Search results for: language therapy
Commenced in January 2007
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Edition: International
Paper Count: 5485

Search results for: language therapy

415 Meaning Interpretation of Persian Noun-Noun Compounds: A Conceptual Blending Approach

Authors: Bahareh Yousefian, Laurel Smith Stvan

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Linguistic structures have two facades: form and meaning. These structures could have either literal meaning or figurative meaning (although it could also depend on the context in which that structure appears). The literal meaning is understandable more easily, but for the figurative meaning, a word or concept is understood from a different word or concept. In linguistic structures with a figurative meaning, it’s more difficult to relate their forms to the meanings than structures with literal meaning. In these cases, the relationship between form and figurative meaning could be studied from different perspectives. Various linguists have been curious about what happens in someone’s mind to understand figurative meaning through the forms; they have used different perspectives and theories to explain this process. It has been studied through cognitive linguistics as well, in which mind and mental activities are really important. In this viewpoint, meaning (in other words, conceptualization) is considered a mental process. In this descriptive-analytic study, 20 Persian compound nouns with figurative meanings have been collected from the Persian-language Moeen Encyclopedic Dictionary and other sources. Examples include [“Sofreh Xaneh”] (traditional restaurant) and [“Dast Yar”] (Assistant). These were studied in a cognitive semantics framework using “Conceptual Blending Theory” which hasn’t been tested on Persian compound nouns before. It was noted that “Conceptual Blending Theory” could lead to the process of understanding the figurative meanings of Persian compound nouns. Many cognitive linguists believe that “Conceptual Blending” is not only a linguistic theory but it’s also a basic human cognitive ability that plays important roles in thought, imagination, and even everyday life as well (though unconsciously). The ability to use mental spaces and conceptual blending (which is exclusive to humankind) is such a basic but unconscious ability that we are unaware of its existence and importance. What differentiates Conceptual Blending Theory from other ways of understanding figurative meaning, are arising new semantic aspects (emergent structure) that lead to a more comprehensive and precise meaning. In this study, it was found that Conceptual Blending Theory could explain reaching the figurative meanings of Persian compound nouns from their forms, such as [talkative for compound word of “Bolbol + Zabani” (nightingale + tongue)] and [wage for compound word of “Dast + Ranj” (hand + suffering)].

Keywords: cognitive linguistics, conceptual blending, figurative meaning, Persian compound nouns

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414 Proficiency Testing of English for Specific Academic Purpose: Using a Pilot Test in a Taiwanese University as an Example

Authors: Wenli Tsou, Jessica Wu

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Courses of English for specific academic purposes (ESAP) have become popular for higher education in Taiwan; however, no standardized tests have been developed for evaluating learners’ English proficiency in individual designated fields. Assuming a learner’s proficiency in a specific academic area is built up with one’s general proficiency in English with specific knowledge and vocabulary in the content areas, an adequate ESAP proficiency test may be constructed by some selected test items related to the designated academic areas. In this study, through collaboration between a language testing institution and a university in Taiwan, three sets of ESAP tests, covering three disciplinary areas of business and the workplace, science and engineering, and health and medicine majors, were developed and administered to sophomore students (N=1704) who were enrolled in ESAP courses at a university in southern Taiwan. For this study, the courses were grouped into the above-mentioned three disciplines, and students took the specialized proficiency test based on the ESAP course they were taking. Because students were free to select which ESAP course to take, each course had both major and non-major students. Toward the end of the one-semester course, ending in January, 2015, each student took two tests, one of general English (General English Proficiency Test, or GEPT) and the other ESAP. Following each test, students filled out a survey, reporting their test taking experiences. After comparing students’ two test scores, it was found that business majors and health and medical students performed better in ESAP than the non-majors in the class, whereas science and engineering majors did about the same as their non-major counterparts. In addition, test takers with CERF B2 (upper intermediate) level or above performed well in both tests, while students who are below B2 did slightly better in ESAP. The findings suggest that students’ test performance have been enhanced by their specialist content and vocabulary knowledge. Furthermore, results of the survey show that the difficulty levels reported by students are consistent with their test performances. Based on the item analysis, the findings can be used to develop proficiency tests for specific disciplines and to identify ability indicators for college students in their designated fields.

Keywords: english for specific academic purposes (ESAP), general english proficiency test (GEPT), higher education, proficiency test

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413 Delicate Balance between Cardiac Stress and Protection: Role of Mitochondrial Proteins

Authors: Zuzana Tatarkova, Ivana Pilchova, Michal Cibulka, Martin Kolisek, Peter Racay, Peter Kaplan

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Introduction: Normal functioning of mitochondria is crucial for cardiac performance. Mitochondria undergo mitophagy and biogenesis, and mitochondrial proteins are subject to extensive post-translational modifications. The state of mitochondrial homeostasis reflects overall cellular fitness and longevity. Perturbed mitochondria produce less ATP, release greater amounts of reactive molecules, and are more prone to apoptosis. Therefore mitochondrial turnover is an integral aspect of quality control in which dysfunctional mitochondria are selectively eliminated through mitophagy. Currently, the progressive deterioration of physiological functions is seen as accumulation of modified/damaged proteins with limiting regenerative ability and disturbance of such affected protein-protein communication throughout aging in myocardial cells. Methodologies: For our study was used immunohistochemistry, biochemical methods: spectrophotometry, western blotting, immunodetection as well as more sophisticated 2D electrophoresis and mass spectrometry for evaluation protein-protein interactions and specific post-translational modification. Results and Discussion: Mitochondrial stress response to reactive species was evaluated as electron transport chain (ETC) complexes, redox-active molecules, and their possible communication. Protein-protein interactions revealed a strong linkage between age and ETC protein subunits. Redox state was strongly affected in senescent mitochondria with shift in favor of more pro-oxidizing condition within cardiomyocytes. Acute myocardial ischemia and ischemia-reperfusion (IR) injury affected ETC complexes I, II and IV with no change in complex III. Ischemia induced decrease in total antioxidant capacity, MnSOD, GSH and catalase activity with recovery in some extent during reperfusion. While MnSOD protein content was higher in IR group, activity returned to 95% of control. Nitric oxide is one of the biological molecules that can out compete MnSOD for superoxide and produce peroxynitrite. This process is faster than dismutation and led to the 10-fold higher production of nitrotyrosine after IR injury in adult with higher protection in senescent ones. 2D protein profiling revealed 140 mitochondrial proteins, 12 of them with significant changes after IR injury and 36 individual nitrotyrosine-modified proteins further identified by mass spectrometry. Linking these two groups, 5 proteins were altered after IR as well as nitrated, but only one showed massive nitration per lowering content of protein after IR injury in adult. Conclusions: Senescent cells have greater proportion of protein content, which might be modulated by several post-translational modifications. If these protein modifications are connected to functional consequences and protein-protein interactions are revealed, link may lead to the solution. Assume all together, dysfunctional proteostasis can play a causative role and restoration of protein homeostasis machinery is protective against aging and possibly age-related disorders. This work was supported by the project VEGA 1/0018/18 and by project 'Competence Center for Research and Development in the field of Diagnostics and Therapy of Oncological diseases', ITMS: 26220220153, co-financed from EU sources.

