Search results for: Reuven Cohen
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 75

Search results for: Reuven Cohen

45 Literary Imagination and Leadership: Lessons From the Classroom

Authors: Naor Cohen

Abstract:

In recent years, business schools made teaching ethical leadership a higher priority. Greater attention to moral and ethical concepts and reasoning processes may prove beneficial to future business leaders. But with a shift in focus, there is a need for a shift in pedagogy. This paper explores an imaginative literature-based pedagogy in the teaching of ethical leadership. An imaginative literature-based pedagogy uses works of fiction to help students build moral analysis and moral judgment capabilities through a rigorous assessment of the moral soundness of actions, motivations, rationales, and consequences portrayed in works of fiction. Business students enrolled in 4 leadership senior-level courses were assigned the White Tiger: A Novel by Aravind Adiga as their main course reading. Students' engagement was measured as a three-factor construct exploring cognitive engagement, behavioural engagement and emotional engagement. In addition, students' final papers were analyzed using thematic content analysis. This paper will present the results of this analysis and argue that incorporating fiction into the leadership curriculum allows students to explore the dire consequences of avoiding countervailing interests, engaging in dishonesty and engaging in moral puffery-based leadership.

Keywords: ethical leadership, empathetic imagination, business education, pedagogy, fiction

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44 Understanding Lacan’s ‘Name of the Father’ Concept, the Original Introject, and Personality Functioning

Authors: Chloe T. Cohen, Sarah Johnson

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Psychoanalytic literature has traditionally focused on the theoretical explanations of psychological phenomena rather than empirical research to support those ideas. Many clinicians assume a lack of empirical verification of the theories that underpin psychoanalytic treatment disqualifies psychoanalytic psychotherapy as an effective clinical technique. One such theory is Lacan’s ‘Name of the Father’, which extended Freud’s idea of the importance of a successful resolution of the Oedipal problem, situating it even earlier in psychological development. Lacan posited that the Name of the Father construct (establishing psychological structure and preventing psychosis) was best represented in language use, metaphor, and linguistic structure. However, no study to date has empirically examined the Name of the Father construct. The current study attempts to measure Lacan’s ‘Name of the Father’ construct through linguistic structure and metaphor use and to compare it with Freud’s ‘original introject’. We will then investigate whether they relate to adult personality functioning (measured using the Rorschach Inkblot Test). We aim to contribute to the empirical study of psychoanalytic concepts by operationalizing and validating the Name of the Father empirically. We also aim to examine the relationship of the Name of the Father construct to Freud’s concept of the original introject and to adult pathology. We hypothesize that measures of the original introject will mediate the pathway between linguistic indicators of Lacan’s Name of the Father construct and personality functioning.

Keywords: Lacan, Name of the Father, original introject, personality functioning, psychoanalysis

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43 Good Death as Perceived by the Critically Ill Patients' Family Member

Authors: Wanlapa Kunsongkeit

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When a person gets sick, he or she goes to hospital for the treatment. In the case of severe illness, there might be no hope for some patients to recover. In this state, the patients will face anxiety and fear. These feelings make the patients suffer in mind until the time of death or called bad death. These feeling also directly effect to family members who are loved ones and significant persons of the patients. They can help the dying patients to have good death. From literature reviews, many studies focused on good death in patients and nurses. Little is known about good death in family member. Therefore, the qualitative research based on Heideggerian phenomenology aimed to describe good death as perceived by the critically ill patients’ family members. Five informants who were the critically ill patients’ family members at hospital in Chonburi were purposively selected. Data were collected by in-depth interview, observation and critical reflection during January, 2014 to March, 2014 . Cohen, Kahn and Steeves’s (2000) steps guided data analysis. Trustworthiness was maintained throughout the study following Lincoln and Guba’s guidelines. Four themes were emerged, which were no suffering, acceptance of imminent death, preparing for death, and being with the family. This findings provide deep understanding of good death as perceived by the critically ill patients’ family members. It can be basic information for nurses to provide good death nursing care and further explore for development of knowledge regarding good death nursing care.

Keywords: good death, family member, critically ill patient, phenomenology

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42 Efficacy and Safety of COVID-19 Vaccination in Patients with Multiple Sclerosis: Looking Forward to Post-COVID-19

Authors: Achiron Anat, Mathilda Mandel, Mayust Sue, Achiron Reuven, Gurevich Michael

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Introduction: As coronavirus disease 2019 (COVID-19) vaccination is currently spreading around the world, it is of importance to assess the ability of multiple sclerosis (MS) patients to mount an appropriate immune response to the vaccine in the context of disease-modifying treatments (DMT’s). Objectives: Evaluate immunity generated following COVID-19 vaccination in MS patients, and assess factors contributing to protective humoral and cellular immune responses in MS patients vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus infection. Methods: Review our recent data related to (1) the safety of PfizerBNT162b2 COVID-19 mRNA vaccine in adult MS patients; (2) the humoral post-vaccination SARS-CoV2 IgG response in MS vaccinees using anti-spike protein-based serology; and (3) the cellular immune response of memory B-cells specific for SARS-CoV-2 receptor-binding domain (RBD) and memory T-cells secreting IFN-g and/or IL-2 in response to SARS-CoV2 peptides using ELISpot/Fluorospot assays in MS patients either untreated or under treatment with fingolimod, cladribine, or ocrelizumab; (4) covariate parameters related to mounting protective immune responses. Results: COVID-19 vaccine proved safe in MS patients, and the adverse event profile was mainly characterised by pain at the injection site, fatigue, and headache. Not any increased risk of relapse activity was noted and the rate of patients with acute relapse was comparable to the relapse rate in non-vaccinated patients during the corresponding follow-up period. A mild increase in the rate of adverse events was noted in younger MS patients, among patients with lower disability, and in patients treated with DMTs. Following COVID-19 vaccination protective humoral immune response was significantly decreased in fingolimod- and ocrelizumab- treated MS patients. SARS-CoV2 specific B-cell and T-cell cellular responses were respectively decreased. Untreated MS patients and patients treated with cladribine demonstrated protective humoral and cellular immune responses, similar to healthy vaccinated subjects. Conclusions: COVID-19 BNT162b2 vaccine proved as safe for MS patients. No increased risk of relapse activity was noted post-vaccination. Although COVID-19 vaccination is new, accumulated data demonstrate differences in immune responses under various DMT’s. This knowledge can help to construct appropriate COVID-19 vaccine guidelines to ensure proper immune responses for MS patients.

