The National Alzheimer’s Coordinating Center (NACC) developed the telephone‐based cognitive battery (T‐Cog) to ensure continued data collection and participant retention. The objective of this study was to (1) assess the feasibility and reliability of T‐Cog data collected during the pandemic, (2) evaluate these data in the context of prior in‐person data and (3) inform future use of remote data collection.MethodThe Wisconsin ADRC Clinical Core staff administered T‐Cog batteries to participants with normal cognition, mild cognitive impairment (MCI), or dementia (n = 380, mean age = 68.7±8.9, 66.1% female, 78.4% white, mean education = 16.2±2.48) (Table 1). Examiners rated the validity of the testing session and noted reasons for an invalid session. Reliability was assessed by comparing individual neuropsychological test performances from the T‐Cog to the most recent in‐person evaluation using intraclass correlation coefficients (ICC). Chi‐square was used to test if research diagnoses (normal cognition, MCI, dementia) varied by modality (T‐Cog, in‐person).ResultsMost T‐Cog sessions were rated as valid by examiners (87.8%). The most common reasons for questionable or not valid session included hearing impairments, distractions, and interruptions (Figure 1). Measures of verbal fluency (Animal Naming (ICC = 0.69), F+L Fluency (ICC = 0.73)), list‐learning and memory (RAVLT Trials 1–5 (ICC = 0.75), RAVLT Long Delay Recall (ICC = 0.70), RAVLT Recognition (ICC = 0.71)), and story memory (Craft Story‐Immediate (ICC = 0.65), Craft Story‐Delayed (ICC = 0.73)) showed moderate to excellent reliability and were significant (p<0.01), suggesting good agreement between T‐Cog and in‐person assessments (Table 2). Measures of attention (Digit Span Forward (ICC = 0.66), Digit Span Backward (ICC = 0.15)) varied from moderately reliable to not reliable, respectively. Lastly, research diagnoses did not differ by testing modality.ConclusionThese results suggest T‐Cog assessments are feasible for participants who cannot complete in‐person visits, given adequate hearing and limited distractions and interruptions to ensure test validity. Preliminary comparisons of T‐Cog vs in‐person performances suggest good reliability for verbal fluency, story memory, and list‐learning measures. Although remote assessments can expand access and diversify the population involved in AD research, identifying assessments that are both feasible and reliable across varied administrations will be essential to track longitudinal change in cognitive status.

The Objective Buttocks Assessment Scale: A New and Complete Method to Assess the Gluteal Region.

New treatment methods to improve and enhance the appearance of the buttocks require globally accepted scales for aesthetic research and patient evaluation. The purpose of this study was to develop a set of grading scales for objective assessment of the gluteal region and assess their reliability and validity. Twelve photonumeric grading scales were created. Eleven aesthetic experts rated photographs of 650 women in two validation sessions. Responses were analyzed to assess interrater and intrarater reliability. The Rasch model was used as part of the validation process. All the scales exceeded criteria for acceptability, reliability, and validity. Overall interrater reliability and intrarater reliability were both "almost perfect" ( p = 0.15 and p = 0.16, respectively). Consistent outcomes between raters and by individual raters at two time points confirm the reliability of the Objective Buttocks Assessment Scale in female patients and suggest it will be a valuable tool for use in research and clinical practice.

A New Secure Lightweight Authentication Protocol for NFC mobile Payment

As mobile applications grow, securing these applications become an important factor for their success. Especially, when these applications are related to financial transactions. Nowadays, mobile payment that is based on NFC technology is considered one of these important topics. In this paper, we propose A New Secure and Lightweight Authentication Protocol for NFC mobile Payment (NSLA) protocol. NSLA protocol presents a new method to update the users’ identities and the valid session keys, which preserves the privacy and ensures the integrity of the system. The presented performance analysis shows that NSLA protocol satisfies low computation overhead. Moreover, the security analysis proves that NSLA protocol has an immunity against replay attack, brute force attack, denial of service attack, and others types of attacks.

Feedback support system for training of excavator operators

On-equipment and practical sessions are indispensable part of construction equipment training. Currently, however, instructors receive very little to no technological support during these practical sessions, where they have to observe and provide feedback to multiple trainees concurrently. Therefore, the objective of this research is to develop a virtual Feedback Support System that can support instructors/trainees in providing/receiving feedback. This system captures the performance of trainees, translates it into a virtual model, and automatically identifies points of attention for the instructors. Instructors and trainees can use this system to communicate in a more unambiguous and objective manner. A working prototype is developed and tested in a case study at a construction training school. The usability validation session with the end-users showed that the developed system has the potential to support both trainees and instructors during the practical on-equipment sessions.

