Search results for: prior experience
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6161

Search results for: prior experience

1781 Engineered Control of Bacterial Cell-to-Cell Signaling Using Cyclodextrin

Authors: Yuriko Takayama, Norihiro Kato

Abstract:

Quorum sensing (QS) is a cell-to-cell communication system in bacteria to regulate expression of target genes. In gram-negative bacteria, activation on QS is controlled by a concentration increase of N-acylhomoserine lactone (AHL), which can diffuse in and out of the cell. Effective control of QS is expected to avoid virulence factor production in infectious pathogens, biofilm formation, and antibiotic production because various cell functions in gram-negative bacteria are controlled by AHL-mediated QS. In this research, we applied cyclodextrins (CDs) as artificial hosts for the AHL signal to reduce the AHL concentration in the culture broth below its threshold for QS activation. The AHL-receptor complex induced under the high AHL concentration activates transcription of the QS-target gene. Accordingly, artificial reduction of the AHL concentration is one of the effective strategies to inhibit the QS. A hydrophobic cavity of the CD can interact with the acyl-chain of the AHL due to hydrophobic interaction in aqueous media. We studied N-hexanoylhomoserine lactone (C6HSL)-mediated QS in Serratia marcescens; accumulation of C6HSL is responsible for regulation of the expression of pig cluster. Inhibitory effects of added CDs on QS were demonstrated by determination of prodigiosin amount inside cells after reaching stationary phase, because production of prodigiosin depends on the C6HSL-mediated QS. By adding approximately 6 wt% hydroxypropyl-β-CD (HP-β-CD) in Luria-Bertani (LB) medium prior to inoculation of S. maecescens AS-1, the intracellularly accumulated prodigiosin was drastically reduced to 7-10%, which was determined after the extraction of prodigiosin in acidified ethanol. The AHL retention ability of HP-β-CD was also demonstrated by Chromobacterium violacuem CV026 bioassay. The CV026 strain is an AHL-synthase defective mutant that activates QS solely by adding AHLs from outside of cells. A purple pigment violacein is induced by activation of the AHL-mediated QS. We demonstrated that the violacein production was effectively suppressed when the C6HSL standard solution was spotted on a LB agar plate dispersing CV026 cells and HP-β-CD. Physico-chemical analysis was performed to study the affinity between the immobilized CD and added C6HSL using a quartz crystal microbalance (QCM) sensor. The COOH-terminated self-assembled monolayer was prepared on a gold electrode of 27-MHz AT-cut quartz crystal. Mono(6-deoxy-6-N, N-diethylamino)-β-CD was immobilized on the electrode using water-soluble carbodiimide. The C6HSL interaction with the β-CD cavity was studied by injecting the C6HSL solution to a cup-type sensor cell filled with buffer solution. A decrement of resonant frequency (ΔFs) clearly showed the effective C6HSL complexation with immobilized β-CD and its stability constant for MBP-SpnR-C6HSL complex was on the order of 102 M-1. The CD has high potential for engineered control of QS because it is safe for human use.

Keywords: acylhomoserine lactone, cyclodextrin, intracellular signaling, quorum sensing

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1780 Business Program Curriculum with Industry-Recognized Certifications: An Empirical Study of Exam Results and Program Curriculum

Authors: Thomas J. Bell III

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Pursuing a business degree is fraught with perplexing questions regarding the rising tuition cost and the immediate value of earning a degree. Any decision to pursue an undergraduate business degree is perceived to have value if it facilitates post-graduate job placement. Business programs have decreased value in the absence of innovation in business programs that close the skills gap between recent graduates and employment opportunities. Industry-based certifications are seemingly becoming a requirement differentiator among job applicants. Texas Wesleyan University offers a Computer Information System (CIS) program with an innovative curriculum that integrates industry-recognized certification training into its traditional curriculum with core subjects and electives. This paper explores a culture of innovation in the CIS business program curriculum that creates sustainable stakeholder value for students, employers, the community, and the university. A quantitative research methodology surveying over one-hundred students in the CIS program will be used to examine factors influencing the success or failure of students taking certification exams. Researchers will analyze control variables to identify specific correlations between practice exams, teaching pedagogy, study time, age, work experience, etc. This study compared various exam preparation techniques to corresponding exam results across several industry certification exams. The findings will aid in understanding control variables with correlations that positively and negatively impact exam results. Such discovery may provide useful insight into pedagogical impact indicators that positively contribute to certification exam success and curriculum enhancement.

Keywords: taking certification exams, exam training, testing skills, exam study aids, certification exam curriculum

Procedia PDF Downloads 69
1779 Impact of Mammographic Screening on Ethnic Inequalities in Breast Cancer Stage at Diagnosis and Survival in New Zealand

Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson

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Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.

Keywords: breast cancer, screening, ethnicity, inequity

Procedia PDF Downloads 501
1778 Importance of Field Hospitals in Trauma Management: An Experience from Nepal Earthquake

Authors: Krishna Gopal Lageju

Abstract:

On 25th April 2015, a 7.6 magnitude earthquake struck Gorkha district of Nepal, which resulted over 8,790 deaths and 22,300 injuries. In addition, almost one-third of the country’s healthcare service has been disrupted. A total of 1,211 health facilities became non-operational, due to 446 completely and other 765 partially damaged. Nearly 84 percent (375 out of 446) of the completely damaged health facilities are in the 14 most affected districts. As a result, the ability of health facilities to respond to health care needs has been harshly affected. In addition, 18 health workers lost their lives and 75 are injured, which added further challenges in the delivery of health services. Thus, to address the immediate health needs in the most devastated areas, Nepal Red Cross Society (NRCS) in coordination with IFRC and Nepal Government, 8 Field hospitals established with surgical capacities, where around 492 international Emergency Response Units (ERUs) Members are mobilized for 3 months period. More than 54,000 patients have been treated in the Red Cross operated field hospitals. Trauma cases accounted 9,180 (17%) of the total patients off which 1,285 (14%) are major surgical cases. Most of the case loads 44,830 (83%) are outpatients and 9,180 patients got inpatients service. Similarly, 112 births have been performed in the field hospitals. Inpatient mortality rate remained 1.5% (21 deaths), many of them are presented with critical injuries or illnesses. No outbreak has been seen during the ERU operation. Deployment of ERUs together with national health workers are very important to address the immediate health needs of the affected communities. This will ease for transition and handover of emergency service and equipments to local provider. Likewise, capacity building of local staff as on the job training on various clinical teachings would be another important issue to look at before phasing out such services.

