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At least 217 records · Page 12

Percutaneous Ultrasound-Guided Carpal Tunnel Release: Study Upon Clinical Efficacy and Safety

ObjectivesTo evaluate the feasibility and 6 months clinical result of sectioning of the transverse carpal ligament (TCL) and median nerve decompression after ultra-minimally invasive, ultrasound-guided percutaneous carpal tunnel release (PCTR) surgery.MethodsConsecutive patients with carpal tunnel syndrome were enrolled in this descriptive, open-label study. The procedure was performed in the interventional radiology room. Magnetic resonance imaging was performed at baseline and 1 month. The Boston Carpal Tunnel Questionnaire was administered at baseline, 1, and 6 months.Results129 patients were enrolled. Significant decreases in mean symptom severity scores (3.3 ± 0.7 at baseline, 1.7 ± 0.4 at Month 1, 1.3 ± 0.3 at Month 6) and mean functional status scores (2.6 ± 1.1 at baseline, 1.6 ± 0.4 at Month 1, 1.3 ± 0.5 at Month 6) were noted. Magnetic resonance imaging showed a complete section of all TCL and nerve decompression in 100% of patients. No complications were identified.ConclusionsUltrasound-guided PCTR was used successfully to section the TCL, decompress the median nerve, and reduce self-reported symptoms.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study

PurposeTo investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).Materials and MethodsTwelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH. Patients were followed up with repeat MP-MRI at 3 months and 1 year. International prostate symptom score (IPSS), international index for erectile function (IIEF), and quality of life assessment from the IPSS and EQ-5D-5S questionnaires were recorded pre-PAE and at 6 weeks, 3 months, and 1 year.ResultsThe mean age of patients was 68 (61–76). All patients had PAE as a day-case procedure. The technical success in the cohort was 23/24 (96%). There was a significant reduction in prostate volume following embolization with a median reduction of 34% (30–55) in the AdBPH group, compared to a mean volume reduction of 22% (9–44) in the non-AdBPH group (p = 0.04). There was a significant reduction in IPSS in the AdBPH group following PAE when compared with the control group [AdBPH median IPSS 8 (3–15) vs. non-AdBPH median IPSS 13 (8–18), p = 0.01]. IPSS QOL scores significantly improved in the AdBPH group (p = 0.007). There was no deterioration in sexual function in either group post-PAE.ConclusionsThis is the first time that AdBPH has been identified as being a predictor of clinical success following PAE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

The Interventional Radiology (IR) Gender Gap: A Prospective Online Survey by the Cardiovascular and Interventional Radiological Society of Europe (CIRSE)

AimA prospective online survey was conducted by the Cardiovascular Interventional Radiological Society of Europe (CIRSE) to evaluate the gender gap within interventional radiology (IR) and the barriers facing women in IR.Materials and MethodsA questionnaire (“Appendix”) was devised by the authors and the CIRSE communication and publication team and sent electronically to 750 identifiable female members of CIRSE. Responses were collected from 7 August to 24 August 2017.ResultsThe response rate was 19.9% (n = 149) with highest responses from UK (18%), Italy (11%), Germany (11%), Spain (7%), Netherlands (5%), France (5%), Sweden (4%), USA (4%). 91% of the respondents were between 31 and 46 years, 83% work full time, 62% spend > 50% of their working time in IR, and 67% practice in a university or tertiary referral institution. 85% were in the minority in their department. 52% had no leadership role in their department, but 67% expressed willingness to consider a leadership position. Their main concerns were work/family life balance, the risks of radiation exposure, the effect of pregnancy on training and practice and the male-dominated work environment.ConclusionThis survey highlights issues experienced by women in IR. Clear guidance on concerns regarding radiation exposure particularly during pregnancy is needed. Structured and supportive training is required for female IRs who may wish to train or work flexibly. The male-dominated environment is discouraging, and a scheme to promote female IRs would encourage women to take on senior leadership positions and attract more women into the specialty.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Transarterial (Chemo-)Embolization and Lipiodolization for Hepatic Haemangioma