Ask us! Adjusting experience-based codesign to be responsive to people with intellectual disabilities, serious mental illness or older persons receiving support with independent living.

Experience-based codesign (EBCD) is a valuable tool for participatory quality improvement. However, the EBCD process needs to be adjusted to make it suitable for long-term care. The focus of the improvement process needs to shift to the care relationship, as this is an important part of the quality of care in these settings. Furthermore, the EBCD process needs to be made more accessible to vulnerable populations. Through a participatory research approach, EBCD was adjusted to long-term care. The research was conducted in two care organisations: one supporting people with serious mental illness and intellectual disabilities in independent living and one providing homecare services for older persons. The participatory research resulted in the development of 'Ask us!'-a method for critical reflective codesign. The research furthermore provided valuable lessons for participatory projects with vulnerable clients. A common problem with participatory research in long-term care is ensuring the involvement of clients and informal carers. We report on various strategies developed to include experiences of a diverse set of services users, such as combining interviews with participant observation, photo-voice and involving experts-by-experiences as co-ethnographers. In close collaboration with an inclusive theatre company, these experiences were translated into 42 short videos on complex situations in the care relationship from the perspective of clients, professionalsor informal carers. These videos instigate critical reflection and accelerate the participatory quality improvement process. Moreover, practical tools were developed to overcome barriers regarding the involvement of people with disabilities. These include the use of photo-elicitation to enable participation of clients with disabilities in heterogeneous group discussions and involving experts-by-experience as proxies to share experiences of clients for whom participation in the 'Ask us' method remains inaccessible. The result of a robust participatory process, 'Ask us!' is a promising method for participatory quality improvement in long-term care. The research furthermore generated lessons for involving vulnerable populations in participatory research and codesign. Clients were involved as informants, sharing their experiences with the care relationship in interviews, photovoice and observations. They were also involved as consultants, helping to analyse input for the film scripts during data validation sessions.

A Critical Heuristics Approach for Approximating Fairness in Method Engineering

Information system (IS) development projects often fail because of unclear wishes and needs of concerned parties, or because the developed IS or the used system development method (SDM) is not fully supported by concerned parties. In this study it is investigated how stakeholders that are concerned with the SDM are identified and involved in the engineering of such methods. The Critical Systems Heuristics (CSH) method can be used to identify stakeholders in method engineering, along with their concerns. CSH is meta-modelled and reviewed in twelve interviews with practitioners in software development, system engineering, and consultancy in order to evaluate its applicability in an organizational context. Subsequent modifications made to the contemporary CSH method are validated in an expert validation session. The resulting evolved CSH method enables method engineers to take into account their challenges and contexts, and the method can be instantiated for organizations that engineer methods for internal or external use.

Validation of a Chin Retrusion Scale for Chinese Subjects.

Chin augmentation procedures are gaining in popularity. The purpose of this study was to validate the China (Allergan) Chin Retrusion Scale (CACRS) and to evaluate the reliability of the scale. A team of 10 physicians based in Beijing, China, consisting of 1 principal investigator and 9 independent raters, assessed a pool of subject images. Using standardized equipment to capture 2-dimensional images, 100 subjects were photographed from a left, lateral, 90° view. Two measures were used to assess the validity of the scale: rater evaluations of clinically significant differences in 52 pairs of images and rater assessment of chin retrusion using the CACRS to grade the 100 images. The CACRS demonstrated almost perfect inter-rater agreement during 2 validation sessions, with intraclass correlation coefficients of 0.89 and 0.90 at sessions 1 and 2, respectively. Overall inter-rater agreement for all 9 raters was almost perfect, with a weighted kappa of 0.82. Based on inter- and intra-rater agreement, the CACRS was validated for physician ratings of chin retrusion in Chinese subjects. Results from clinical significance evaluations indicated that a 1-grade difference between image pairs was considered clinically meaningful for the CACRS. The CACRS is a validated and reliable photonumeric scale for the assessment of chin retrusion in Chinese men and women. The scale is a clinically significant reference tool for evaluating the effect of chin augmentation.

Ketamine treatment for depression: qualitative study exploring patient views.

