Search results for: James Patrick A. Diaz
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 644

Search results for: James Patrick A. Diaz

314 In Vitro Antibacterial Activity of Selected Tanzania Medicinal Plants

Authors: Mhuji Kilonzo, Patrick Ndakidemi, Musa Chacha

Abstract:

Objective: To evaluate antibacterial activity from four selected medicinal plants namely Mystroxylon aethiopicum, Lonchocarpus capassa, Albizia anthelmentica and Myrica salicifolia used for management of bacterial infection in Tanzania. Methods: Minimum Inhibitory Concentration (MIC) of plants extracts against the tested bacterial species was determined by using 96 wells microdilution method. In this method, 50 μL of nutrient broth were loaded in each well followed by 50 μL of extract (100 mg/mL) to make a final volume of 100 μL. Subsequently, 50 μL were transferred from first rows of each well to the second rows and the process was repeated down the columns to the last wells from which 50 μL were discarded. Thereafter, 50 μL of the selected bacterial suspension were added to each well thus making a final volume of 100 μL. The lowest concentration which showed no bacterial growth was considered as MIC. Results: It was revealed that L. capassa leaf ethyl acetate extract exhibited antibacterial activity against Salmonella kisarawe and Salmonella typhi with MIC values of 0.39 and 0.781 mg/mL respectively. Likewise, L. capassa root bark ethyl acetate extracts inhibited growth of S. typhi and E. coli with MIC values of 0.39 and 0.781 mg/mL respectively. The M. aethiopicum leaf and root bark chloroform extracts displayed antibacterial activity against S. kisarawe and S. typhi respectively with MIC value of 0.781 mg/mL. The M. salicifolia stem bark ethyl acetate exhibited antibacterial activity against P. aeruginosa with MIC value of 0.39 mg/mL whereas the methanolic stem and root bark of the same plant inhibited the growth of Proteus mirabilis and Klebsiella pneumoniae with MIC value of 0.781 mg/mL. Conclusion: It was concluded that M. aethiopicum, L. capassa, A. anthelmentica and M. salicifolia are potential source of antibacterial agents. Further studies to establish structures of antibacterial and evaluate active ingredients are recommended.

Keywords: Albizia anthelmentica, Lonchocarpus capassa, Mystroxylon aethiopicum, Myrica salicifolia

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313 Evaluation of DNA Oxidation and Chemical DNA Damage Using Electrochemiluminescent Enzyme/DNA Microfluidic Array

Authors: Itti Bist, Snehasis Bhakta, Di Jiang, Tia E. Keyes, Aaron Martin, Robert J. Forster, James F. Rusling

Abstract:

DNA damage from metabolites of lipophilic drugs and pollutants, generated by enzymes, represents a major toxicity pathway in humans. These metabolites can react with DNA to form either 8-oxo-7,8-dihydro-2-deoxyguanosine (8-oxodG), which is the oxidative product of DNA or covalent DNA adducts, both of which are genotoxic and hence considered important biomarkers to detect cancer in humans. Therefore, detecting reactions of metabolites with DNA is an effective approach for the safety assessment of new chemicals and drugs. Here we describe a novel electrochemiluminescent (ECL) sensor array which can detect DNA oxidation and chemical DNA damage in a single array, facilitating a more accurate diagnostic tool for genotoxicity screening. Layer-by-layer assembly of DNA and enzyme are assembled on the pyrolytic graphite array which is housed in a microfluidic device for sequential detection of two type of the DNA damages. Multiple enzyme reactions are run on test compounds using the array, generating toxic metabolites in situ. These metabolites react with DNA in the films to cause DNA oxidation and chemical DNA damage which are detected by ECL generating osmium compound and ruthenium polymer, respectively. The method is further validated by the formation of 8-oxodG and DNA adduct using similar films of DNA/enzyme on magnetic bead biocolloid reactors, hydrolyzing the DNA, and analyzing by liquid chromatography-mass spectrometry (LC-MS). Hence, this combined DNA/enzyme array/LC-MS approach can efficiently explore metabolic genotoxic pathways for drugs and environmental chemicals.

Keywords: biosensor, electrochemiluminescence, DNA damage, microfluidic array

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312 Thermochemical Modelling for Extraction of Lithium from Spodumene and Prediction of Promising Reagents for the Roasting Process

Authors: Allen Yushark Fosu, Ndue Kanari, James Vaughan, Alexandre Changes

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Spodumene is a lithium-bearing mineral of great interest due to increasing demand of lithium in emerging electric and hybrid vehicles. The conventional method of processing the mineral for the metal requires inevitable thermal transformation of α-phase to the β-phase followed by roasting with suitable reagents to produce lithium salts for downstream processes. The selection of appropriate reagent for roasting is key for the success of the process and overall lithium recovery. Several researches have been conducted to identify good reagents for the process efficiency, leading to sulfation, alkaline, chlorination, fluorination, and carbonizing as the methods of lithium recovery from the mineral.HSC Chemistry is a thermochemical software that can be used to model metallurgical process feasibility and predict possible reaction products prior to experimental investigation. The software was employed to investigate and explain the various reagent characteristics as employed in literature during spodumene roasting up to 1200°C. The simulation indicated that all used reagents for sulfation and alkaline were feasible in the direction of lithium salt production. Chlorination was only feasible when Cl2 and CaCl2 were used as chlorination agents but not NaCl nor KCl. Depending on the kind of lithium salt formed during carbonizing and fluorination, the process was either spontaneous or nonspontaneous throughout the temperature range investigated. The HSC software was further used to simulate and predict some promising reagents which may be equally good for roasting the mineral for efficient lithium extraction but have not yet been considered by researchers.

