Search results for: clinical communication

Authors: Nahed Al-Hajeri

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Time and cost is an integral part of every construction plan and can affect each party’s contractual obligations. The performance of both time and cost are usually important to the client and contractor during the project. Almost all construction projects are experiencing time overrun. These time overruns always contributed as expensive to both client and contractor. Construction of any project inside the gathering centers involves complex management skills related to work force, materials, plant, machineries, new technologies etc. It also involves many agencies interdependent on each other like the vendors, structural and functional designers including various types of specialized engineers and it includes support of contractors and specialized contractors. This paper mainly highlights the types of construction delays due to which project suffer time and cost overrun. This paper also speaks about the delay causes and factors that contribute to the construction sequence delay for the oil and gas projects. Construction delay is supposed to be one of the repeated problems in the construction projects and it has an opposing effect on project success in terms of time, cost and quality. Some effective methods are identified to minimize delays in construction projects such as: 1. Site management and supervision, 2. Effective strategic planning, 3. Clear information and communication channel. Our research paper studies the types of delay with some real examples with statistic results and suggests solutions to overcome this problem.

Keywords: non-compensable delay, delays caused by force majeure, compensable delay, delays caused by the owner or the owner’s representative, non-excusable delay, delay caused by the contractor or the contractor’s representative, concurrent delay, delays resulting from two separate causes at the same time

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

Procedia PDF Downloads 76

Authors: Nadhifah A. Nugraha, Dida D. Damayanti, Widia Juliani

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Airplanes manufacturing is growing along with the increasing demand from consumers. The helicopter's tail called Tailboom is a product of the helicopter division at XYZ Corp, where the Tailboom assembly line is a pull system. Based on observations of existing conditions that occur at XYZ Corp, production is still unable to meet the demands of consumers; lead time occurs greater than the plan agreed upon by the consumers. In the assembly process, each work station experiences a lack of parts and components needed to assemble components. This happens because of the delay in getting the required part information, and there is no warning about the availability of parts needed, it makes some parts unavailable in assembly warehouse. The lack of parts and components from the previous work station causes the assembly process to stop, and the assembly line also stops at the next station. In its completion, the production time was late and not on the schedule. In resolving these problems, the controlling process is needed, which is controlling the assembly line to get all components and subassembly in the right amount and at the right time. This study applies one of Just In Time tools, namely Kanban and automation, should be added as efficiently and effectively communication line becomes electronic Kanban. The problem can be solved by reducing non-value added time, such as waiting time and idle time. The proposed results of controlling the assembly line of Tailboom result in a smooth assembly line without waiting, reduced lead time, and achieving production time according to the schedule agreed with the consumers.

Keywords: kanban, e-Kanban, lead time, pull system

Procedia PDF Downloads 96

Authors: Boon Yih Mah

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Web-based Cognitive Writing Instruction (WeCWI)’s contribution towards language development can be divided into linguistic and non-linguistic perspectives. In linguistic perspective, WeCWI focuses on the literacy and language discoveries, while the cognitive and psychological discoveries are the hubs in non-linguistic perspective. In linguistic perspective, WeCWI draws attention to free reading and enterprises, which are supported by the language acquisition theories. Besides, the adoption of process genre approach as a hybrid guided writing approach fosters literacy development. Literacy and language developments are interconnected in the communication process; hence, WeCWI encourages meaningful discussion based on the interactionist theory that involves input, negotiation, output, and interactional feedback. Rooted in the e-learning interaction-based model, WeCWI promotes online discussion via synchronous and asynchronous communications, which allows interactions happened among the learners, instructor, and digital content. In non-linguistic perspective, WeCWI highlights on the contribution of reading, discussion, and writing towards cognitive development. Based on the inquiry models, learners’ critical thinking is fostered during information exploration process through interaction and questioning. Lastly, to lower writing anxiety, WeCWI develops the instructional tool with supportive features to facilitate the writing process. To bring a positive user experience to the learner, WeCWI aims to create the instructional tool with different interface designs based on two different types of perceptual learning style.