Keywords: covid-19, vaccination, multiple sclerosis, IgG

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41 Stress and Coping Strategies: A Correlational Analysis to Profiling Maladaptive Behaviors at Work

Authors: Silvia Riva, Ezekiel Chinyio

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Introduction: Workers in different sectors are prone to stress at varying levels. They also respond to stress in different ways. An inspiration was to study stress development amongst workers in a work dangerous setting (Construction Industry) as well as how they cope with specific stress incidences. Objective: The overarching objective of the study was to study and correlate between stress and coping strategies. The research was conducted in an organizational industrial setting, and its findings on the coping actions of construction workers are reported in this article. Methods: An online cross-sectional survey was conducted with 80 participants aged 18-62. These were working for three different construction organizations in the West Midland region of the UK. Their coping actions were assessed using the COPE Inventory (Carver, 2013) instrument while the level of stress was assessed by the Perceived Stress Scale (Cohen, 1994). Results: Out of 80 workers (20 female, 25%, mean age 40.66), positive reinterpretation (M=4.15, SD=2.60) and active coping (M=4.18, SD=2.55) were the two most adaptive strategies reported by the workers while the most frequent maladaptive behavior was mental disengagement (M=3.62, SD=2.25). Among the maladaptive tactics, alcohol and drug abuse was a significant moderator in stress reactions (t=6.12, p=.000). Conclusion: Some maladaptive strategies are adopted by construction workers to cope with stress. So, it could be argued that programs of stress prevention and control in the construction industry have a basis to develop solutions that can improve and strengthen effective interventions when workers are stressed or getting stressed.

Keywords: coping, organization, strategies, stress

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40 Investigation of Physical Properties of W-Doped CeO₂ and Mo-Doped CeO₂: A Density Functional Theory Study

Authors: Aicha Bouhlala, Sabah Chettibi

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A systematic investigation on structural, electronic, and magnetic properties of Ce₀.₇₅A₀.₂₅O₂ (A = W, Mo) is performed using first-principles calculations within the framework Full-Potential Linear Augmented Plane Wave (FP-LAPW) method based on the Density Functional Theory (DFT). The exchange-correlation potential has been treated using the generalized gradient approximation (WC-GGA) developed by Wu-Cohen. The host compound CeO2 was doped with transition metal atoms W and Mo in the doping concentration of 25% to replace the Ce atom. In structural properties, the equilibrium lattice constant is observed for the W-doped CeO₂ compound which exists within the value of 5.314 A° and the value of 5.317 A° for Mo-doped CeO2. The present results show that Ce₀.₇₅A₀.₂₅O₂ (A=W, Mo) systems exhibit semiconducting behavior in both spin channels. Although undoped CeO₂ is a non-magnetic semiconductor. The band structure of these doped compounds was plotted and they exhibit direct band gap at the Fermi level (EF) in the majority and minority spin channels. In the magnetic properties, the doped atoms W and Mo play a vital role in increasing the magnetic moments of the supercell and the values of the total magnetic moment are found to be 1.998 μB for Ce₀.₇₅W₀.₂₅O₂ and to be 2.002 μB for Ce₀.₇₅Mo₀.₂₅O₂ compounds. Calculated results indicate that the magneto-electronic properties of the Ce₁₋ₓAₓO₂(A= W, Mo) oxides supply a new way to the experimentalist for the potential applications in spintronics devices.

Keywords: FP-LAPW, DFT, CeO₂, properties

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39 Reading the Memoirs of American Caregiving Daughters: A Care-Focused Feminist Approach

Authors: Su-Lin Yu

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This paper will explore how gender and care discourse are intersected, reformulated and contested in American daughters’ caregiving memoirs. In particular, it will attempt to show how gender structure has worked to regulate a daughter’s response to her mother’s illness. In other words, how do certain cultural notions and class difference affect the ways in which the daughter enacts her caregiving response to her mother’s illness? What is the interrelation of female subjectivity and care practice? To understand care and gender politics in the memoirs, this paper will engage in close readings of five texts: Sandra Bullock Simith’s Trading Places: Becoming My Mother’s Mother: A Daughter’s Memoir (2015),Martha Stettinius’s Inside the Dementia Epidemic: A Daughter’s Memoir (2012), Patricia Thompson Collamer’s Grace on the Ledge: a Caregiver's Memoir, Judith Henry’s The Dutiful Daughter's Guide to Caregiving: A Practical Memoir (2015), and The Daughter's Dilemma: A Survival Guide to Caring for an Aging, Abusive Parent by Emily Wanderer Cohen (2018). By analyzing these texts, this paper will show why adult daughters become the primary caregivers, how gender norms and care practices influence a daughter’s thoughts and actions, and how it affects her self-understanding. Taken as a whole, then, the paper will provide an important examination not only of care and gender politics, but also a contribution to the intersecting discourses of illness, death, and mother-daughter relationship.

Keywords: care ethics, daughter-mother relationship, gender politics, memoirs

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38 Electrokinetic Regulation of Flow in Microcrack Reservoirs

Authors: Aslanova Aida Ramiz

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One of the important aspects of rheophysical problems in oil and gas extraction is the regulation of thermohydrodynamic properties of liquid systems using physical and physicochemical methods. It is known that the constituent parts of real fluid systems in oil and gas production are practically non-conducting, non-magnetically active components. Real heterogeneous hydrocarbon systems, from the structural point of view, consist of an infinite number of microscopic local ion-electrostatic cores distributed in the volume of the dispersion medium. According to Cohen's rule, double electric layers are formed at the contact boundaries of components in contact (oil-gas, oil-water, water-condensate, etc.) in a heterogeneous system, and as a result, each real fluid system can be represented as a complex composition of a set of local electrostatic fields. The electrokinetic properties of this structure are characterized by a certain electrode potential. Prof. F.H. Valiyev called this potential the α-factor and came up with the idea that many natural and technological rheophysical processes (effects) are essentially electrokinetic in nature, and by changing the α-factor, it is possible to adjust the physical properties of real hydraulic systems, including thermohydrodynamic parameters. Based on this idea, extensive research work was conducted, and the possibility of reducing hydraulic resistances and improving rheological properties was experimentally discovered in real liquid systems by reducing the electrical potential with various physical and chemical methods.