Keywords: thermochemical modelling, HSC chemistry software, lithium, spodumene, roasting

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311 Clinicians’ Perspectives on Child Language Brokering

Authors: Carmen Pena-Díaz

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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

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310 Ethnomedicinal Assets of Plants Collected from Nasarawa State, North Central Nigeria

Authors: Enock E. Goler, Emmanuel H. Kwon-Ndung, Gbenga F. Akomolafe, Terna T. Paul, Markus Musa, Joshua I. Waya, James H. Okogbaa

Abstract:

An ethno-medicinal survey of plants used in treating various diseases and ailments was carried out in the study area of Nasarawa State, North Central Nigeria to obtain information on their uses and potentials. The ethno-medicinal survey was administered through structured questionnaires among local inhabitants from areas with high plant density and diversity within the various Local Government Areas of the State. A total of 84 (Eighty four) plant species belonging to 45 (Forty five) families were found to be useful in treatment of various ailments such as diabetes, measles, fever, asthma, jaundice, pneumonia, sexually transmitted diseases (STDs), aches, diarrhea, cough, arthritis, yellow fever, typhoid, erectile dysfunction and excessive bleeding. Different parts of the plant such as the roots, leaves and stems are used in preparing herbal remedies which could be from dry or freshly collected plants. The main methods of preparation are decoction or infusion, while in some cases the plant parts used are consumed directly. Residents in the study areas find the herbal remedy cheaper and more accessible and claimed that there are no side effects compared to orthodox medicine. This study has confirmed the need towards the conscious conservation of plant genetic resources in order to ensure sustained access to these ethno-medicinal plant materials.

Keywords: ethno-medicinal, Nasarawa, plants, survey

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309 Applying Business Model Patterns: A Case Study in Latin American Building Industry

Authors: James Alberto Ortega Morales, Nelson Andrés Martínez Marín

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The bulding industry is one of the most important sectors all around the world in terms of contribution to index like GDP and labor. On the other hand, it is a major contributor to Greenhouse Gases (GHG) and waste generation contributing to global warming. In this sense, it is necessary to establish sustainable practices both from the strategic point of view to the operations point of view as well in all business and industries. Business models don’t scape to this reality attending it´s mediator role between strategy and operations. Business models can turn from the traditional practices searching economic benefits to sustainable bussines models that generate both economic value and value for society and the environment. Recent advances in the analysis of sustainable business models find different classifications that allow finding potential triple bottom line (economic, social and environmental) solutions applicable in every business sector. Into the metioned Advances have been identified, 11 groups and 45 patterns of sustainable business models have been identified; such patterns can be found either in the business models as a whole or found concurrently in their components. This article presents the analysis of a case study, seeking to identify the components and elements that are part of it, using the ECO CANVAS conceptual model. The case study allows showing the concurrent existence of different patterns of business models for sustainability empirically, serving as an example and inspiration for other Latin American companies interested in integrating sustainability into their new and existing business models.

Keywords: sustainable business models, business sustainability, business model patterns, case study, construction industry

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308 A Straightforward Method for Determining Inorganic Selenium Speciations by Graphite Furnace Atomic Absorption Spectroscopy in Water Samples

Authors: Sahar Ehsani, David James, Vernon Hodge

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In this experimental study, total selenium in solution was measured with Graphite Furnace Atomic Absorption Spectroscopy, GFAAS, then chemical reactions with sodium borohydride were used to reduce selenite to hydrogen selenide. Hydrogen selenide was then stripped from the solution by purging the solution with nitrogen gas. Since the two main speciations in oxic waters are usually selenite, Se(IV) and selenate, Se(VI), it was assumed that after Se(IV) is removed, the remaining total selenium was Se(VI). Total selenium measured after stripping gave Se(VI) concentration, and the difference of total selenium measured before and after stripping gave Se(IV) concentration. An additional step of reducing Se(VI) to Se(IV) was performed by boiling the stripped solution under acidic conditions, then removing Se(IV) by a chemical reaction with sodium borohydride. This additional procedure of removing Se(VI) from the solution is useful in rare cases where the water sample is reducing and contains selenide speciation. In this study, once Se(IV) and Se(VI) were both removed from the water sample, the remaining total selenium concentration was zero. The method was tested to determine Se(IV) and Se(VI) in both purified water and synthetic irrigation water spiked with Se(IV) and Se(VI). Average recovery of spiked samples of diluted synthetic irrigation water was 99% for Se(IV) and 97% for Se(VI). Detection limits of the method were 0.11 µg L⁻¹ and 0.32 µg L⁻¹ for Se(IV) and Se(VI), respectively.

Keywords: Analytical Method, Graphite Furnace Atomic Absorption Spectroscopy, Selenate, Selenite, Selenium Speciations

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307 Bayesian Flexibility Modelling of the Conditional Autoregressive Prior in a Disease Mapping Model

Authors: Davies Obaromi, Qin Yongsong, James Ndege, Azeez Adeboye, Akinwumi Odeyemi

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The basic model usually used in disease mapping, is the Besag, York and Mollie (BYM) model and which combines the spatially structured and spatially unstructured priors as random effects. Bayesian Conditional Autoregressive (CAR) model is a disease mapping method that is commonly used for smoothening the relative risk of any disease as used in the Besag, York and Mollie (BYM) model. This model (CAR), which is also usually assigned as a prior to one of the spatial random effects in the BYM model, successfully uses information from adjacent sites to improve estimates for individual sites. To our knowledge, there are some unrealistic or counter-intuitive consequences on the posterior covariance matrix of the CAR prior for the spatial random effects. In the conventional BYM (Besag, York and Mollie) model, the spatially structured and the unstructured random components cannot be seen independently, and which challenges the prior definitions for the hyperparameters of the two random effects. Therefore, the main objective of this study is to construct and utilize an extended Bayesian spatial CAR model for studying tuberculosis patterns in the Eastern Cape Province of South Africa, and then compare for flexibility with some existing CAR models. The results of the study revealed the flexibility and robustness of this alternative extended CAR to the commonly used CAR models by comparison, using the deviance information criteria. The extended Bayesian spatial CAR model is proved to be a useful and robust tool for disease modeling and as a prior for the structured spatial random effects because of the inclusion of an extra hyperparameter.