Keywords: trauma management, critical injuries, earthquake, health

Procedia PDF Downloads 224
1777 Knowledge Management Efficiency of Personnel in Rajamangala University of Technology Srivijaya Songkhla, Thailand

Authors: Nongyao Intasaso, Atchara Rattanama, Navarat Pewnual

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This research is survey research purposed to study the factor affected to knowledge management efficiency of personnel in Rajamangala University of Technology Srivijaya, and study the problem of knowledge management affected to knowledge development of personnel in the university. The tool used in this study is structures questioner standardize rating scale in 5 levels. The sample selected by purposive sampling and there are 137 participation calculated in 25% of population. The result found that factor affected to knowledge management efficiency in the university included (1) result from the organization factor found that the university provided project or activity that according to strategy and mission of knowledge management affected to knowledge management efficiency in highest level (x̅ = 4.30) (2) result from personnel factor found that the personnel are eager for knowledge and active to learning to develop themselves and work (Personal Mastery) affected to knowledge management efficiency in high level (x̅ = 3.75) (3) result from technological factor found that the organization brought multimedia learning aid to facilitate learning process affected to knowledge management efficiency in high level (x̅ = 3.70) and (4) the result from learning factor found that the personnel communicated and sharing knowledge and opinion based on acceptance to each other affected to knowledge management efficiency in high level (x̅ = 3.78). The problem of knowledge management in the university included the personnel do not change their work behavior, insufficient of collaboration, lack of acceptance in knowledge and experience to each other, and limited budget. The solutions to solve these problems are the university should be support sufficient budget, the university should follow up and evaluate organization development based on knowledge using, the university should provide the activity emphasize to personnel development and assign the committee to process and report knowledge management procedure.

Keywords: knowledge management, efficiency, personnel, learning process

Procedia PDF Downloads 285
1776 Assessment of the Effect of Farmer-Herder Conflict on the Livelihood of Rural Households in Bogoro Local Government Area of Bauchi State, Nigeria

Authors: Luka Jumma Gizaki

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The study assessed the effect of farmer-herder conflict on the livelihood of rural households in Bogoro L.G.A., Bauchi State, Nigeria. Multistage sampling procedures were used to randomly select 66 crop farmers in the study area. Data were collected by means of a structured questionnaire. The result was analyzed using descriptive and inferential statistics. Results showed that the majority of the respondents were males with a mean age of 39 years and a farming experience of 16 years. About 95% of the respondents had formal education, with a mean household size of 8 persons per household. Farmer-herder conflicts were found to be caused by grazing on growing crops, wrong approach by farmers in raising complaints and harassment of herdsmen, absence of grazing route and poisoning of uncultivated lands. Constraints to resolving conflict were found to include personal interest, lack of government will, ethnicity and religious difference and open grazing ranking first, second and third, among others. Six factors connected to farmer-herder conflict were found to significantly affect the livelihood of rural households. These were the value of crops destroyed, the number of livestock lost, and the cost of treatment of wounds sustained from the conflict. The value of crops and the size of farmland abandoned in fear were significant, and the cost of seeking redress was significant at P≤0.01. It was concluded that farmer-herder conflict impacts negatively not only crops and animals but also affects the lives of farmers and herders as well as their economy. It is recommended that proper methods be adopted to avoid its occurrence, and when it occurs, the erring party should be appropriately punished.

Keywords: farmer, herder, conflict, effect, coping

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1775 English Language Teachers' Perceptions of Educational Research

Authors: Pinar Sali, Esim Gursoy, Ebru Atak Damar

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Teachers’ awareness of and involvement in educational research (ER) is regarded as an indispensable aspect of professional growth and development. It is also believed to be a catalyst for effective teaching and learning. This strong emphasis on the significance of teacher research engagement has sparked inquiry into how teachers construe ER and whether or not they practice it. However, there seems to exist a few researches on teachers’ perceptions of and experience with ER in the field of English Language Teaching (ELT). The present study thus attempts to fill this gap in the ELT literature and aims to unearth English language teachers’ perceptions of ER. Understanding these perceptions would undoubtedly aid in the development of strategies to promote teacher interest and involvement in research. The participants of the present study are 70 English language teachers in public and private schools in Turkey. A mixed-method approach has been used in the study. Both qualitative and quantitative data have been gathered by means of a questionnaire consisting of two parts. The first part of the questionnaire consists of 20 close-ended items of Teachers’ Attitude Scale Towards Educational Research (TASTER). The second part of the questionnaire has been developed by the researchers via an extensive literature review and consists of a mixture of close- and open-ended questions. In addition, 15 language teachers have been interviewed for an in-depth understanding of the results. Descriptive statistics and dual comparisons have been employed for the quantitative data, and the qualitative data have been analyzed by means of content analysis. The present study provides intriguing information as to the English language teachers’ perceptions of the usefulness and practicality of ER as well as the value they attain to it. The findings are discussed in relation to language teacher education. The research has implications for the teacher education process, teacher trainers and policy makers.