Keywords: aging heart, mitochondria, proteomics, redox state

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412 The Impact of Resettlement Challenges in Seeking Employment on the Mental Health and Well-Being of African Refugee Youth in South Australia

Authors: Elvis Munyoka

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While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the paper will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugee youth, mental health, employment, resettlement, racism

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411 Prevalence of Chronic Diseases and Predictors of Mortality in Home Health Care Service: Data From Saudi Arabia

Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

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Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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410 Photobleaching Kinetics and Epithelial Distribution of Hexylaminoleuilinate Induced PpIX in Rat Bladder Cancer

Authors: Sami El Khatib, Agnès Leroux, Jean-Louis Merlin, François Guillemin, Marie-Ange D’Hallewin

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Photodynamic therapy (PDT) is a treatment modality based on the cytotoxic effect occurring on the target tissues by interaction of a photosensitizer with light in the presence of oxygen. One of the major advances in PDT can be attributed to the use of topical aminolevulinic (ALA) to induce Protoporphyrin IX (PpIX) for the treatment of early stage cancers as well as diagnosis. ALA is a precursor of the heme synthesis pathway. Locally delivered to the target tissue ALA overcomes the negative feedback exerted by heme and promotes the transient formation of PpIX in situ to reach critical effective levels in cells and tissue. Whereas early steps of the heme pathway occur in the cytosol, PpIX synthesis is shown to be held in the mitochondrial membranes and PpIX fluorescence is expected to accumulate in close vicinity of the initial building site and to progressively diffuse to the neighboring cytoplasmic compartment or other lipophylic organelles. PpIX is known to be highly reactive and will be degraded when irradiated with light. PpIX photobleaching is believed to be governed by a singlet oxygen mediated mechanism in the presence of oxidized amino acids and proteins. PpIX photobleaching and subsequent spectral phototransformation were described widely in tumor cells incubated in vitro with ALA solution, or ex vivo in human and porcine mucosa superfused with hexylaminolevulinate (hALA). PpIX photobleaching was also studied in vivo, using animal models such as normal or tumor mice skin and orthotopic rat bladder model. Hexyl aminolevulinate a more potent lipophilic derivative of ALA was proposed as an adjunct to standard cystoscopy in the fluorescence diagnosis of bladder cancer and other malignancies. We have previously reported the effectiveness of hALA mediated PDT of rat bladder cancer. Although normal and tumor bladder epithelium exhibit similar fluorescence intensities after intravesical instillation of two hALA concentrations (8 and 16 mM), the therapeutic response at 8mM and 20J/cm2 was completely different from the one observed at 16mM irradiated with the same light dose. Where the tumor is destroyed, leaving the underlying submucosa and muscle intact after an 8 mM instillation, 16mM sensitization and subsequent illumination results in the complete destruction of the underlying bladder wall but leaves the tumor undamaged. The object of the current study is to try to unravel the underlying mechanism for this apparent contradiction. PpIX extraction showed identical amounts of photosensitizer in tumor bearing bladders at both concentrations. Photobleaching experiments revealed mono-exponential decay curves in both situations but with a two times faster decay constant in case of 16mM bladders. Fluorescence microscopy shows an identical fluorescence pattern for normal bladders at both concentrations and tumor bladders at 8mM with bright spots. Tumor bladders at 16 mM exhibit a more diffuse cytoplasmic fluorescence distribution. The different response to PDT with regard to the initial pro-drug concentration can thus be attributed to the different cellular localization.

Keywords: bladder cancer, hexyl-aminolevulinate, photobleaching, confocal fluorescence microscopy

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409 Engendered Noises: The Gender Politics of Sensorial Pleasure in Neoliberal Korean Food Commercials

Authors: Eunyup Yeom

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The roles of male and female in context of cuisine have developed into stereotypes throughout history. However¬— with Korea’s fast advancement in politics, technology, society and social standards¬— gender stereotypes have become blurred. This is not to say that such stereotypes no longer exist for they still remain present in media and advertisements embedding ‘idealistic’ ideas into the unconscious state of minds of viewers. Many media outlets, especially commercials, portray males expressing pleasure of food [that they are advertising] through audible qualities generally considered ‘rude’ and ‘unmannered’ in the Korean society. Females, on the other hand, express such pleasures only verbally. This happenstance of a stereotype is displayed bluntly in instant noodle, namely ramen, commercials. This research explores the cultural significance of a type of audible gesture that can be found in Korean speech in which is termed the Fricative Voice Gesture (FVG). There are two forms of FVGs: the reactive and the prosodic. The reactive FVG is a legitimate form of expression while the prosodic FVG works as a speech intensifier. So, in order to understand this stereotype of who is authorized to express sensorial pleasure as a reactive FVG as opposed to a prosodic FVG, information has been extracted from interviews and dissected numerous ramen/instant noodle commercials and its appearances in other mediums of media. The commercials were tediously analyzed in all aspects of dialogue, featured contents, background music, actors and/or actresses selling the product, body language, and voice gestures. To effectively understand the exact impact these commercials have on the audience, each commercial was viewed with an interviewee. In this research, there were main informants whom were all Korean students residing in South Korea. All three interviewees were able to attend interview and commercial viewing sessions via Skype. This research, overall, focuses and concludes on Harkness’s statement of how the reactive FVG is a recognizable index of the privileging of males for Korean culture norms and, in parallel, food commercials are still conforming to male ideals and fantasies.

Keywords: advertisement, food politics, fricative voice gestures, gender politics

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408 Development and Implementation of An "Electric Island" Monitoring Infrastructure for Promoting Energy Efficiency in Schools

Authors: Vladislav Grigorovitch, Marina Grigorovitch, David Pearlmutter, Erez Gal

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The concept of “electric island” is involved with achieving the balance between the self-power generation ability of each educational institution and energy consumption demand. Photo-Voltaic (PV) solar system installed on the roofs of educational buildings is a common way to absorb the available solar energy and generate electricity for self-consumption and even for returning to the grid. The main objective of this research is to develop and implement an “electric island” monitoring infrastructure for promoting energy efficiency in educational buildings. A microscale monitoring methodology will be developed to provide a platform to estimate energy consumption performance classified by rooms and subspaces rather than the more common macroscale monitoring of the whole building. The monitoring platform will be established on the experimental sites, enabling an estimation and further analysis of the variety of environmental and physical conditions. For each building, separate measurement configurations will be applied taking into account the specific requirements, restrictions, location and infrastructure issues. The direct results of the measurements will be analyzed to provide deeper understanding of the impact of environmental conditions and sustainability construction standards, not only on the energy demand of public building, but also on the energy consumption habits of the children that study in those schools and the educational and administrative staff that is responsible for providing the thermal comfort conditions and healthy studying atmosphere for the children. A monitoring methodology being developed in this research is providing online access to real-time data of Interferential Therapy (IFTs) from any mobile phone or computer by simply browsing the dedicated website, providing powerful tools for policy makers for better decision making while developing PV production infrastructure to achieve “electric islands” in educational buildings. A detailed measurement configuration was technically designed based on the specific conditions and restriction of each of the pilot buildings. A monitoring and analysis methodology includes a large variety of environmental parameters inside and outside the schools to investigate the impact of environmental conditions both on the energy performance of the school and educational abilities of the children. Indoor measurements are mandatory to acquire the energy consumption data, temperature, humidity, carbon dioxide and other air quality conditions in different parts of the building. In addition to that, we aim to study the awareness of the users to the energy consideration and thus the impact on their energy consumption habits. The monitoring of outdoor conditions is vital for proper design of the off-grid energy supply system and validation of its sufficient capacity. The suggested outcomes of this research include: 1. both experimental sites are designed to have PV production and storage capabilities; 2. Developing an online information feedback platform. The platform will provide consumer dedicated information to academic researchers, municipality officials and educational staff and students; 3. Designing an environmental work path for educational staff regarding optimal conditions and efficient hours for operating air conditioning, natural ventilation, closing of blinds, etc.