Ketamine is a new and promising treatment for depression but comes with challenges to implement because of its potential for abuse. We sought the views of patients to inform policy and practical decisions about the clinical use of ketamine before large-scale roll-out is considered. This qualitative study used three focus groups and three validation sessions from 14 patients with prior diagnoses of depression but no experience of ketamine treatment. Focus groups explored their views about clinical use of ketamine and the best way for ketamine to be administered and monitored. The qualitative data were analysed by three service-user researchers using thematic analysis. Five themes were generated: changing public perceptions, risks, monitoring, privacy and data protection, and practical aspects. Participants were conscious of the stigma attached to ketamine as a street drug and wanted better public education, and evidence on the safety of ketamine after long-term use. They felt that monitoring was required to provide evidence for ketamine's safe use and administration, but there were concerns about the misuse of this information. Practical aspects included discussions about treatment duration, administration and accessibility (for example who would receive it, under what criteria and how). Patients are enthusiastic about ketamine treatment but need more information before national roll-out. The wider societal impact of ketamine treatment also needs to be considered and patients need to be part of any future roll-out to ensure its success.

An engineering‐oriented variable water flow air‐conditioning system terminal flow rate estimation method based on component flow resistance characteristics

AbstractWater flow rate plays an important role in the modeling prediction, fault detection and diagnosis, and performance optimization of the variable water flow air‐conditioning (VWFAC) system. However, flowmeters employed by the system's terminals have not been widely used in engineering applications for the constraints in installation space and high installation and retrofit costs. Therefore, in this study, a terminal flow rate estimation method is proposed for the VWFAC system to reduce the dependency on flowmeters. The water flow rate estimation model is developed based on the flow resistance characteristics inside the air handling unit (AHU) and was trained and verified at the Monitoring and Control Laboratory established in the Dalian University of Technology. The results indicate that the maximum root‐mean‐square error (RMSE) during the training and validation sessions are 0.038 m3/h and 0.028 m3/h, respectively, while the corresponding mean absolute percentage error (MAPE) are below 1.4% and 6.5%, which is acceptable for engineering applications. To improve the flow rate estimation accuracy of the model, water temperature, water flow rate, and pressure difference are suggested to cover a wide varied range during the training session as much as possible. Systematic error is an important index in determining the demands for sensor's accuracy class. According to the results of water flow rate, the systematic errors of the estimates are ranged between 0.51% and 0.76%, only about 1/4 to 1/3 of the measurements systematic errors. Based on the error propagation theory, the water flow rate estimates would be reliable if the systematic error of the pressure measurements does not over twice that of the water flow rate measurements. This flow rate estimation method can be further applied to other thermal engineering systems to bring considerable economic benefits for engineering applications.

LO43: First Nations emergency care visits in Alberta: Descriptive results of a retrospective cohort study

Introduction: Emergency care serves as an important health resource for First Nations (FN) persons. Previous reporting shows that FN persons visit emergency departments at almost double the rate of non-FN persons. Working collaboratively with FN partners, academic researchers and health authority staff, the objective of this study is to investigate FN emergency care patient visit statistics in Alberta over a five year period. Methods: Through a population-based retrospective cohort study for the period from April 1, 2012 to March 31, 2017, patient demographics and emergency care visit characteristics for status FN patients in Alberta were analyzed and compared to non-FN statistics. Frequencies and percentages (%) describe patients and visits by categorical variables (e.g., Canadian Triage Acuity Scale (CTAS)). Means and standard deviations (medians and interquartile ranges (IQR)) describe continuous variables (e.g., distances) as appropriate for the data distribution. These descriptions are repeated for the FN and non-FN populations, separately. Results: The data set contains 11,686,288 emergency facility visits by 3,024,491 unique persons. FN people make up 4.8% of unique patients and 9.4% of emergency care visits. FN persons live further from emergency facilities than their non-FN counterparts (FN median 6 km, IQR 1-24; vs. non-FN median 4 km, IQR 2-8). FN visits arrive more often by ground ambulance (15.3% vs. 10%). FN visits are more commonly triaged as less acute (59% CTAS levels 4 and 5, compared to non-FN 50.4%). More FN visits end in leaving without completing treatment (6.7% vs. 3.6%). FN visits are more often in the evening – 4:01pm to 12:00am (43.6% vs. 38.1%). Conclusion: In a collaborative validation session, FN Elders and health directors contextualized emergency care presentation in evenings and receiving less acute triage scores as related to difficulties accessing primary care. They explained presentation in evenings, arrival by ambulance, and leaving without completing treatment in terms of issues accessing transport to and from emergency facilities. Many factors interact to determine FN patients’ emergency care visit characteristics and outcomes. Further research needs to separate the impact of FN identity from factors such as reasons for visiting emergency facilities, distance traveled to care, and the size of facility where care is provided.