Keywords: attitudes toward educational research, educational research, language teachers, teacher research

Procedia PDF Downloads 238
1774 Identification of Clinical Characteristics from Persistent Homology Applied to Tumor Imaging

Authors: Eashwar V. Somasundaram, Raoul R. Wadhwa, Jacob G. Scott

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The use of radiomics in measuring geometric properties of tumor images such as size, surface area, and volume has been invaluable in assessing cancer diagnosis, treatment, and prognosis. In addition to analyzing geometric properties, radiomics would benefit from measuring topological properties using persistent homology. Intuitively, features uncovered by persistent homology may correlate to tumor structural features. One example is necrotic cavities (corresponding to 2D topological features), which are markers of very aggressive tumors. We develop a data pipeline in R that clusters tumors images based on persistent homology is used to identify meaningful clinical distinctions between tumors and possibly new relationships not captured by established clinical categorizations. A preliminary analysis was performed on 16 Magnetic Resonance Imaging (MRI) breast tissue segments downloaded from the 'Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and Molecular Analysis' (I-SPY TRIAL or ISPY1) collection in The Cancer Imaging Archive. Each segment represents a patient’s breast tumor prior to treatment. The ISPY1 dataset also provided the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status data. A persistent homology matrix up to 2-dimensional features was calculated for each of the MRI segmentation. Wasserstein distances were then calculated between all pairwise tumor image persistent homology matrices to create a distance matrix for each feature dimension. Since Wasserstein distances were calculated for 0, 1, and 2-dimensional features, three hierarchal clusters were constructed. The adjusted Rand Index was used to see how well the clusters corresponded to the ER/PR/HER2 status of the tumors. Triple-negative cancers (negative status for all three receptors) significantly clustered together in the 2-dimensional features dendrogram (Adjusted Rand Index of .35, p = .031). It is known that having a triple-negative breast tumor is associated with aggressive tumor growth and poor prognosis when compared to non-triple negative breast tumors. The aggressive tumor growth associated with triple-negative tumors may have a unique structure in an MRI segmentation, which persistent homology is able to identify. This preliminary analysis shows promising results in the use of persistent homology on tumor imaging to assess the severity of breast tumors. The next step is to apply this pipeline to other tumor segment images from The Cancer Imaging Archive at different sites such as the lung, kidney, and brain. In addition, whether other clinical parameters, such as overall survival, tumor stage, and tumor genotype data are captured well in persistent homology clusters will be assessed. If analyzing tumor MRI segments using persistent homology consistently identifies clinical relationships, this could enable clinicians to use persistent homology data as a noninvasive way to inform clinical decision making in oncology.

Keywords: cancer biology, oncology, persistent homology, radiomics, topological data analysis, tumor imaging

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1773 Generic Early Warning Signals for Program Student Withdrawals: A Complexity Perspective Based on Critical Transitions and Fractals

Authors: Sami Houry

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Complex systems exhibit universal characteristics as they near a tipping point. Among them are common generic early warning signals which precede critical transitions. These signals include: critical slowing down in which the rate of recovery from perturbations decreases over time; an increase in the variance of the state variable; an increase in the skewness of the state variable; an increase in the autocorrelations of the state variable; flickering between different states; and an increase in spatial correlations over time. The presence of the signals has management implications, as the identification of the signals near the tipping point could allow management to identify intervention points. Despite the applications of the generic early warning signals in various scientific fields, such as fisheries, ecology and finance, a review of literature did not identify any applications that address the program student withdrawal problem at the undergraduate distance universities. This area could benefit from the application of generic early warning signals as the program withdrawal rate amongst distance students is higher than the program withdrawal rate at face-to-face conventional universities. This research specifically assessed the generic early warning signals through an intensive case study of undergraduate program student withdrawal at a Canadian distance university. The university is non-cohort based due to its system of continuous course enrollment where students can enroll in a course at the beginning of every month. The assessment of the signals was achieved through the comparison of the incidences of generic early warning signals among students who withdrew or simply became inactive in their undergraduate program of study, the true positives, to the incidences of the generic early warning signals among graduates, the false positives. This was achieved through significance testing. Research findings showed support for the signal pertaining to the rise in flickering which is represented in the increase in the student’s non-pass rates prior to withdrawing from a program; moderate support for the signals of critical slowing down as reflected in the increase in the time a student spends in a course; and moderate support for the signals on increase in autocorrelation and increase in variance in the grade variable. The findings did not support the signal on the increase in skewness of the grade variable. The research also proposes a new signal based on the fractal-like characteristic of student behavior. The research also sought to extend knowledge by investigating whether the emergence of a program withdrawal status is self-similar or fractal-like at multiple levels of observation, specifically the program level and the course level. In other words, whether the act of withdrawal at the program level is also present at the course level. The findings moderately supported self-similarity as a potential signal. Overall, the assessment of the signals suggests that the signals, with the exception with the increase of skewness, could be utilized as a predictive management tool and potentially add one more tool, the fractal-like characteristic of withdrawal, as an additional signal in addressing the student program withdrawal problem.

Keywords: critical transitions, fractals, generic early warning signals, program student withdrawal

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1772 Stressors Faced by Border Security Officers: The Singapore Experience

Authors: Jansen Ang, Andrew Neo, Dawn Chia

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Border Security is unlike mainstream policing in that officers are essentially in static deployment, working round the clock every day and every hour of the year looking for illegitimate entry of persons and goods. In Singapore, Border Security officers perform multiple functions to ensure the nation’s safety and security. They are responsible for safeguarding the borders of Singapore to prevent threats from entering the country. Being the first line of defence in ensuring the nation’s border security officers are entrusted with the responsibility of screening travellers inbound and outbound of Singapore daily. They examined 99 million arrivals and departures at the various checkpoints in 2014, which is a considerable volume compared to most immigration agencies. The officers’ work scopes also include cargo clearance, protective and security functions of checkpoints. The officers work in very demanding environment which can range from the smog at the land checkpoints to the harshness of the ports at the sea checkpoints. In addition, all immigration checkpoints are located at the boundaries, posing commuting challenges for officers. At the land checkpoints, festive seasons and school breaks are peak periods as given the surge of inbound and outbound travellers at the various checkpoints. Such work provides unique challenges in comparison to other law enforcement duties. This paper assesses the current stressors faced by officers of a border security agency through the conduct of ground observations as well as a perceived stress survey as well as recommendations in combating stressors faced by border security officers. The findings from the field observations and surveys indicate organisational and operational stressors that are unique to border security and recommends interventions in managing these stressors. Understanding these stressors would better inform border security agencies on the interventions needed to enhance the resilience of border security officers.