Keywords: Besag2, CAR models, disease mapping, INLA, spatial models

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306 Impacts of COVID-19 on Communal Based Natural Resources Management in Newtown, Bekezela Village, Eastern Cape, South Africa

Authors: James Donald Nyamahono, Kelvin Tinashe Pikirai

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Communal based natural resource management (CBNRM) is regarded as one of the most significant methods for sustainable natural resource conservation. This is due to the fact that it entails the engagement of local communities as well as the use of indigenous knowledge and customary conservation. The emergence of COVID-19 had a devastating impact on this sector since it has resulted in the disbandment of all collective activities, such as group gatherings, including those with a good cause. This is supported by research, which demonstrates that throughout the era of full lockdowns, the coordination of diverse activities and the sustainability of various working groups were severely harmed. This study was undertaken in the CBNRM niche to examine how COVID-19 affected this sector. Data were gathered through focus group discussions with youths, women, and the elderly active in CBNRM in Newtown, Bekezela Village, Eastern Cape. The study concluded that the sustainability of indigenous knowledge in natural resource management was endangered due to the restricted movements and community participation in developmental initiatives. The study also revealed a 'environment-community divide,' since COVID-19 hindered local communities from holding their regular conservation meetings. The research, on the other hand, discovered that there were 'secret' gatherings in which local communities attempted to adopt Afrocentric ways in which the available natural resources would provide a remedy for COVID-19.

Keywords: CBNRM, COVID-19, indigenous knowledge, South Africa

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305 The Implications of the Lacanian Concept of 'Lalangue' for Lacanian Theory and Clinical Practice

Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

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304 Case Report on ‘Primary Adenocarcinoma of Aberrant HER2+ Anogenital Mammary-like Glands in a Male'

Authors: Shivani Kuttuva, James Sampson, Timothy Simmons, Vinayak Thattaruparambil, Holly Burton, Peter Coyne

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Anogenital mammary-like glands were established to be embryological remnants of breast tissue due to failed resolution of the ectodermal mammary ridge. However, recent studies are now considering this to represent normal constituents of the anogenital area with histological resemblance to the orthotopic breast tissue with multiple benign and malignant lesions arising from it. The incidence of the above has been predominant in females in the vulval region. Due to the paucity of cases reported in men, this poses a diagnostic and therapeutic challenge resulting in a delay in treatment and, thereby, poor outcomes. Our patient presented to the dermatology clinic with an itchy, purplish lesion in the peri-anal region which, on punch biopsy, was diagnosed to be Extra-mammary Paget’s disease and taken up for Wide local excision. Immunochemically, staining was positive for HER2, ER and Cytokeratin 7, keeping with the presence of actual breast tissue with no primary breast carcinoma. Due to the invasive nature of the disease, he required Abdominoperineal resection with flap reconstruction. Despite complete surgical clearance and adjuvant radiotherapy, the disease progressed to adjacent inguinal and obturator lymph nodes with origin resembling anogenital type mammary glands but histology negative for hormonal receptors of the breast.

Keywords: anogenital mammary-like glands, abdominoperineal resection, ectopic breast tissue, ectopic male breast carcinoma, peri-anal skin lesion

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303 Alignment between Governance Structures and Food Safety Standards on the Shrimp Supply Chain in Indonesia

Authors: Maharani Yulisti, Amin Mugera, James Fogarty

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Food safety standards have received significant attention in the fisheries global market due to health issues, free trade agreements, and increasing aquaculture production. Vertical coordination throughout the supply chain of fish producing and exporting countries is needed to meet food safety demands imposed by importing countries. However, the complexities of the supply chain governance structures and difficulties in standard implementation can generate safety uncertainty and high transaction costs. Using a Transaction Cost Economics framework, this paper examines the alignment between food safety standards and the governance structures in the shrimp supply chain in Indonesia. We find the supply chain is organized closer to the hierarchy-like governance structure where private standard (organic standard) are implemented and more towards a market-like governance structure where public standard (IndoGAP certification) are more prevalent. To verify the statements, two cases are examined from Sidoarjo district as a centre of shrimp production in Indonesia. The results show that public baseline FSS (Food Safety Standards) need additional mechanism to achieve a coordinated chain-wide response because uncertainty, asset specificity, and performance measurement problems are high in this chain. Organic standard as private chain-wide FSS is more efficient because it has been achieved by hierarchical-like type of governance structure.

Keywords: governance structure, shrimp value chain, food safety standards, transaction costs economics

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302 Effect of Video-Based Instructional Strategy on Junior Secondary School Students' Academic Achievement in Social Studies in Ondo State, Nigeria

Authors: Abidoye James Alabi

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This study investigated the effect of video-based instructional strategy on junior secondary school academic achievement in social studies. The influence of gender on the academic achievement of student taught with video-based instructional strategy was also examined. The study adopted a pre-test and pro-test control group quasi-experimental design. Simple random sampling technique was used to select 40 students from two schools in Akure town in Ondo State. The researcher developed instructional video package on social studies concept which was used as treatment instrument for the experimental group while the control group was exposed to conventional teaching method. The instruments used in this study are social studies achievement test and instructional video package (IVP). T-test statistic was used to analyse the hypotheses. The findings revealed that experimental group performed better than the control group. It was also shown that gender has no significant effect on students’ academic achievement when exposed to an instructional video package. It was recommended that appropriate training and workshop should be organized by the government for the social studies teachers for effective use of instructional video package in order to enhance teachers productivities and learning among students in secondary schools.

