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Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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Authors: Renu Satish Nair

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Indian higher education system is the third largest in the world next to United States and China. India is experiencing a rapid growth in higher education in terms of student enrollment as well as establishment of new universities, colleges and institutes of national importance. Presently about 22 million students are being enrolled in higher education and more than 46 thousand institutions’ are functioning as centers of higher education. Indian government plays a 'command and control' role in higher education. The main governing body is University Grants Commission, which enforces its standards, advises the government, and helps coordinate between the centre and the state. Accreditation of higher learning is over seen by 12 autonomous institutions established by the University Grants Commission. The present paper is an effort to analyze the strength, weakness, opportunities and threat (SWOT Analysis) of Indian Higher education system. The higher education in India is progressing ahead by virtue of its strength which is being recognized at global level. Several institutions of India, such as Indian Institutes of Technology (IITs), Indian Institutes of Management (IIMs) and National Institutes of Technology (NITs) have been globally acclaimed for their standard of education. Three Indian universities were listed in the Times Higher Education list of the world’s top 200 universities i.e. Indian Institutes of Technology, Indian Institute of Management and Jawahar Lal Nehru University in 2005 and 2006. Six Indian Institutes of Technology and the Birla Institute of Technology and Science - Pilani were listed among the top 20 science and technology schools in Asia by the Asia Week. The school of Business situated in Hyderabad was ranked number 12 in Globe MBA ranking by the Financial Times of London in 2010 while the All India Institute of Medical Sciences has been recognized as a global leader in medical research and treatment. But at the same time, because of vast expansion, the system bears several weaknesses. The Indian higher education system in many parts of the country is in the state of disrepair. In almost half the districts in the country higher education enrollment are very low. Almost two third of total universities and 90% of colleges are rated below average on quality parameters. This can be attributed to the under prepared faculty, unwieldy governance and other obstacles to innovation and improvement that could prohibit India from meeting its national education goals. The opportunities in Indian higher education system are widely ranged. The national institutions are training their products to compete at global level and make them capable to grab opportunities worldwide. The state universities and colleges with their limited resources are giving the products that are capable enough to secure career opportunities and hold responsible positions in various government and private sectors with in the country. This is further creating opportunities for the weaker section of the society to join the main stream. There are several factors which can be defined as threats to Indian higher education system. It is a matter of great concern and needs proper attention. Some important factors are -Conservative society, particularly for women education; -Lack of transparency, -Taking higher education as a means of business

Keywords: Indian higher education system, SWOT analysis, university grants commission, Indian institutes of technology

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Authors: Wendy De Gomez

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The University of Waterloo is situated in central Canada in the Province of Ontario- one hour from the metropolitan city of Toronto. For over 30 years, it has held Canada’s top spot as the most innovative university; and has been consistently ranked in the top 25 computer science and top 50 engineering schools in the world. Waterloo benefits from the federal government’s over 100 domestic innovation policies which have assisted in the country’s 15th place global ranking in the World Intellectual Property Organization’s (WIPO) 2022 Global Innovation Index. Yet undoubtedly, the University of Waterloo’s unique characteristics are what propels its innovative creativeness forward. This paper will provide a contextual definition of innovation in higher education and then demonstrate the five operational attributes that contribute to the University of Waterloo’s innovative reputation. The methodology is based on statistical analyses obtained from ranking bodies such as the QS World University Rankings, a secondary literature review related to higher education innovation in Canada, and case studies that exhibit the operationalization of the attributes outlined below. The first attribute is geography. Specifically, the paper investigates the network structure effect of the Toronto-Waterloo high-tech corridor and the resultant industrial relationships built there. The second attribute is University Policy 73-Intellectal Property Rights. This creator-owned policy grants all ownership to the creator/inventor regardless of the use of the University of Waterloo property or funding. Essentially, through the incentivization of IP ownership by all researchers, further commercialization and entrepreneurship are formed. Third, this IP policy works hand in hand with world-renowned business incubators such as the Accelerator Centre in the dedicated research and technology park and velocity, a 14-year-old facility that equips and guides founders to build and scale companies. Communitech, a 25-year-old provincially backed facility in the region, also works closely with the University of Waterloo to build strong teams, access capital, and commercialize products. Fourth, Waterloo’s co-operative education program contributes 31% of all co-op participants to the Canadian economy. Home to the world’s largest co-operative education program, data shows that over 7,000 from around the world recruit Waterloo students for short- and long-term placements- directly contributing to the student’s ability to learn and optimize essential employment skills when they graduate. Finally, the students themselves at Waterloo are exceptional. The entrance average ranges from the low 80s to the mid-90s depending on the program. In computer, electrical, mechanical, mechatronics, and systems design engineering, to have a 66% chance of acceptance, the applicant’s average must be 95% or above. Singularly, none of these five attributes could lead to the university’s outstanding track record of innovative creativity, but when bundled up into a 1000 acre- 100 building main campus with 6 academic faculties, 40,000+ students, and over 1300 world-class faculty, the recipe for success becomes quite evident.

Keywords: IP policy, higher education, economy, innovation

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Authors: Kate Allman, Heather Maranges, Elise Dykhuis

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Moral Growth Mindset (MGM) is the belief that one has the capacity to become a more moral person, as opposed to a fixed conception of one’s moral ability and capacity (Han et al., 2018). Building from Dweck’s work in incremental implicit theories of intelligence (2008), Moral Growth Mindset (Han et al., 2020) extends growth mindsets into the moral dimension. The concept of MGM has the potential to help researchers understand how both mindsets and interventions can impact character development, and it has even been shown to have connections to voluntary service engagement (Han et al., 2018). Understanding the contexts in which MGM might be cultivated could help to promote the further cultivation of character, in addition to prosocial behaviors like service engagement, which may, in turn, promote larger scale engagement in social justice-oriented thoughts, feelings, and behaviors. In particular, college may be a place to intentionally cultivate a growth mindset toward moral capacities, given the unique developmental and maturational components of the college experience, including contextual opportunity (Lapsley & Narvaez, 2006) and independence requiring the constant consideration, revision, and internalization of personal values (Lapsley & Woodbury, 2016). In a semester-long, quasi-experimental study, we examined the impact of a pedagogical approach designed to cultivate college student character development on participants’ MGM. With an intervention (n=69) and a control group (n=97; Pre-course: 27% Men; 66% Women; 68% White; 18% Asian; 2% Black; <1% Hispanic/Latino), we investigated whether college courses that intentionally incorporate character education pedagogy (Lamb, Brant, Brooks, 2021) affect a variety of psychosocial variables associated with moral thoughts, feelings, identity, and behavior (e.g. moral growth mindset, honesty, compassion, etc.). The intervention group consisted of 69 undergraduate students (Pre-course: 40% Men; 52% Women; 68% White; 10.5% Black; 7.4% Asian; 4.2% Hispanic/Latino) that voluntarily enrolled in five undergraduate courses that encouraged students to engage with key concepts and methods of character development through the application of research-based strategies and personal reflection on goals and experiences. Moral Growth Mindset was measured using the four-item Moral Growth Mindset scale (Han et al., 2020), with items such as You can improve your basic morals and character considerably on a six-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Higher scores of MGM indicate a stronger belief that one can become a more moral person with personal effort. Reliability at Time 1 was Cronbach’s ɑ= .833, and at Time 2 Cronbach’s ɑ= .772. An Analysis of Covariance (ANCOVA) was conducted to explore whether post-course MGM scores were different between the intervention and control when controlling for pre-course MGM scores. The ANCOVA indicated significant differences in MGM between groups post-course, F(1,163) = 8.073, p = .005, R² = .11, where descriptive statistics indicate that intervention scores were higher than the control group at post-course. Results indicate that intentional character development pedagogy can be leveraged to support the development of Moral Growth Mindset and related capacities in undergraduate settings.