Keywords: microcracked, electrode potential, hydraulic resistance, Newtonian fluid, rheophysical properties

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37 Simulating Elevated Rapid Transit System for Performance Analysis

Authors: Ran Etgar, Yuval Cohen, Erel Avineri

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One of the major challenges of transportation in medium sized inner-cities (such as Tel-Aviv) is the last-mile solution. Personal rapid transit (PRT) seems like an applicable candidate for this, as it combines the benefits of personal (car) travel with the operational benefits of transit. However, the investment required for large area PRT grid is significant and there is a need to economically justify such investment by correctly evaluating the grid capacity. PRT main elements are small automated vehicles (sometimes referred to as podcars) operating on a network of specially built guideways. The research is looking at a specific concept of elevated PRT system. Literature review has revealed the drawbacks PRT modelling and simulation approaches, mainly due to the lack of consideration of technical and operational features of the system (such as headways, acceleration, safety issues); the detailed design of infrastructure (guideways, stations, and docks); the stochastic and sessional characteristics of demand; and safety regulations – all of them have a strong effect on the system performance. A highly detailed model of the system, developed in this research, is applying a discrete event simulation combined with an agent-based approach, to represent the system elements and the podecars movement logic. Applying a case study approach, the simulation model is used to study the capacity of the system, the expected throughput of the system, the utilization, and the level of service (journey time, waiting time, etc.).

Keywords: capacity, productivity measurement, PRT, simulation, transportation

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36 Determining the Relationship Between Maternal Stress and Depression and Child Obesity: The Mediating Role of Maternal Self-efficacy

Authors: Alireza Monzavi Chaleshtori, Mahnaz Aliakbari Dehkordi, Maryam Aliakbari, Solmaz Seyed Mostafaii

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Objective: Considering the growing obesity among children and the role of mother's psychological factors as well as the need to prevent childhood obesity, this study aimed to investigate the mediating role of mother's self-efficacy in the relationship between mother's stress and depression and child obesity. Method: For this purpose, in a descriptive-correlation study, 222 mothers and children aged 1 to 5 years in Tehran, who had the opportunity to answer an online questionnaire, were selected by random sampling and to the depression scales of the Kroenke and Spitzer Patient Health Questionnaire, Cohen's stress and Self-efficacy of Berkeley mothers answered. Pearson correlation test and path analysis were used for data analysis. Findings: The findings showed that maternal depression had an indirect and significant effect on child obesity, and the effect of stress and depression on child obesity was indirect and non-significant. Therefore, the model has a good fit with the research data, and stress and depression indirectly predicted child obesity with the mediating role of self-efficacy. Conclusion: The hypothesized model tested based on mother's stress and depression with the mediating role of mother's self-efficacy was a good model in explaining the prediction of child obesity. Based on the findings of this research, a practical framework can be provided to explain the psychological factors of the mother in relation to child obesity and its treatment.

Keywords: stress, self-efficacy, child obesity, depression

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35 Comparison of the Classification of Cystic Renal Lesions Using the Bosniak Classification System with Contrast Enhanced Ultrasound and Magnetic Resonance Imaging to Computed Tomography: A Prospective Study

Authors: Dechen Tshering Vogel, Johannes T. Heverhagen, Bernard Kiss, Spyridon Arampatzis

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In addition to computed tomography (CT), contrast enhanced ultrasound (CEUS), and magnetic resonance imaging (MRI) are being increasingly used for imaging of renal lesions. The aim of this prospective study was to compare the classification of complex cystic renal lesions using the Bosniak classification with CEUS and MRI to CT. Forty-eight patients with 65 cystic renal lesions were included in this study. All participants signed written informed consent. The agreement between the Bosniak classifications of complex renal lesions ( ≥ BII-F) on CEUS and MRI were compared to that of CT and were tested using Cohen’s Kappa. Sensitivity, specificity, positive and negative predictive values (PPV/NPV) and the accuracy of CEUS and MRI compared to CT in the detection of complex renal lesions were calculated. Twenty-nine (45%) out of 65 cystic renal lesions were classified as complex using CT. The agreement between CEUS and CT in the classification of complex cysts was fair (agreement 50.8%, Kappa 0.31), and was excellent between MRI and CT (agreement 93.9%, Kappa 0.88). Compared to CT, MRI had a sensitivity of 96.6%, specificity of 91.7%, a PPV of 54.7%, and an NPV of 54.7% with an accuracy of 63.1%. The corresponding values for CEUS were sensitivity 100.0%, specificity 33.3%, PPV 90.3%, and NPV 97.1% with an accuracy 93.8%. The classification of complex renal cysts based on MRI and CT scans correlated well, and MRI can be used instead of CT for this purpose. CEUS can exclude complex lesions, but due to higher sensitivity, cystic lesions tend to be upgraded. However, it is useful for initial imaging, for follow up of lesions and in those patients with contraindications to CT and MRI.

Keywords: Bosniak classification, computed tomography, contrast enhanced ultrasound, cystic renal lesions, magnetic resonance imaging

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34 Simulation and Controller Tunning in a Photo-Bioreactor Applying by Taguchi Method

Authors: Hosein Ghahremani, MohammadReza Khoshchehre, Pejman Hakemi

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This study involves numerical simulations of a vertical plate-type photo-bioreactor to investigate the performance of Microalgae Spirulina and Control and optimization of parameters for the digital controller by Taguchi method that MATLAB software and Qualitek-4 has been made. Since the addition of parameters such as temperature, dissolved carbon dioxide, biomass, and ... Some new physical parameters such as light intensity and physiological conditions like photosynthetic efficiency and light inhibitors are involved in biological processes, control is facing many challenges. Not only facilitate the commercial production photo-bioreactor Microalgae as feed for aquaculture and food supplements are efficient systems but also as a possible platform for the production of active molecules such as antibiotics or innovative anti-tumor agents, carbon dioxide removal and removal of heavy metals from wastewater is used. Digital controller is designed for controlling the light bioreactor until Microalgae growth rate and carbon dioxide concentration inside the bioreactor is investigated. The optimal values of the controller parameters of the S/N and ANOVA analysis software Qualitek-4 obtained With Reaction curve, Cohen-Con and Ziegler-Nichols method were compared. The sum of the squared error obtained for each of the control methods mentioned, the Taguchi method as the best method for controlling the light intensity was selected photo-bioreactor. This method compared to control methods listed the higher stability and a shorter interval to be answered.