Keywords: instructional video package, conventional teaching method, social studies, junior secondary school

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301 Mass Media Products Consumption Patterns in Rural South-South, Nigeria Communities

Authors: Inemesit Akpan Umoren, Aniekan James Akpan

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Media practitioners and information managers have often erroneously operated on the premise that media messages are received as disseminated to the extent that audiences of whatever background assimilate the content uniformly. This does not subsist since media audiences are often segmented in terms of educational level, social category, place of residence, gender, among others. While those who are highly educated, live in urban areas and are of highest standing are more likely to have direct access to the media, those in the rural areas and of low education and standing, may not have direct or easy access. These, therefore, informed the study to establish the consumption patterns of mass media products by residents of rural communities in south-south, Nigeria. The study, which was anchored on the multi-step flow and social categories theories, adopted a survey research design and a sample of 383 using Mayer’s 1979 guide drawn from nine rural communities in the south-south, Nigeria states of Akwa Ibom, Rivers and Edo. Findings among others showed that while a negligible percentage is highly exposed to media messages of all types, a greater member depend on opinion leaders, social groups, drinking joints, among other such for filtered content. It was concluded that since rural or community media organizations are very vital in ensuring media content get to all audience without necessarily being passing through intermediaries. Among the recommendations was that information managers and media organizations should always have in mind the ruralites while packaging their contents even in the mainstream media.

Keywords: consumption, media, media product, pattern

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300 Macrocycles Enable Tuning of Uranyl Electrochemistry by Lewis Acids

Authors: Amit Kumar, Davide Lionetti, Victor Day, James Blakemore

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Capture and activation of the water-soluble uranyl dication (UO22+) remains a challenging problem, as few rational approaches are available for modulating the reactivity of this species. Here, we report the divergent synthesis of heterobimetallic complexes in which UO22+ is held in close proximity to a range of redox-inactive metals by tailored macrocyclic ligands. Crystallographic and spectroscopic studies confirm assembly of homologous UVI(μ-OAr)2Mn+ cores with a range of mono-, di-, and trivalent Lewis acids (Mn+). X-ray diffraction (XRD) and cyclic voltammetry (CV) data suggest preferential binding of K+ in an 18-crown-6-like cavity and Na+ in a 15-crown-5-like cavity, both appended to Schiff-base type sites that selectively bind UO22+. CV data demonstrate that the UVI/UV reduction potential in these complexes shifts positive and the rate of electron transfer decreases with increasing Lewis acidity of the incorporated redox-inactive metals. Moreover, spectroelectrochemical studies confirm the formation of [UV] species in the case of monometallic UO22+ complex, consistent with results from prior studies. However, unique features were observed during spectroelectrochemical studies in the presence of the K+ ion, suggesting new insights into electronic structure may be accessible with the heterobimetallic complexes. Overall, these findings suggest that interactions with Lewis acids could be effectively leveraged for rational tuning of the electronic and thermochemical properties of the 5f elements, reminiscent of strategies more commonly employed with 3d transition metals.

Keywords: electrochemistry, Lewis acid, macrocycle, uranyl

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299 DOG1 Expression Is in Common Human Tumors: A Tissue Microarray Study on More than 15,000 Tissue Samples

Authors: Kristina Jansen, Maximilian Lennartz, Patrick Lebok, Guido Sauter, Ronald Simon, David Dum, Stefan Steurer

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DOG1 (Discovered on GIST1) is a voltage-gated calcium-activated chloride and bicarbonate channel that is highly expressed in interstitial cells of Cajal and in gastrointestinal stromal tumors (GIST) derived from Cajal cells. To systematically determine in what tumor entities and normal tissue types DOG1 may be further expressed, a tissue microarray (TMA) containing 15,965 samples from 121 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry. DOG1 immunostaining was found in 67 tumor types, including GIST (95.7%), esophageal squamous cell carcinoma (31.9%), pancreatic ductal adenocarcinoma (33.6%), adenocarcinoma of the Papilla Vateri (20%), squamous cell carcinoma of the vulva (15.8%) and the oral cavity (15.3%), mucinous ovarian cancer (15.3%), esophageal adenocarcinoma (12.5%), endometrioid endometrial cancer (12.1%), neuroendocrine carcinoma of the colon (11.1%) and diffuse gastric adenocarcinoma (11%). Low level-DOG1 immunostaining was seen in 17 additional tumor entities. DOG1 expression was unrelated to histopathological parameters of tumor aggressiveness and/or patient prognosis in cancers of the breast (n=1,002), urinary bladder (975), ovary (469), endometrium (173), stomach (233), and thyroid gland (512). High DOG1 expression was linked to estrogen receptor expression in breast cancer (p<0.0001) and the absence of HPV infection in squamous cell carcinomas (p=0.0008). In conclusion, our data identify several tumor entities that can show DOG1 expression levels at similar levels as in GIST. Although DOG1 is tightly linked to a diagnosis of GIST in spindle cell tumors, the differential diagnosis is much broader in DOG1 positive epithelioid neoplasms.