Keywords: WeCWI, literacy discovery, language discovery, cognitive discovery, psychological discovery

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Authors: Jalal Khan, Daniyal Ali Sehrai, Shakeel Ahmad

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This paper presents the design and performance evaluation of multiband metamaterial based antenna operating in the 3.6 GHz (4G), 14.33 GHz, and 28.86 GHz (5G) frequency bands, for future mobile and handheld devices. The radiating element of the proposed design is made up of a conductive material supported by a 1.524 mm thicker Rogers-4003 substrate, having a relative dielectric constant and loss tangent of 3.55 and 0.0027, respectively. The substrate is backed by truncated ground plane. The future mobile communication system is based on higher frequencies, which are highly affected by the atmospheric conditions. Therefore, to overcome the path loss problem, essential enhancements and improvements must be made in the overall performance of the antenna. The traditional ground plane does not provide the in-phase reflection and surface wave suppression due to which side and back lobes are produced. This will affect the antenna performance in terms of gain and efficiency. To enhance the overall performance of the antenna, a metamaterial acting as a high impedance surface (HIS) is used as a reflector in the proposed design. The simulated gain of the metamaterial based antenna is enhanced from {2.76-6.47, 4.83-6.71 and 7.52-7.73} dB at 3.6, 14.33 and 28.89 GHz, respectively relative to the gain of the antenna backed by a traditional ground plane. The proposed antenna radiated efficiently with a radiated efficiency (>85 %) in all the three frequency bands with and without metamaterial surface. The total volume of the antenna is (L x W x h=45 x 40 x 1.524) mm³. The antenna can be potentially used for wireless handheld devices and mobile terminal. All the simulations have been performed using the Computer Simulation Technology (CST) software.

Keywords: CST MWS, fourth generation/fifth generation, 4G/5G, high gain, multiband, metamaterial

Procedia PDF Downloads 149

Authors: Vishwanath Pethri Kamath, Jayantha Gowda Sarapanahalli, Vishal Mishra, Siddhesh Balwant Bandgar

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Recognition of emotional information is essential in any form of communication. Growing HCI (Human-Computer Interaction) in recent times indicates the importance of understanding of emotions expressed and becomes crucial for improving the system or the interaction itself. In this research work, textual data for emotion recognition is used. The text being the least expressive amongst the multimodal resources poses various challenges such as contextual information and also sequential nature of the language construction. In this research work, the proposal is made for a neural architecture to resolve not less than 8 emotions from textual data sources derived from multiple datasets using google pre-trained word2vec word embeddings and a Multi-head attention-based bidirectional LSTM model with a one-vs-all Multi-Level Classification. The emotions targeted in this research are Anger, Disgust, Fear, Guilt, Joy, Sadness, Shame, and Surprise. Textual data from multiple datasets were used for this research work such as ISEAR, Go Emotions, Affect datasets for creating the emotions’ dataset. Data samples overlap or conflicts were considered with careful preprocessing. Our results show a significant improvement with the modeling architecture and as good as 10 points improvement in recognizing some emotions.

Keywords: text emotion recognition, bidirectional LSTM, multi-head attention, multi-level classification, google word2vec word embeddings

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Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

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Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

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Authors: Leo Latasch, Mario Di Gennaro

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Introduction: The goal of this project was to increase the resilience of the population as well as rescue organizations to make both quality and time-related improvements in handling crises. A helper network was created for this purpose. Methods: Social questions regarding the structure and purpose of helper networks were considered - specifically with regard to helper motivation, the level of commitment and collaboration between populations and agencies. The exchange of information, the coordinated use of volunteers, and the distribution of available resources will be ensured through defined communication and cooperation routines. Helper smartphones will also be used provide a picture of the situation on the ground. Results: The helper network was established and deployed based on the RESIBES information technology system. It consists of a service platform, a web portal and a smartphone app. The service platform is the central element for collaboration between the various rescue organizations, as well as for persons, associations, and companies from the population offering voluntary aid. The platform was used for: Registering helpers and resources and then requesting and assigning it in case of a disaster. These services allow the population's resources to be organized. The service platform also allows for a secure data exchange between services and external systems. Conclusions: The social and technical work priorities have allowed us to cover a full cycle of advance structural work, gaining an overview, damage management, evaluation, and feedback on experiences. This cycle allows experiences gained while handling the crisis to feed back into the cycle and improve preparations and management strategies.