Keywords: sustainability, electric island, IOT, smart building

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407 In vivo Evaluation of LAB Probiotic Potential with the Zebrafish Animal Model

Authors: Iñaki Iturria, Pasquale Russo, Montserrat Nacher-Vázquez, Giuseppe Spano, Paloma López, Miguel Angel Pardo

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Introduction: It is known that some Lactic Acid Bacteria (LAB) present an interesting probiotic effect. Probiotic bacteria stimulate host resistance to microbial pathogens and thereby aid in immune response, and modulate the host's immune responses to antigens with a potential to down-regulate hypersensitivity reactions. Therefore, probiotic therapy is valuable against intestinal infections and may be beneficial in the treatment of Inflammatory Bowel Disease (IBD). Several in vitro tests are available to evaluate the probiotic potential of a LAB strain. However, an in vivo model is required to understand the interaction between the host immune system and the bacteria. During the last few years, zebrafish (Danio rerio) has gained interest as a promising vertebrate model in this field. This organism has been extensively used to study the interaction between the host and the microbiota, as well as the host immune response under several microbial infections. In this work, we report on the use of the zebrafish model to investigate in vivo the colonizing ability and the immunomodulatory effect of probiotic LAB. Methods: Lactobacillus strains belonging to different LAB species were fluorescently tagged and used to colonize germ-free zebrafish larvae gastrointestinal tract (GIT). Some of the strains had a well-documented probiotic effect (L. acidophilus LA5); while others presented an exopolysaccharide (EPS) producing phenotype, thus allowing evaluating the influence of EPS in the colonization and immunomodulatory effect. Bacteria colonization was monitored for 72 h by direct observation in real time using fluorescent microscopy. CFU count per larva was also evaluated at different times. The immunomodulatory effect was assessed analysing the differential expression of several innate immune system genes (MyD88, NF-κB, Tlr4, Il1β and Il10) by qRT- PCR. The anti-inflammatory effect was evaluated using a chemical enterocolitis zebrafish model. The protective effect against a pathogen was also studied. To that end, a challenge test was developed using a fluorescently tagged pathogen (Vibrio anguillarum-GFP+). The progression of the infection was monitored up to 3 days using a fluorescent stereomicroscope. Mortality rates and CFU counts were also registered. Results and conclusions: Larvae exposed to EPS-producing bacteria showed a higher fluorescence and CFU count than those colonized with no-EPS phenotype LAB. In the same way, qRT-PCR results revealed an immunomodulatory effect on the host after the administration of the strains with probiotic activity. A downregulation of proinflammatory cytoquines as well as other cellular mediators of inflammation was observed. The anti-inflammatory effect was found to be particularly marked following exposure to LA% strain, as well as EPS producing strains. Furthermore, the challenge test revealed a protective effect of probiotic administration. As a matter of fact, larvae fed with probiotics showed a decrease in the mortality rate ranging from 20 to 35%. Discussion: In this work, we developed a promising model, based on the use of gnotobiotic zebrafish coupled with a bacterial fluorescent tagging in order to evaluate the probiotic potential of different LAB strains. We have successfully used this system to monitor in real time the colonization and persistence of exogenous LAB within the gut of zebrafish larvae, to evaluate their immunomodulatory effect and for in vivo competition assays. This approach could bring further insights into the complex microbial-host interactions at intestinal level.

Keywords: gnotobiotic, immune system, lactic acid bacteria, probiotics, zebrafish

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406 The Saying of Conceptual Metaphors about Law, Righteousness, and Justice in the Old Testament: Cardinal Tendencies

Authors: Ivana Prochazkova

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Cognitive linguistics offers biblical scholarship a specific methodological tool for analysis and interpretation of metaphorical expressions. Its methodology makes it possible to study processes involved in constructing the meaning of individual metaphorical expressions and whole conceptual metaphors; to analyze their function in the text; to follow the semantic development of concepts and conceptual domains, and to trace semantic changes and their motivation. The legal language in the Hebrew canon is extremely specific and formalized. Especially in the preambles to the collections of laws in the Pentateuch, more general considerations of the motif of keeping and breaking the law are encountered. This is also true in the psalms and wisdom literature. Legal theory and the philosophy of law deal with these motifs today. Metaphors play an important role in texts that reflect on more general issues. The purpose of this conference contribution is to write all over the central metaphorical concept, conceptual metaphor ךרד תורה (TORAH/LAW IS A JOURNEY), its function in the Torah and principal trends of the further development in the Prophets and the Writings. The conceptual metaphor תורה ךרד (TORAH/LAW IS A JOURNEY) constitutes a coherent system in conjunction with other metaphors that include e.g., conceptual metaphors נחה תורה (TORAH/LAW LEADS); its variant רעה תורה (TORAH IS A SHEPHERD/GUIDE); מקור תורה (TORAH/LAW IS A FOUNTAIN/A SOURCE OF LIFE). Some conceptual metaphors are well known, and their using are conventional (עשׁר תורה TORAH/LAW IS RICHES, שׂשׂון תורה TORAH/LAW IS DELIGHT, דבשׁ תורה TORAH/LAW IS HONEY, שׁמשׁ תורה TORAH/LAW IS SUN ). But some conceptual metaphors are by its occurrence innovative and unique (e.g., שׁריון תורה TORAH /LAW IS BODY ARMOR, כובע תורה TORAH /LAW IS A HELMET, בגד תורה TORAH/LAW IS A GARMENT, etc.). There will be given examples. Conceptual metaphors will be described by means of some 'metaphorical vehicles,' which are Hebrew expressions in the source domain that are repeatedly used in metaphorical conceptualizations of the target domain(s). Conceptual metaphors will be further described by means of 'generic narrative structures,' which are the particular aspects of a conceptual metaphor that emerge during the metaphorical structuring of concepts. They are the units of the metaphorical vehicles – the Hebrew expressions in the source domain – that structure concepts in much the same way that the conceptual metaphor in the target domain does. And finally, they will be described by means of the network of correspondences that exist between metaphorical vehicles – or generic metaphorical structures – and the Hebrew expressions in the target domain.

Keywords: cognitive theology, conceptual metaphor in the Old Testament, conceptual metaphors of the Torah, conceptual domain of law, righteousness, and justice

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405 Linguistic Competencies of Students with Hearing Impairment

Authors: Munawar Malik, Muntaha Ahmad, Khalil Ullah Khan

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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in recent era vows to have addressed the situation and claims significant contribution in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess linguistic competencies of students with hearing impairment in English language. The goals were further broken down to identify level of reading abilities in the subject population. The population involved students with HI studying at higher secondary level in Lahore. Simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with accelerated learning program by Punjab Government, to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach to the findings. Spearman’s correlation was used to find out relationship between degree of hearing loss, grade level, gender and type of amplification device. Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify an independent level of reading according to their grades as majority falls at frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence as it shows in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade wise, however scores could only correspond to frustration level and independent levels was never achieved. Reported achievements at instructional level of subject population may further to linguistic skills if practiced purposively.

Keywords: linguistic competence, hearing impairment, reading levels, educationist

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404 Vertebral Artery Dissection Complicating Pregnancy and Puerperium: Case Report and Review of the Literature

Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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403 Prevalence, Median Time, and Associated Factors with the Likelihood of Initial Antidepressant Change: A Cross-Sectional Study

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

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Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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402 Obstructive Bronchitis and Pneumonia by a Mixed Infection of HPIV- 3, S. pneumoniae in an Immunocompromised 10M Infant: Case Report

Authors: Olga Smilevska Spasova, Katerina Boshkovska, Gorica Popova, Mirjana Popovska