Keywords: border security, Singapore, stress, operations

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1771 Matching Coping Strategies to Athletic Retirement Stressors among Japanese Female Athletes

Authors: Miyako Oulevey, David Lavallee, Naohiko Kohtake

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Retirement from sport can be stressful to athletes for many reasons. Accordingly, it is necessary to match coping strategies depending on the stressors. One of the athlete career assistance programs for Japanese top athletes in Japan, the Japan Olympic Committee Career Academy (JCA), has focused on the service contents regarding occupational supports which can be said to cope with financial and occupational stress; however, other supports such as psychological support were unclear due to the lack of psychological professionals in the JCA. Tailoring the program, it is important to match the needs of the athletes at athletic retirement with the service contents. Japanese Olympic athletes have been found to retire for different reasons. Especially female athletes who competed in the Summer Olympic Games were found to retire with psychological reasons. The purpose of this research was to investigate the types of stressors Japanese female athletes experience as a result of athletic retirement. As part of the study, 44 female retired athletes from 13 competitive sports completed an open-ended questionnaire. The KJ method was used to analyze stress experienced as a result of retirement. As a result, nine conceptualized stressors were aggregated such as “Conflict with athletic identity”, “Desire to live as an athlete”, and “Career plan after retirement”. In order to match the coping strategies according to the stressors, each stressor was classified with the four types of adjustments; psychological, social, financial, and occupational changes. As a result, the stressor relating to psychological adjustment accounted for 69.0% of coping-related needs, the financial and occupational adjustment was 21.8%, and social adjustment was 9.2%. In conclusion, coping strategies according to the stressors are suggested.

Keywords: athletic retirement, coping, female athlete, stress

Procedia PDF Downloads 138
1770 Management of Dysphagia after Supra Glottic Laryngectomy

Authors: Premalatha B. S., Shenoy A. M.

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Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

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1769 The Underestimation of Cultural Risk in the Execution of Megaprojects

Authors: Alan Walsh, Peter Walker, Michael Ellis

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There is a real danger that both practitioners and researchers considering risks associated with megaprojects ignore or underestimate the impacts of cultural risk. The paper investigates the potential impacts of a failure to achieve cultural unity between the principal actors executing a megaproject. The principle relationships include the relationships between the principle Contractors and the project stakeholders or the project stakeholders and their principle advisors, Western Consultants. This study confirms that cultural dissonance between these parties can delay or disrupt the megaproject execution and examines why cultural issues should be prioritized as a significant risk factor in megaproject delivery. This paper addresses the practical impacts and potential mitigation measures, which may reduce cultural dissonance for a megaproject's delivery. This information is retrieved from on-going case studies in live infrastructure megaprojects in Europe and the Middle East's GCC states, from Western Consultants' perspective. The collaborating researchers each have at least 30 years of construction experience and are engaged in architecture, project management and contracts management, dealing with megaprojects in Europe or the GCC. After examining the cultural interfaces they have observed during the execution of megaprojects, they conclude that globally, culture significantly influences their efficient delivery. The study finds that cultural risk is ever-present, where different nationalities co-manage megaprojects and that cultural conflict poses a real threat to the timely delivery of megaprojects. The study indicates that the higher the cultural distance between the principal actors, the more pronounced the risk, with the risk of cultural dissonance more prominent in GCC megaprojects. The findings support a more culturally aware and cohesive team approach and recommend cross-cultural training to mitigate the effects of cultural disparity.

Keywords: cultural risk underestimation, cultural distance, megaproject characteristics, megaproject execution

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1768 A Preliminary Randomized Controlled Trial of Pure L-Ascorbic Acid with Using a Needle-Free and Micro-Needle Mesotherapy in Treatment of Anti-Aging Procedure

Authors: M. Zasada, A. Markiewicz, A. Erkiert-Polguj, E. Budzisz

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The epidermis is a keratinized stratified squamous epithelium covered by the hydro-lipid barrier. Therefore, active substances should be able to penetrate through this hydro-lipid coating. L-ascorbic acid is one of the vitamins which plays an important role in stimulation fibroblast to produce collagen type I and in hyperpigmentation lightening. Vitamin C is a water-soluble antioxidant, which protects skin from oxidation damage and rejuvenates photoaged skin. No-needle mesotherapy is a non-invasive rejuvenation technique depending on electric pulses, electroporation, and ultrasounds. These physicals factors result in deeper penetration of cosmetics. It is important to increase the penetration of L-ascorbic acid, thereby increasing the spectrum of its activity. The aim of the work was to assess the effectiveness of pure L-ascorbic acid activity in anti-aging therapy using a needle-free and micro-needling mesotherapy. The study was performed on a group of 35 healthy volunteers in accordance with the Declaration of Helsinki of 1964 and agreement of the Ethics Commissions no RNN/281/16/KE 2017. Women were randomized to mesotherapy or control group. Control group applied topically 2,5 ml serum containing 20% L-ascorbic acid with hydrate from strawberries, every 10 days for a period of 9 weeks. No-needle mesotherapy, on the left half of the face and micro-needling on the right with the same serum, was done in mesotherapy group. The pH of serum was 3.5-4, and the serum was prepared directly prior to the facial treatment. The skin parameters were measured at the beginning and before each treatment. The measurement of the forehead skin was done using Cutometer® (measurement of skin elasticity and firmness), Corneometer® (skin hydration measurement), Mexameter® (skin tone measurement). Also, the photographs were taken by Fotomedicus system. Additionally, the volunteers fulfilled the questionnaire. Serum was tested for microbiological purity and stability after the opening of the cosmetic. During the study, all of the volunteers were taken care of a dermatologist. The regular application of the serum has caused improvement of the skin parameters. Respectively, after 4 and 8 weeks improvement in hydration and elasticity has been seen (Corneometer®, Cutometer® results). Moreover, the number of hyper-pigmentated spots has decreased (Mexameter®). After 8 weeks the volunteers has claimed that the tested product has smoothing and moisturizing features. Subjective opinions indicted significant improvement of skin color and elasticity. The product containing the L-ascorbic acid used with intercellular penetration promoters demonstrates higher anti-aging efficiency than control. In vivo studies confirmed the effectiveness of serum and the impact of the active substance on skin firmness and elasticity, the degree of hydration and skin tone. Mesotherapy with pure L-ascorbic acid provides better diffusion of active substances through the skin.