Keywords: coordination, disaster, resilience, volunteers

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Authors: May Fadheel Estephan, Richard Perks

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Context: Cancer is a serious health concern that affects millions of people worldwide. Early detection and treatment are essential for improving patient outcomes. However, current methods for cancer detection have limitations, such as low sensitivity and specificity. Research Aim: The aim of this study was to develop an optical sensor for cancer detection using elastic light scattering spectroscopy (ELSS). ELSS is a noninvasive optical technique that can be used to characterize the size and concentration of particles in a solution. Methodology: An optical probe was fabricated with a 100-μm-diameter core and a 132-μm centre-to-centre separation. The probe was used to measure the ELSS spectra of polystyrene spheres with diameters of 2, 0.8, and 0.413 μm. The spectra were then analysed to determine the size and concentration of the spheres. Findings: The results showed that the optical probe was able to differentiate between the three different sizes of polystyrene spheres. The probe was also able to detect the presence of polystyrene spheres in suspension concentrations as low as 0.01%. Theoretical Importance: The results of this study demonstrate the potential of ELSS for cancer detection. ELSS is a noninvasive technique that can be used to characterize the size and concentration of cells in a tissue sample. This information can be used to identify cancer cells and assess the stage of the disease. Data Collection: The data for this study were collected by measuring the ELSS spectra of polystyrene spheres with different diameters. The spectra were collected using a spectrometer and a computer. Analysis Procedures: The ELSS spectra were analysed using a software program to determine the size and concentration of the spheres. The software program used a mathematical algorithm to fit the spectra to a theoretical model. Question Addressed: The question addressed by this study was whether ELSS could be used to detect cancer cells. The results of the study showed that ELSS could be used to differentiate between different sizes of cells, suggesting that it could be used to detect cancer cells. Conclusion: The findings of this research show the utility of ELSS in the early identification of cancer. ELSS is a noninvasive method for characterizing the number and size of cells in a tissue sample. To determine cancer cells and determine the disease's stage, this information can be employed. Further research is needed to evaluate the clinical performance of ELSS for cancer detection.

Keywords: elastic light scattering spectroscopy, polystyrene spheres in suspension, optical probe, fibre optics

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Authors: Rubina Shakya, Srijana Dangol, Dil Islam Mansur

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The exposure of constant stress stimuli in our daily lives is causing deterioration of neural connectivity in the brain. Interestingly, the improvement in larger-scale neural communication has been argued to rely on brain rhythms, which might be sensitive to binaural beats of particular frequency bands. The theoretical idea behind neural entrainment is that the rhythmic oscillatory activity within and between different brain regions can enhance cognitive function and mood state. So, we aimed to investigate whether the binaural beats of 40 Hz could enhance the cognition and the mood stability of the medical students at Kathmandu University of age 18-25 years old, which possibly, in the long run, might help to enhance their work productivity. The participants were asked to focus on the auditory stimuli of binaural beats with 200 Hz on the right side and 240 Hz on the left side of the headset for 15 minutes, every alternative day of three consecutive weeks. The Stroop’s test and the Brunel Mood Scale (BRUMS) were applied to assess the cognitive function and the mood state, respectively. The binaural beats significantly decreased the reaction time for the incoherent component of Stroop’s test in both male and female participants. For the mood state, scores of all positive emotions except ‘Calmness’ were significantly increased in the case of males. Whereas, scores of all positive emotions except ‘Vigor’ were significantly increased in the case of females. The results suggested that the meditation aided by binaural beats of 40 Hz helps in improving cognition and mood states to some extent.

Keywords: binaural beats, cognitive function, gamma neural oscillation, mood states

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Authors: Rizky Kertanegara

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Reception studies is one of the cultural studies lately evolved in the realm of communication science. This qualitative study was pioneered by Stuart Hall who initiated the dominant, negotiation, and opposition of audience reading to the text of the media. In its development, this reception studies is developed by Kim Christian Schroder become multidimensional reception studies. In this update, Schroder aware that there has been a bias between readings made by the informant with readings conducted by researchers over the informant. Therefore, he classifies the reception into two dimensions, namely the dimension of reading by informants and implications dimensions conducted by researcher. Using Schroder approach, these studies seek to describe the reception of adolescent girls, as research subjects, to the elements contained sexual openness in the music video Cinta Laura as the object of research. Researcher wanted to see how they interpret the values of Western culture based on the values of their culture as a teenager. Researchers used a descriptive qualitative research method by conducting in-depth interviews to the informants who comes from a religious school. The selection of informants was done by using purposeful sampling. Collaboration with the school, the researchers were able to select informants who could provide rich data related to the topic. The analysis showed that there is permissiveness informants in addressing sexual openness in the music video. In addition, informants from Catholic schools were more open than the informant derived from Islamic schools in accepting the values of sexual openness. This permisiveness is regarded as a form of self-actualization and gender equality.