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Introduction: Pneumonia is an infection of the pulmonary parenchyma. HPIV 3 is one of four viruses that is a member of the Paramyxoviridae family designated types 1-4 that have a nonsegmented, single-stranded RNA genome with a lipid-containing envelope. They are spread from the respiratory tract by aerosolized secretions or by direct contact with secretions. Type 3 is endemic and can cause serious illness in immunocompromised patients. Illness caused by parainfluenza occurs shortly after inoculation with the virus. The level of immunoglobulin A antibody in serum is the best predictor of susceptibility to infection. Streptococcus pneumonia or pneumococcus is a Gram-positive, spherical bacteria, usually found in pairs and it is a member of the genus Streptococcus. Streptococcus pneumonia resides asymptomatically in healthy carriers typically colonizing the respiratory tract, sinuses, and nasal cavity. In individuals with weaker immune systems like young infants, pneumococcal bacterium is the most common cause of community-acquired pneumonia in the world. Case Report: The aim is to present a case of lower respiratory tract infection in an infant caused by parainfluenza virus 3, S. pneumonia and undifferentiated gram-negative bacteria that was successfully treated. The infant is with a history of recurrent episodes of wheezing in the past 3mounts.Infant of 10months presents 2weeks before admittance with high fever, runny nose, and cough. The primary pediatrician prescribed oral cefpodoxime for 10days and inhaled salbutamol. Two days before admittance in hospital the infant with high fever, cough, and difficulty breathing. At admittance, infant is pale, anxious with rapid respirations, cough, wheezing and tachycardia. On auscultation: vesicular breathing sounds with high pitched wheezing and on the right coarse crackles. Investigations: Blood analysis: RBC: 4, 7 x1012L, WBC: 8,3x109L: Neut: 42.73% Lym: 41.57%, Hgb: 9.38 g/dl MCV: 62.7fl, MCH: 20.0pg MCHC: 31.8 g/dl RDW: 18.7% Plt-307.9 x109LCRP: 2,5mg/l, serum iron-7.92umol/l, O2sat-97% on blood gas analysis, puls-125/min.X-ray of chest with hyperinflationand right pericardial consolidation. Microbiological analysis of sputum sample is positive for undifferentiated gram-negative bacteria (colonizer)–resistant to cefotaxime, ampicillin, cefoxitin, sulfamet.+trimetoprim and sensitive to amikacin, gentamicin, and ciprofloxacin. Molecular multiplex RT-PCR for 19 viruses and multiplex PCR for 7 bacteria test for respiratory pathogens positive for Parainfluenza virus 3(Ct=22.73), Streptococcus pneumonia (Ct=26.75).IED: IgG-9.31g/l, IgA-0.351g/l, IgM-0.86g/l. Therapy: Treatment was started with inhaled salbutamol, intravenous antibiotic cefotaxime as well as systemic corticosteroids. On day 7 because of slow clinical resolution of chest auscultation findings and an etiologic clue with a positive sputum sample for resistant undifferentiated gram negative bacteria, a second intravenous antibiotic was administered amikacin. The infant is discharged on day 14 with resolution of clinical findings. Conclusion: Mixed co-infections with respiratory viruses and bacteria in immunocompromised infants are likely to lead to a more severe form of community acquired pneumonia that will need hospitalization.

Keywords: HPIV- 3, infant, pneumonia, S. pneumonia, x-ray chest

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401 Fluctuations in Motivational Strategies EFL Teachers Use in Virtual and In-Person Classes across Context

Authors: Sima Modirkhamene, Arezoo Khezri

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The purpose of the present investigation was to probe the main motivational strategies Iranian school vs. institute teachers use in virtual and in-person classes to motivate students in learning the English language. Yet another purpose was to understand teachers’ perceptions about any modifications in their use of motivational strategies before and during/after the pandemic. For the purpose of this investigation, a total of 63 EFL teachers (35 female, 28 male) were conveniently sampled from schools and institutes in the cities of Mahabad and Sardasht. Moreover, for the interview phase of the study, 20 percent (n=16) of the sample was selected conveniently. The required data was gathered through a modified questionnaire (Cheng & Dornyei, 2007) consisting of 42 items and a set of semi-structured interviews. The outcomes of a set of non-parametric Mann-Whitney U tests demonstrated that presenting tasks properly in online classes and familiarizing learners with L2- related values in in-person classes came out as the most influential source of motivational strategies practiced by EFL school teachers. Additionally, it was found that proper teacher behavior(showing enthusiasm) in both in-person and virtual classes and presenting tasks properly in in-person classes were overwhelmingly endorsed by EFL institute teachers. The study also portrayed no statistically significant mean difference between school and institute EFL teachers’ overall use of motivational strategies in virtual and in-person classes. The interview results indicated that the strategies of designing tasks through technological aids, provision of videos, gamification techniques, assigning projects, and delivering formative online feedback were held in high regard during/after the pandemic due to the high reliance of teaching on the Internet connection. Meanwhile, the research has indicated that the spread of COVID-19 was the main reason for teachers’ modifications in motivational strategies, in response to the crisis of the pandemic, all educational contexts at all levels resorted to online education as a result their strategies were adapted to the new situation. The findings brought to light through this investigation provided initial evidence of the unintended consequences of the pandemic on teachers’ strategic choices. Therefore, to deliver a better education for the future, the study suggests more concentration on the quality of teaching as well as reframing the status quo of teaching .

Keywords: virtual teaching, motivational teaching strategies, teaching context, online education

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400 Differential Expression Profile Analysis of DNA Repair Genes in Mycobacterium Leprae by qPCR

Authors: Mukul Sharma, Madhusmita Das, Sundeep Chaitanya Vedithi

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Leprosy is a chronic human disease caused by Mycobacterium leprae, that cannot be cultured in vitro. Though treatable with multidrug therapy (MDT), recently, bacteria reported resistance to multiple antibiotics. Targeting DNA replication and repair pathways can serve as the foundation of developing new anti-leprosy drugs. Due to the absence of an axenic culture medium for the propagation of M. leprae, studying cellular processes, especially those belonging to DNA repair pathways, is challenging. Genomic understanding of M. Leprae harbors several protein-coding genes with no previously assigned function known as 'hypothetical proteins'. Here, we report identification and expression of known and hypothetical DNA repair genes from a human skin biopsy and mouse footpads that are involved in base excision repair, direct reversal repair, and SOS response. Initially, a bioinformatics approach was employed based on sequence similarity, identification of known protein domains to screen the hypothetical proteins in the genome of M. leprae, that are potentially related to DNA repair mechanisms. Before testing on clinical samples, pure stocks of bacterial reference DNA of M. leprae (NHDP63 strain) was used to construct standard graphs to validate and identify lower detection limit in the qPCR experiments. Primers were designed to amplify the respective transcripts, and PCR products of the predicted size were obtained. Later, excisional skin biopsies of newly diagnosed untreated, treated, and drug resistance leprosy cases from SIHR & LC hospital, Vellore, India were taken for the extraction of RNA. To determine the presence of the predicted transcripts, cDNA was generated from M. leprae mRNA isolated from clinically confirmed leprosy skin biopsy specimen across all the study groups. Melting curve analysis was performed to determine the integrity of the amplification and to rule out primer‑dimer formation. The Ct values obtained from qPCR were fitted to standard curve to determine transcript copy number. Same procedure was applied for M. leprae extracted after processing a footpad of nude mice of drug sensitive and drug resistant strains. 16S rRNA was used as positive control. Of all the 16 genes involved in BER, DR, and SOS, differential expression pattern of the genes was observed in terms of Ct values when compared to human samples; this was because of the different host and its immune response. However, no drastic variation in gene expression levels was observed in human samples except the nth gene. The higher expression of nth gene could be because of the mutations that may be associated with sequence diversity and drug resistance which suggests an important role in the repair mechanism and remains to be explored. In both human and mouse samples, SOS system – lexA and RecA, and BER genes AlkB and Ogt were expressing efficiently to deal with possible DNA damage. Together, the results of the present study suggest that DNA repair genes are constitutively expressed and may provide a reference for molecular diagnosis, therapeutic target selection, determination of treatment and prognostic judgment in M. leprae pathogenesis.