Keywords: anti-aging, l-ascorbic acid, mesotherapy, promoters

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1767 Auto Surgical-Emissive Hand

Authors: Abhit Kumar

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The world is full of master slave Telemanipulator where the doctor’s masters the console and the surgical arm perform the operations, i.e. these robots are passive robots, what the world needs to focus is that in use of these passive robots we are acquiring doctors for operating these console hence the utilization of the concept of robotics is still not fully utilized ,hence the focus should be on active robots, Auto Surgical-Emissive Hand use the similar concept of active robotics where this anthropomorphic hand focuses on the autonomous surgical, emissive and scanning operation, enabled with the vision of 3 way emission of Laser Beam/-5°C < ICY Steam < 5°C/ TIC embedded in palm of the anthropomorphic hand and structured in a form of 3 way disc. Fingers of AS-EH (Auto Surgical-Emissive Hand) as called, will have tactile, force, pressure sensor rooted to it so that the mechanical mechanism of force, pressure and physical presence on the external subject can be maintained, conversely our main focus is on the concept of “emission” the question arises how all the 3 non related methods will work together that to merged in a single programmed hand, all the 3 methods will be utilized according to the need of the external subject, the laser if considered will be emitted via a pin sized outlet, this radiation is channelized via a thin channel which further connect to the palm of the surgical hand internally leading to the pin sized outlet, here the laser is used to emit radiation enough to cut open the skin for removal of metal scrap or any other foreign material while the patient is in under anesthesia, keeping the complexity of the operation very low, at the same time the TIC fitted with accurate temperature compensator will be providing us the real time feed of the surgery in the form of heat image, this gives us the chance to analyze the level, also ATC will help us to determine the elevated body temperature while the operation is being proceeded, the thermal imaging camera in rooted internally in the AS-EH while also being connected to the real time software externally to provide us live feedback. The ICY steam will provide the cooling effect before and after the operation, however for more utilization of this concept we can understand the working of simple procedure in which If a finger remain in icy water for a long time it freezes the blood flow stops and the portion become numb and isolated hence even if you try to pinch it will not provide any sensation as the nerve impulse did not coordinated with the brain hence sensory receptor did not got active which means no sense of touch was observed utilizing the same concept we can use the icy stem to be emitted via a pin sized hole on the area of concern ,temperature below 273K which will frost the area after which operation can be done, this steam can also be use to desensitized the pain while the operation in under process. The mathematical calculation, algorithm, programming of working and movement of this hand will be installed in the system prior to the procedure, since this AS-EH is a programmable hand it comes with the limitation hence this AS-EH robot will perform surgical process of low complexity only.

Keywords: active robots, algorithm, emission, icy steam, TIC, laser

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1766 Qualitative Analysis of Current Child Custody Evaluation Practices

Authors: Carolyn J. Ortega, Stephen E. Berger

Abstract:

The role of the custody evaluator is perhaps one of the most controversial and risky endeavors in clinical practice. Complaints filed with licensing boards regarding a child-custody evaluation constitute the second most common reason for such an event. Although the evaluator is expected to answer for the family-law court what is in the “best interest of the child,” there is a lack of clarity on how to establish this in any empirically validated manner. Hence, practitioners must contend with a nebulous framework in formulating their methodological procedures that inherently places them at risk in an already litigious context. This study sought to qualitatively investigate patterns of practice among doctoral practitioners conducting child custody evaluations in the area of Southern California. Ten psychologists were interviewed who devoted between 25 and 100% of their California private practice to custody work. All held Ph.D. degrees with a range of eight to 36 years of experience in custody work. Semi-structured interviews were used to investigate assessment practices, ensure adherence to guidelines, risk management, and qualities of evaluators. Forty-three Specific Themes were identified using Interpretive Phenomenological Analysis (IPA). Seven Higher Order Themes clustered on salient factors such as use of Ethics, Law, Guidelines; Parent Variables; Child Variables; Psychologist Variables; Testing; Literature; and Trends. Evaluators were aware of the ever-present reality of a licensure complaint and thus presented idiosyncratic descriptions of risk management considerations. Ambiguity about quantifying and validly tapping parenting abilities was also reviewed. Findings from this study suggested a high reliance on unstructured and observational methods in child custody practices.

Keywords: forensic psychology, psychological testing, assessment methodology, child custody

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1765 Computerized Cognitive Training and Psychological Resiliency among Adolescents with Learning Disabilities

Authors: Verd Shomrom, Gilat Trabelsi

Abstract:

The goal of the study was to examine the effects of Computerized Cognitive Training (CCT) with and without cognitive mediation on Executive Function (EF) (planning and self- regulation) and on psychological resiliency among adolescents with Attention Deficits Hyperactive Disorder (ADHD) with or without Learning Disabilities (LD). Adolescents diagnosed with Attention Deficit Disorder and / or Learning Disabilities have multidimensional impairments that result from neurological damage. This work explored the possibility of influencing cognitive aspects in the field of Executive Functions (specifically: patterns of planning and self-regulation) among adolescents with a diagnosis of Attention Deficit Disorder and / or Learning Disabilities who study for a 10-12 grades. 46 adolescents with ADHD and/or with LD were randomly applied to experimental and control groups. All the participants were tested (BRC- research version, Resiliency quaternaries) before and after the intervention: mediated/ non-mediated Computerized Cognitive Training (MINDRI). The results indicated significant effects of cognitive modification in the experimental group, between pre and post Phases, in comparison to control group, especially in self- regulation (BRC- research version, Resiliency quaternaries), and on process analysis of Computerized Cognitive Training (MINDRI). The main conclusion was that even short- term mediation synchronized with CCT could greatly enhance the performance of executive functions demands. Theoretical implications for the positive effects of MLE in combination with CCT indicate the ability for cognitive change. The practical implication is the awareness and understanding of efficient intervention processes to enhance EF, learning awareness, resiliency and self-esteem of adolescents in their academic and daily routine.