Keywords: cultural studies, multidimensional reception model, sexual openness, youth audience

Procedia PDF Downloads 398

Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

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Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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Authors: Temesgen Sidamo, Prakruti S. Rao, Eleni Akllilu, Workineh Shibeshi, Yumi Park, Yong-Soon Cho, Jae-Gook Shin, Scott K. Heysell, Stellah G. Mpagama, Ephrem Engidawork

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The fluoroquinolones (FQs) are used off-label for the treatment of multidrug-resistant tuberculosis (MDR-TB), and for evaluation in shortening the duration of drug-susceptible TB in recently prioritized regimens. Within the class, levofloxacin (LFX) and moxifloxacin (MXF) play a substantial role in ensuring success in treatment outcomes. However, sub-therapeutic plasma concentrations of either LFX or MXF may drive unfavorable treatment outcomes. To the best of our knowledge, the pharmacokinetics of LFX and MXF in Ethiopian patients with MDR-TB have not yet been investigated. Therefore, the aim of this study was to develop a population pharmacokinetic (PopPK) model of levofloxacin (LFX) and moxifloxacin (MXF) and assess the percent probability of target attainment (PTA) as defined by the ratio of the area under the plasma concentration-time curve over 24-h (AUC0-24) and the in vitro minimum inhibitory concentration (MIC) (AUC0-24/MIC) in Ethiopian MDR-TB patients. Steady-state plasma was collected from 39 MDR-TB patients enrolled in the programmatic treatment course and the drug concentrations were determined using optimized liquid chromatography-tandem mass spectrometry. In addition, the in vitro MIC of the patients' pretreatment clinical isolates was determined. PopPK and simulations were run at various doses, and PK parameters were estimated. The effect of covariates on the PK parameters and the PTA for maximum mycobacterial kill and resistance prevention was also investigated. LFX and MXF both fit in a one-compartment model with adjustments. The apparent volume of distribution (V) and clearance (CL) of LFX were influenced by serum creatinine (Scr), whereas the absorption constant (Ka) and V of MXF were influenced by Scr and BMI, respectively. The PTA for LFX maximal mycobacterial kill at the critical MIC of 0.5 mg/L was 29%, 62%, and 95% with the simulated 750 mg, 1000 mg, and 1500 mg doses, respectively, whereas the PTA for resistance prevention at 1500 mg was only 4.8%, with none of the lower doses achieving this target. At the critical MIC of 0.25 mg/L, there was no difference in the PTA (94.4%) for maximum bacterial kill among the simulated doses of MXF (600 mg, 800 mg, and 1000 mg), but the PTA for resistance prevention improved proportionately with dose. Standard LFX and MXF doses may not provide adequate drug exposure. LFX PopPK is more predictable for maximum mycobacterial kill, whereas MXF's resistance prevention target increases with dose. Scr and BMI are likely to be important covariates in dose optimization or therapeutic drug monitoring (TDM) studies in Ethiopian patients.

Keywords: population PK, PTA, moxifloxacin, levofloxacin, MDR-TB patients, ethiopia

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Authors: Gupta Indu

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This paper aims to examine the relationship between foreign direct investment and globalization. Foreign direct investment plays an important role in globalization. It is dramatically increasing in the age of globalization. It has played an important role for economic growth in this global process. It can provide new markets and marketing channels, cheaper production facilities, access to new technology, products to a firm. FDI has come to play a major role in the internationalization of business. FDI has become even more important than trade. Growing liberalization of the national regulatory framework governing investment in enterprises and changes in capital markets profound changes have occurred in the size, scope and methods of FDI. New information technology systems, decline in global communication costs have made management of foreign investments far easier than in the past. FDI provide opportunities to host countries to enhance their economic development and opens new opportunities to home countries to optimize their earnings by employing their ideal resources. Smaller and weaker economies can drive out much local competition. For small and medium sized companies, FDI represents an opportunity to become more actively involved in international business activities. In the past decade, foreign direct investment has expanded its role by change in trade policy, investment policy, tariff liberalization, easing of restrictions on foreign investment and acquisition in many nations, and the deregulation and privatization of many industries. In present competitive scenario, FDI has become a prominent external source of finance for developing countries.