Keywords: photo-bioreactor, control and optimization, Light intensity, Taguchi method

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33 Research Trends in Early Childhood Education Graduate Theses: A Content Analysis

Authors: Seden Demirtaş, Feyza Tantekin Erden

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The importance of research in early childhood education is growing all around the world. This study aims to investigate research trends in graduate theses written in Turkey in the area of early childhood education. Descriptive, contextual and methodological aspects of graduate theses were analyzed to investigate the trends. A sample of the study consisted of 1000 graduate theses (n= 1000) including both MS theses and Ph.D. dissertations. Theses and dissertations were obtained from the thesis database of Council of Higher Education (CoHE). An investigation form was developed by the researcher to analyze graduate theses. The investigation forms validated by expert opinion from early childhood education department. To enhance the reliability of the investigation form, inter-coder agreement was measured by Cohen’s Kappa value (.86). Data were gathered via using the investigation form, and content analysis method was used to analyze the data. Results of the analysis were presented by descriptive statistics and frequency tables. Analysis of the study is on-going and preliminary results of the study show that master theses related to early childhood education have started to be written in 1986, and the number of the theses has increased gradually. In most of the studies, sample group consisted of children especially in between 5-6 age group. Child development, activities (applied in daily curriculum of preschools) and teaching methods are the mostly examined concepts in graduate theses. Qualitative and quantitative research methods were referred equally by researchers in these theses.

Keywords: content analysis, early childhood education, graduate thesis, research trends

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32 Spiritual Warriors: Christian Testimony and Psychotherapy in Ritual Abuse Memoir

Authors: Jocelyn Cohen

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This paper identifies a powerful synchronicity of two traditions of life-story writing in the autobiographies of ritual abuse (RA) survivors, the Christian conversion narrative and the memoir of healing from childhood sexual trauma. Using methodologies from literary studies, history, and psychology, a close reading of three RA memoirs sheds light on a taboo and deeply suspect form of violence. Treatment of RA survivors and the unique role of psychotherapists, in particular, deserve far greater attention from multi-disciplinary scholars. Each story reflects salient characteristics of the Christian conversion narrative, a genre which originated in the US in the early 19th century with the serendipitous confluence of the simultaneous emergence of print culture and the basic structures of evangelicalism during the Second Great Awakening. The impulse of writing is thus to give testimony against the sin they witnessed and endured as young children during ritual violence perpetrated within the church. Importantly, RA is seen as an inherent if obscure aspect of Christian discourse itself, not in opposition to it, and not as an aberration. In RA's memoir, healing comes in part from the Christian narrative praxis of personal redemption, framed as prevailing in a war between good and evil. In other words, storytelling itself affects the healing, much as it does by means of each writer’s 'talking cure,' in the relationship with a psychotherapist who guides her through a repair of the life-story through the excavation of traumatic memories and their integration into the writer’s psyche. Integrating literary techniques into the psychotherapeutic relationship, therapists leverage the deep linguistic structures that clients possess as a resource to aid in their healing.

Keywords: memoir, psychotherapy, religion, trauma

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31 The Effects of Supportive Care Interventions with Psychotherapeutic and Exercise Approaches on Depressive Symptoms Among Patients with Lung Cancer: A Meta-Analysis

Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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30 The Effect of Filter Cake Powder on Soil Stability Enhancement in Active Sand Dunes, In the Long and Short Term

Authors: Irit Rutman Halili, Tehila Zvulun, Natali Elgabsi, Revaya Cohen, Shlomo Sarig

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Active sand dunes (ASD) may cause significant damage to field crops and livelihood, and therefore, it is necessary to find a treatment that would enhance ADS soil stability. Biological soil crusts (biocrusts) contain microorganisms on the soil surface. Metabolic polysaccharides secreted by biocrust cyanobacteria glue the soil particles into aggregates, thereby stabilizing the soil surface. Filter cake powder (FCP) is a waste by-product in the final stages of the production of sugar from sugarcane, and its disposal causes significant environmental pollution. FCP contains high concentrations of polysaccharides and has recently been shown to be soil stability enhancing agent in ASD. It has been reported that adding FCP to the ASD soil surface by dispersal significantly increases the level of penetration resistance of soil biocrust (PRSB) nine weeks after a single treatment. However, it was not known whether a similar effect could be obtained by administering the FCP in liquid form by means of spraying. It has now been found that spraying a water solution of FCP onto the ASD soil surface significantly increased the level of penetration resistance of soil biocrust (PRSB) three weeks after a single treatment. These results suggest that FCP spraying can be used as a short-term soil stability-enhancing agent for ASD, while administration by dispersal might be more efficient over the long term. Finally, an additional benefit of using FCP as a soil stabilizer, either by dispersal or by spraying, is the reduction in environmental pollution that would otherwise result from the disposal of FCP solid waste.

Keywords: active sand dunes, filter cake powder, biological soil crusts, penetration resistance of soil biocrust

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29 Impacts of Social Support on Perceived Level of Stress and Self-Esteem among Students of Private Universities of Karachi-Pakistan

Authors: Sheeba Farhan

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This study is conducted to explore the predictive relationship of perceived stress and self-esteem with social support of students and to explore the factors, which contribute to develop or enhance the level of stress in students of private universities in Karachi-Pakistan. After literature review following hypotheses were formulated; 1)social support would predict perceived stress of students of business administration of private organizations of Higher education, 2) social support would predict the self-esteem of students of private organizations of Higher education, 3) there will be a relationship of perceived stress and self-esteem of students of private organizations of Higher education, 4) there will be a relationship of self esteem and social support of students of private organizations of Higher education. Sample of the study is comprise of 100 students of private organizations of Higher education in Karachi- Pakistan (i.e. males= 50 & females= 50). The age range of participants is 18-26 years. The measures, used in the study are: Demographic information form, a semi structured interview form, Rosenberg self esteem scale (Rosenberg, 1965) and perceived stress scale (Cohen, Kamarck, and Mermelstein, 1983) and multidimensional scale of perceived social support (Zimet, 1988) Descriptive statistics is used for getting a better statistical view of characteristics of sample. Regression analysis is used to explore the predictive relationship of study related stress and self esteem with academic achievement of students of private organizations of Higher education. Percentages and ratios were calculated to explore the level of perceived stress with respect to Socio-demographic characteristics in students of private organizations of Higher education. Finding shows that social support is significantly associated with the higher level of self-esteem among students of graduation but insignificantly associated with stress that has been experienced by them. These results are correlated with a wide variety of studies in which social support has proposed to be a predictor of well being for the students.