Keywords: attention deficits hyperactive disorder, computerized cognitive training, executive function, mediated learning experience, learning disabilities

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1764 The Impact of Artificial Intelligence on Pharmacy and Pharmacology

Authors: Mamdouh Milad Adly Morkos

Abstract:

Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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1763 Analyzing the Effectiveness of Communication Practices and Processes within Project-Based Firms

Authors: Paul Saah, Charles Mbohwa, Nelson Sizwe Madonsela

Abstract:

The capacity to deliver projects on schedule, within budget, and to the pleasure of the client depends on effective communication, which is the lifeblood of project-based businesses. In order to pinpoint areas for development and shed light on the crucial role that communication plays in project success, the aim of this study is to evaluate the efficacy of communication practises and processes inside project-based organisations. In order to analyse concepts and get a greater grasp of their theoretical basis, this study's methodology combines a careful review of the relevant literature with a conceptual analysis of the subject. Data from a varied sample of project-based businesses spanning all industries and sizes were collected via document analysis. The relationship between communication practises, and processes were investigated in connection to key performance measures such as project outcomes, client satisfaction, and team dynamics. According to the study's findings, project-based businesses that adopt effective communication practises, and procedures experience a reduction in unfavourable experiences, stronger integration, and coordination, clarity of purpose, and practises that can hasten problem resolution. However, failing to adopt effective communication practises and procedures in project-based company result in counter issues, including project derailment from the schedule, failure to meet goals, inefficient use of existing resources, and failure to meet organisational goals. Therefore, optimising their communication practises, and procedures are crucial for sustainable growth and competitive advantage as project-based enterprises continue to play a crucial part in today's dynamic business scene.

Keywords: effective communication, project-based firms, communication practices, project success, communication strategies

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1762 The Ideology of the Jordanian Media Women’s Discourse: Lana Mamkgh as an Example

Authors: Amani Hassan Abu Atieh

Abstract:

This study aims at examining the patterns of ideology reflected in the written discourse of women writers in the media of Jordan; Lana Mamkgh is taken as an example. This study critically analyzes the discursive, linguistic, and cognitive representations that she employs as an agent in the institutionalized discourse of the media. Grounded in van Dijk’s critical discourse analysis approach to Sociocognitive Discourse Studies, the present study builds a multilayer framework that encompasses van Dijk’s triangle: discourse, society, and cognition. Specifically, the study attempts to analyze, at both micro and macro levels, the underlying cognitive processes and structures, mainly ideology and discursive strategies, which are functional in the production of women’s discourse in terms of meaning, forms, and functions. Cognitive processes that social actors adopt are underlined by experience/context and semantic mental models on the one hand and social cognition on the other. This study is based on qualitative research and adopts purposive sampling, taking as an example a sample of an opinion article written by Lana Mamkgh in the Arabic Jordanian Daily, Al Rai. Taking her role as an agent in the public sphere, she stresses the National and feminist ideologies, demonstrating the use of assertive, evaluative, and expressive linguistic and rhetorical devices that appeal to the logic, ethics, and emotions of the addressee. Highlighting the agency of Jordanian writers in the media, the study sought to achieve the macro goal of dispensing political and social justice to the underprivileged. Further, the study seeks to prove that the voice of Jordanian women, viewed as underrepresented and invisible in the public arena, has come through clearly.

Keywords: critical discourse analysis, sociocognitive theory, ideology, women discourse, media

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1761 Analysis of Pressure Drop in a Concentrated Solar Collector with Direct Steam Production

Authors: Sara Sallam, Mohamed Taqi, Naoual Belouaggadia

Abstract:

Solar thermal power plants using parabolic trough collectors (PTC) are currently a powerful technology for generating electricity. Most of these solar power plants use thermal oils as heat transfer fluid. The latter is heated in the solar field and transfers the heat absorbed in an oil-water heat exchanger for the production of steam driving the turbines of the power plant. Currently, we are seeking to develop PTCs with direct steam generation (DSG). This process consists of circulating water under pressure in the receiver tube to generate steam directly into the solar loop. This makes it possible to reduce the investment and maintenance costs of the PTCs (the oil-water exchangers are removed) and to avoid the environmental risks associated with the use of thermal oils. The pressure drops in these systems are an important parameter to ensure their proper operation. The determination of these losses is complex because of the presence of the two phases, and most often we limit ourselves to describing them by models using empirical correlations. A comparison of these models with experimental data was performed. Our calculations focused on the evolution of the pressure of the liquid-vapor mixture along the receiver tube of a PTC-DSG for pressure values and inlet flow rates ranging respectively from 3 to 10 MPa, and from 0.4 to 0.6 kg/s. The comparison of the numerical results with experience allows us to demonstrate the validity of some models according to the pressures and the flow rates of entry in the PTC-DSG receiver tube. The analysis of these two parameters’ effects on the evolution of the pressure along the receiving tub, shows that the increase of the inlet pressure and the decrease of the flow rate lead to minimal pressure losses.

Keywords: direct steam generation, parabolic trough collectors, Ppressure drop, empirical models

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1760 Ilizarov's External Fixator. A Bone Regeneration Method Little Used in Africa. Our Experience of 20 Years in Cameroon.

Authors: Ibrahima Farikou, Kolontchang Gatchou Alberic Lionel, Tsiagadgui Jean Gustave, Ngo Yamben Marie-Ange, Handy Eone Daniel

Abstract:

Introduction: It was in 1956 that Ilizarov pioneered the concept of osteogenesis in distraction by the device that bears his name to help produce bone and soft tissue regeneration and bone consolidation. This technique is not widely used in Africa where, however, its applications are numerous (loss of bone substances, congenital or acquired malformations). Our goal is to bring the indications of Ilizarov's device back to our practice conditions. Methods: Our study was conducted in 2 hospitals over a period of 20 years. For the retrospective phase, this study included all complete usable records of patients operated on in the Ilizarov external fixator department, and for the prospective phase, all patients operated on in the departments with complete usable records. Our sample was consecutive and not exhaustive. Data were analyzed by SPSS software version 23.0. Results: A total of 52 patients were reviewed. The average age of our patients was 14.7 years. The sex ratio was 1.6 in favor of men. The lower limb was the most affected (49), with a predominance of the tibia (62.4%). The average elongation was 6.4 cm. Traumatic acquired pathologies (delayed union, malunion) represented 60.6%. The mean time to union was seven months. Correction of the limb length discrepancy or filling of loss of bone substance was obtained in 75% of cases. Functionally, 80.8% of the patients treated had regained autonomy at the end of treatment, but in 17.3% of the patients, pain and limping persisted. Conclusion: This technique should be popularized in Africa because the benefit that would accrue to patients is invaluable and would be an attractive alternative to many amputations sometimes carried out in Africa by despair.