Keywords: biomarker, DOG1, immunohistochemistry, tissue microarray

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298 Developing a Spatial Transport Model to Determine Optimal Routes When Delivering Unprocessed Milk

Authors: Sunday Nanosi Ndovi, Patrick Albert Chikumba

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In Malawi, smallholder dairy farmers transport unprocessed milk to sell at Milk Bulking Groups (MBGs). MBGs store and chill the milk while awaiting collection by processors. The farmers deliver milk using various modes of transportation such as foot, bicycle, and motorcycle. As a perishable food, milk requires timely transportation to avoid deterioration. In other instances, some farmers bypass the nearest MBGs for facilities located further away. Untimely delivery worsens quality and results in rejection at MBG. Subsequently, these rejections lead to revenue losses for dairy farmers. Therefore, the objective of this study was to optimize routes when transporting milk by selecting the shortest route using time as a cost attribute in Geographic Information Systems (GIS). A spatially organized transport system impedes milk deterioration while promoting profitability for dairy farmers. A transportation system was modeled using Route Analysis and Closest Facility network extensions. The final output was to find the quickest routes and identify the nearest milk facilities from incidents. Face-to-face interviews targeted leaders from all 48 MBGs in the study area and 50 farmers from Namahoya MBG. During field interviews, coordinates were captured in order to create maps. Subsequently, maps supported the selection of optimal routes based on the least travel times. The questionnaire targeted 200 respondents. Out of the total, 182 respondents were available. Findings showed that out of the 50 sampled farmers that supplied milk to Namahoya, only 8% were nearest to the facility, while 92% were closest to 9 different MBGs. Delivering milk to the nearest MBGs would minimize travel time and distance by 14.67 hours and 73.37 km, respectively.

Keywords: closest facility, milk, route analysis, spatial transport

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297 Comparison of the Factor of Safety and Strength Reduction Factor Values from Slope Stability Analysis of a Large Open Pit

Authors: James Killian, Sarah Cox

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The use of stability criteria within geotechnical engineering is the way the results of analyses are conveyed, and sensitivities and risk assessments are performed. Historically, the primary stability criteria for slope design has been the Factor of Safety (FOS) coming from a limit calculation. Increasingly, the value derived from Strength Reduction Factor (SRF) analysis is being used as the criteria for stability analysis. The purpose of this work was to study in detail the relationship between SRF values produced from a numerical modeling technique and the traditional FOS values produced from Limit Equilibrium (LEM) analyses. This study utilized a model of a 3000-foot-high slope with a 45-degree slope angle, assuming a perfectly plastic mohr-coulomb constitutive model with high cohesion and friction angle values typical of a large hard rock mine slope. A number of variables affecting the values of the SRF in a numerical analysis were tested, including zone size, in-situ stress, tensile strength, and dilation angle. This paper demonstrates that in most cases, SRF values are lower than the corresponding LEM FOS values. Modeled zone size has the greatest effect on the estimated SRF value, which can vary as much as 15% to the downside compared to FOS. For consistency when using SRF as a stability criteria, the authors suggest that numerical model zone sizes should not be constructed to be smaller than about 1% of the overall problem slope height and shouldn’t be greater than 2%. Future work could include investigations of the effect of anisotropic strength assumptions or advanced constitutive models.

Keywords: FOS, SRF, LEM, comparison

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296 Variance-Aware Routing and Authentication Scheme for Harvesting Data in Cloud-Centric Wireless Sensor Networks

Authors: Olakanmi Oladayo Olufemi, Bamifewe Olusegun James, Badmus Yaya Opeyemi, Adegoke Kayode

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The wireless sensor network (WSN) has made a significant contribution to the emergence of various intelligent services or cloud-based applications. Most of the time, these data are stored on a cloud platform for efficient management and sharing among different services or users. However, the sensitivity of the data makes them prone to various confidentiality and performance-related attacks during and after harvesting. Various security schemes have been developed to ensure the integrity and confidentiality of the WSNs' data. However, their specificity towards particular attacks and the resource constraint and heterogeneity of WSNs make most of these schemes imperfect. In this paper, we propose a secure variance-aware routing and authentication scheme with two-tier verification to collect, share, and manage WSN data. The scheme is capable of classifying WSN into different subnets, detecting any attempt of wormhole and black hole attack during harvesting, and enforcing access control on the harvested data stored in the cloud. The results of the analysis showed that the proposed scheme has more security functionalities than other related schemes, solves most of the WSNs and cloud security issues, prevents wormhole and black hole attacks, identifies the attackers during data harvesting, and enforces access control on the harvested data stored in the cloud at low computational, storage, and communication overheads.

Keywords: data block, heterogeneous IoT network, data harvesting, wormhole attack, blackhole attack access control

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295 Food Insecurity and Mental Health among Adolescents in Southwest Ethiopia: Structural Equation Modeling Analysis

Authors: Mulusew G. Jebena, David Lindstrom, Tefera Belachew, Craig Hadley, Carl Lachat, Patrick Kolsteren

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Background: The biological and psychosocial consequence of food insecurity on physical health and nutritional status has been reported. But, its effect on mental health during adolescence remains unexplored. Thus, the main aim of this analysis is to examine the mechanism by which food insecurity is linked to mental health among adolescents living in Jimma, Southwest Ethiopia. Methods: We used data from third round observation of Jimma Longitudinal Family and Youth Survey (JLFSY). A total of 1,521 adolescents included for the main analysis. Food insecurity was measured using 5-items scale and The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress. Structural equation modeling analysis was done using maximum likelihood estimation method. Model diagnostics test was reported. All p values were two tailed and P value ≤ 0.05 was used to determine statistical significance. Results: The prevalence of mental distress was 20.8%, 95% CI: (18.8, 22.9). After adjusted for covariates, the final model depicts food insecurity was associated with adolescent mental distress (β=.324). This analysis showed 94.1% of the effect of food insecurity on mental distress is direct. By contrast, 5.9% of the food insecurity effect is mediated by physical health. In addition, Self-rated health (β=.356), socioeconomic status (β=-.078) parental educational (β= .170), living in urban (β= .193) and female headed household (β=.205) were associated with adolescent mental distress. Conclusions: This finding highlights the direct effect of food insecurity on adolescent mental distress. Therefore, any intervention aimed to improve mental distress of adolescents should consider strategies to improve access to sufficient, safe, and nutritious food. Beside this, prevention of underlying factors such as psychosomatic health illness and improving socio economic status is also very critical. Furthermore longitudinal relationship of the long term effect of food insecurity on mental health should be investigated.