Keywords: private universities of Karachi-Pakistan, Self-esteem, social support, stress

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28 The Use of Respiratory Index of Severity in Children (RISC) for Predicting Clinical Outcomes for 3 Months-59 Months Old Patients Hospitalized with Community-Acquired Pneumonia in Visayas Community Medical Center, Cebu City from January 2013 - June 2

Authors: Karl Owen L. Suan, Juliet Marie S. Lambayan, Floramay P. Salo-Curato

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Objective: To predict the outcome among patients admitted with community-acquired pneumonia (ages 3 months to 59 months old) admitted in Visayas Community Medical Center using the Respiratory Index of Severity in Children (RISC). Design: A cross-sectional study design was used. Setting: The study was done in Visayas Community Medical Center, which is a private tertiary level in Cebu City from January-June 2013. Patients/Participants: A total of 72 patients were initially enrolled in the study. However, 1 patient transferred to another institution, thus 71 patients were included in this study. Within 24 hours from admission, patients were assigned a RISC score. Statistical Analysis: Cohen’s kappa coefficient was used for inter-rater agreement for categorical data. This study used frequency and percentage distribution for qualitative data. Mean, standard deviation and range were used for quantitative data. To determine the relationship of each RISC score parameter and the total RISC score with the outcome, a Mann Whitney U Test and 2x2 Fischer Exact test for testing associations were used. A p value less of than 0.05 alpha was considered significant. Results: There was a statistical significance between RISC score and clinical outcome. RISC score of greater than 4 was correlated with intubation and/or mortality. Conclusion: The RISC scoring system is a simple combination of clinical parameters and a reliable tool that will help stratify patients aged 3 months to 59 months in predicting clinical outcome.

Keywords: RISC, clinical outcome, community-acquired pneumonia, patients

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27 The Impact of Model Specification Decisions on the Teacher ValuE-added Effectiveness: Choosing the Correct Predictors

Authors: Ismail Aslantas

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Value-Added Models (VAMs), the statistical methods for evaluating the effectiveness of teachers and schools based on student achievement growth, has attracted decision-makers’ and researchers’ attention over the last decades. As a result of this attention, many studies have conducted in recent years to discuss these statistical models from different aspects. This research focused on the importance of conceptual variables in VAM estimations; therefor, this research was undertaken to examine the extent to which value-added effectiveness estimates for teachers can be affected by using context predictions. Using longitudinal data over three years from the international school context, value-added teacher effectiveness was estimated by ordinary least-square value-added models, and the effectiveness of the teachers was examined. The longitudinal dataset in this study consisted of three major sources: students’ attainment scores up to three years and their characteristics, teacher background information, and school characteristics. A total of 1,027 teachers and their 35,355 students who were in eighth grade were examined for understanding the impact of model specifications on the value-added teacher effectiveness evaluation. Models were created using selection methods that adding a predictor on each step, then removing it and adding another one on a subsequent step and evaluating changes in model fit was checked by reviewing changes in R² values. Cohen’s effect size statistics were also employed in order to find out the degree of the relationship between teacher characteristics and their effectiveness. Overall, the results indicated that prior attainment score is the most powerful predictor of the current attainment score. 47.1 percent of the variation in grade 8 math score can be explained by the prior attainment score in grade 7. The research findings raise issues to be considered in VAM implementations for teacher evaluations and make suggestions to researchers and practitioners.

Keywords: model specification, teacher effectiveness, teacher performance evaluation, value-added model

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26 Effectiveness of a Sports Nutrition Intervention for High-School Athletes: A Feasibility Study

Authors: Michael Ryan, Rosemary E. Borgerding, Kimberly L. Oliver

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The objective of this study was to assess the effectiveness of a sports nutrition intervention on body composition in high-school athletes. The study aimed to improve the food and water intake of high-school athletes, evaluate the cost-effectiveness of the intervention, and assess changes in body fat. Data were collected through observations, questionnaires, and interviews. Additionally, bioelectrical impedance analysis was performed to assess the body composition of athletes both before and after the intervention. Athletes (n=25) participated in researcher-monitored training sessions three times a week over the course of 12 weeks. During these sessions, in addition to completing their auxiliary sports training, participants were exposed to educational interventions aimed at improving their nutrition. These included discussions regarding current eating habits, nutritional guidelines for athletes, and individualized recommendations. Food was also made available to athletes for consumption before and after practice. Meals of balanced macronutrient composition were prepared and provided to athletes on four separate occasions throughout the intervention, either prior to or following a competitive event such as a tournament or game. A paired t-test was used to determine the statistical significance of the changes in body fat percentage. The results showed that there was a statistically significant difference between pre and post-intervention body fat percentage (p= .006). Cohen's d of 0.603 was calculated, indicating a moderate effect size. In conclusion, this study provides evidence that a sports nutrition intervention that combines food availability, explicit prescription, and education can be effective in improving the body composition of high-school athletes. However, it's worth noting that this study had a small sample size, and the conclusions cannot be generalized to a larger population. Further research is needed to assess the scalability of this study. This preliminary study demonstrated the feasibility of this type of nutritional intervention and laid the groundwork for a larger, more extensive study to be conducted in the future.

Keywords: bioelectrical impedance, body composition, high-school athletes, sports nutrition, sports pedagogy

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25 Immigration in British Southern Cameroons from 2016 to 2020

Authors: Geraldine Ambe

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Cameroon is a country in a country in Central Africa. Before the first World War, Germany colonized Cameroon, including some parts of Gabon, Chad, Nigeria, and the Central African Republic. After the war, the United Nations divided most of the colony into Britain and France. In 1960, Eastern Cameroon (‘La Republique du Cameroon’) gained its independence from France while British Southern Cameroons obtained its independence from Britain. The two entities agreed to live together as a federal state officially called the Federal Republic of Cameroon. In 1962, the name of the name of the country was changed from the Federal Republic of Cameroon to the United Republic of Cameroon, while the Prime Minister of Western Cameroon was moved to Yaounde. In 1984, President Paul Biya singlehandedly changed the name to the Republic of Cameroon, implying that Southern Cameroon is not recognized in the union again. From the words of Am Cohen, the two territories came together to form a federal government with one currency, one army, and one foreign policy like states in the United States of America. However, the name Republic of Cameroon (‘La Republique du Cameroun’) does not recognize BSC, and this is exactly what has been practiced: politics of exclusion and excessive centralization in Yaounde. In 2016, teachers and Lawyers started strikes to call the attention of the government on the inhalation of the English culture/people. They were greeted with guns, causing the radicalization of the youths. The civil society came together to form a union to address the issues facing the people, and the government took their leaders and sentenced them to live imprisonment. The consequence was a civil war with nobody to dialogue with. Out of Cameroon, more than half a million people from BSC have been taking dangerous trips through the air, land, and sea. In the jungles and the deserts, the snow of Europe, these people have been seen for the last 4 years. This paper will present some personalities, political fractions, and their stands of decentralization, federalism, and independence as the war continues. The paper will further look at the consequence of this crisis on migration in Central and Eastern Europe.