Keywords: ilizarov, external fixator, limb lengthening, bone regeneration, africa

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1759 A Methodology to Integrate Data in the Company Based on the Semantic Standard in the Context of Industry 4.0

Authors: Chang Qin, Daham Mustafa, Abderrahmane Khiat, Pierre Bienert, Paulo Zanini

Abstract:

Nowadays, companies are facing lots of challenges in the process of digital transformation, which can be a complex and costly undertaking. Digital transformation involves the collection and analysis of large amounts of data, which can create challenges around data management and governance. Furthermore, it is also challenged to integrate data from multiple systems and technologies. Although with these pains, companies are still pursuing digitalization because by embracing advanced technologies, companies can improve efficiency, quality, decision-making, and customer experience while also creating different business models and revenue streams. In this paper, the issue that data is stored in data silos with different schema and structures is focused. The conventional approaches to addressing this issue involve utilizing data warehousing, data integration tools, data standardization, and business intelligence tools. However, these approaches primarily focus on the grammar and structure of the data and neglect the importance of semantic modeling and semantic standardization, which are essential for achieving data interoperability. In this session, the challenge of data silos in Industry 4.0 is addressed by developing a semantic modeling approach compliant with Asset Administration Shell (AAS) models as an efficient standard for communication in Industry 4.0. The paper highlights how our approach can facilitate the data mapping process and semantic lifting according to existing industry standards such as ECLASS and other industrial dictionaries. It also incorporates the Asset Administration Shell technology to model and map the company’s data and utilize a knowledge graph for data storage and exploration.

Keywords: data interoperability in industry 4.0, digital integration, industrial dictionary, semantic modeling

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1758 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

Abstract:

This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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1757 A Study on the Effects of a Mindfulness Training on Managers: The Case of the Malian Company for the Development of Textile

Authors: Aboubacar Garba Konte, Wei Jun, Li Xiaohui

Abstract:

Nowadays companies are facing increasing pressure. The market environment changes more frequently than ever. Therefore, managers have to develop their agility, their performance and their capacity for innovation. Most companies look for managerial innovations to develop in their employees qualities such as motivation, commitment, creativity, autonomy or even the ability to adapt to change and manage intensive pressure. On a more collective level, companies are looking for teams that are able to organize, communicate and develop a form of collective intelligence based on cooperation and solidarity. Among the many managerial innovations that are currently developing, mindfulness (or mindfulness) is drawing the attention of a growing number of companies (Google, Apple, Sony, ING ...), These companies have implemented programs based on mindfulness. Although the concept of mindfulness and its effects have been the subject of in-depth research in the psychological field, research on mindfulness in the field of management is still in its infancy and it is necessary to evaluate its contribution to organizations. The purpose of this research is to evaluate the effects of a mindfulness training among the managers of a Malian textile company (CMDT). We conducted a case study on their experience and their managerial practices. In addition, we discuss the innovative nature of mindfulness in terms of managerial practice The results show significant positive effects on two major skills identified by managers that raise significant difficulties in their daily lives: their ability to supervise a team of employees with all that this implies in terms of interpersonal skills and their ability to organize and prioritize their activities. In addition, the research methodology sheds light on the innovative nature of mindfulness in a favorable organizational environment.

Keywords: mindfulness, manager, managerial innovation, relational skills, organization and prioritization

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1756 Moving from Computer Assisted Learning Language to Mobile Assisted Learning Language Edutainment: A Trend for Teaching and Learning

Authors: Ahmad Almohana

Abstract:

Technology has led to rapid changes in the world, and most importantly to education, particularly in the 21st century. Technology has enhanced teachers’ potential and has resulted in the provision of greater interaction and choices for learners. In addition, technology is helping to improve individuals’ learning experiences and building their capacity to read, listen, speak, search, analyse, memorise and encode languages, as well as bringing learners together and creating a sense of greater involvement. This paper has been organised in the following way: the first section provides a review of the literature related to the implementation of CALL (computer assisted learning language), and it explains CALL and its phases, as well as attempting to highlight and analyse Warschauer’s article. The second section is an attempt to describe the move from CALL to mobilised systems of edutainment, which challenge existing forms of teaching and learning. It also addresses the role of the teacher and the curriculum content, and how this is affected by the computerisation of learning that is taking place. Finally, an empirical study has been conducted to collect data from teachers in Saudi Arabia using quantitive and qualitative method tools. Connections are made between the area of study and the personal experience of the researcher carrying out the study with a methodological reflection on the challenges faced by the teachers of this same system. The major findings were that it is worth spelling out here that despite the circumstances in which students and lecturers are currently working, the participants revealed themselves to be highly intelligent and articulate individuals who were constrained from revealing this criticality and creativity by the system of learning and teaching operant in most schools.

Keywords: CALL, computer assisted learning language, EFL, English as a foreign language, ELT, English language teaching, ETL, enhanced technology learning, MALL, mobile assisted learning language

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1755 Practical Ways to Acquire the Arabic Language through Electronic Means

Authors: Hondozi Jahja

Abstract:

There is an obvious need to learn Arabic language and teach it to other speakers through the new curricula. The idea is to bridge the gap between theory and practice. To that end, we have sought to offer some means of help to master the Arabic language, in addition to our efforts to apply these means, enriching the culture of the student and develop his vocabulary. There is no doubt that taking care of the practical aspect of the grammar was our constant goal, and this particular aspect is what builds the student’s positive values and refine his taste and develop his language. In addressing these issues, we have adopted a school-based approach based primarily on the active and positive participation of the student. The theoretical linguistic issues - in our opinion - are not a primary goal, but the goal is to be used them by students through speaking and applying them. Among the objectives of this research is to establish the basic language skills of the students using new means that help the student to acquire these skills and apply them in various subjects of interest in his progress and development. Unfortunately, some of our students consider the grammar as ‘difficult’, ‘complex’ and ‘heavy’ in itself. This is one of the obstacles that stand in the way of their desired results. As a consequence, they end up talking – mumbling - about the difficulties they face in applying those rules. Therefore, some of our students finish their university studies and are unable to express what they feel using language correctly. For this purpose, we have sought in this research to follow a new integrated approach, which is to study the grammar of the language through modern means of the consolidation of the principle of functional language, and that the rule implies to control tongues and linguistic expressions properly. This research is a result of a practical experience as a teacher of Arabic language for non-native speakers at the ‘Hassan Pristina’ University, located in Pristina, the capital of Kosovo and at the Qatar Training Center since its establishment in 2012.