Keywords: moral personality, character education, incremental theories of personality, growth mindset

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Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer

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Model assessment, in the Bayesian context, involves evaluation of the goodness-of-fit and the comparison of several alternative candidate models for predictive accuracy and improvements. In posterior predictive checks, the data simulated under the fitted model is compared with the actual data. Predictive model accuracy is estimated using information criteria such as the Akaike information criterion (AIC), the Bayesian information criterion (BIC), the Deviance information criterion (DIC), and the Watanabe-Akaike information criterion (WAIC). The goal of an information criterion is to obtain an unbiased measure of out-of-sample prediction error. Since posterior checks use the data twice; once for model estimation and once for testing, a bias correction which penalises the model complexity is incorporated in these criteria. Cross-validation (CV) is another method used for examining out-of-sample prediction accuracy. Leave-one-out cross-validation (LOO-CV) is the most computationally expensive variant among the other CV methods, as it fits as many models as the number of observations. Importance sampling (IS), truncated importance sampling (TIS) and Pareto-smoothed importance sampling (PSIS) are generally used as approximations to the exact LOO-CV and utilise the existing MCMC results avoiding expensive computational issues. The reciprocals of the predictive densities calculated over posterior draws for each observation are treated as the raw importance weights. These are in turn used to calculate the approximate LOO-CV of the observation as a weighted average of posterior densities. In IS-LOO, the raw weights are directly used. In contrast, the larger weights are replaced by their modified truncated weights in calculating TIS-LOO and PSIS-LOO. Although, information criteria and LOO-CV are unable to reflect the goodness-of-fit in absolute sense, the differences can be used to measure the relative performance of the models of interest. However, the use of these measures is only valid under specific circumstances. This study has developed 11 models using normal, log-normal, gamma, and student’s t distributions to improve the PCR stutter prediction with forensic data. These models are comprised of four with profile-wide variances, four with locus specific variances, and three which are two-component mixture models. The mean stutter ratio in each model is modeled as a locus specific simple linear regression against a feature of the alleles under study known as the longest uninterrupted sequence (LUS). The use of AIC, BIC, DIC, and WAIC in model comparison has some practical limitations. Even though, IS-LOO, TIS-LOO, and PSIS-LOO are considered to be approximations of the exact LOO-CV, the study observed some drastic deviations in the results. However, there are some interesting relationships among the logarithms of pointwise predictive densities (lppd) calculated under WAIC and the LOO approximation methods. The estimated overall lppd is a relative measure that reflects the overall goodness-of-fit of the model. Parallel log-likelihood profiles for the models conditional on equal posterior variances in lppds were observed. This study illustrates the limitations of the information criteria in practical model comparison problems. In addition, the relationships among LOO-CV approximation methods and WAIC with their limitations are discussed. Finally, useful recommendations that may help in practical model comparisons with these methods are provided.

Keywords: cross-validation, importance sampling, information criteria, predictive accuracy

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Authors: I. N. Nwafia, U. C. Ozumba, M. E. Ohanu, S. O. Ebede

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Antibiotic resistance is increasing globally and has become a major health challenge. Extended-spectrum beta-lactamase is clinically important because the ESBL gene are mostly plasmid encoded and these plasmids frequently carry genes encoding resistance to other classes of antimicrobials thereby limiting antibiotic options in the treatment of infections caused by these organisms. The specific objectives of this study were to determine the prevalence of ESBLs production in Escherichia coli, to determine the antibiotic susceptibility pattern of ESBLs producing Escherichia coli, to detect TEM, SHV and CTX-M genes and the risk factors to acquisition of ESBL producing Escherichia coli. The protocol of the study was approved by Health Research and Ethics committee of the University of Nigeria Teaching Hospital (UNTH), Enugu. It was a descriptive cross-sectional study that involved all hospitalized patients in UNTH from whose specimens Escherichia coli was isolated during the period of the study. The samples analysed were urine, wound swabs, blood and cerebrospinal fluid. These samples were cultured in 5% sheep Blood agar and MacConkey agar (Oxoid Laboratories, Cambridge UK) and incubated at 35-370C for 24 hours. Escherichia coli was identified with standard biochemical tests and confirmed using API 20E auxanogram (bioMerieux, Marcy 1'Etoile, France). The antibiotic susceptibility testing was done by disc diffusion method and interpreted according to the Clinical and Laboratory Standard Institute guideline. ESBL production was confirmed using ESBL Epsilometer test strips (Liofilchem srl, Italy). The ESBL bla genes were detected with polymerase chain reaction, after extraction of DNA with plasmid mini-prep kit (Jena Bioscience, Jena, Germany). Data analysis was with appropriate descriptive and inferential statistics. One hundred and six isolates (53.00%) out of the 200 were from urine, followed by isolates from different swabs specimens 53(26.50%) and the least number of the isolates 4(2.00) were from blood (P value = 0.096). Seventy (35.00%) out of the 200 isolates, were confirmed positive for ESBL production. Forty-two (60.00%) of the isolates were from female patients while 28(40.00%) were from male patients (P value = 0.13). Sixty-eight (97.14%) of the isolates were susceptible to imipenem while all of the isolates were resistant to ampicillin, chloramphenicol and tetracycline. From the 70 positive isolates the ESBL genes detected with polymerase chain reaction were blaCTX-M (n=26; 37.14%), blaTEM (n=7; 10.00%), blaSHV (n=2; 2.86%), blaCTX-M/TEM (n=7; 10.0%), blaCTX-M/SHV (n=14; 20.0%) and blaCTX-M/TEM/SHV (n=10; 14.29%). There was no gene detected in 4(5.71%) of the isolates. The most associated risk factors to infections caused by ESBL producing Escherichia coli was previous antibiotics use for the past 3 months followed by admission in the intensive care unit, recent surgery, and urinary catheterization. In conclusion, ESBLs was detected in 4 of every 10 Escherichia coli with the predominant gene detected being CTX-M. This knowledge will enable appropriate measures towards improvement of patient health care, antibiotic stewardship, research and infection control in the hospital.

Keywords: antimicrobial, Escherichia coli, extended spectrum beta lactamase, resistance

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Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

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Authors: Parveen Kundu, Zile Singh, Kunika Kundu, Swaran Kaur

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Context: Tuberculous osteomyelitis is a relatively uncommon condition that can present with various clinical and radiological features, often mimicking bone tumors or tumor-like lesions. In endemic countries like India, tuberculosis should be considered as a potential differential diagnosis for lytic bone lesions. This study aimed to highlight the different presentations of tuberculosis that can mimic tumors or tumor-like lesions in bone and emphasize the successful outcome of antitubercular therapy (ATT) in treating these cases. Research Aim: The main objective of this research was to explore the varied presentations of tuberculosis that mimic bone tumors or tumor-like lesions both clinically and radiologically, focusing on different bones. The study aimed to raise awareness among clinicians about this possibility and highlight the importance of histopathological confirmation before initiating treatment for lytic bone lesions. Methodology: This study utilized a retrospective review of 22 patients with suspected lytic bone lesions, who were subsequently diagnosed with tuberculous osteomyelitis through histopathological examination. The cases were collected over a period of ten years. Eleven cases required curettage for extensive lesions with sequestrations, while all 22 patients received 12 months of antitubercular therapy. Findings: The study included 14 male and 8 female patients, ranging in age from 3 to 61 years, with an average age of 22.05. The clinical and radiological presentations varied, with examples including bone cysts in the metaphyseal area of long bones, lesions resembling chondroblastomas, giant cell tumors, and osteoid osteoma, as well as multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had lesions in both the clavicle and hand. Lesions mimicking chondromas were also observed in the phalanges of the hand and foot metatarsal. All patients showed resolution of the lesions and no residual disability following ATT. Theoretical Importance: This study highlights the importance of considering tuberculosis as a potential differential diagnosis for lytic bone lesions, particularly in endemic regions. It emphasizes the need for histopathological confirmation to accurately diagnose tuberculous osteomyelitis, as this is considered the gold standard. Data Collection and Analysis Procedures: Data for this study were collected retrospectively from medical records and radiological images of the 22 patients. The cases were analyzed based on clinical presentation, radiological findings, and histopathological confirmation. The outcomes of antitubercular therapy were also assessed. The data were summarized and presented descriptively. Question Addressed: This study aimed to address the question of how tuberculosis can mimic different bone tumors and tumor-like lesions clinically and radiologically. It also aimed to assess the successful outcome of antitubercular therapy in treating these cases. Conclusion: Tuberculous osteomyelitis can present with varied clinical and radiological features, often mimicking bone tumors or tumor-like lesions. Clinicians should consider tuberculosis as a potential diagnosis for lytic bone lesions, especially in endemic areas. Histopathological confirmation is essential for accurate diagnosis. Antitubercular therapy is an effective treatment for tuberculous osteomyelitis, leading to the resolution of the lesions with no residual disability.