Keywords: foreign direct investment, globalization, economic development, information technology systems new opportunities

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Authors: Saeed Ullah Jan

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This study has examined the e-readiness in libraries of public sector universities in Khyber Pakhtunkhwa. Efforts were made to evaluate the availability of human resources, electronic infrastructure, and network services and programs in the public sector university libraries. The population of the study was the twenty-seven public sector university libraries of Khyber Pakhtunkhwa. A quantitative approach was adopted, and a questionnaire-based survey was conducted to collect data from the librarian/in charge of public sector university libraries. The collected data were analyzed using Statistical Package for Social Sciences version 22 (SPSS). The mean score of the knowledge component interpreted magnitudes below three which indicates that the respondents are poorly or moderately satisfied regards knowledge of libraries. The satisfaction level of the respondents about the other components, such as electronic infrastructure, network services and programs, and enhancers of the networked world, was rated as average or below. The study suggested that major aspects of existing public-sector university libraries require significant transformation. For this purpose, the government should provide all the required resources and facilities to meet the population's informational and recreational demands. The Information Communication Technology (ICT) infrastructure of public university libraries needs improvement in terms of the availability of computer equipment, databases, network servers, multimedia projectors, digital cameras, uninterruptible power supply, scanners, and backup devices such as hard discs and Digital Video Disc/Compact Disc.

Keywords: ICT-libraries, e-readiness-libraries, e-readiness-university libraries, e-readiness-Pakistan

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Authors: Munira Al-Azraqi

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Modern South Arabian Languages (MSAL) belong to the Semitic language family and are believed to be either a southern member of the west Semitic branch (Rubin 2010; Moscati et al 1969) or an eastern member of the south Semitic branch (Faber 1997), (Watson 2012). They are six languages which are still spoken in southern Arabia. They are used in Oman, Yemen, Saudi Arabia and in some of the Gulf states. Mehri is one of them however it has the highest number of speakers comparing to the other members of MSAL. It is used in Yemen, Oman, in parts of southern and eastern Saudi Arabia and in some of the Gulf states. The number of Mehri speakers is estimated at between 100,000 and 180,000. The problem that this language might face is that its speakers live in different places which are belonging to different countries. This might cause the language to change rapidly due to education and communication. There are some studies on Omani and Yemeni Mehri but not in Saudi Mehri. In the nineteenth century, travelers, western scholars and explorers played their parts in the discovery of these peoples and their languages. The historical turning point for the knowledge of the MSAL is 1898, when the Südarabische Expedition of the Imperial Academy of Vienna started. The three scholars, Müller, Jahn and Hein began their systematic collection of texts, which were later studied grammatically and lexically by Bittner (1908-1917), Jahn (1915), Leslau (1938) and Wagner (1953). Saudi Mehri has not been studied. This might be caused by the lack of information or the difficulty in collecting the data which this paper aims to shed light on.

Keywords: Modern South Arabian, Mehri, Saudi Arabia, endangered languages

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Authors: Joulié Aurélien, Jourdain Elsa, Bailly Xavier, Gasqui Patrick, Yang Elise, Leblond Agnès, Rousset Elodie, Sidi-Boumedine Karim

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Q fever is a worldwide zoonosis caused by the gram-negative obligate intracellular bacterium Coxiella burnetii. Following the recent outbreaks in the Netherlands, a hyper virulent clone was found to be the cause of severe human cases of Q fever. In livestock, Q fever clinical manifestations are mainly abortions. Although the abortion rates differ between ruminant species, C. burnetii’s virulence remains understudied, especially in enzootic areas. In this study, the infectious potential of three C. burnetii isolates collected from French farms of small ruminants were compared to the reference strain Nine Mile (in phase II and in an intermediate phase) using an in vivo (CD1 mice) model. Mice were challenged with 105 live bacteria discriminated by propidium monoazide-qPCR targeting the icd-gene. After footpad inoculation, spleen and popliteal lymph node were harvested at 10 days post-inoculation (p.i). The strain invasiveness in spleen and popliteal nodes was assessed by qPCR assays targeting the icd-gene. Preliminary results showed that the avirulent strains (in phase 2) failed to pass the popliteal barrier and then to colonize the spleen. This model allowed a significant differentiation between strain’s invasiveness on biological host and therefore identifying distinct virulence profiles. In view of these results, we plan to go further by testing fifteen additional C. burnetii isolates from French farms of sheep, goat and cattle by using the above-mentioned in vivo model. All 15 strains display distant MLVA (multiple-locus variable-number of tandem repeat analysis) genotypic profiles. Five of the fifteen isolates will bee also tested in vitro on ovine and bovine macrophage cells. Cells and supernatants will be harvested at day1, day2, day3 and day6 p.i to assess in vitro multiplication kinetics of strains. In conclusion, our findings might help the implementation of surveillance of virulent strains and ultimately allow adapting prophylaxis measures in livestock farms.