Keywords: DNA repair, human biopsy, hypothetical proteins, mouse footpads, Mycobacterium leprae, qPCR

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399 Ecosystem Services and Human Well-Being: Case Study of Tiriya Village, Bastar India

Authors: S. Vaibhav Kant Sahu, Surabhi Bipin Seth

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Human well-being has multiple constituents including the basic material for a good life, freedom and choice, health, good social relations, and security. Poverty is also multidimensional and has been defined as the pronounced deprivation of well-being. Dhurwa tribe of Bastar (India) have symbiotic relation with nature, it provisions ecosystem service such as food, fuel and fiber; regulating services such as climate regulation and non-material benefits such as spiritual or aesthetic benefits and they are managing their forest from ages. The demand for ecosystem services is now so great that trade-off among services become rule. Aim of study to explore evidences for linkages between ecosystem services and well-being of indigenous community, how much it helps them in poverty reduction and interaction between them. Objective of study was to find drivers of change and evidence concerning link between ecosystem, human development and sustainability, evidence in decision making does it opt for multi sectoral objectives. Which means human well-being as the central focus for assessment, while recognizing that biodiversity and ecosystems also have intrinsic value. Ecosystem changes that may have little impact on human well-being over days or weeks may have pronounced impacts over years or decades; so assessments needed to be conducted at spatial and temporal scales under social, political, economic scales to have high-resolution data. Researcher used framework developed by Millennium ecosystem assessment; since human action now directly or unknowingly virtually alter ecosystem. Researcher used ethnography study to get primary qualitative data, secondary data collected from panchayat office. The responses were transcribed and translated into English, as interview held in Hindi and local indigenous language. Focus group discussion were held with group of 10 women at Tiriya village. Researcher concluded with well-being is not just gap between ecosystem service supply but also increases vulnerability. Decision can have consequences external to the decision framework these consequences are called externalities because they are not part of the decision-making calculus.

Keywords: Bastar, Dhurwa tribe, ecosystem services, millennium ecosystem assessment, sustainability

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398 Developing a Methodology to Examine Psychophysiological Responses during Stress Exposure and Relaxation: An Experimental Paradigm

Authors: M. Velana, G. Rinkenauer

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Nowadays, nurses are facing unprecedented amounts of pressure due to the ongoing global health demands. Work-related stress can cause a high physical and psychological workload, which can lead, in turn, to burnout. On the physiological level, stress triggers an initial activation of the sympathetic nervous and adrenomedullary systems resulting in increases in cardiac activity. Furthermore, activation of the hypothalamus-pituitary-adrenal axis provokes endocrine and immune changes leading to the release of cortisol and cytokines in an effort to re-establish body balance. Based on the current state of the literature, it has been identified that resilience and mindfulness exercises among nurses can effectively decrease stress and improve mood. However, it is still unknown what relaxation techniques would be suitable for and to what extent would be effective to decrease psychophysiological arousal deriving from either a physiological or a psychological stressor. Moreover, although cardiac activity and cortisol are promising candidates to examine the effectiveness of relaxation to reduce stress, it still remains to shed light on the role of cytokines in this process so as to thoroughly understand the body’s response to stress and to relaxation. Therefore, the main aim of the present study is to develop a comprehensive experimental paradigm and assess different relaxation techniques, namely progressive muscle relaxation and a mindfulness exercise originating from cognitive therapy by means of biofeedback, under highly controlled laboratory conditions. An experimental between-subject design will be employed, where 120 participants will be randomized either to a physiological or a psychological stress-related experiment. Particularly, the cold pressor test refers to a procedure in which the participants have to immerse their non-dominant hands into ice water (2-3 °C) for 3 min. The participants are requested to keep their hands in the water throughout the whole duration. However, they can immediately terminate the test in case it would be barely tolerable. A pre-test anticipation phase and a post-stress period of 3 min, respectively, are planned. The Trier Social Stress Test will be employed to induce psychological stress. During this laboratory stressor, the participants are instructed to give a 5-min speech in front of a committee of communication specialists. Before the main task, there is a 10-min anticipation period. Subsequently, participants are requested to perform an unexpected arithmetic task. After stress exposure, the participants will perform one of the relaxation exercises (treatment condition) or watch a neutral video (control condition). Electrocardiography, salivary samples, and self-report will be collected at different time points. The preliminary results deriving from the pilot study showed that the aforementioned paradigm could effectively induce stress reactions and that relaxation might decrease the impact of stress exposure. It is of utmost importance to assess how the human body responds under different stressors and relaxation exercises so that an evidence-based intervention could be transferred in a clinical setting to improve nurses’ general health. Based on suggestive future laboratory findings, the research group plans to conduct a pilot-level randomized study to decrease stress and promote well-being among nurses who work in the stress-riddled environment of a hospital located in Northern Germany.

Keywords: nurses, psychophysiology, relaxation, stress

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397 Santo Niño in Canada: Religion, Migration, and the Filipino Underside

Authors: Alison Marshall

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“Santo Niño in Canada – Religion, Migration, and the Filipino Underside” seeks to explore the intersection of religion, migration and the Filipino underside through research participant narratives, archival research, and fieldwork on the cult of Santo Niño in Canada. Santo Niño is the single most revered saint in Filipino religiosity. According to popular lore, the original statue of Santo Niño was brought to the Philippines by Portuguese explorer Ferdinand Magellan in 1521, who claimed the islands on behalf of Spain. While Santo Niño is meant to be a manifestation of Jesus as a child, in Filipino thought and culture he very much resembles pre-Hispanic spirits, as well as patron saints introduced by the Spanish. Santo Niño shrines appear in churches, restaurants, businesses, and homes throughout the diaspora suggesting that he was much more than a Catholic image. He represents a deity who often shares a business or home shrine with non-Christian statues such as lucky cats, the Buddha, Guanyin, and Guangong, and sometimes the Chinese God of the Earth. He represents how Christian culture has been refashioned through indigenous, Chinese, Malay, and Indonesian influences. He embodies the religious superstructure that defines Christian piety and habits. On the one hand, he stands for Jesus, a pious son of God, and yet, on the other hand, he can be a simple vindictive child who punishes those who ignore him. Santo Niño is a complex character linked to the past before Christianity. As Filipinos engage with Santo Niño in Canada, they connect to him as Jesus, the son of God. They are also connecting to a childlike figure who sometimes uses his spiritual power to punish. A hybrid figure who comes came into being at the beginning of the Spanish colonial moment, he is maintained throughout the American one and continues to be a powerful reminder of Filipino identity and resilience when people leave the Philippines for migrant work. As this paper argues, Santo Niño beliefs, practices, and stories unite people in the diaspora regardless of language, gender, or nation. Santo Niño enables one to think about and understand what it means to be Filipino and living migrant lives in the diaspora today. In this way, the cult of Santo Niño expresses both Catholic orthodoxy and the heterodox Filipino underside that includes the use of magical amulets, healing, visions, and spirit mediumship.

Keywords: ethnography, migration, Philippines, religion

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396 Broad Host Range Bacteriophage Cocktail for Reduction of Staphylococcus aureus as Potential Therapy for Atopic Dermatitis

Authors: Tamar Lin, Nufar Buchshtab, Yifat Elharar, Julian Nicenboim, Rotem Edgar, Iddo Weiner, Lior Zelcbuch, Ariel Cohen, Sharon Kredo-Russo, Inbar Gahali-Sass, Naomi Zak, Sailaja Puttagunta, Merav Bassan

Abstract:

Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder that is characterized by dry skin and flares of eczematous lesions and intense pruritus. Multiple lines of evidence suggest that AD is associated with increased colonization by Staphylococcus aureus, which contributes to disease pathogenesis through the release of virulence factors that affect both keratinocytes and immune cells, leading to disruption of the skin barrier and immune cell dysfunction. The aim of the current study is to develop a bacteriophage-based product that specifically targets S. aureus. Methods: For the discovery of phage, environmental samples were screened on 118 S. aureus strains isolated from skin samples, followed by multiple enrichment steps. Natural phages were isolated, subjected to Next-generation Sequencing (NGS), and analyzed using proprietary bioinformatics tools for undesirable genes (toxins, antibiotic resistance genes, lysogeny potential), taxonomic classification, and purity. Phage host range was determined by an efficiency of plating (EOP) value above 0.1 and the ability of the cocktail to completely lyse liquid bacterial culture under different growth conditions (e.g., temperature, bacterial stage). Results: Sequencing analysis demonstrated that the 118 S. aureus clinical strains were distributed across the phylogenetic tree of all available Refseq S. aureus (~10,750 strains). Screening environmental samples on the S. aureus isolates resulted in the isolation of 50 lytic phages from different genera, including Silviavirus, Kayvirus, Podoviridae, and a novel unidentified phage. NGS sequencing confirmed the absence of toxic elements in the phages’ genomes. The host range of the individual phages, as measured by the efficiency of plating (EOP), ranged between 41% (48/118) to 79% (93/118). Host range studies in liquid culture revealed that a subset of the phages can infect a broad range of S. aureus strains in different metabolic states, including stationary state. Combining the single-phage EOP results of selected phages resulted in a broad host range cocktail which infected 92% (109/118) of the strains. When tested in vitro in a liquid infection assay, clearance was achieved in 87% (103/118) of the strains, with no evidence of phage resistance throughout the study (24 hours). A S. aureus host was identified that can be used for the production of all the phages in the cocktail at high titers suitable for large-scale manufacturing. This host was validated for the absence of contaminating prophages using advanced NGS methods combined with multiple production cycles. The phages are produced under optimized scale-up conditions and are being used for the development of a topical formulation (BX005) that may be administered to subjects with atopic dermatitis. Conclusions: A cocktail of natural phages targeting S. aureus was effective in reducing bacterial burden across multiple assays. Phage products may offer safe and effective steroid-sparing options for atopic dermatitis.

Keywords: atopic dermatitis, bacteriophage cocktail, host range, Staphylococcus aureus

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395 A Smartphone-Based Real-Time Activity Recognition and Fall Detection System

Authors: Manutchanok Jongprasithporn, Rawiphorn Srivilai, Paweena Pongsopha

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Fall is the most serious accident leading to increased unintentional injuries and mortality. Falls are not only the cause of suffering and functional impairments to the individuals, but also the cause of increasing medical cost and days away from work. The early detection of falls could be an advantage to reduce fall-related injuries and consequences of falls. Smartphones, embedded accelerometer, have become a common device in everyday life due to decreasing technology cost. This paper explores a physical activity monitoring and fall detection application in smartphones which is a non-invasive biomedical device to determine physical activities and fall event. The combination of application and sensors could perform as a biomedical sensor to monitor physical activities and recognize a fall. We have chosen Android-based smartphone in this study since android operating system is an open-source and no cost. Moreover, android phone users become a majority of Thai’s smartphone users. We developed Thai 3 Axis (TH3AX) as a physical activities and fall detection application which included command, manual, results in Thai language. The smartphone was attached to right hip of 10 young, healthy adult subjects (5 males, 5 females; aged< 35y) to collect accelerometer and gyroscope data during performing physical activities (e.g., walking, running, sitting, and lying down) and falling to determine threshold for each activity. Dependent variables are including accelerometer data (acceleration, peak acceleration, average resultant acceleration, and time between peak acceleration). A repeated measures ANOVA was performed to test whether there are any differences between DVs’ means. Statistical analyses were considered significant at p<0.05. After finding threshold, the results were used as training data for a predictive model of activity recognition. In the future, accuracies of activity recognition will be performed to assess the overall performance of the classifier. Moreover, to help improve the quality of life, our system will be implemented with patients and elderly people who need intensive care in hospitals and nursing homes in Thailand.

Keywords: activity recognition, accelerometer, fall, gyroscope, smartphone

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394 Rural-Urban Knowledge Transfer: Directions and Outcomes

Authors: J. Banski

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Regardless of residence place, the type of business and the social system, an individual or groups of people use the accumulated knowledge and continuously deepen and expand its scope. Knowledge is needed by human beings to carry out certain tasks, achieve desired goals or make decisions. Knowledge is an attribute of the people of a region and is identified with the total experience and information that its residents and institutions possess, including the ability to use it. It is subject to constant development, which is the result of both the deepening and exchange of knowledge among the residents of a particular area, as well as the influx of knowledge with newly arriving residents. A good example of the aforementioned processes is in rural areas, where we are dealing with two basic groups of people between whom knowledge transfer takes place. The first group is made up of people who have lived in the village for a long time, while the second group is made up of people who migrate temporarily or permanently to the countryside. The English-language literature uses the terms oldtimers and newcomers for these groups, respectively. Newcomers, usually possessing different life experiences, cultural patterns and competencies, can be rich sources of knowledge for villagers. At the same time, the latter, with different knowledge and experience, along with knowledge of local conditions and customs, can also be an important source of knowledge for incomers to the countryside. The countryside is a particularly interesting environment for studying social interactions and the accompanying transfer of knowledge. This is because it is characterized by a high intensity of neighborly contact and a high level of trust in the private sphere. As a result of the migratory influx of new residents, the social and cultural image of the countryside is changing due to the interpenetration of urban and rural life patterns. Research on rural-urban knowledge transfer is both an opportunity to halt negative trends in the social and economic development of rural areas and support the establishment of a basis for rural renewal. This paper discusses the results of research on urban-rural knowledge transfer based on case studies carried out in a dozen villages from different regions of Poland. Their purpose was to answer three basic research questions: 1) what types of knowledge are transferred between urban and rural residents? 2) what are the main directions and intensity in knowledge transfer? And 3) what are the consequences of knowledge transfer between urban and rural residents?

Keywords: rural areas, villages, newcomers, knowledge transfer, Poland

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393 Implementation of Cord- Blood Derived Stem Cells in the Regeneration of Two Experimental Models: Carbon Tetrachloride and S. Mansoni Induced Liver Fibrosis

Authors: Manal M. Kame, Zeinab A. Demerdash, Hanan G. El-Baz, Salwa M. Hassan, Faten M. Salah, Wafaa Mansour, Olfat Hammam

Abstract:

Cord blood (CB) derived Unrestricted Somatic Stem Cells (USSCs) with their multipotentiality hold great promise in liver regeneration. This work aims at evaluation of the therapeutic potentiality of USSCs in two experimental models of chronic liver injury induced either by S. mansoni infection in balb/c mice or CCL4 injection in hamsters. Isolation, propagation, and characterization of USSCs from CB samples were performed. USSCs were induced to differentiate into osteoblasts, adipocytes and hepatocyte-like cells. Cells of the third passage were transplanted in two models of liver fibrosis: (1) Twenty hamsters were induced to liver fibrosis by repeated i. p. injection of 100 μl CCl4 /hamster for 8 weeks. This model was designed as; 10 hamsters with liver fibrosis and treated with i.h. injection of 3x106 USSCs (USSCs transplanted group), 10 hamsters with liver fibrosis (pathological control group), and 10 hamsters with healthy livers (normal control group). (2) Murine chronics S.mansoni model: twenty mice were induced to liver fibrosis with S. mansoni ceracariae (60 cercariae/ mouse) using the tail immersion method and left for 12 weeks. This model was designed as; 10 mice with liver fibrosis were transplanted with i. v. injection of 1×106 USCCs (USSCs transplanted group). Other 2 groups were designed as in hamsters model. Animals were sacrificed 12 weeks after USSCs transplantation, and their liver sections were examined for detection of human hepatocyte-like cells by immunohistochemistry staining. Moreover, liver sections were examined for fibrosis level, and fibrotic indices were calculated. Sera of sacrificed animals were tested for liver functions. CB USSCs, with fibroblast-like morphology, expressed high levels of CD44, CD90, CD73 and CD105 and were negative for CD34, CD45, and HLA-DR. USSCs showed high expression of transcripts for Oct4 and Sox2 and were in vitro differentiated into osteoblasts, adipocytes. In both animal models, in vitro induced hepatocyte-like cells were confirmed by cytoplasmic expression of glycogen, alpha-fetoprotein, and cytokeratin18. Livers of USSCs transplanted group showed engraftment with human hepatocyte-like cells as proved by cytoplasmic expression of human alpha-fetoprotein, cytokeratin18, and OV6. In addition, livers of this group showed less fibrosis than the pathological control group. Liver functions in the form of serum AST & ALT level and serum total bilirubin level were significantly lowered in USSCs transplanted group than pathological control group (p < 0.001). Moreover, the fibrotic index was significantly lower (p< 0.001) in USSCs transplanted group than pathological control group. In addition liver sections, of i. v. injection of 1×106 USCCs of mice, stained with either H&E or sirius red showed diminished granuloma size and a relative decrease in hepatic fibrosis. Our experimental liver fibrosis models transplanted with CB-USSCs showed liver engraftment with human hepatocyte-like cells as well as signs of liver regeneration in the form of improvement in liver function assays and fibrosis level. These data provide hope that human CB- derived USSCs are introduced as multipotent stem cells with great potentiality in regenerative medicine & strengthens the concept of cellular therapy for the treatment of liver fibrosis.