Keywords: British Southern Cameroons, decolonization, Second World War, dialogue, civil war, immigration

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24 DNA Methylation Score Development for In utero Exposure to Paternal Smoking Using a Supervised Machine Learning Approach

Authors: Cristy Stagnar, Nina Hubig, Diana Ivankovic

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The epigenome is a compelling candidate for mediating long-term responses to environmental effects modifying disease risk. The main goal of this research is to develop a machine learning-based DNA methylation score, which will be valuable in delineating the unique contribution of paternal epigenetic modifications to the germline impacting childhood health outcomes. It will also be a useful tool in validating self-reports of nonsmoking and in adjusting epigenome-wide DNA methylation association studies for this early-life exposure. Using secondary data from two population-based methylation profiling studies, our DNA methylation score is based on CpG DNA methylation measurements from cord blood gathered from children whose fathers smoked pre- and peri-conceptually. Each child’s mother and father fell into one of three class labels in the accompanying questionnaires -never smoker, former smoker, or current smoker. By applying different machine learning algorithms to the accessible resource for integrated epigenomic studies (ARIES) sub-study of the Avon longitudinal study of parents and children (ALSPAC) data set, which we used for training and testing of our model, the best-performing algorithm for classifying the father smoker and mother never smoker was selected based on Cohen’s κ. Error in the model was identified and optimized. The final DNA methylation score was further tested and validated in an independent data set. This resulted in a linear combination of methylation values of selected probes via a logistic link function that accurately classified each group and contributed the most towards classification. The result is a unique, robust DNA methylation score which combines information on DNA methylation and early life exposure of offspring to paternal smoking during pregnancy and which may be used to examine the paternal contribution to offspring health outcomes.

Keywords: epigenome, health outcomes, paternal preconception environmental exposures, supervised machine learning

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23 The Effect of the Base Computer Method on Repetitive Behaviors and Communication Skills

Authors: Hoorieh Darvishi, Rezaei

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Introduction: This study investigates the efficacy of computer-based interventions for children with Autism Spectrum Disorder , specifically targeting communication deficits and repetitive behaviors. The research evaluates novel software applications designed to enhance narrative capabilities and sensory integration through structured, progressive intervention protocols Method: The study evaluated two intervention software programs designed for children with autism, focusing on narrative speech and sensory integration. Twelve children aged 5-11 participated in the two-month intervention, attending three 45-minute weekly sessions, with pre- and post-tests measuring speech, communication, and behavioral outcomes. The narrative speech software incorporated 14 stories using the Cohen model. It progressively reduced software assistance as children improved their storytelling abilities, ultimately enabling independent narration. The process involved story comprehension questions and guided story completion exercises. The sensory integration software featured approximately 100 exercises progressing from basic classification to complex cognitive tasks. The program included attention exercises, auditory memory training (advancing from single to four-syllable words), problem-solving, decision-making, reasoning, working memory, and emotion recognition activities. Each module was accompanied by frequency and pitch-adjusted music that child enjoys it to enhance learning through multiple sensory channels (visual, auditory, and tactile). Conclusion: The results indicated that the use of these software programs significantly improved communication and narrative speech scores in children, while also reducing scores related to repetitive behaviors. Findings: These findings highlight the positive impact of computer-based interventions on enhancing communication skills and reducing repetitive behaviors in children with autism.

Keywords: autism, communication_skills, repetitive_behaviors, sensory_integration

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22 The Effect of the Base Computer Method on Repetitive Behaviors and Communication Skills

Authors: Hoorieh Darvishi, Rezaei

Abstract:

Introduction: This study investigates the efficacy of computer-based interventions for children with Autism Spectrum Disorder , specifically targeting communication deficits and repetitive behaviors. The research evaluates novel software applications designed to enhance narrative capabilities and sensory integration through structured, progressive intervention protocols Method: The study evaluated two intervention software programs designed for children with autism, focusing on narrative speech and sensory integration. Twelve children aged 5-11 participated in the two-month intervention, attending three 45-minute weekly sessions, with pre- and post-tests measuring speech, communication, and behavioral outcomes. The narrative speech software incorporated 14 stories using the Cohen model. It progressively reduced software assistance as children improved their storytelling abilities, ultimately enabling independent narration. The process involved story comprehension questions and guided story completion exercises. The sensory integration software featured approximately 100 exercises progressing from basic classification to complex cognitive tasks. The program included attention exercises, auditory memory training (advancing from single to four-syllable words), problem-solving, decision-making, reasoning, working memory, and emotion recognition activities. Each module was accompanied by frequency and pitch-adjusted music that child enjoys it to enhance learning through multiple sensory channels (visual, auditory, and tactile). Conclusion: The results indicated that the use of these software programs significantly improved communication and narrative speech scores in children, while also reducing scores related to repetitive behaviors. Findings: These findings highlight the positive impact of computer-based interventions on enhancing communication skills and reducing repetitive behaviors in children with autism.