Keywords: adolescent, Ethiopia, food insecurity, mental health

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294 A Combinatorial Approach of Treatment for Landfill Leachate

Authors: Anusha Atmakuri, R. D. Tyagi, Patrick Drogui

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Landfilling is the most familiar and easy way to dispose solid waste. Landfill is generally received via wastes from municipal near to a landfill. The waste collected is from commercial, industrial, and residential areas and many more. Landfill leachate (LFL) is formed when rainwater passes through the waste placed in landfills and consists of several dissolved organic materials, for instance, aquatic humic substances (AHS), volatile fatty acids (VFAs), heavy metals, inorganic macro components, and xenobiotic organic matters, highly toxic to the environment. These components of LFL put a load on it, hence it necessitates the treatment of LFL prior to its discharge into the environment. Various methods have been used to treat LFL over the years, such as physical, chemical, biological, physicochemical, electrical, and advanced oxidation methods. This study focuses on the combination of biological and electrochemical methods- extracellular polymeric substances and electrocoagulation(EC). The coupling of electro-coagulation process with extracellular polymeric substances (EPS) (as flocculant) as pre and\or post treatment strategy provides efficient and economical process for the decontamination of landfill leachate contaminated with suspended matter, metals (e.g., Fe, Mn) and ammonical nitrogen. Electro-coagulation and EPS mediated coagulation approach could be an economically viable for the treatment of landfill leachate, along with possessing several other advantages over several other methods. This study utilised waste substrates such as activated sludge, crude glycerol and waste cooking oil for the production of EPS using fermentation technology. A comparison of different scenarios for the treatment of landfill leachate is presented- such as using EPS alone as bioflocculant, EPS and EC with EPS being the 1st stage, and EPS and EC with EC being the 1st stage. The work establishes the use of crude EPS as a bioflocculant for the treatment of landfill leachate and wastewater from a site near a landfill, along with EC being successful in removal of some major pollutants such as COD, turbidity, total suspended solids. A combination of these two methods is to be explored more for the complete removal of all pollutants from landfill leachate.

Keywords: landfill leachate, extracellular polymeric substances, electrocoagulation, bioflocculant.

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293 Family Medicine Residents in End-of-Life Care

Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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292 A Xenon Mass Gauging through Heat Transfer Modeling for Electric Propulsion Thrusters

Authors: A. Soria-Salinas, M.-P. Zorzano, J. Martín-Torres, J. Sánchez-García-Casarrubios, J.-L. Pérez-Díaz, A. Vakkada-Ramachandran

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The current state-of-the-art methods of mass gauging of Electric Propulsion (EP) propellants in microgravity conditions rely on external measurements that are taken at the surface of the tank. The tanks are operated under a constant thermal duty cycle to store the propellant within a pre-defined temperature and pressure range. We demonstrate using computational fluid dynamics (CFD) simulations that the heat-transfer within the pressurized propellant generates temperature and density anisotropies. This challenges the standard mass gauging methods that rely on the use of time changing skin-temperatures and pressures. We observe that the domes of the tanks are prone to be overheated, and that a long time after the heaters of the thermal cycle are switched off, the system reaches a quasi-equilibrium state with a more uniform density. We propose a new gauging method, which we call the Improved PVT method, based on universal physics and thermodynamics principles, existing TRL-9 technology and telemetry data. This method only uses as inputs the temperature and pressure readings of sensors externally attached to the tank. These sensors can operate during the nominal thermal duty cycle. The improved PVT method shows little sensitivity to the pressure sensor drifts which are critical towards the end-of-life of the missions, as well as little sensitivity to systematic temperature errors. The retrieval method has been validated experimentally with CO2 in gas and fluid state in a chamber that operates up to 82 bar within a nominal thermal cycle of 38 °C to 42 °C. The mass gauging error is shown to be lower than 1% the mass at the beginning of life, assuming an initial tank load at 100 bar. In particular, for a pressure of about 70 bar, just below the critical pressure of CO2, the error of the mass gauging in gas phase goes down to 0.1% and for 77 bar, just above the critical point, the error of the mass gauging of the liquid phase is 0.6% of initial tank load. This gauging method improves by a factor of 8 the accuracy of the standard PVT retrievals using look-up tables with tabulated data from the National Institute of Standards and Technology.