Keywords: tuberculosis, tumor, curettage, bone

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Authors: Milada Krejci, Martin Hill, Vaclav Hosek, Dobroslava Jandova, Jiri Kajzar, Pavel Blaha

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The paper declares effects of exercise intervention of the research project “Basic research of balance changes in seniors”, granted by the Czech Science Foundation. The objective of the presented study is to define predictors, which influence bio-psycho-social consequences and effects of balance ability in senior 65 years old and above. We focused on the Fall-Efficacy Scale changes evaluation in seniors. Comprehensive hypothesis of the project declares, that motion uncertainty (dyskinesia) can negatively affect the well-being of a senior in bio-psycho-social context. In total, random selection and testing of 100 seniors (30 males, 70 females) from Prague and Central Bohemian region was provided. The sample was divided by stratified random selection into experimental and control groups, who underwent input and output testing. For diagnostics the methods of Medical Anamnesis, Functional anthropological examinations, Tinetti Balance Assessment Tool, SF-36 Health Survey, Anamnestic comparative self-assessment scale were used. Intervention method called "Life in Balance" based on yoga techniques was applied in four-week cycle. Results of multivariate regression were verified by repeated measures ANOVA: subject factor, phase of intervention (between-subject factor), body fluid (within-subject factor) and phase of intervention × body fluid interaction). ANOVA was performed with a repetition involving the factors of subjects, experimental/control group, phase of intervention (independent variable), and x phase interaction followed by Bonferroni multiple comparison assays with a test strength of at least 0.8 on the probability level p < 0.05. In the paper results of the first-year investigation of the three years running project are analysed. Results of balance tests confirmed no significant difference between females and males in pre-test. Significant improvements in balance and walking ability were observed in experimental group in females comparing to males (F = 128.4, p < 0.001). In the females control group, there was no significant change in post- test, while in the female experimental group positive changes in posture and spine flexibility in post-tests were found. It seems that females even in senior age react better to incentives of intervention in balance and spine flexibility. On the base of results analyses, we can declare the significant improvement in social balance markers after intervention in the experimental group (F = 10.5, p < 0.001). In average, seniors are used to take four drugs daily. Number of drugs can contribute to allergy symptoms and balance problems. It can be concluded that static balance and walking ability of seniors according Tinetti Balance scale correlate significantly with psychic and social monitored markers.

Keywords: exercises, balance, seniors 65+, health, mental and social balance

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Estela Díaz

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This article aims to make three contributions. First, build on the literature on ethical decision-making literature by exploring factors that influence the intention of adopting veganism. Second, study the superiority of extended models of the Theory of Planned Behavior (TPB) for understanding the process involved in forming the intention of adopting veganism. Third, analyze the moderating effect of gender on TPB given that attitudes and behavior towards animals are gender-sensitive. No study, to our knowledge, has examined these questions. Veganism is not a diet but a political and moral stand that exclude, for moral reasons, the use of animals. Although there is a growing interest in studying veganism, it continues being overlooked in empirical research, especially within the domain of social psychology. TPB has been widely used to study a broad range of human behaviors, including moral issues. Nonetheless, TPB has rarely been applied to examine ethical decisions about animals and, even less, to veganism. Hence, the validity of TPB in predicting the intention of adopting veganism remains unanswered. A total of 476 non-vegan Spanish university students (55.6% female; the mean age was 23.26 years, SD= 6.1) responded to online and pencil-and-paper self-reported questionnaire based on previous studies. TPB extended models incorporated two background factors: ‘general attitudes towards humanlike-attributes ascribed to animals’ (AHA) (capacity for reason/emotions/suffer, moral consideration, and affect-towards-animals); and ‘general attitudes towards 11 uses of animals’ (AUA). SPSS 22 and SmartPLS 3.0 were used for statistical analyses. This study constructed a second-order reflective-formative model and took the multi-group analysis (MGA) approach to study gender effects. Six models of TPB (the standard and five competing) were tested. No a priori hypotheses were formulated. The results gave partial support to TPB. Attitudes (ATTV) (β = .207, p < .001), subjective norms (SNV) (β = .323, p < .001), and perceived control behavior (PCB) (β = .149, p < .001) had a significant direct effect on intentions (INTV). This model accounted for 27,9% of the variance in intention (R2Adj = .275) and had a small predictive relevance (Q2 = .261). However, findings from this study reveal that contrary to what TPB generally proposes, the effect of the background factors on intentions was not fully mediated by the proximal constructs of intentions. For instance, in the final model (Model#6), both factors had significant multiple indirect effect on INTV (β = .074, 95% C = .030, .126 [AHA:INTV]; β = .101, 95% C = .055, .155 [AUA:INTV]) and significant direct effect on INTV (β = .175, p < .001 [AHA:INTV]; β = .100, p = .003 [AUA:INTV]). Furthermore, the addition of direct paths from background factors to intentions improved the explained variance in intention (R2 = .324; R2Adj = .317) and the predictive relevance (Q2 = .300) over the base-model. This supports existing literature on the superiority of enhanced TPB models to predict ethical issues; which suggests that moral behavior may add additional complexity to decision-making. Regarding gender effect, MGA showed that gender only moderated the influence of AHA on ATTV (e.g., βWomen−βMen = .296, p < .001 [Model #6]). However, other observed gender differences (e.g. the explained variance of the model for intentions were always higher for men that for women, for instance, R2Women = .298; R2Men = .394 [Model #6]) deserve further considerations, especially for developing more effective communication strategies.

Keywords: veganism, Theory of Planned Behavior, background factors, gender moderation

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Authors: Patrick Weber, Daniel Gredig

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Background and Purpose: Research has well documented the impact of discrimination and micro-aggressions on the wellbeing of gay men and, especially, adolescents. For the prevention of homophobic behavior against gay adolescents, however, the focus has to shift on those who discriminate: For the design and tailoring of prevention and intervention, it is important to understand the factors responsible for homophobic behavior such as, for example, verbal abuse. Against this background, the present study aimed to assess homophobic – in terms of verbally abusive – behavior against gay people among high school students. Furthermore, it aimed to establish the predictors of the reported behavior by testing an explanatory model. This model posits that homophobic behavior is determined by negative attitudes and knowledge. These variables are supposed to be predicted by the acceptance of traditional gender roles, religiosity, orientation toward social dominance, contact with gay men, and by the perceived expectations of parents, friends and teachers. These social-cognitive variables in turn are assumed to be determined by students’ gender, age, immigration background, formal school level, and the discussion of gay issues in class. Method: From August to October 2016, we visited 58 high school classes in 22 public schools in a county in Switzerland, and asked the 8th and 9th year students on three formal school levels to participate in survey about gender and gay issues. For data collection, we used an anonymous self-administered questionnaire filled in during class. Data were analyzed using descriptive statistics and structural equation modelling (Generalized Least Square Estimates method). The sample included 897 students, 334 in the 8th and 563 in the 9th year, aged 12–17, 51.2% being female, 48.8% male, 50.3% with immigration background. Results: A proportion of 85.4% participants reported having made homophobic statements in the 12 month before survey, 4.7% often and very often. Analysis showed that respondents’ homophobic behavior was predicted directly by negative attitudes (β=0.20), as well as by the acceptance of traditional gender roles (β=0.06), religiosity (β=–0.07), contact with gay people (β=0.10), expectations of parents (β=–0.14) and friends (β=–0.19), gender (β=–0.22) and having a South-East-European or Western- and Middle-Asian immigration background (β=0.09). These variables were predicted, in turn, by gender, age, immigration background, formal school level, and discussion of gay issues in class (GFI=0.995, AGFI=0.979, SRMR=0.0169, CMIN/df=1.199, p>0.213, adj. R2 =0.384). Conclusion: Findings evidence a high prevalence of homophobic behavior in the responding high school students. The tested explanatory model explained 38.4% of the assessed homophobic behavior. However, data did not found full support of the model. Knowledge did not turn out to be a predictor of behavior. Except for the perceived expectation of teachers and orientation toward social dominance, the social-cognitive variables were not fully mediated by attitudes. Equally, gender and immigration background predicted homophobic behavior directly. These findings demonstrate the importance of prevention and provide also leverage points for interventions against anti-gay bias in adolescents – also in social work settings as, for example, in school social work, open youth work or foster care.