Keywords: autism, narrative speech, persian, SI, repetitive behaviors, communication

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21 The Fidget Widget Toolkit: A Positive Intervention Designed and Evaluated to Enhance Wellbeing for People in the Later Stage of Dementia

Authors: Jane E. Souyave, Judith Bower

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This study is an ongoing collaborative project between the University of Central Lancashire and the Alzheimer’s Society to design and test the idea of using interactive tools for a person living with dementia and their carers. It is hoped that the tools will fulfill the possible needs of engagement and interaction as dementia progresses, therefore enhancing wellbeing and improving quality of life for the person with dementia and their carers. The project was informed by Kitwood’s five psychological needs for producing wellbeing and explored evidence that fidgeting is often seen as a form of agitation and a negative symptom of dementia. Although therapy for agitation may be well established, there is a lack of appropriate items aimed at people in the later stage of dementia, that are not childlike or medical in their aesthetic. Individuals may fidget in a particular way and the tools in the Fidget Widget Toolkit have been designed to encourage repetitive movements of the hand, specifically to address the abilities of people with relatively advanced dementia. As an intervention, these tools provided a new approach that had not been tested in dementia care. Prototypes were created through an iterative design process and tested with a number of people with dementia and their carers, using quantitative and qualitative methods. Dementia Care Mapping was used to evaluate the impact of the intervention in group settings. Cohen Mansfield’s Agitation Inventory was used to record the daily use and interest of the intervention for people in their usual place of residence. The results informed the design of a new set of devices to promote safe, stigma free fidgeting as a positive experience, meaningful activity and enhance wellbeing for people in the later stage of dementia. The outcomes addressed the needs of individuals by reducing agitation and restlessness through helping them to connect, engage and act independently, providing the means of doing something for themselves that they were able to do. The next stage will be to explore the commercial feasibility of the Fidget Widget Toolkit so that it can be introduced as good practice and innovation in dementia care. It could be used by care homes, with carers and their families to support wellbeing and lead the way in providing some positive experiences and person-centred approaches that are lacking in the later stage of dementia.

Keywords: dementia, design, fidgeting, healthcare, positive moments, quality of life, wellbeing

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20 Dialectical Behavior Therapy in Managing Emotional Dysregulation, Depression, and Suicidality in Autism Spectrum Disorder Patients: A Systematic Review

Authors: Alvin Saputra, Felix Wijovi

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Background: Adults with Autism Spectrum Disorder (ASD) often experience emotional dysregulation and heightened suicidality. Dialectical Behavior Therapy (DBT) and Radically Open DBT (RO-DBT) have shown promise in addressing these challenges, though research on their effectiveness in ASD populations remains limited. This systematic review aims to evaluate the impact of DBT and RO-DBT on emotional regulation, depression, and suicidality in adults with ASD. Methods: A systematic review was conducted by searching databases such as PubMed, PsycINFO, and Scopus for studies published on DBT and RO-DBT interventions in adults with Autism Spectrum Disorder (ASD). Inclusion criteria were peer-reviewed studies that reported on emotional regulation, suicidality, or depression outcomes. Data extraction focused on sample characteristics, intervention details, and outcome measures. Quality assessment was performed using standard systematic review criteria to ensure reliability and relevance of findings. Results: 4 studies comprising a total of 343 participants were included in this study. DBT and RO-DBT interventions demonstrated a medium effect size (Cohen's d = 0.53) in improving emotional regulation for adults with ASD, with ASD participants achieving significantly better outcomes than non-ASD individuals. RO-DBT was particularly effective in reducing maladaptive overcontrol, though high attrition and a predominantly White British sample limited generalizability. At end-of-treatment, DBT significantly reduced suicidal ideation (z = −2.24; p = 0.025) and suicide attempts (z = −3.15; p = 0.002) compared to treatment as usual (TAU), although this effect did not sustain at 12 months. Depression severity decreased with DBT (z = −1.99; p = 0.046), maintaining significance at follow-up (z = −2.46; p = 0.014). No significant effects were observed for social anxiety, and two suicides occurred in the TAU group. Conclusions: DBT and RO-DBT show potential efficacy in reducing emotional dysregulation, suicidality, and depression in adults with ASD, though the effects on suicidality may diminish over time. High dropout rates and limited sample diversity suggest further research is needed to confirm long-term benefits and improve applicability across broader populations.

Keywords: dialectical behaviour therapy, emotional dysregulation, autism spectrum disorder, suicidality

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19 Non-Invasive Assessment of Peripheral Arterial Disease: Automated Ankle Brachial Index Measurement and Pulse Volume Analysis Compared to Ultrasound Duplex Scan

Authors: Jane E. A. Lewis, Paul Williams, Jane H. Davies

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Introduction: There is, at present, a clear and recognized need to optimize the diagnosis of peripheral arterial disease (PAD), particularly in non-specialist settings such as primary care, and this arises from several key facts. Firstly, PAD is a highly prevalent condition. In 2010, it was estimated that globally, PAD affected more than 202 million people and furthermore, this prevalence is predicted to further escalate. The disease itself, although frequently asymptomatic, can cause considerable patient suffering with symptoms such as lower limb pain, ulceration, and gangrene which, in worse case scenarios, can necessitate limb amputation. A further and perhaps the most eminent consequence of PAD arises from the fact that it is a manifestation of systemic atherosclerosis and therefore is a powerful predictor of coronary heart disease and cerebrovascular disease. Objective: This cross sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (i) ankle brachial index (ABI) and (ii) pulse volume waveform (PVW) recorded by the same automated device, with the presence or absence of peripheral arterial disease (PAD) being verified by an Ultrasound Duplex Scan (UDS). Methods: Patients (n = 205) referred for lower limb arterial assessment underwent an ABI and PVW measurement using volume plethysmography followed by a UDS. Presence of PAD was recorded for ABI if < 0.9 (noted if > 1.30) if PVW was graded as 2, 3 or 4 or a hemodynamically significant stenosis > 50% with UDS. Outcome measure was agreement between measured ABI and interpretation of the PVW for PAD diagnosis, using UDS as the reference standard. Results: Sensitivity of ABI was 80%, specificity 91%, and overall accuracy 88%. Cohen’s kappa revealed good agreement between ABI and UDS (k = 0.7, p < .001). PVW sensitivity 97%, specificity 81%, overall accuracy 84%, with a good level of agreement between PVW and UDS (k = 0.67, p < .001). The combined sensitivity of ABI and PVW was 100%, specificity 76%, and overall accuracy 85% (k = 0.67, p < .001). Conclusions: Combing these two diagnostic modalities within one device provided a highly accurate method of ruling out PAD. Such a device could be utilized within the primary care environment to reduce the number of unnecessary referrals to secondary care with concomitant cost savings, reduced patient inconvenience, and prioritization of urgent PAD cases.