Background: Transarterial (chemo-)embolization/lipiodolization (TAE/TAL) might be an attractive minimally invasive alternative to surgery in the treatment of symptomatic hepatic haemangioma. This review assesses the efficacy and safety of TAE/TAL as primary treatment for symptomatic hepatic haemangioma. Methods: A systematic search of the literature was performed by two reviewers following the PRISMA guidelines. Cohort studies and case reports were identified; outcomes of cohort studies were reported. The primary efficacy outcome was tumour size before and after TAE/TAL. Improvement of symptoms and quality of life (QoL) were secondary outcomes; the primary safety outcome was complications. The Downs and Black statement was used for quality assessment. Results: Eighteen cohort studies were identified, including 1284 patients. TAE/TAL led to a decrease in tumour size in 1100/1223 (89.9%) patients and to improvement or disappearance of symptoms in 1080/1096 (98.5%) patients. A significant decrease in tumour size from 9.79 ± 0.79 cm to 4.00 ± 1.36 cm (p < 0.001) was shown. Grade 3 complications occurred in 37/1284 (2.9%) patients. Surgical treatment was necessary in 35/1284 (2.7%) of patients. Conclusion: TAE/TAL appears to be a promising and safe treatment to decrease tumour size of hepatic haemangioma. The technique might also provide partial relief of symptoms, although no randomized clinical trials or prospective studies using validated QoL questionnaires are available. TAE/TAL may be considered as a viable alternative to resection.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Effects of Prostatic Artery Embolization on the Dynamic Component of Benign Prostate Hyperplasia as Assessed by Ultrasound Elastography: A Pilot Series

Purpose: To determine the effects of prostatic artery embolization (PAE) on prostatic elasticity as assessed by Ultrasound Elastography (US-E), as well as to describe the feasibility and role of US-E as a novel tool in both pre- and post-PAE evaluation. Materials and Methods: This is a prospective, single-center investigation that included eight patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline and 3-month follow-up evaluations were performed and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. US-E with measurement of the prostatic Elastic Modulus (EM) was performed before PAE and at 1-month follow-up. Results: After PAE, US-E showed a significant reduction of prostatic EM as assessed in kPa (33.14 vs. 47.24, − 29.8%, p = 0.002) and in m/s (3.75 vs. 4.63, − 19.0%, p < 0.001). Also, the transitional/peripheral zone ratio was significantly reduced by 45.36% (0.53 vs. 0.97, p < 0.05). All eight patients presented with significant LUTS improvement after PAE (p < 0.05 for IPSS, QoL, prostate volume, peak urinary flow rate and PSA). Conclusions: Findings described in this study suggest that PAE significantly reduces prostatic EM, leading to a positive effect on BPH dynamic component related to prostatic elasticity. Also, it features US-E as an additional tool for pre- and post-PAE evaluation, describing a novel indication for this technology.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Understanding the Awareness, Knowledge and Perceptions of Interventional Radiology Amongst Undergraduates in the UK

Introduction: The role of interventional radiology (IR) in health care is rapidly expanding in the United Kingdom (UK). However, the presence of IR in the current undergraduate curriculum is lacking. Purpose: This study investigates the awareness, knowledge and perceptions of IR in undergraduates through the clinical years of medical school to suggest future interventions. Methods: A total of 360 questionnaires, designed to test undergraduates’ knowledge of, and exposure to, IR were distributed over a 14-day period in a UK medical institution. Results: Of the 312 respondents (86.7%), the majority had never formally shadowed a radiologist (65.4%) or encountered teaching from an interventional radiologist (54.5%). Most students (88.5%) felt their knowledge of IR was lower than other specialties. Students’ knowledge of IR procedures did not statistically increase through the clinical years. Students were most cognisant of vascular procedures and least aware of IR’s role in oncology. Only 10.9% would consider a career in IR, with 39.7% citing the lack of knowledge and 18.6% citing patient contact as the top reasons for this. Conclusion: Current students have poor exposure to IR through the undergraduate curriculum. Consequently, there is no increase in knowledge of IR clinical practice through the clinical years. Multi-level interventions, incorporating universities and radiological societies are required to increase undergraduate awareness and promote IR as a career. Level of Evidence: Level 3, Local non-random sample.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Drug-Coated Balloon Angioplasty of Infrapopliteal Lesions in Patients with Critical Limb Ischaemia: 1-Year Results of the APOLLO Trial