Keywords: Q fever, invasiveness, ruminant, virulence

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Authors: Lucia Perez, Maria Gaton y Santa Palella

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Starting from the etymology of the word culture, the Latin term ‘colere’, whose meaning is to cultivate, we understand that the society that cultivates its knowledge is laying the foundations for new possibilities. In this sense, art and fashion contain the same attributes: concept, aesthetic principles, and refined techniques. Both play a crucial role, communication, and this implies a sense of community, relationship with tradition, and innovation. This is the mirror in which to contemplate, but also the space that helps to grow. This is the framework where our object of study opens up: the anthropological management or the mission management model applied to fashion exhibitions in museums and cultural institutions. For this purpose, a bibliographic review has been carried out with its subsequent analysis, a case study of three successful exhibitions: ‘Christian Dior: designer of dreams’, ‘Balenciaga and the Spanish painting’, and ‘China: Through the Looking Glass’. The methodology has been completed with interviews focused on the curators. Amongst the results obtained, it is worth highlighting the fundamental role of transcendent leadership, which, in addition to being results-oriented, must align the motivations of the collaborators with the mission. The anthropological management model conceives management as a service, and it is oriented to the interests of the staff and the public, in short, of the person; this is what enables the objectives of effectiveness, efficiency, and social value to be achieved; dimensions, all necessary for the proper development of the mission of the exhibitions. Fashion, understood as art, is at the service of culture, and therefore of the human being, which defines a transcendent mission. We conclude that the profile of an anthropological management model applied to fashion exhibitions in museums is the ideal one to achieve the purpose of these institutions.

Keywords: art, culture, fashion, anthropological model, fashion exhibitions

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Authors: Susan Cardillo

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This research will consider ways to bridge the gap between Computer Science and Media Communications and while doing so create Social Entrepreneurship for student success. New Media, as it has been referred to, is considered content available on-demand through Internet, a digital device, usually containing some kind of interactivity and creative participation. It is the interplay between technology, images, media and communications. The next generation of the newspaper, radio, television, and film students need to have a working knowledge of the technologies that are available for the creation of their work and taught to use this knowledge to create a voice. The work is interdisciplinary; in communications, we understand the necessity of reporting and disseminating information. In documentary film we understand the instructional and historic aspects of media and technology and in the non-profit sector, we see the need for expanding outlets for good. So, the true necessity is to utilize ‘new media’ technologies to advance social causes while reporting information, teaching and creating art. Goals: The goal of this research is to give communications students a better understanding of the technology that is both, currently at their disposal, and on the horizon, so that they can use it in their media, communications and art endeavors to be a voice for their generation. There is no longer a need to be a computer scientist to have a working knowledge of communication technologies and how they will benefit our work. There are many free and easy to use applications available for the creation of interactive communications. Methodology: This is Qualitative-Case Study that puts these ideas into action. There is a survey at the end of the experiment that is qualitative in nature and allows for the participants to share ideas and feelings about the technology and approach.

Keywords: interactive storytelling, web documentary, mass communications, teaching

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Authors: Muhammad Shafi'u Adamu

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This study examined the effects of two Group Cognitive Behavioural Therapies (Cognitive Restructuring and Rational Emotive Behavioural Therapy) on Psychological Distress of awaiting-trial Inmates in Correctional Centres in North-West, Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centres in North-west, Nigeria. 131 awaiting trial inmates from three intact Correctional Centres were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to pilot study using Cronbach's Alpha with reliability co-efficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean sores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicating the posttreatment reduction of psychological distress on the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference on those exposed to REBT. The research recommends that a standardized structured CBT counselling technique treatment should be designed for correctional centres across Nigeria, and CBT counselling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centres, group cognitive behavioural therapies, rational emotive behavioural therapy

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Authors: Lito M. Amit, Venecio U. Ultra, Young Woong Song