Keywords: ankle brachial index, peripheral arterial disease, pulse volume waveform, ultrasound duplex scan

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18 The Relationship Between Weight Gain, Cyclicality of Diabetologic Education and the Experienced Stress: A Study Involving Pregnant Women

Authors: Agnieszka Rolinska, Marta Makara-Studzinska

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Introduction: In recent years, there has been an intensive development of research into the physiological relationships between the experienced stress and obesity. Moreover, strong chronic stress leads to the disorganization of a person’s activeness on various levels of functioning, including the behavioral and cognitive sphere (also in one’s diet). Aim: The present work addresses the following research questions: Is there a relationship between an increase in stress related to the disease and the need for the cyclicality of diabetologic education in gestational diabetes? Are there any differences in terms of the experienced stress during the last three months of pregnancy in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Are there any differences in terms of stress coping styles in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Method: The study involved pregnant women with gestational diabetes (treated with diet, without insulin therapy) and in normal pregnancy – 206 women in total. The following psychometric tools were employed: Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein), Coping Inventory for Stressful Situations (CISS; Endler, Parker) and authors’ own questionnaire. Gestational diabetes mellitus was diagnosed on the basis of the results of fasting oral glucose tolerance test (75 g OGTT). Body weight measurements were confirmed in a diagnostic interview, taking into account medical data. Regularities in weight gains in pregnancy were determined according to the recommendations of the Polish Gynecological Society and American norms determined by the Institute of Medicine (IOM). Conclusions: An increase in stress related to the disease varies in patients with differing requirements for the cyclical nature of diabetologic education (i.e. education which is systematically repeated). There are no differences in terms of recently experienced stress and stress coping styles between women with gestational diabetes and those in normal pregnancy. There is a relationship between weight gains in pregnancy and the stress experienced in life as well as stress coping styles – both in pregnancy complicated by diabetes and in physiological pregnancy. In the discussion of the obtained results, the authors refer to scientific reports from English-language magazines of international range.

Keywords: diabetologic education, gestational diabetes, stress, weight gain in pregnancy

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17 Teachers' Design and Implementation of Collaborative Learning Tasks in Higher Education

Authors: Bing Xu, Kerry Lee, Jason M. Stephen

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Collaborative learning (CL) has been regarded as a way to facilitate students to gain knowledge and improve social skills. In China, lecturers in higher education institutions have commonly adopted CL in their daily practice. However, such a strategy could not be effective when it is designed and applied in an inappropriate way. Previous research hardly focused on how CL was applied in Chinese universities. This present study aims to gain a deep understanding of how Chinese lecturers design and implement CL tasks. The researchers interviewed ten lecturers from different faculties in various universities in China and usedGroup Learning Activity Instructional Design (GLAID) framework to analyse the data. We found that not all lecturers pay enough attention to eight essential components (proposed by GLAID) when they designed CL tasks, especially the components of Structure and Guidance. Meanwhile, only a small part of lecturers made formative assessment to help students improve learning. We also discuss the strengths and limitations and CL design and further provide suggestions to the lecturers who intend to use CL in class. Research Objectives: The aims of the present research are threefold. We intend to 1) gain a deep understanding of how Chinese lecturers design and implement collaborative learning (CL) tasks, 2) find strengths and limitations of CL design in higher education, and 3) give suggestions about how to improve the design and implement. Research Methods: This research adopted qualitative methods. We applied the semi-structured interview method to interview ten Chinese lecturers about how they designed and implemented CL tasks in their courses. There were 9 questions in the interview protocol focusing on eight components of GLAID. Then, underpinning the GLAID framework, we utilized the coding reliability thematic analysis method to analyse the research data. The coding work was done by two PhD students whose research fields are CL, and the Cohen’s Kappa was 0.772 showing the inter-coder reliability was good. Contribution: Though CL has been commonly adopted in China, few studies have paid attention to the details about how lecturers designed and implemented CL tasks in practice. This research addressed such a gap and found not lecturers were aware of how to design CL and felt it difficult to structure the task and guide the students on collaboration, and further ensure student engagement in CL. In summary, this research advocates for teacher training; otherwise, students may not gain the expected learning outcomes.

Keywords: collaborative learning, higher education, task design, GLAID framework

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16 Histological Grade Concordance between Core Needle Biopsy and Corresponding Surgical Specimen in Breast Carcinoma

Authors: J. Szpor, K. Witczak, M. Storman, A. Orchel, D. Hodorowicz-Zaniewska, K. Okoń, A. Klimkowska

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Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease. In comparison to fine needle aspiration (FNA), CNB provides more architectural information allowing for the evaluation of prognostic and predictive factors for breast cancer, including histological grade—one of three prognostic factors used to calculate the Nottingham Prognostic Index. Several studies have previously described the concordance rate between CNB and surgical excision specimen in determination of histological grade (HG). The concordance rate previously ascribed to overall grade varies widely across literature, ranging from 59-91%. The aim of this study is to see how the data looks like in material at authors’ institution and are the results as compared to those described in previous literature. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. Both materials were evaluated for the determination of histological grade (scale from 1 to 3). HG was assessed only in core needle biopsies containing at least 10 well preserved HPF with invasive tumor. The degree of concordance between CNB and surgical excision specimen for the determination of tumor grade was assessed by Cohen’s kappa coefficient. The level of agreement between core needle biopsy and surgical resection specimen for overall histologic grading was 73% (113 of 155 cases). CNB correctly predicted the grade of the surgical excision specimen in 21 cases for grade 1 tumors (Kappa coefficient κ = 0.525 95% CI (0.3634; 0.6818), 52 cases for grade 2 (Kappa coefficient κ = 0.5652 95% CI (0.458; 0.667) and 40 cases for stage 3 tumors (Kappa coefficient κ = 0.6154 95% CI (0.4862; 0.7309). The highest level of agreement was observed in grade 3 malignancies. In 9 of 42 (21%) discordant cases, the grade was higher in the CNB than in the surgical excision. This composed 6% of the overall discordance. These results correspond to the noted in the literature, showing that underestimation occurs more frequently than overestimation. This study shows that authors’ institution’s histologic grading of CNBs and surgical excisions shows a fairly good correlation and is consistent with findings in previous reports. Despite the inevitable limitations of CNB, CNB is an effective method for diagnosing breast cancer and managing treatment options. Assessment of tumour grade by CNB is useful for the planning of treatment, so in authors’ opinion it is worthy to implement it in daily practice.

Keywords: breast cancer, concordance, core needle biopsy, histological grade

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