Keywords: electric propulsion, mass gauging, propellant, PVT, xenon

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291 A Photoemission Study of Dye Molecules Deposited by Electrospray on rutile TiO2 (110)

Authors: Nouf Alharbi, James O'shea

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For decades, renewable energy sources have received considerable global interest due to the increase in fossil fuel consumption. The abundant energy produced by sunlight makes dye-sensitised solar cells (DSSCs) a promising alternative compared to conventional silicon and thin film solar cells due to their transparency and tunable colours, which make them suitable for applications such as windows and glass facades. The transfer of an excited electron onto the surface is an important procedure in the DSSC system, so different groups of dye molecules were studied on the rutile TiO2 (110) surface. Currently, the study of organic dyes has become an interest of researchers due to ruthenium being a rare and expensive metal, and metal-free organic dyes have many features, such as high molar extinction coefficients, low manufacturing costs, and ease of structural modification and synthesis. There are, of course, some groups that have developed organic dyes and exhibited lower light-harvesting efficiency ranging between 4% and 8%. Since most dye molecules are complicated or fragile to be deposited by thermal evaporation or sublimation in the ultra-high vacuum (UHV), all dyes (i.e, D5, SC4, and R6) in this study were deposited in situ using the electrospray deposition technique combined with X-ray photoelectron spectroscopy (XPS) as an alternative method to obtain high-quality monolayers of titanium dioxide. These organic molecules adsorbed onto rutile TiO2 (110) are explored by XPS, which can be used to obtain element-specific information on the chemical structure and study bonding and interaction sites on the surface.

Keywords: dyes, deposition, electrospray, molecules, organic, rutile, sensitised, XPS

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290 Unzipping the Stress Response Genes in Moringa oleifera Lam. through Transcriptomics

Authors: Vivian A. Panes, Raymond John S. Rebong, Miel Q. Diaz

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Moringa oleifera Lam. is known mainly for its high nutritional value and medicinal properties contributing to its popular reputation as a 'miracle plant' in the tropical climates where it usually grows. The main objective of this study is to discover the genes and gene products involved in abiotic stress-induced activity that may impact the M. oleifera Lam. mature seeds as well as their corresponding functions. In this study, RNA-sequencing and de novo transcriptome assembly were performed using two assemblers, Trinity and Oases, which produced 177,417 and 120,818 contigs respectively. These transcripts were then subjected to various bioinformatics tools such as Blast2GO, UniProt, KEGG, and COG for gene annotation and the analysis of relevant metabolic pathways. Furthermore, FPKM analysis was performed to identify gene expression levels. The sequences were filtered according to the 'response to stress' GO term since this study dealt with stress response. Clustered Orthologous Groups (COG) showed that the highest frequencies of stress response gene functions were those of cytoskeleton which make up approximately 14% and 23% of stress-related sequences under Trinity and Oases respectively, recombination, repair and replication at 11% and 14% respectively, carbohydrate transport and metabolism at 23% and 9% respectively and defense mechanisms 16% and 12% respectively. KEGG pathway analysis determined the most abundant stress-response genes in the phenylpropanoid biosynthesis at counts of 187 and 166 pathways for Oases and Trinity respectively, purine metabolism at 123 and 230 pathways, and biosynthesis of antibiotics at 105 and 102. Unique and cumulative GO term counts revealed that majority of the stress response genes belonged to the category of cellular response to stress at cumulative counts of 1,487 to 2,187 for Oases and Trinity respectively, defense response at 754 and 1,255, and response to heat at 213 and 208, response to water deprivation at 229 and 228, and oxidative stress at 508 and 488. Lastly, FPKM was used to determine the levels of expression of each stress response gene. The most upregulated gene encodes for thiamine thiazole synthase chloroplastic-like enzyme which plays a significant role in DNA damage tolerance. Data analysis implies that M. oleifera stress response genes are directed towards the effects of climate change more than other stresses indicating the potential of M. oleifera for cultivation in harsh environments because it is resistant to climate change, pathogens, and foreign invaders.

Keywords: stress response, genes, Moringa oleifera, transcriptomics

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289 Algebraic Coupled Level Set-Volume of Fluid Method with Capillary Pressure Treatment for Surface Tension Dominant Two-Phase Flows

Authors: Majid Haghshenas, James Wilson, Ranganathan Kumar

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In this study, an Algebraic Coupled Level Set-Volume of Fluid (A-CLSVOF) method with capillary pressure treatment is proposed for the modeling of two-phase capillary flows. The Volume of Fluid (VOF) method is utilized to incorporate one-way coupling with the Level Set (LS) function in order to further improve the accuracy of the interface curvature calculation and resulting surface tension force. The capillary pressure is determined and treated independently of the hydrodynamic pressure in the momentum balance in order to maintain consistency between cell centered and interpolated values, resulting in a reduction in parasitic currents. In this method, both VOF and LS functions are transported where the new volume fraction determines the interface seed position used to reinitialize the LS field. The Hamilton-Godunov function is used with a second order (in space and time) discretization scheme to produce a signed distance function. The performance of the current methodology has been tested against some common test cases in order to assess the reduction in non-physical velocities and improvements in the interfacial pressure jump. The cases of a static drop, non-linear Rayleigh-Taylor instability and finally a droplets impact on a liquid pool were simulated to compare the performance of the present method to other well-known methods in the area of parasitic current reduction, interface location evolution and overall agreement with experimental results.