Keywords: cord blood, liver fibrosis, stem cells, transplantation

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392 A Comparative Study of Efficacy and Safety of Salicylic Acid, Trichloroacetic Acid and Glycolic Acid in Various Facial Melanosis

Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Chemical peeling is a popular, relatively inexpensive day procedure and generally safe method for treatment of pigmentary skin disorders and for skin rejuvenation. Chemical peels are classified by the depth of action into superficial, medium, and deep peels.Various facial pigmentary conditions have significant impact on quality of life causing psychological stress, necessitating its safe and effective treatment.Aim & Objectives:To compare the efficacy of Salicylic acid, Trichloroaceticacid & Glycolic Acid in facial melanosis(melasma,photomelanosis& post acne pigmentation).To study the side effects of above mentioned peeling agents. Method and Materials:It was a randomized parallel control single blind study consisting of total of 36 cases, 12 cases each of melasma, photo melanosis and post acne pigmentation within age group 20-50 years having fitzpatrick’s skin type4. Woods lamp examination was done to confirm the type of melasma.Patients with keloidal tendency, active herpes infection or past history of hypersensitivity to salicylic acid, trichloroaceticand glycolic acid as well aspatients on systemic isotretinoin were excluded.Clinical photographs at the beginning of therapy and then serially, were taken to assess the clinical response. Prior to application a written informed consent was obtained. A post auricular test peel was performed. Patients were divided into 3 groups, containing 12 patients each of melasma, photomelanosis and post acnepigmentation.All the three peels SA peel 20% (done once in 2 weeks), GA peel 50% (done once in 3 weeks) and TCA 15% (done once in 3 weeks) were used with total six settings for each patient. Before application of peel patients were counseled to wash the face with soap and water. Then face was dried and cleaned with spirit and acetone to remove all cutaneous oils. GA, TCA, SA were applied with cotton buds/gauze withmild strokes. After a contact period off 5-10mins neutralization was done with cold water. Post peel topical sunscreen application was mandatory. MASI was used pre and post treatment to assess melasma. Investigator’s global improvement scale- overall hyperpigmentation (4-significant, 3-moderate, 2-mild, 1-minimal, 0-no change ) and Patient’s satisfaction grading scale (>70%- excellent response, 50-70%- good response, <50%- average response) was used to assess improvement in all the three facial melanosis.Results:In our study of 12 patients of melasma, 4 (33.33%)patients showed excellent results;3 (25%) with GAand 1(8.33%) of TCA.Good response was seen in 4 (33.33%) patients;1(8.33%) each for GA & SA and 2(16.66%) for TCA.Poor response was seen in 4(33.33%) patients;1(8.33%) for TCA and 3 (25%) for SA.Of 12 patients of photomelanosis, excellent resultswas seen in 3(25%)patients of TCA. Good response was seen in 4 (33.33%) patients, 1(8.33%) each of TCA &SA and 2(16.66%) of GA.Poor responsewas seen in 5(41.66%) patients;3 (25%) for SA and 2(16.66%) of GA.Of 12 patients of post acne pigmentation, excellent responsein 3 (25%) patients;2(16.66%) of SA and 1(8.33%) of TCA.Good responsewas seen in 5(41.66%) patients;2(16.66%) of SA and GA and1(8.33%) of TCA.Poor response was seen in 4 (33.33%) patients; 2 (16.66%) for SA and TCA both. No major side effects in the form of scarring or persistant pigmentation was seen. Transient blackening of skin with burning sensation was seen in cases treated with TCA and SA. Post procedural itching and redness was noted with GA peel. Conclusion- In our study GA(50%),TCA(15%) & SA(20%) peels showed excellent response in melasma, photomelanosis and post-acne pigmentation respectively.All the 3 peeling agents were well tolerated without any significant side-effects in the above specified concentrations.

Keywords: facial melanosis, gycolic acid, salicylic acid, trichloroacetic acid

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391 Developing a Discourse Community of Doctoral Students in a Multicultural Context

Authors: Jinghui Wang, Minjie Xing

Abstract:

The increasing number of international students for doctoral education has brought vitality and diversity to the educational environment in China, and at the same time constituted a new challenge to the English teaching in the higher education as the majority of international students come from developing countries where English is not their first language. To make their contribution to knowledge development and technical innovation, these international doctoral students need to present their research work in English, locally and globally. This study reports an exploratory study with an emphasis on the cognition and construction of academic discourse in the multicultural context. The present study aims to explore ways to better prepare them for international academic exchange in English. Voluntarily, all international doctoral students (n = 81) from 35 countries enrolled in the English Course: Speaking and Writing as a New Scientist, participated in the study. Two research questions were raised: 1) What did these doctoral students say about their cognition and construction of English academic discourses? 2) How did they manage to develop their productive skills in a multicultural context? To answer the research questions, data were collected from self-reports, in-depth interviews, and video-recorded class observations. The major findings of the study suggest that the participants to varying degrees benefitted from the cognition and construction of English academic discourse in the multicultural context. Specifically, 1) The cognition and construction of meta-discourse allowed them to construct their own academic discourses in English; 2) In the light of Swales’ CARS Model, they became sensitive to the “moves” involved in the published papers closely related to their study, and learned to use them in their English academic discourses; 3) Multimodality-driven presentation (multimedia modes) enabled these doctoral student to have their voice heard for technical innovation purposes; 4) Speaking as a new scientist, every doctoral student felt happy and able to serve as an intercultural mediator in the multicultural context, bridging the gap between their home culture and the global culture; and most importantly, 5) most of the participants reported developing an English discourse community among international doctoral students, becoming resourceful and productive in the multicultural context. It is concluded that the cognition and construction of academic discourse in the multicultural context proves to be conducive to the productivity and intercultural citizenship education of international doctoral students.