Keywords: discrimination, high school students, gay men, predictors, Switzerland

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Authors: B. Shaw, K. Doherty

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The Cultural Communication and Computing Research Institute (C3RI) is a diverse multidisciplinary research institute including art, design, media production, communication studies, computing and engineering. Across these disciplines it can seem like there are enormous differences of research practice and convention, including differing positions on objectivity and subjectivity, certainty and evidence, and different political and ethical parameters. These differences sit within, often unacknowledged, histories, codes, and communication styles of specific disciplines, and it is all these aspects that can make understanding of research practice across disciplines difficult. To explore this, a one day event was orchestrated, testing how a PhD community might communicate and share research in progress in a multi-disciplinary context. Instead of presenting results at a conference, research students were tasked to articulate their method of inquiry. A working party of students from across disciplines had to design a conference call, visual identity and an event framework that would work for students across all disciplines. The process of establishing the shape and identity of the conference was revealing. Even finding a linguistic frame that would meet the expectations of different disciplines for the conference call was challenging. The first abstracts submitted either resorted to reporting findings, or only described method briefly. It took several weeks of supported intervention for research students to get ‘inside’ their method and to understand their research practice as a process rich with philosophical and practical decisions and implications. In response to the abstracts the conference committee generated key methodological categories for conference sessions, including sampling, capturing ‘experience’, ‘making models’, researcher identities, and ‘constructing data’. Each session involved presentations by visual artists, communications students and computing researchers with inter-disciplinary dialogue, facilitated by alumni Chairs. The apparently simple focus on method illuminated research process as a site of creativity, innovation and discovery, and also built epistemological awareness, drawing attention to what is being researched and how it can be known. It was surprisingly difficult to limit students to discussing method, and it was apparent that the vocabulary available for method is sometimes limited. However, by focusing on method rather than results, the genuine process of research, rather than one constructed for approval, could be captured. In unlocking the twists and turns of planning and implementing research, and the impact of circumstance and contingency, students had to reflect frankly on successes and failures. This level of self – and public- critique emphasised the degree of critical thinking and rigour required in executing research and demonstrated that honest reportage of research, faults and all, is good valid research. The process also revealed the degree that disciplines can learn from each other- the computing students gained insights from the sensitive social contextualizing generated by communications and art and design students, and art and design students gained understanding from the greater ‘distance’ and emphasis on application that computing students applied to their subjects. Finding the means to develop dialogue across disciplines makes researchers better equipped to devise and tackle research problems across disciplines, potentially laying the ground for more effective collaboration.

Keywords: interdisciplinary, method, research student, training

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Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar

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Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.

Keywords: radiology, rare, cystic ganglionosis, child

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Authors: Nadeen Felemban, Hamsa Banjer, Rabaah Jaafari

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One of the most common hazards in the pharmaceutical industry is the chemical hazard, which can cause harm or develop occupational health diseases/illnesses due to chronic exposures to hazardous substances. Therefore, a chemical agent management system is required, including hazard identification, risk assessment, controls for specific hazards and inspections, to keep your workplace healthy and safe. However, routine management monitoring is also required to verify the effectiveness of the control measures. Moreover, Betamethasone Valerate and Clobetasol Propionate are some of the APIs (Active Pharmaceutical Ingredients) with highly hazardous classification-Occupational Hazard Category (OHC 4), which requires a full containment (ECA-D) during handling to avoid chemical exposure. According to Safety Data Sheet, those chemicals are reproductive toxicants (reprotoxicant H360D), which may affect female workers’ health and cause fatal damage to an unborn child, or impair fertility. In this study, qualitative (chemical Risk assessment-qCRA) was conducted to assess the chemical exposure during handling of Betamethasone Valerate and Clobetasol Propionate in pharmaceutical laboratories. The outcomes of qCRA identified that there is a risk of potential chemical exposure (risk rating 8 Amber risk). Therefore, immediate actions were taken to ensure interim controls (according to the Hierarchy of controls) are in place and in use to minimize the risk of chemical exposure. No open handlings should be done out of the Steroid Glove Box Isolator (SGB) with the required Personal Protective Equipment (PPEs). The PPEs include coverall, nitrile hand gloves, safety shoes and powered air-purifying respirators (PAPR). Furthermore, a quantitative assessment (personal air sampling) was conducted to verify the effectiveness of the engineering controls (SGB Isolator) and to confirm if there is chemical exposure, as indicated earlier by qCRA. Three personal air samples were collected using an air sampling pump and filter (IOM2 filters, 25mm glass fiber media). The collected samples were analyzed by HPLC in the BV lab, and the measured concentrations were reported in (ug/m3) with reference to Occupation Exposure Limits, 8hr OELs (8hr TWA) for each analytic. The analytical results are needed in 8hr TWA (8hr Time-weighted Average) to be analyzed using Bayesian statistics (IHDataAnalyst). The results of the Bayesian Likelihood Graph indicate (category 0), which means Exposures are de "minimus," trivial, or non-existent Employees have little to no exposure. Also, these results indicate that the 3 samplings are representative samplings with very low variations (SD=0.0014). In conclusion, the engineering controls were effective in protecting the operators from such exposure. However, routine chemical monitoring is required every 3 years unless there is a change in the processor type of chemicals. Also, frequent management monitoring (daily, weekly, and monthly) is required to ensure the control measures are in place and in use. Furthermore, a Similar Exposure Group (SEG) was identified in this activity and included in the annual health surveillance for health monitoring.

Keywords: occupational health and safety, risk assessment, chemical exposure, hierarchy of control, reproductive

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Authors: Muccifora S., Rinallo C., Bellani L.

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Calcium (Ca²+) is an element essential to the plant being involved in plant growth and development. At high concentrations, it is toxic and can influence every stage, process and cellular activity of plant life. Given its toxicity, cells implement mechanisms to compartmentalize calcium in a vacuole, endoplasmic reticulum, mitochondria, plastids and cell wall. One of the most effective mechanisms to reduce the excess of calcium, thus avoiding cellular damage, is its complexation with oxalic acid to form calcium oxalate crystals that are no longer osmotically or physiologically active. However, the sequestered calcium can be mobilized when the plant needs it. Calcium crystals can be accumulated in the vacuole of specialized sink-cells called idioblasts, with different crystalline forms (druse, raphyde and styloid) of diverse physiological meanings. Actinidia deliciosa cv. Hayward presents raphydes and styloid localized in idioblasts in cells of photosynthetic and non-photosynthetic tissues. The purpose of this work was to understand if there is a relationship between the age of Actinidia leaves and the presence, distribution, dimension and shape of oxalate crystals by means of light, fluorescent, polarized and transmission electron microscopy. Three vines from female plants were chosen at the beginning of the season and used throughout the study. The leaves with petioles were collected at various stages of development from the bottom to the shoot of the plants monthly from April to July. The samples were taken in corresponding areas of the central and lateral parts of the leaves and of the basal portion of the petiole. The results showed that in the leaves, the number of raphyde idioblasts decreased with the progress of the growing season, while the styloid idioblasts increased progressively, becoming very numerous in the upper nodes of July. In June and in July samples, in the vacuoles of the highest nodes, a portion regular in shape strongly stained with rubeanic acid was present. Moreover, the chlortetracycline (CTC) staining for localization of free calcium marked the wall of the idioblasts and the wall of the cells near vascular bundles. In April petiole samples, moving towards the youngest nodes, the raphydes idioblast decreased in number and in the length of the single raphydes. Besides, crystals stained with rubeanic acid appeared in the vacuoles of some cells. In June samples, numerous raphyde idioblasts oriented parallel to vascular bundles were evident. Under the electron microscope, numerous idioblasts presented not homogeneous electrondense aggregates of material, in which a few crystals (styloids) in the form of regular holes were scattered. In July samples, an increase in the number of styloid idioblasts in the youngest nodes and little masses stained with CTC near styloids were observed. Peculiar cells stained with rubeanic acid were detected and hypothesized to be involved in the formation of the idioblasts. In conclusion, in Actinidia leaves and petioles, it seems to confirm the hypothesis that the formation of styloid idioblasts can be correlated to increasing calcium levels in growing tissues.