Keywords: arabic, applied methods, acquire, learning

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1754 Monitoring the Responses to Nociceptive Stimuli During General Anesthesia Based on Electroencephalographic Signals in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway (LMA)

Authors: Ofelia Loani Elvir Lazo, Roya Yumul, Sevan Komshian, Ruby Wang, Jun Tang

Abstract:

Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices.

Keywords: antinociception, bispectral index (BIS), general anesthesia, laryngeal mask airway, qCON/qNOX

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1753 Treatment with Triton-X 100: An Enhancement Approach for Cardboard Bioprocessing

Authors: Ahlam Said Al Azkawi, Nallusamy Sivakumar, Saif Nasser Al Bahri

Abstract:

Diverse approaches and pathways are under development with the determination to develop cellulosic biofuels and other bio-products eventually at commercial scale in “bio-refineries”; however, the key challenge is mainly the high level of complexity in processing the feedstock which is complicated and energy consuming. To overcome the complications in utilizing the naturally occurring lignocellulose biomass, using waste paper as a feedstock for bio-production may solve the problem. Besides being abundant and cheap, bioprocessing of waste paper has evolved in response to the public concern from rising landfill cost from shrinking landfill capacity. Cardboard (CB) is one of the major components of municipal solid waste and one of the most important items to recycle. Although 50-70% of cardboard constitute is known to be cellulose and hemicellulose, the presence of lignin around them cause hydrophobic cross-link which physically obstructs the hydrolysis by rendering it resistant to enzymatic cleavage. Therefore, pretreatment is required to disrupt this resistance and to enhance the exposure of the targeted carbohydrates to the hydrolytic enzymes. Several pretreatment approaches have been explored, and the best ones would be those can influence cellulose conversion rates and hydrolytic enzyme performance with minimal or less cost and downstream processes. One of the promising strategies in this field is the application of surfactants, especially non-ionic surfactants. In this study, triton-X 100 was used as surfactants to treat cardboard prior enzymatic hydrolysis and compare it with acid treatment using 0.1% H2SO4. The effect of the surfactant enhancement was evaluated through its effect on hydrolysis rate in respect to time in addition to evaluating the structural changes and modification by scanning electron microscope (SEM) and X-ray diffraction (XRD) and through compositional analysis. Further work was performed to produce ethanol from CB treated with triton-X 100 via separate hydrolysis and fermentation (SHF) and simultaneous saccharification and fermentation (SSF). The hydrolysis studies have demonstrated enhancement in saccharification by 35%. After 72 h of hydrolysis, a saccharification rate of 98% was achieved from CB enhanced with triton-X 100, while only 89 of saccharification achieved from acid pre-treated CB. At 120 h, the saccharification % exceeded 100 as reducing sugars continued to increase with time. This enhancement was not supported by any significant changes in the cardboard content as the cellulose, hemicellulose and lignin content remained same after treatment, but obvious structural changes were observed through SEM images. The cellulose fibers were clearly exposed with very less debris and deposits compared to cardboard without triton-X 100. The XRD pattern has also revealed the ability of the surfactant in removing calcium carbonate, a filler found in waste paper known to have negative effect on enzymatic hydrolysis. The cellulose crystallinity without surfactant was 73.18% and reduced to 66.68% rendering it more amorphous and susceptible to enzymatic attack. Triton-X 100 has proved to effectively enhance CB hydrolysis and eventually had positive effect on the ethanol yield via SSF. Treating cardboard with only triton-X 100 was a sufficient treatment to enhance the enzymatic hydrolysis and ethanol production.

Keywords: cardboard, enhancement, ethanol, hydrolysis, treatment, Triton-X 100

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1752 The Moderating Roles of Bedtime Activities and Anxiety and Depression in the Relationship between Attention-Deficit/Hyperactivity Disorder and Sleep Problems in Children

Authors: Lian Tong, Yan Ye, Qiong Yan

Abstract:

Background: Children with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, but the comorbidity mechanism has not been sufficiently studied. This study aimed to determine the comorbidity of ADHD and sleep problems as well as the moderating effects of bedtime activities and depression/anxiety symptoms on the relationship between ADHD and sleep problems. Methods: We recruited 934 primary students from third to fifth grade and their parents by stratified random sampling from three primary schools in Shanghai, China. This study used parent-reported versions of the ADHD Rating Scale-IV, Children’s Sleep Habits Questionnaire, and Achenbach Child Behavior Checklist. We used hierarchical linear regression analysis to clarify the moderating effects of bedtime activities and depression/anxiety symptoms. Results: We found that children with more ADHD symptoms had shorter sleep durations and more sleep problems on weekdays. Screen time before bedtime strengthened the relationship between ADHD and sleep-disordered breathing. Children with more screen time were more likely to have sleep onset delay, while those with less screen time had more sleep onset problems with increasing ADHD symptoms. The high bedtime eating group experienced more night waking with increasing ADHD symptoms compared with the low bedtime eating group. Anxiety/depression exacerbated total sleep problems and further interacted with ADHD symptoms to predict sleep length and sleep duration problems. Conclusions: Bedtime activities and emotional problems had important moderating effects on the relationship between ADHD and sleep problems. These findings indicate that appropriate bedtime management and emotional management may reduce sleep problems and improve sleep duration for children with ADHD symptoms.

Keywords: ADHD, sleep problems, anxiety/depression, bedtime activities, children

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