Keywords: academic discourse, international doctoral students, meta-discourse, multicultural context

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390 Communication in the Sciences: A Discourse Analysis of Biology Research Articles and Magazine Articles

Authors: Gayani Ranawake

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Effective communication is widely regarded as an important aspect of any discipline. This particular study deals with written communication in science. Writing conventions and linguistic choices play a key role in conveying the message effectively to a target audience. Scientists are responsible for conveying their findings or research results not only to their discourse community but also to the general public. Recognizing appropriate linguistic choices is crucial since they vary depending on the target audience. The majority of scientists can communicate effectively with their discourse community, but public engagement seems more challenging to them. There is a lack of research into the language use of scientists, and in particular how it varies by discipline and audience (genre). A better understanding of the different linguistic conventions used in effective science writing by scientists for scientists and by scientists for the public will help to guide scientists who are familiar with their discourse community norms to write effectively for the public. This study investigates the differences and similarities of linguistic choices in biology articles written by scientists for their discourse community and biology magazine articles written by scientists and science communicators for the general public. This study is a part of a larger project investigating linguistic differences in different genres of science academic writing. The sample for this particular study is composed of 20 research articles from the journal Biological Reviews and 20 magazine articles from the magazine Australian Popular Science. Differences in the linguistic devices were analyzed using Hyland’s metadiscourse model for academic writing proposed in 2005. The frequency of the usage of interactive resources (transitions, frame markers, endophoric markers, evidentials and code glosses) and interactional resources (hedges, boosters, attitude markers, self-mentions and engagement markers) were compared and contrasted using the NVivo textual analysis tool. The results clearly show the differences in the frequency of usage of interactional and interactive resources in the two disciplines under investigation. The findings of this study provide a reference guide for scientists and science writers to understand the differences in the linguistic choices between the two genres. This will be particularly helpful for scientists who are proficient at writing for their discourse community, but not for the public.

Keywords: discourse analysis, linguistic choices, metadiscourse, science writing

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389 Mental Health Promotion for Children of Mentally Ill Parents in Schools. Assessment and Promotion of Teacher Mental Health Literacy in Order to Promote Child Related Mental Health (Teacher-MHL)

Authors: Dirk Bruland, Paulo Pinheiro, Ullrich Bauer

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Introduction: Over 3 million children, about one quarter of all students, experience at least one parent with mental disorder in Germany every year. Children of mentally-ill parents are at considerably higher risk of developing serious mental health problems. The different burden patterns and coping attempts often become manifest in children's school lives. In this context, schools can have an important protective function, but can also create risk potentials. In reference to Jorm, pupil-related teachers’ mental health literacy (Teacher-MHL) includes the ability to recognize change behaviour, the knowledge of risk factors, the implementation of first aid intervention, and seeking professional help (teacher as gatekeeper). Although teachers’ knowledge and increased awareness of this topic is essential, the literature provides little information on the extent of teachers' abilities. As part of a German-wide research consortium on health literacy, this project, launched in March for 3 years, will conduct evidence-based mental health literacy research. The primary objective is to measure Teacher-MHL in the context of pupil-related psychosocial factors at primary and secondary schools (grades 5 & 6), while also focussing on children’s social living conditions. Methods: (1) A systematic literature review in different databases to identify papers with regard to Teacher-MHL (completed). (2) Based on these results, an interview guide was developed. This research step includes a qualitative pre-study to inductively survey the general profiles of teachers (n=24). The evaluation will be presented on the conference. (3) These findings will be translated into a quantitative teacher survey (n=2500) in order to assess the extent of socio-analytical skills of teachers as well as in relation to institutional and individual characteristics. (4) Based on results 1 – 3, developing a training program for teachers. Results: The review highlights a lack of information for Teacher-MHL and their skills, especially related to high-risk-groups like children of mentally ill parents. The literature is limited to a few studies only. According to these, teacher are not good at identifying burdened children and if they identify those children they do not know how to handle the situations in school. They are not sufficiently trained to deal with these children, especially there are great uncertainties in dealing with the teaching situation. Institutional means and resources are missing as well. Such a mismatch can result in insufficient support and use of opportunities for children at risk. First impressions from the interviews confirm these results and allow a greater insight in the everyday school-life according to critical life events in families. Conclusions: For the first time schools will be addressed as a setting where children are especially "accessible" for measures of health promotion. Addressing Teacher-MHL gives reason to expect high effectiveness. Targeting professionals' abilities for dealing with this high-risk-group leads to a discharge for teacher themselves to handle those situations and increases school health promotion. In view of the fact that only 10-30% of such high-risk families accept offers of therapy and assistance, this will be the first primary preventive and health-promoting approach to protect the health of a yet unaffected, but particularly burdened, high-risk group.

Keywords: children of mentally ill parents, health promotion, mental health literacy, school

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388 Coaches Attitudes, Efficacy and Proposed Behaviors towards Athletes with Hidden Disabilities: A Review of Recent Survey Research

Authors: Robbi Beyer, Tiffanye Vargas, Margaret Flores

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Within the United States, youths with hidden disabilities (specific learning disabilities, attention deficit hyperactivity disorder, emotional behavioral disorders, mild intellectual disabilities and speech/language disorders) can often be part of the kindergarten through twelfth grade school population. Because individuals with hidden disabilities have no apparent physical disability, learning difficulties may be overlooked and these youths may be mistakenly labeled as unmotivated, or defiant because they don't understand and follow directions, or maintain enough attention to remember and perform. These behaviors are considered especially challenging for youth sport coaches to manage and they often find it difficult to successfully select and deliver effective accommodations for the athletes. These deficits can be remediated and compensated through the use of research-validated strategies and instructional methods. However, while these techniques are commonly included in teacher preparation, they rarely, if ever, are included in coaching preparation. Therefore, the purpose of this presentation is to summarize consecutive research studies that examined coaching education within the United States for youth athletes with hidden disabilities. Each study utilized a questionnaire format to collect data from coaches on attitudes, efficacy and solutions for addressing challenging behaviors. Results indicated that although the majority of coaches’ attitudes were positive and they perceived themselves confident in working with athletes who have hidden disabilities, there were significant differences in the understanding of appropriate teaching strategies and techniques for this population. For example, when asked to describe a videotaped situation of why an athlete is not performing correctly, coaches often found the athlete to be at fault, as opposed to considering the possibility of faulty directions, or the need for accommodations in teaching/coaching style. When considering coaches’ preparation, 83% of participants declared they were inadequately prepared to coach athletes with hidden disabilities and 92% strongly supported improved preparation for coaches. The comprehensive examination of coaches’ perceptions and efficacy in working with youth athletes with hidden disabilities has provided valuable insight and highlights the need for continued research in this area.

Keywords: health, hidden disabilties, physical activity, youth recreational sports

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387 Smart Defect Detection in XLPE Cables Using Convolutional Neural Networks

Authors: Tesfaye Mengistu

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Power cables play a crucial role in the transmission and distribution of electrical energy. As the electricity generation, transmission, distribution, and storage systems become smarter, there is a growing emphasis on incorporating intelligent approaches to ensure the reliability of power cables. Various types of electrical cables are employed for transmitting and distributing electrical energy, with cross-linked polyethylene (XLPE) cables being widely utilized due to their exceptional electrical and mechanical properties. However, insulation defects can occur in XLPE cables due to subpar manufacturing techniques during production and cable joint installation. To address this issue, experts have proposed different methods for monitoring XLPE cables. Some suggest the use of interdigital capacitive (IDC) technology for online monitoring, while others propose employing continuous wave (CW) terahertz (THz) imaging systems to detect internal defects in XLPE plates used for power cable insulation. In this study, we have developed models that employ a custom dataset collected locally to classify the physical safety status of individual power cables. Our models aim to replace physical inspections with computer vision and image processing techniques to classify defective power cables from non-defective ones. The implementation of our project utilized the Python programming language along with the TensorFlow package and a convolutional neural network (CNN). The CNN-based algorithm was specifically chosen for power cable defect classification. The results of our project demonstrate the effectiveness of CNNs in accurately classifying power cable defects. We recommend the utilization of similar or additional datasets to further enhance and refine our models. Additionally, we believe that our models could be used to develop methodologies for detecting power cable defects from live video feeds. We firmly believe that our work makes a significant contribution to the field of power cable inspection and maintenance. Our models offer a more efficient and cost-effective approach to detecting power cable defects, thereby improving the reliability and safety of power grids.

Keywords: artificial intelligence, computer vision, defect detection, convolutional neural net

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386 Fresh Amnion Membrane Grafting for the Regeneration of Skin in Full Thickness Burn in Newborn - Case Report

Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar

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The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.

Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin

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