Keywords: two-phase flow, capillary flow, surface tension force, coupled LS with VOF

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288 Positive Interactions among Plants in Pinegroves over Quarzitic Sands

Authors: Enrique González Pendás, Vidal Pérez Hernández, Jorge Ferro Díaz, Nelson Careaga Pendás

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The investigation is carried out on the Protected Area of San Ubaldo, toward the interior of an open pinegrove with palm trees in a dry plainness of quar zitic sands, belonging to the Floristic Managed Reservation San Ubaldo-Sabanalamar, Guane, Pinar del Río, Cuba. This area is characterized by drastic seasonal variations, high temperatures and water evaporation, strong solar radiation, with sandy soils of almost pure quartz, which are very acid and poor in nutrients. The objective of the present work is to determine evidence of facilitation and its relationship with the structure and composition of plant communities in these peculiar ecosystems. For this study six lineal parallel transepts of 100 m are traced, in those, a general recording of the flora is carried out. To establish which plants act as nurses, is taken into account a height over 1 meter, canopy over 1.5 meter and the occurrence of several species under it. Covering was recorded using the line intercept method; the medium values of species richness for the taxa under nurses is compared with those that are located in open spaces among them. Then, it is determined which plants are better recruiter of other species (better nurses). An experiment is made to measure and compare some parameters in pine seedlings under the canopy of the Byrsonima crassifolia (L.) Kunth. and in open spaces, also the number of individuals is counted by species to calculate the frequency and total abundance in the study area. As a result, it is offered an up-to-date floristic list, a phylogenetic tree of the plant community showing a high phylodiversity, it is proven that the medium values of species richness and abundance of species under the nurses, is significantly superior to those occurring in open spaces. Furthermore, by means of phylogenetic trees it is shown that the species which cohabit under the nurses are not phylogenetically related. The former results are cited evidences of facilitation among plants, as well as it is one more time shown the importance of the nurse effect in preserving plant diversity on extreme environments.

Keywords: facilitation, nurse plants, positive interactions, quarzitic sands

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287 Effect of Fermentation Time on Some Functional Properties of Moringa (Moringa oleifera) Seed Flour

Authors: Ocheme B. Ocheme, Omobolanle O. Oloyede, S. James, Eleojo V. Akpa

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The effect of fermentation time on some functional properties of Moringa (Moringa oleifera) seed flour was examined. Fermentation, an effective processing method used to improve nutritional quality of plant foods, tends to affect the characteristics of food components and their behaviour in food systems just like other processing methods. Hence the need for this study. Moringa seeds were fermented naturally by soaking in potable water and allowing it to stand for 12, 24, 48 and 72 hours. At the end of fermentation, the seeds were oven dried at 600C for 12 hours and then milled into flour. Flour obtained from unfermented seeds served as control: hence a total of five flour samples. The functional properties were analyzed using standard methods. Fermentation significantly (p<0.05) increased the water holding capacity of Moringa seed flour from 0.86g/g - 2.31g/g. The highest value was observed after 48 hours of fermentation The same trend was observed for oil absorption capacity with values between 0.87 and 1.91g/g. Flour from unfermented Moringa seeds had a bulk density of 0.60g/cm3 which was significantly (p<0.05) higher than the bulk densities of flours from seeds fermented for 12, 24 and 48. Fermentation significantly (p<0.05) decreased the dispersibility of Moringa seed flours from 36% to 21, 24, 29 and 20% after 12, 24, 48 and 72 hours of fermentation respectively. The flours’ emulsifying capacities increased significantly (p<0.05) with increasing fermentation time with values between 50 – 68%. The flour obtained from seeds fermented for 12 hours had a significantly (p<0.05) higher foaming capacity of 16% while the flour obtained from seeds fermented for 0, 24 and 72 hours had the least foaming capacities of 9%. Flours from seeds fermented for 12 and 48 hours had better functional properties than flours from seeds fermented for 24 and 72 hours.

Keywords: fermentation, flour, functional properties, Moringa

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286 Behavioral and Electroantennographic Responses of the Tea Shot Hole Borer, Euwallacea fornicatus, Eichhoff (Scolytidae: Coleoptera) to Volatiles Compounds of Montanoa bipinnatifida (Compositae: Asteraceae) and Development of a Kairomone Trap

Authors: Sachin Paul James, Selvasundaram Rajagopal, Muraleedharan Nair, Babu Azariah

Abstract:

The shot hole borer (SHB), Euwallacea fornicatus (= Xyleborus fornicatus) (Scolytidae: Coleoptera) is one of the major pests of tea in southern India and Sri Lanka. The partially dried cut stem of a jungle plant, Montanoa bipinnatifida (C.Koch) (Compositae: Asteraceae) reported to attract shot hole borer beetles in the field. Collection, isolation, identification and quantification of the emitted volatiles from the partially dried cut stems of M. bipinnatifida using dynamic head space and GC-MS revealed the presence of seven compounds viz. α- pinene, β- phellandrene, β - pinene, D- limonene, trans-caryophyllene, iso- caryophyllene and germacrene– D. Behavioural bioassays using electroantennogram (EAG) and wind tunnel proved that, among these identified compounds only α - pinene, trans-caryophyllene, β – phellandrene and germacrene-D evoked significant behavioral response and maximum response was obtained to a specific blend of these four compounds @ 10:1:0.1:3. Field trapping experiments of this blend conducted in the SHB infested field using multiple funnel traps further proved the efficiency of the blend with a mean trap catch of 176.7 ± 13.1 beetles. Mass trapping studies in the field helped to develop a kairomone trap for the management of SHB in the tea fields of southern India.

Keywords: electroantennogram, kairomone trap, Montanoa bipinnatifida, tea shot hole borer

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285 Communication and Management of Incidental Pathology in a Cohort of 1,214 Consecutive Appendicectomies

Authors: Matheesha Herath, Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore

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Background: Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. It is unknown whether the acute surgical unit (ASU) model affects the management and disclosure of these findings. Methods: An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings and communication of the findings to the patient and to their general practitioner (GP). Results: 1,214 patients underwent emergency appendicectomy; 465 in the traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the traditional and ASU group with regards to communication of the findings to the patient (p=0.44) and their GP (p=0.27), and there was no difference in the rates of appropriate management (p=0.21). Conclusions: The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during an appendectomy.

Keywords: acute care surgery, appendicitis, appendicectomy, incidental

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