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The purpose of this study was to document the prevalence and types of work-related health and safety problems among Filipino migrant workers and the link between their migration status and occupational health and safety (OHS) problems. We conducted a survey among 116 Filipino migrant workers who were both legal and undocumented. To assess the various forms of occupational health problems, we utilized the Korean occupational stress scale (KOSS), Nordic musculoskeletal questionnaire (NMQ) and a validated health and safety questionnaire. A focus group discussion (FGD) was also conducted to record relevant information that was limited by the questionnaires. Descriptive data were presented in frequency with percentages, mean, and standard deviation. Chi-square tests and logistic regression analyses were performed to estimate the degree of association between variables (p < 0.05). Among the eight subscales of KOSS, inadequate social support (2.48), organizational injustice (2.57), and lack of reward (2.52) were experienced by workers. There was a 44.83% prevalence of musculoskeletal disorders with arm/elbow having the highest rate, followed by shoulder and low back regions. Inadequate social support and discomfort in organizational climate and overall MSDs prevalence showed significant relationships with migration status (p < 0.05). There was a positive association between migration status and seven items under language and communication. A positive association was seen between migration status and some of the OHS problems of Filipino migrant workers in Korea. Undocumented workers in this study were seen to be more vulnerable to those stressors compared to those employed legally.

Keywords: Filipino workers, migration status, occupational health and safety, undocumented workers

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Authors: Saleh Maina

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There is an on-going debate among intellectuals and scholars of international relations and world politics over the direction which the world is heading particularly in the current era of globalization. On the one hand are adherents to the convergence thesis which is premised on the assumption that global social order is tending toward universalism which could translate into the possible end of the classical state system and the unification of world societies under a single and common ideological dispensation. The convergence thesis is hinged on the globalization process which is gradually reducing world societies into a 'global village'. On the other hand are intellectuals who hold the view that despite advances made in communication technology which appear to threaten the survival of the classical state system. Invariance, as expressed in the survival of the existing state system and the diverse social traditions in world societies, remain a realistic possibility contrary to the conclusions of the convergence thesis. The invariance thesis has been advanced by scholars like Samuel P. Huntington whose work on clash of civilizations suggests that world peace can only be sustained through the co-habitation of diverse civilizations across the world. The purpose of this paper is to examine both sides of the debate with the aim of making a realistic assessment on where world societies are headed, between convergence and invariance. Using the realist theory of international relations as our theoretical premise the paper argues that while there is sufficient ground to predict the future direction of world societies as headed towards some form of convergence, invariance as expressed in the co-existence of diverse civilizations will for a long time remain a major feature of the international system.

Keywords: convergence, invariance, clash of civilization, classical state system, universalism

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Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

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Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

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Authors: Cetin Arslan, Senol Tayan

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Social media is one of the most important and effective means of social interaction among people in which they create, share and exchange their ideas via photos, videos or voice messages. Although there are lots of communication tools, social media sites are the most prominent ones that allows the users articulate themselves in a matter of seconds all around the world with almost any expenses and thus, they became very popular and widespread after its emergence. As the usage of social media increases, it becomes an effective instrument in social matters. While it is possible to use social media to emphasize basic human rights and protest some failures of any government as in “Arab Spring”, it is also possible to spread propaganda and misinformation just to cause long lasting insurgency, upheaval, turmoil or disorder as an instrument of intervention to internal affairs and state sovereignty by some hostile groups or countries. It is certain that “social media” has positive effects on democracies letting people have chance to express themselves and to organize, but it is also obvious that the misuse of it, is very common that even a five-minute-long video can cause to wage a campaign against a country. Although it looks anti-democratic, when you consider the catastrophic effects of misuse of social media, it is a kind of area that serious precautions are to be taken without limiting democratic rights while allowing constant and perpetual share but preventing the criminal events. This article begins with the current developments in social media and gives some examples on misuse of it. Second part tries to put emphasize on the legal basis that can prevent criminal activities and the upheavals and insurgencies against state security. Last part makes comparison between democratic countries and international organizations’’ actions against such activities and proposes some further actions that are compatible with democratic norms.