Purpose: This study intended to assess effectiveness and safety of the drug-coated balloon (DCB) angioplasty of infrapopliteal atherosclerotic lesions in patients with critical limb ischaemia (CLI) in a real-world setting. Methods: Consecutive patients with critical limb ischaemia who underwent infrapopliteal drug-coated balloon angioplasty with the ELUTAX SV DCB were enrolled into the prospective, multicentre, single-arm observational registry. Primary outcome was clinical improvement at 6 and 12 months. Secondary outcomes were change in quality of life, primary patency, freedom from repeat revascularisation, and amputation-free survival at 6 and 12 months. Results: A total of 164 patients (74.7 ± 9.2 years) with CLI were included at nine German sites between November 2015 and September 2017. The majority (79.9%) of patients had diabetes mellitus, 57.3% had renal insufficiency, and 35.3% had coronary artery disease. Mean lesion length was 71.2 ± 76.5 mm. The Rutherford category improved by 3.0 ± 2.0 (p < 0.0001) within 12 months, resulting in a clinical improvement by at least one Rutherford category in 80.2% of the patients. Walking impairment questionnaire score, European Quality of Life index, and patient-reported pain improved significantly from baseline to 6 and 12 months. Primary patency was 68.5%, freedom from target lesion revascularisation 90.6%, and amputation-free survival 83.5% at 12 months. Conclusion: Infrapopliteal drug-coated balloon angioplasty with the ELUTAX SV DCB in patients with critical limb ischaemia was efficacious and safe over the medium term. The study is registered with Clinical.Trials.gov (Identifier: NCT02539940).

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Biomarkers of oxidative stress, diet and exercise distinguish soldiers selected and non-selected for special forces training

The metabolomic profiles of Soldiers entering the U.S. Special Forces Assessment and Selection course (SFAS) have not been evaluated. To compare pre-SFAS blood metabolomes of Soldiers selected during SFAS versus those not selected, and explore the relationships between the metabolome, physical performance, and diet quality. Fasted blood samples and food frequency questionnaires were collected from 761 Soldiers prior to entering SFAS to assess metabolomic profiles and diet quality, respectively. Physical performance was assessed throughout SFAS. Between-group differences (False Discovery Rate < 0.05) in 108 metabolites were detected. Selected candidates had higher levels of compounds within xenobiotic, pentose phosphate, and corticosteroid metabolic pathways, while non-selected candidates had higher levels of compounds potentially indicative of oxidative stress (i.e., sphingomyelins, acylcarnitines, glutathione, amino acids). Multiple compounds higher in non-selected versus selected candidates included: 1-carboxyethylphenylalanine; 4-hydroxy-nonenal-glutathione; α-hydroxyisocaproate; hexanoylcarnitine; sphingomyelin and were associated with lower diet quality and worse physical performance. Candidates selected during SFAS had higher pre-SFAS levels of circulating metabolites that were associated with resistance to oxidative stress, higher physical performance and higher diet quality. In contrast, non-selected candidates had higher levels of metabolites potentially indicating elevated oxidative stress. These findings indicate that Soldiers who were selected for continued Special Forces training enter the SFAS course with metabolites associated with healthier diets and better physical performance. Additionally, the non-selected candidates had higher levels of metabolites that may indicate elevated oxidative stress, which could result from poor nutrition, non-functional overreaching/overtraining, or incomplete recovery from previous physical activity.

59 BASIC BIOLOGICAL SCIENCES↗

Effect of Diets, Familial History, and Alternative Therapies on Genomic Instability of Breast Cancer Patients

This study evaluates a correlation between family history, micronutrients intake, and alternative therapies with genetic instability, before and during breast cancer treatment. For this study, a total of 150 women were selected. Among those, 50 women were breast cancer patients on chemotherapy, while 50 breast cancer patients were on radiotherapy, and 50 were healthy females. All the participants signed the informed consent form and answered the public health questionnaire. Samples of buccal epithelial and peripheral blood cells were collected and analyzed through micronucleus and comet assays. The cells were evaluated for apoptosis and DNA damage. Results showed the association of patients’ family history with an increase in toxicogenetic damage before and during cancer therapy. On the other hand, patients with late-onset cancer also presented genetic instability before and during therapy, along with those who did not take sufficient vegetables and alternative therapies. A positive correlation was observed between the genetic instability and alternative therapies, while inverse correlation was recorded with the vegetable consumption. Results clearly explain that the nutritional aspects and alternative therapies influence the genetic instability before and during cancer therapies especially in radiotherapy treated patients. Our data could be used for the monitoring therapies and management of breast cancer patients.