Keywords: calcium oxalate crystals, actinidia deliciosa, light and electron microscopy, idioblasts

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Authors: Ani Kojoyan

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The Syrian refugee crisis has been a matter of worldwide concern during the recent years. And though refugees’ problems are contextualized in terms of time and space, the refugee crisis still remains a global issue to discuss. Since the start of the conflict, Armenia has welcomed thousands of Syrian refugees too. Taking into consideration Armenia’s current socio-economic and geopolitical situation, the flow of refugees is a challenge both for the country and for refugees themselves. However, these people are not simply refugees from Syria, they are Syrian-Armenian refugees; people whose ancestors were survivals of the Armenian Genocide, perpetrated by the Ottoman Turks in 1915, people whose ancestors became refugees a century ago in Syria and now, ironically, a century later they follow their ancestors’ paths, turning into refugees themselves in their historical homeland, facing various difficulties, among them socio-economic, socio-ideological, and identity and gender issues, the latter being the main topic of discussion in the present paper. The situation presented above makes us discuss certain questions within this study: how do Syrian-Armenian refugees define themselves and their status? Which are their gender roles in the socio-economic context? How do social and economic challenges re-shape Syrian-Armenian women refugees’ identities? The study applies qualitative research methods of analysis, which includes semi-structured and in-depth interviews with 15 participants (18-25, 26-40 age groups), and two focus group works, involving 8 participants (18-35 age group) for each focus group activity. The activities were carried out in October 2016, Yerevan, Armenia. The study also includes Secondary Data Analysis. In addition, in order to centralize refugee women’s experiences and identity issues, the study adopts a qualitative lens from a feminist standpoint position. It is based on the assumption that human activity structures and limits understanding, and that the distorted comprehension of events or activities has emerged from the male-oriented dominant judgement which can be discovered through uncovering the understanding of the situation from women’s activity perspectives. The findings suggest that identity is dynamic, complex, over-changing and sensitive to time and space, gender and class. The process of re-shaping identity is even more complicated and multi-layered and is based on internal and external factors, conditioned by individual and collective needs and interests. Refugees are mostly considered as people who lost their identity in the past since they have no longer connection anywhere and try to find it in the present. In turn, female refugees, being a more vulnerable class, go through more complicated identity re-formulating discourse negotiations. They stand between the borders of the old and new, borders of lost and re-found selves, borders of creating and self-fashioning, between illusions and the challenging reality. Particularly, refugee women become more sensitive within the discourses of the private and the public domains: some of them try to create a ‘new-self’, creating their space in a new society, whereas others try to negotiate their affective/emotional labour within their own family domains.

Keywords: feminist standpoint position, gender, identity, refugee studies, Syrian-Armenian women refugees

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Authors: Pamela Chia, Tay Yoong Chuan

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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

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Authors: Allison Tucker, Carolyn Clarke, Erin Keith

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Introduction: In education, the determination to uncover privileged practices requires critical reflection to be placed at the center of both pre-service and in-service teacher education. Confronting deficit thinking about children’s abilities and shifting to holding an image of the child as capable and competent is necessary for teachers to engage in responsive pedagogy that meets children where they are in their learning and builds on strengths. This paper explores the ways in which early elementary teachers' perceptions of the assets of children might shift through the pedagogical use of video clubs. Video club is a pedagogical practice whereby teachers record and view short videos with the intended purpose of deepening their practices. The use of video club as a learning tool has been an extensively documented practice. In this study, a video club is used to watch short recordings of playing children to identify the assets of their students. Methodology: The study on which this paper is based asks the question: What are the ways in which teachers’ image of the child and teaching practices evolve through the use of video club focused on the strengths of children demonstrated during play? Using critical reflection, it aims to identify and describe participants’ experiences of examining their personally held image of the child through the pedagogical tool video club, and how that image influences their practices, specifically in implementing play pedagogy. Teachers enrolled in a graduate-level play pedagogy course record and watch videos of their own students as a means to notice and reflect on the learning that happens during play. Using a co-constructed viewing protocol, teachers identify student strengths and consider their pedagogical responses. Video club provides a framework for teachers to critically reflect in action, return to the video to rewatch the children or themselves and discuss their noticings with colleagues. Critical reflection occurs when there is focused attention on identifying the ways in which actions perpetuate or challenge issues of inherent power in education. When the image of the child held by the teacher is from a deficit position and is influenced by hegemonic dimensions of practice, critical reflection is essential in naming and addressing power imbalances, biases, and practices that are harmful to children and become barriers to their thriving. The data is comprised of teacher reflections, analyzed using phenomenology. Phenomenology seeks to understand and appreciate how individuals make sense of their experiences. Teacher reflections are individually read, and researchers determine pools of meaning. Categories are identified by each researcher, after which commonalities are named through a recursive process of returning to the data until no more themes emerge or saturation is reached. Findings: The final analysis and interpretation of the data are forthcoming. However, emergent analysis of the data collected using teacher reflections reveals the ways in which the use of video club grew teachers’ awareness of their image of the child. It shows video club as a promising pedagogical tool when used with in-service teachers to prompt opportunities for play and to challenge deficit thinking about children and their abilities to thrive in learning.

Keywords: asset-based teaching, critical reflection, image of the child, video club

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Authors: Maria Cardova

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Aim and objectives: The purpose of this studywas to explore to what extent the deprivation statusinfluenced children’s physical activity, dietary behaviour, and health outcomes such as weight status. Background: The United Kingdom’s childhood obesity rates are currently ranked among the highest in Europe. North West England deals with highest rates of childhood obesity. Data from the UK Millennium Cohort Study suggested a deprivation gradient to childhood obesity in England, with obesity rates being the highest in the most deprived areas. Traditionally, it has been individual conception of health, but the contemporary stance is that health behaviours affecting obesity are influenced by a broad range of factors operating at multiple levels. According to socio-ecological model of health behaviour, differences in obesity rates and health outcomes are likely explained by differences in lifestyle behaviours including physical activity and diet behaviours. However, higher rates of obesity among deprived children are not due to physical inactivity, in fact, most socially disadvantaged children are the most physically active. Poor diet including high consumption of fast food and sugar-sweetened beverages and low consumption of fruit and vegetables was found to be the most prevalent among adolescents living in poverty. Methods: This study adopted quantitative approach. It consisted of combination of basic demographic data, anthropometry, and questionnaires. Children (N = 165, mean age = 10.04 years; 53.33% female; 46.66% male) completed survey packs during school day including KIDSCREEN, Youth Activity Profile, Beverage and Snack Questionnaire, and Child Body Image Scale questionnaires as well as had anthropometric measurements taken including Body mass index, waist circumference, weight, and height. Children’s deprivation status was based on the English Indices of Multiple Deprivation scores of the school they attended. Results: Children from more deprived areas had higher weight status, waist circumference. Deprivation status had also effect on some dimensions of the KIDSCREEN questionnaire, such as that those from more deprived areas felt less socially accepted and bullied by their peers, had worse feelings about themselves such as body image, and more difficulty with school and learning. Children from more deprived areas reported higher rates of physical activity and also differences in snack and fruit and vegetable intake than their more affluent peers. Conclusion: Results demonstrated that, children living in the most-deprived areas appear to be at greater risk of unfavourable health-related variables and behaviours and are exposed to home and neighbourhood environments that are less conducive to health-promoting behaviours compared to their peers from less deprived areas. These findings indicate that children living in highly deprived areas represent an important group for future interventions designed to promote health-behaviours that would impact on the quality of life of the child and other health variables such as weight status.