Keywords: democracy, disorder, security, Social Media

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Authors: Ali A. Ukasha, Majdi F. Elbireki, Mohammad F. Abdullah

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Data security needed in data transmission, storage, and communication to ensure the security. This paper is divided into two parts. This work interests with the color image which is decomposed into red, green and blue channels. The blue and green channels are compressed using 3-levels discrete wavelet transform. The Arnold transform uses to changes the locations of red image channel pixels as image scrambling process. Then all these channels are encrypted separately using the key image that has same original size and are generating using private keys and modulo operations. Performing the X-OR and modulo operations between the encrypted channels images for image pixel values change purpose. The extracted contours from color images recovery can be obtained with accepted level of distortion using single step parallel contour extraction (SSPCE) method. Experiments have demonstrated that proposed algorithm can fully encrypt 2D Color images and completely reconstructed without any distortion. Also shown that the analyzed algorithm has extremely large security against some attacks like salt and pepper and Jpeg compression. Its proof that the color images can be protected with a higher security level. The presented method has easy hardware implementation and suitable for multimedia protection in real time applications such as wireless networks and mobile phone services.

Keywords: SSPCE method, image compression and salt and peppers attacks, bitplanes decomposition, Arnold transform, color image, wavelet transform, lossless image encryption

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Authors: Qasim HamaKhurshid HamaMurad, Normal Mat Jusoh, Uznir Ujang

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The concept of the city with an infrastructure of (information and communication) Technology embraces several definitions depending on the meanings of the word "smart" are (intelligent city, smart city, knowledge city, ubiquitous city, sustainable city, digital city). Many definitions of the city exist, but this chapter explores which one has been universally acknowledged. From literature analysis, it emerges that Smart City is the most used terminologies in literature through the digital database to indicate the smartness of a city. This paper share exploration the research from main seven website digital databases and journal about Smart City from "January 2015 to the February of 2020" to (a) Time research, to examine the causes of the Smart City phenomenon and other concept literature in the last five years (b) Review of words, to see how and where the smart city specification and relation different definition And(c) Geographical research to consider where Smart Cities' greatest concentrations are in the world and are Malaysia has interacting with the smart city, and (d) how many papers published from all Malaysia from 2015 to 2020 about smart citie. Three steps are followed to accomplish the goal. (1)The analysis covered publications Build a systematic literature review search strategy to gather a representative sub-set of papers on Smart City and other definitions utilizing (GoogleScholar, Elsevier, Scopus, ScienceDirect, IEEEXplore, WebofScience, Springer) January2015-February2020. (2)A bibliometric map was formed based on the bibliometric evaluation using the mapping technique VOSviewer to visualize differences. (3)VOSviewer application program was used to build initial clusters. The Map of Bibliometric Visualizes the analytical findings which targeted the word harmony.

Keywords: bibliometric research, smart city, ICT, VOSviewer, urban modernization

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Authors: Anderson Rocha-Buelvas, Jaqueline Mena Huertas, Edith Burbano Rosero, Arsenio Hidalgo Troya, Mauricio Casas Cruz

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COVID-19 is a disruptive pandemic for the public health and economic system of whole countries, including Colombia. Nariño Department is the southwest of the country and draws attention to being on the border with Ecuador, constantly facing demographic transition affecting infections between countries. In Nariño, the early routine diagnosis of SARS-CoV-2, which can be handled at BSL-2, has affected the transmission dynamics of COVID-19. However, new emerging and re-emerging viruses with biological flexibility classified as a Risk Group 3 agent can take advantage of epidemiological opportunities, generating the need to increase clinical diagnosis, mainly in border regions between countries. The overall objective of this project was to assure the quality of the analytical process in the diagnosis of high biological risk pathogens in Nariño by building a laboratory that includes biosafety level (BSL)-2 and (BSL)-3 containment zones. The delimitation of zones was carried out according to the Verification Tool of the National Health Institute of Colombia and following the standard requirements for the competence of testing and calibration laboratories of the International Organization for Standardization. This is achieved by harmonization of methods and equipment for effective and durable diagnostics of the large-scale spread of highly pathogenic microorganisms, employing negative-pressure containment systems and UV Systems in accordance with a finely controlled electrical system and PCR systems as new diagnostic tools. That increases laboratory capacity. Protection in BSL-3 zones will separate the handling of potentially infectious aerosols within the laboratory from the community and the environment. It will also allow the handling and inactivation of samples with suspected pathogens and the extraction of molecular material from them, allowing research with pathogens with high risks, such as SARS-CoV-2, Influenza, and syncytial virus, and malaria, among others. The diagnosis of these pathogens will be articulated across the spectrum of basic, applied, and translational research that could receive about 60 daily samples. It is expected that this project will be articulated with the health policies of neighboring countries to increase research capacity.

Keywords: medical laboratory science, SARS-CoV-2, public health surveillance, Colombia

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Authors: Yun Chan Lee

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Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

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Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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