60 APPLIED LIFE SCIENCES↗

Occupant Perceptions and a Health Outcome in Retail Stores

Indoor Environmental Quality (IEQ) in commercial buildings, such as retail stores, can affect employee satisfaction, productivity, and health. This study administered an IEQ survey to retail employees and found correlations between measured IEQ parameters and the survey responses. The survey included 611 employees in 14 retail stores located in Pennsylvania (climate zone 5A) and Texas (climate zone 2A). The survey questionnaire featured ratings of different aspects of IEQ, including thermal comfort, lighting and noise level, indoor smells, overall cleanness, and environmental quality. Simultaneously with the survey, on-site physical measurements were taken to collect data of relative humidity levels, air exchange rates, dry bulb temperatures, and contaminant concentrations. This data was analyzed using multinomial logit regression with independent variables being the measured IEQ parameters, employees’ gender, and age. This study found that employee perception of stuffy smells is related to formaldehyde and PM10 concentrations. Furthermore, the survey also asked the employees to report an annual frequency of common colds as a health indicator. The regression analysis showed that the cold frequency statistically correlates with the measured air exchange rates, outdoor temperatures, and indoor PM concentrations. Overall, the air exchange rate is the most influential parameter on the employee perception of the overall environmental quality and self-reported health outcome.

Field study↗

Visual feedback and guided balance training in an immersive virtual reality environment for lower extremity rehabilitation

Balance training is essential for physical rehabilitation procedures, as it can improve functional mobility and enhance cognitive coordination. However, conventional balance training methods may have limitations in terms of motivation, real-time objective feedback, and personalization, which a virtual reality (VR) setup may provide a better alternative. In this work, we present an immersive VR training environment for lower extremity balance rehabilitation with real-time guidance and feedback. The VR training environment immerses the user in a 3D ice rink model where a virtual coach (agent) leads them through a series of balance poses, and the user controls a trainee avatar with their own movements. Here we developed two coaching styles: positive-reinforcement and autonomous-supportive, and two viewpoints of the trainee avatar: first-person and third-person. The proposed environment was evaluated in a user study with healthy, non-clinical participants (n = 16, 24.4 ± 5.7 years old, 9 females). Our results show that participants showed stronger performance in the positive-reinforcement style compared to the autonomous-supportive style. Additionally, in the third-person viewpoint, the participants exhibited more stability in the positive-reinforcement style compared to the autonomous-supportive style. For viewpoint, participants exhibited stronger performance in the first-person viewpoint compared to third-person in the autonomous-supportive style, while they were comparable in the positive-reinforcement style. We observed no significant effects on the foot height and number of mistakes. Furthermore, we report the analysis of user performance with balance training poses and subjective measures based on questionnaires to assess the user experience, usability, and task load. The proposed VR balance training could offer an interactive, adaptive, and engaging environment and open new potential research directions for lower extremity rehabilitation.

97 MATHEMATICS AND COMPUTING↗

Characterizing Long COVID: Deep Phenotype of a Complex Condition

Background: Numerous publications describe the clinical manifestations of post-acute sequelae of SARS-CoV-2 (PASC or "long COVID"), but they are difficult to integrate because of heterogeneous methods and the lack of a standard for denoting the many phenotypic manifestations. Patient-led studies are of particular importance for understanding the natural history of COVID-19, but integration is hampered because they often use different terms to describe the same symptom or condition. This significant disparity in patient versus clinical characterization motivated the proposed ontological approach to specifying manifestations, which will improve capture and integration of future long COVID studies. Methods: The Human Phenotype Ontology (HPO) is a widely used standard for exchange and analysis of phenotypic abnormalities in human disease but has not yet been applied to the analysis of COVID-19. Funding: We identified 303 articles published before April 29, 2021, curated 59 relevant manuscripts that described clinical manifestations in 81 cohorts three weeks or more following acute COVID-19, and mapped 287 unique clinical findings to HPO terms. We present layperson synonyms and definitions that can be used to link patient self-report questionnaires to standard medical terminology. Long COVID clinical manifestations are not assessed consistently across studies, and most manifestations have been reported with a wide range of synonyms by different authors. Across at least 10 cohorts, authors reported 31 unique clinical features corresponding to HPO terms; the most commonly reported feature was Fatigue (median 45.1%) and the least commonly reported was Nausea (median 3.9%), but the reported percentages varied widely between studies. Interpretation: Translating long COVID manifestations into computable HPO terms will improve analysis, data capture, and classification of long COVID patients. If researchers, clinicians, and patients share a common language, then studies can be compared/pooled more effectively. Furthermore, mapping lay terminology to HPO will help patients assist clinicians and researchers in creating phenotypic characterizations that are computationally accessible, thereby improving the stratification, diagnosis, and treatment of long COVID.