Keywords: children, dietary behaviour, health, obesity, physical Activity, weight Status

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Authors: Tatsiana Ihnatovich, Darya Nizheharodava, Mikalai Halabarodzka, Tatsiana Savitskaya, Marina Zafranskaya

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Liver fibrosis is a complex of histological changes resulting from chronic liver disease accompanied by an excessive production and deposition of extracellular matrix components in the hepatic parenchyma. Liver fibrosis is a serious medical and social problem. Hepatic stellate cells (HSCs) make a significant contribution to the extracellular matrix deposition due to liver injury. Mesenchymal stem cells (MSCs) have a pronounced anti-inflammatory, regenerative and immunomodulatory effect; they are able to differentiate into hepatocytes and induce apoptosis of activated HSCs that opens the prospect of their use for preventing the excessive fibro-formation and the development of liver cirrhosis. The aim of the study is to evaluate the effect of MSCs therapy on the expression of fibrogenesis markers genes in liver tissue and HSCs cultures of rats with experimental liver cirrhosis (ELC). Materials and methods: ELC was induced by the common bile duct ligation (CBDL) in female Wistar rats (n = 19) with an average body weight of 250 (220 ÷ 270) g. Animals from the control group (n = 10) were sham-operated. On the 56th day after the CBDL, the rats of the experimental (n = 12) and the control (n = 5) groups received intraportal MSCs in concentration of 1×106 cells/animal (previously obtained from rat’s bone marrow) or saline, respectively. The animals were taken out of the experiment on the 21st day. HSCs were isolated by sequential liver perfusion in situ with following disaggregation, enzymatic treatment and centrifugation of cell suspension on a two-stage density gradient. The expression of collagen type I (Col1a1) and type III (Col3a1), matrix metalloproteinase type 2 (MMP2) and type 9 (MMP9), tissue inhibitor of matrix metalloproteinases type 1 (TIMP1), transforming growth factor β type 1 (TGFβ1) and type 3 (TGFβ3) was determined by real-time polymerase chain reaction. Statistical analysis was performed using Statistica 10.0. Results: In ELC rats compared to sham-operated animals, a significant increase of all studied markers expression was observed. The administration of MSCs led to a significant decrease of all detectable markers in the experimental group compared to rats without cell therapy. In ELC rats, an increased MMP9/TIMP1 ratio after cell therapy was also detected. The infusion of MSCs in the sham-operated animals did not lead to any changes. In the HSCs from ELC animals, the expression of Col1a1 and Col3a1 exceeded the similar parameters of the control group (p <0.05) and statistically decreased after the MSCs administration. The correlation between Col3a1 (Rs = 0.51, p <0.05), TGFβ1 (Rs = 0.6, p <0.01), and TGFβ3 (Rs = 0.75, p <0.001) expression in HSCs cultures and liver tissue has been found. Conclusion: Intraportal administration of MSCs to rats with ELC leads to a decreased Col1a1 and Col3a1, MMP2 and MMP9, TIMP1, TGFβ1 and TGFβ3 expression. The correlation between the expression of Col3a1, TGFβ1 and TGFβ3 in liver tissue and in HSCs cultures indicates the involvement of activated HSCs in the fibrogenesis that allows considering HSCs to be the main cell therapy target in ELC.

Keywords: cell therapy, experimental liver cirrhosis, hepatic stellate cells, mesenchymal stem cells

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Authors: Eleftheria Atta, Yianna Vovides, Marios Katsioloudes

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In the fusion of neoliberalism and globalization, Higher Education (HE) is becoming increasingly complex. The changing patterns of the economy worldwide caused the development of high value-added economy HE has been viewed as a social investment, significant for the development of knowledge-based societies and economies. In order to contribute to economic competitiveness universities are required to produce local and employable workers in order to fit into the neoliberal economic environment. The emergence of neoliberal performativity, which measures outcomes, is a key aspect in a neoliberal era. It facilitates the redesign of institutions making organizations and individuals to think about themselves in relation to their performance. Performativity and performance management systems lead academics to become more effective, professionally advance, improve and become better than others and therefore act competitively. Besides the aforementioned complexities, universities also encounter the challenge of maintaining a set of values to guide an institution’s actions and which have always been highly respected in developing a HE institution. The formulation of a clear set of values also determines the institutional culture which will be maintained. It is evident that values create a significant framework for the workplace and may determine positive institutional results. Universities are required to engage in activities for capacity building which will improve their students’ competence as well as offer opportunities to administrative and academic staff to professionally develop in light of neoliberal performativity. Additionally, the University is now considered as an innovation ecosystem playing a significant role in providing education, research and innovation to help create solutions to meet social, environmental and economic challenges. Thus, Universities become central in orchestrating multi-actor innovation networks. This presentation will discuss the establishment of an institutional unit entitled ‘Human Development Unit’ (HDU) in a European start-up university. The activities of the HDU are envisioned as drivers for innovation that would enable the university as a whole to maintain its position in a fast-changing world and be ready to face adaptive challenges. In addition, the HDU provides its students, staff, and faculty with opportunities to advance their academic and professional development through engagement in programs that align with institutional values. It also serves as a connector with the broader community. The presentation will highlight the functions of three centers which the unit will coordinate namely, the Student Development Center (SDC), the Faculty & Staff Development Center (FSDC) and the Continuing Education Center (CEC). The presentation aligns with the aim of the conference as it welcomes presentations to discuss innovations and challenges encountered in HE. Particularly, this presentation seeks to discuss the establishment of an innovative unit at a start-up university which will contribute to creating an institutional culture shaped by the value of academic excellence for students as well as for staff, shaping and defining the functions and activities of the unit. The establishment of the proposed unit is crucial in a start-up university both to differentiate from other competitors but also to sustain its presence given the pressures in a neoliberal HE context.

Keywords: academic excellence, globalization, human development unit, neoliberalism

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Authors: Lillian M. Seo, Curtis L. Petersen, Ryan J. Halter, David Kotz, John A. Batsis

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Background: Resistance-based exercises effectively enhance muscle strength, which is especially important in older populations as it reduces the risk of disability. Our group developed a Bluetooth-enabled handle for resistance exercise bands that wirelessly transmits relative force data through low-energy Bluetooth to a local smartphone or similar device. The system has the potential to measure home-based exercise interventions, allowing health professionals to monitor compliance. Its feasibility has already been demonstrated in both clinical and field-based settings, but it remained unclear whether the system’s usability persisted upon repeated use. The current study sought to assess the usability of this system and its users’ satisfaction with repeated use by deploying the device among younger adults to gather formative information that can ultimately improve the device’s design for older adults. Methods: A usability study was conducted in which 32 participants used the above system. Participants executed 10 repetitions of four commonly performed exercises: bicep flexion, shoulder abduction, elbow extension, and triceps extension. Each completed three exercise sessions, separated by at least 24 hours to minimize muscle fatigue. At its conclusion, subjects completed an adapted version of the usefulness, satisfaction, and ease (USE) questionnaire – assessing the system across four domains: usability, satisfaction, ease of use, and ease of learning. The 20-item questionnaire examined how strongly a participant agrees with positive statements about the device on a seven-point Likert scale, with one representing ‘strongly disagree’ and seven representing ‘strongly agree.’ Participants’ data were aggregated to calculate mean response values for each question and domain, effectively assessing the device’s performance across different facets of the user experience. Summary force data were visualized using a custom web application. Finally, an optional prompt at the end of the questionnaire allowed for written comments and feedback from participants to elicit qualitative indicators of usability. Results: Of the n=32 participants, 13 (41%) were female; their mean age was 32.4 ± 11.8 years, and no participants had a physical impairment. No usability questions received a mean score < 5 of seven. The four domains’ mean scores were: usefulness 5.66 ± 0.35; satisfaction 6.23 ± 0.06; ease of use 6.25 ± 0.43; and ease of learning 6.50 ± 0.19. Representative quotes of the open-ended feedback include: ‘A non-rigid strap-style handle might be useful for some exercises,’ and, ‘Would need different bands for each exercise as they use different muscle groups with different strength levels.’ General impressions were favorable, supporting the expectation that the device would be a useful tool in exercise interventions. Conclusions: A simple usability assessment of a Bluetooth-enabled resistance exercise band supports a consistent and positive user experience among young adults. This study provides adequate formative data, assuring the next steps can be taken to continue testing and development for the target population of older adults.

Keywords: Bluetooth, exercise, mobile health, mHealth, usability

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Authors: Piyaorn Wajanatinapart, Diane R. Lauver

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The number of persons with dementia (PWD) has increased. Informal caregivers are the major providing care. They can have perceived gains and burdens. Caregivers who reported high in perceived gains may report low in burdens and better health. Gaps of caregiving literature were: no report psychometrics in a few studies and unclear definitions of gains; most studies with no theory-guided and conducting in Western countries; not fully described relationships among caregiving variables: motivations, satisfaction with psychological needs, social support, gains, burdens, and physical and psycho-emotional health. Those gaps were filled by assessing psychometric properties of selected measures, providing clearly definitions of gains, using self-determination theory (SDT) to guide the study, and developing the study in Thailand. The study purposes were to evaluate six measures for internal consistency reliability, content validity, and construct validity. This study also examined relationships of caregiving variables: motivations (controlled and autonomous motivations), satisfaction with psychological needs (autonomy, competency, and relatedness), perceived social support, perceived gains, perceived burdens, and physical and psycho-emotional health. This study was a cross-sectional and correlational descriptive design with two convenience samples. Sample 1 was five Thai experts to assess content validity of measures. Sample 2 was 146 Thai caregivers of PWD to assess construct validity, reliability, and relationships among caregiving variables. Experts rated questionnaires and sent them back via e-mail. Caregivers answered questionnaires at clinics of four Thai hospitals. Data analysis was used descriptive statistics and bivariate and multivariate analyses using the composite indicator structural equation model to control measurement errors. For study results, most caregivers were female (82%), middle age (M =51.1, SD =11.9), and daughters (57%). They provided care for 15 hours/day with 4.6 years. The content validity indices of items and scales were .80 or higher for clarity and relevance. Experts suggested item revisions. Cronbach’s alphas were .63 to .93 of ten subscales of four measures and .26 to .57 of three subscales. The gain scale was acceptable for construct validity. With controlling covariates, controlled motivations, the satisfaction with three subscales of psychological needs, and perceived social support had positive relationships with physical and psycho-emotional health. Both satisfaction with autonomy subscale and perceived social support had negative relationship with perceived burdens. The satisfaction with three subscales of psychological needs had positive relationships among them. Physical and psycho-emotional health subscales had positive relationships with each other. Furthermore, perceived burdens had negative relationships with physical and psycho-emotional health. This study was the first use SDT to describe relationships of caregiving variables in Thailand. Caregivers’ characteristics were consistent with literature. Four measures were valid and reliable except two measures. Breadth knowledge about relationships was provided. Interpretation of study results was cautious because of using same sample to evaluate psychometric properties of measures and relationships of caregiving variables. Researchers could use four measures for further caregiving studies. Using a theory would help describe concepts, propositions, and measures used. Researchers may examine the satisfaction with psychological needs as mediators. Future studies to collect data with caregivers in communities are needed.

Keywords: caregivers, caregiving, dementia, measures

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Authors: Marta Gràcia, Ana Luisa Adam-Alcocer, Jesús M. Alvarado, Verónica Quezada, Tere Zarza, Priscila Garza

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In secondary education, integrating linguistic content and reflection on it is a crucial challenge that should be included in course plans to enhance students' oral communication competence. In secondary education classrooms, a continuum can be identified in relation to teaching methodologies: 1) the traditional teacher-dominated transmission approach, which is described as that in which teachers transmit content to students unidirectionally; 2) dialogical, bidirectional teaching approach that encourages students to adopt a critical vision of the information provided by the teacher or that is generated through students’ discussion. In this context, the EVALOE-DSS (Assessment Scale of Oral Language Teaching in the School Context-Decision Support System) digital instrument has emerged to help teachers in transforming their classes into spaces for communication, dialogue, reflection, evaluation of the learning process, teaching linguistic contents, and to develop curricular competencies. The tool includes various resources, such as a tutorial with the objectives and an initial screen for teachers to describe the class to be evaluated. One of the main resources of the digital instrument consists of 30 items-actions with three qualitative response options (green, orange, and red face emoji) grouped in five dimensions. In the context of the participation of secondary education teachers in a professional development program using EVALOE-DSS, a digital tool resource aimed to generate more participatory, interactive, dialogic classes, the objectives of the study were: 1) understanding the changes in classrooms’ dynamics and in the teachers’ strategies during their participation in the professional developmental program; 2) analyzing the impact of these changes in students’ oral language development according to their teachers; 3) Deeping on the impact of these changes in the students’ assessment of the classes and the self-assessment of oral competence; 4) knowing teachers’ assessment and reflections about their participation in the professional developmental program. Participants were ten teachers of different subjects and 250 students of secondary education (16-18 years) schools in Spain. The principal instrument used was the digital tool EVALOE-DSS. For 6 months, teachers used the digital tool to reflect on their classes, assess them (their actions and their students’ actions), make decisions, and introduce changes in their classes to be more participatory, interactive, and reflective about linguistic contents. Other collecting data instruments and techniques used during the study were: 1) a questionnaire to assess students’ oral language competence before and at the end of the study, 2) a questionnaire for students’ assessment of the characteristics of classes, 3) teachers’ meetings during the professional developmental program to reflect collaboratively on their experience, 4) questionnaire to assess teacher’s experience during their participation in the professional developmental program, 5) focus group meetings between the teachers and two researchers at the end of the study. The results showed relevant changes in teaching strategies, in the dynamics of the classes, which were more interactive, participative, dialogic and self-managed by the students. Both teachers and students agree about the progressive classes’ transformation into spaces for communication, discussion, and reflection on the language, its development, and its use as an essential instrument to develop curricular competencies.

Keywords: digital tool, individual and collaborative reflection, oral language competence, professional development program, secondary education

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Authors: Natalia C. E. S. Nascimento, Mercia L. Oliveira, Fernando R. A. Lima, Leonardo T. C. do Nascimento, Marina B. Silveira, Brigida G. A. Schirmer, Andrea V. Ferreira, Carlos Malamut, Juliana B. da Silva

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Tissue hypoxia is a common characteristic of solid tumors leading to decreased sensitivity to radiotherapy and chemotherapy. In the clinical context, tumor hypoxia assessment employing the positron emission tomography (PET) tracer ¹⁸F-fluoromisonidazole ([¹⁸F]FMISO) is helpful for physicians for planning and therapy adjusting. The aim of this work was to implement the synthesis of 18F-FMISO in a TRACERlab® MXFDG module and also to establish the quality control procedure. [¹⁸F]FMISO was synthesized at Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN/Brazil) using an automated synthesizer (TRACERlab® MXFDG, GE) adapted for the production of [¹⁸F]FMISO. The FMISO chemical standard was purchased from ABX. 18O- enriched water was acquired from Center of Molecular Research. Reagent kits containing eluent solution, acetonitrile, ethanol, 2.0 M HCl solution, buffer solution, water for injections and [¹⁸F]FMISO precursor (dissolved in 2 ml acetonitrile) were purchased from ABX. The [¹⁸F]FMISO samples were purified by Solid Phase Extraction method. The quality requirements of [¹⁸F]FMISO are established in the European Pharmacopeia. According to that reference, quality control of [¹⁸F]FMISO should include appearance, pH, radionuclidic identity and purity, radiochemical identity and purity, chemical purity, residual solvents, bacterial endotoxins, and sterility. The duration of the synthesis process was 53 min, with radiochemical yield of (37.00 ± 0.01) % and the specific activity was more than 70 GBq/µmol. The syntheses were reproducible and showed satisfactory results. In relation to the quality control analysis, the samples were clear and colorless at pH 6.0. The spectrum emission, measured by using a High-Purity Germanium Detector (HPGe), presented a single peak at 511 keV and the half-life, determined by the decay method in an activimeter, was (111.0 ± 0.5) min, indicating no presence of radioactive contaminants, besides the desirable radionuclide (¹⁸F). The samples showed concentration of tetrabutylammonium (TBA) < 50μg/mL, assessed by visual comparison to TBA standard applied in the same thin layer chromatographic plate. Radiochemical purity was determined by high performance liquid chromatography (HPLC) and the results were 100%. Regarding the residual solvents tested, ethanol and acetonitrile presented concentration lower than 10% and 0.04%, respectively. Healthy female mice were injected via lateral tail vein with [¹⁸F]FMISO, microPET imaging studies (15 min) were performed after 2 h post injection (p.i), and the biodistribution was analyzed in five-time points (30, 60, 90, 120 and 180 min) after injection. Subsequently, organs/tissues were assayed for radioactivity with a gamma counter. All parameters of quality control test were in agreement to quality criteria confirming that [¹⁸F]FMISO was suitable for use in non-clinical and clinical trials, following the legal requirements for the production of new radiopharmaceuticals in Brazil.