60 APPLIED LIFE SCIENCES↗

The paradox of strategic environmental assessment

Strategic Environmental Assessment (SEA) is a tool that can facilitate sustainable development and improve decision-making by introducing environmental concern early in planning processes. However, various international studies conclude that current planning practice is not taking full advantage of the tool, and we therefore define the paradox of SEA as the methodological ambiguity of non-strategic SEA. This article explores causality through at three-step case study on aggregates extraction planning in Denmark, which consists of a document analysis; a questionnaire survey and follow-up communication with key planners. Though the environmental reports on one hand largely lack strategic considerations, practitioners express an inherent will for strategy and reveal that their SEAs in fact have been an integrated part of the planning process. Institutional context is found to be the most significant barrier for a strategy and this suggests that non-strategic planning setups can prove more important than non-strategic planning in SEA practice. Planners may try to execute strategy within the confinements of SEA-restricted planning contexts; however, such efforts can be overlooked if evaluated by a narrow criterion for strategy formation. Consequently, the paradox may also spark from challenged documentation. These findings contribute to the common understanding of SEA quality; however, further research is needed on how to communicate and influence the strategic options which arguably remain inside non-strategic planning realities. - Highlights: • International studies conclude that SEAs are not strategic. = The paradox of SEA. • Even on the highest managerial level, some contexts do not leave room for strategy. • Non-strategic SEA can derive from challenged documentation. • Descriptive and emergent strategy formation can, in practice, be deemed non-strategic.

54 ENVIRONMENTAL SCIENCES↗

Human–environment interactions in urban green spaces — A systematic review of contemporary issues and prospects for future research

Scientific papers on landscape planning underline the importance of maintaining and developing green spaces because of their multiple environmental and social benefits for city residents. However, a general understanding of contemporary human–environment interaction issues in urban green space is still incomplete and lacks orientation for urban planners. This review examines 219 publications to (1) provide an overview of the current state of research on the relationship between humans and urban green space, (2) group the different research approaches by identifying the main research areas, methods, and target groups, and (3) highlight important future prospects in urban green space research. - Highlights: • Reviewed literature on urban green pins down a dearth of comparative studies. • Case studies in Africa and Russia are marginalized – the Europe and US dominate. • Questionnaires are used as major tool followed by GIS and quantitative approaches. • Developing countries should contribute in building an urban green space agenda. • Interdisciplinary, adaptable and pluralistic approaches can satiate a knowledge gap.

54 ENVIRONMENTAL SCIENCES↗

Environmental Impact Assessment in the Visegrad Group countries

Highlights: • Comparison and evaluation of EIA systems in the V4 countries are presented. • Strengths and weaknesses of EIA systems based on a questionnaire survey are stated. • The function and efficiency of the EIA application in the V4 countries are analysed. • Irregularities and shortcomings of EIA systems in the V4 should be eliminated. The Environmental Impact Assessment Directive (EIA Directive) has created a reference framework for the implementation of the system of Environmental Impact Assessment (EIA) into the legal systems of the Member States of the European Union, including the countries belonging to the Visegrad Group (V4): Poland, Slovakia, the Czech Republic and Hungary. The Directive was the basis for the introduction of compulsory stages of the EIA process in the V4. The stages were then adapted to national requirements, including thresholds of the qualifying criteria of projects at the screening and scoping stages. The EIA system in the analysed countries has been growing, changing and being modified together with the political and economic changes of the last 30 years. Although all Visegrad Group countries are members of the EU and should harmonize the provisions of the EIA Directive and its amendments, there still exist singularities in each country's national EIA legislation, in terms of complementarities among the V4 countries, access to information resources, protection of natural resources, mitigation of socio-environmental impacts, or transboundary impact assessment. The article compares and evaluates the EIA systems in the four countries, specifies similarities and differences in the implementation of administrative proceedings and points out opportunities to strengthen the system. It presents selected results of a study conducted in 2013 within the framework of the international project “Assessment of the quality of the environment in the V4 Countries” (AQE V4). This paper indicates examples of good practice in the EIA systems and the obtained results are compared regarding the amendments to the current European Union EIA Directive.