Keywords: automatic radiosynthesis, hypoxic tumors, pharmacopeia, positron emitters, quality requirements

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Authors: Judith Sue Hwa Joo

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Guanyin (Avalokiteśvara in Sanskrit), the Bodhisattva of Mercy and Compassion, is the most widely worshipped Buddhist Divinity in Chinese societies and is also believed by more than half of Asian populations across various countries. The most overwhelming reason for the popularity of Guanyin in Chinese societies is, according to the Lotus Sutra, that Guanyin would apperceive voices of those suffering from immense afflictions and troubles, and liberate them upon crying for his/her holy name with wholeheartedness. Its pervasive social influence has spanned more than two thousand years and is still deeply affecting the lives of most Chinese people. This study aimed to investigate whether Guanyin Worship has evolved and changed in modern Chinese societies across the Taiwan Strait. Taiwan and China, albeit having the same language and culture, have been territorially divided and governed by two different political regimes for over 70 years. It would be scientifically intriguing to unveil any substantial changes in religious behaviors in the context of Guanyin Worship. A comprehensive anonymous questionnaire survey in Chinese communities was conducted from October 2017 to May 2019 across various countries, mostly in China, Taiwan, and Hong Kong areas. Since the religious survey is officially prohibited in China, the study was difficult and could only be exercised by means of snowball sampling. Demographic data (age, sex, education, religious belief) were registered and Guanyin’s salvation functions under various confronting situations were investigated. Psychological dimensions of religious belief in Guanyin were probed in terms of the worship experience, the willingness of veneration, and egoistic or altruistic ideations. A literature review on documented functional attributes was carried out in parallel for comparison analyses with traditional roles. Effective 1123 out of 1139 samples were obtained. Statistical analysis revealed that Guanyin Worship is still commonly practiced and deeply rooted in the hearts of all Chinese people regardless of gender, age, education, and residential area, even though they may not enshrine Guanyin at home nowadays. The conventional roles of Guanyin Bodhisattva are still valid and best satisfy the real interests of lifestyles in modern times. When comparing the traditional Buddhist Sutra and the documented literature, the divine power of modern Guanyin has notably empowered to recover, protect and transform fetal and infant spirits due to the sexual liberation, increased abortion rate, gender awakening and enhanced female autonomy in the reproductive decision. However, the One-Child policy may have critically impacted the trajectory of Guanyin Worship so that people in China prevail over those in Taiwan praying for aborted lives or premature deaths. Furthermore, particularly in Hong Kong and Macao, Guanyin not only serves as the sea guardian for the fishermen but also additional services a new function as the God of Wealth. The divine powers and salvation functions of Guanyin are indeed evolving and expanding to comply with the modern psychosocial, cultural and societal needs. This study sheds light on the modernization process of the two-thousand-year-old Guanyin Worship of contemporary Chinese societies.

Keywords: Buddhism, Guanyin, religious behavior, salvation function

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Authors: Ani Kojoyan

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Linguistic studies have been investigating a connection between gender and linguistic development since 1970s. Scholars claim that gender differences in first and second language learning are socially constructed. Recent studies to language learning and gender reveal that second language acquisition is also a social phenomenon directly influencing one’s gender identity. Those responsible for designing language learning-teaching materials should be encouraged to understand the importance of and address the gender sensitivity accurately in textbooks. Writing or compiling a textbook is not an easy task; it requires strong academic abilities, patience, and experience. For a long period of time Armenia has been involved in the compilation process of a number of foreign language textbooks. However, there have been very few discussions or evaluations of those textbooks which will allow specialists to theorize that practice. The present paper focuses on the analysis of gender sensitivity issues and policy aspects involved in an EFL textbook. For the research the following material has been considered – “A Basic English Grammar: Morphology”, first printed in 2011. The selection of the material is not accidental. First, the mentioned textbook has been widely used in university teaching over years. Secondly, in Armenia “A Basic English Grammar: Morphology” has considered one of the most successful English grammar textbooks in a university teaching environment and served a source-book for other authors to compile and design their textbooks. The present paper aims to find out whether an EFL textbook is gendered in the Armenian teaching environment, and whether the textbook compilers are aware of gendered messages while compiling educational materials. It also aims at investigating students’ attitude toward the gendered messages in those materials. And finally, it also aims at increasing the gender sensitivity among book compilers and educators in various educational settings. For this study qualitative and quantitative research methods of analyses have been applied, the quantitative – in terms of carrying out surveys among students (45 university students, 18-25 age group), and the qualitative one – by discourse analysis of the material and conducting in-depth and semi-structured interviews with the Armenian compilers of the textbook (interviews with 3 authors). The study is based on passive and active observations and teaching experience done in a university classroom environment in 2014-2015, 2015-2016. The findings suggest that the discussed and analyzed teaching materials (145 extracts and examples) include traditional examples of intensive use of language and role-modelling, particularly, men are mostly portrayed as active, progressive, aggressive, whereas women are often depicted as passive and weak. These modeled often serve as a ‘reliable basis’ for reinforcing the traditional roles that have been projected on female and male students. The survey results also show that such materials contribute directly to shaping learners’ social attitudes and expectations around issues of gender. The applied techniques and discussed issues can be generalized and applied to other foreign language textbook compilation processes, since those principles, regardless of a language, are mostly the same.

Keywords: EFL textbooks, gender policy, gender sensitivity, qualitative and quantitative research methods

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Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta

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Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective, observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.

Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases

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Authors: Faheemah N. Mustafaa, Tamarie Macon, Tabbye Chavous

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A major concern of university leaders worldwide is how to create environments where students from diverse racial/ethnic, national, and cultural backgrounds can thrive. Over the past decade or so in the United States, African American women have done exceedingly well in terms of college enrollment, academic performance, and completion. However, the relative academic successes of African American women in higher education has in some ways overshadowed social challenges many Black women continue to encounter on college campuses in the United States. Within predominantly White institutions (PWIs) in particular, there is consistent evidence that many Black students experience racially hostile climates. However, research studies on racial climates within PWIs have mostly focused on cross-sectional comparisons of minority and majority group experiences, and few studies have examined campus racial climate in relation to short- and longer-term well-being. One longitudinal study reported that African American women’s psychological well-being was positively related to their comfort in cross-racial interactions (a concept closely related to campus climate). Thus, our primary research question was: Do African American women’s perceptions of campus climate (tension and positive association) during their freshman year predict their reports of psychological distress and well-being (self-acceptance) during their sophomore year? Participants were part of a longitudinal survey examining African American college students’ academic identity development, particularly in Science, Technology, Engineering, and Mathematics (STEM) fields. The final subsample included 134 self-identified African American/Black women enrolled in PWIs. Accounting for background characteristics (mother’s education, family income, interracial contact, and prior levels of outcomes), we employed hierarchical regression to examine relationships between campus racial climate during freshman year and psychological adjustment one year later. Both regression models significantly predicted African American women’s psychological outcomes (for distress, F(7,91)= 4.34, p < .001; and for self-acceptance, F(7,90)= 4.92, p < .001). Although none of the controls were significant predictors, perceptions of racial tension on campus were associated with both distress and self-acceptance. More perceptions of tension were related to African American women’s greater psychological distress the following year (B= 0.22, p= .01). Additionally, racial tension predicted later self-acceptance in the expected direction: Higher first-year reports of racial tension were related to less positive attitudes toward the self during the sophomore year (B= -0.16, p= .04). However, perceptions that it was normative for Black and White students to socialize on campus (or positive association scores) were unrelated to psychological distress or self-acceptance. Findings highlight the relevance of examining multiple facets of campus racial climate in relation to psychological adjustment, with possible emphasis on the import of racial tension on African American women’s psychological adjustment. Results suggest that negative dimensions of campus racial climate may have lingering effects on psychological well-being, over and above more positive aspects of climate. Thus, programs targeted toward improving student relations on campus should consider addressing cross-racial tensions.

Keywords: higher education, psychological adjustment, university climate, university students

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