54 ENVIRONMENTAL SCIENCES↗

The ‘grey’ assessment practice of IA screening: Prevalence, influence and applied rationale

Research focusing on the practices surrounding screening in Impact Assessment (IA) is limited. Yet, it has been found that development proposals sometimes are adjusted through an informal dialog with IA practitioners prior to or during screening. Such practice is often referred to as ‘grey IA’ in Denmark. This article explores the prevalence, influence and applied rationale of grey IA. Through a questionnaire, data was collected from 121 IA practitioners working within the fields of environmental impact assessment and strategic environmental assessment. It was found that grey IA is a common practice, which influences the outcomes of formal screening procedures through consideration of impacts on neighbours and spatial zones of protection. Grey IA is to some extent motivated by the opportunity to save the resources required for full-scale IA, but an additional ‘green’ rationale also exists. Grey IA may influence the effectiveness of IA systems, but further research is needed before any conclusions can be made. - Highlights: • Screening procedures may function as an informal, ‘grey’ assessment. • Grey assessment is common and influences formal screening outcomes. • Grey assessment is motivated by an opportunity to cut IA costs. • Yet, an environmental, ‘green’ rationale for grey assessment also exists.

54 ENVIRONMENTAL SCIENCES↗

Exploring experts' views and perspectives on the enhancement of Strategic Environmental Assessment in European small islands

Small islands have the attention of the international community because they are territories with unique features, and a pressing need for the enhancement of sustainability. Strategic Environmental Assessment (SEA) has characteristics that may promote the development and improvement of sustainability in these territories: (i) changing the mind-set, and the decision-making and institutional paradigm, (ii) facilitating cooperation and coordination between different stakeholders, and (iii) providing a framework for good governance and community empowerment. The scientific literature suggests that there may be a need for context-specific SEA in these territories. However, SEA studies often do not incorporate local contextual information, including intuitive knowledge and sense of place. Therefore, there is a possible gap between what is found in the literature and what local communities think, including different stakeholders and experts. Hence, the main goal of this research was to gain an insight into the views and perspectives of small islands SEA experts about issues related to SEA in European small islands, including context-specific approaches, as well as the contribution of SEA for sustainability in these territories. To achieve the research aim, exploratory research using a questionnaire-based survey was designed, aimed at experts on SEA in European small islands. Findings showed regional cooperation networks may have a fundamental role when developing SEA-specific approaches in these territories. This is because SEA-specific approaches encourage a joint effort among islands within one region to improve SEA capacity-building, develop and share a baseline information system, and to share and exchange resources, overall. Also, guidelines are preferred among experts over more legal frameworks and regulations. Finally, the research showed that experts view SEA as a way to enhance sustainability in small islands. This study highlights the importance of integrating stakeholders, such as territorial experts, to learn and promote the use and improvement of environmental and sustainability tools such as SEA. - Highlights: • Explored the views and perspectives of European small island experts • Showed the need for cooperation networks while developing SEA in these territories • Encouraged the development of specific guidelines as opposed to more legal frameworks • Highlighted SEA capability for the enhancement of small island sustainability.

54 ENVIRONMENTAL SCIENCES↗

Non-invasive (non-contact) measurements of human thermal physiology signals and thermal comfort/discomfort poses -A review

Heating, ventilation and air-conditioning (HVAC) systems have been adopted to create comfortable, healthy and safe indoor environments. In the control loop, the technical feature of the human demand-oriented supply can help operate HVAC effectively. Among many technical options, real time monitoring based on feedback signals from end users has been frequently reported as a critical technology to confirm optimizing building performance. Recent studies have incorporated human thermal physiology signals and thermal comfort/discomfort status as real-time feedback signals. A series of human subject experiments used to be conducted by primarily adopting subjective questionnaire surveys in a lab-setting study, which is limited in the application for reality. With the help of advanced technologies, physiological signals have been detected, measured and processed by using multiple technical formats, such as wearable sensors. Nevertheless, they mostly require physical contacts with the skin surface in spite of the small physical dimension and compatibility with other wearable accessories, such as goggles, and intelligent bracelets. Most recently, a low cost small infrared camera has been adopted for monitoring human facial images, which could detect the facial skin temperature and blood perfusion in a contactless way. Also, according to latest pilot studies, a conventional digital camera can generate infrared images with the help of new methods, such as the Euler video magnification technology. Human thermal comfort/discomfort poses can also be detected by video methods without contacting human bodies and be analyzed by the skeleton keypoints model. Here, new sensing technologies were summarized, their cons and pros were discussed, and extended applications for the demand-oriented ventilation were also reviewed as potential development and applications.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