Search results for: modified Ashworth scale

Authors: E. Von Cheong, Carol Sinnott, Darren Dahly, Patricia M. Kearney

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Introduction and Aim: Adverse childhood experiences (ACEs) are all too common and have been linked to poorer health and wellbeing across the life course. While the prevention of ACEs is a worthy goal, it is important that we also try to lessen the impact of ACEs for those who do experience them. This study aims to investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. Method: We analysed baseline data from the Mitchelstown (Ireland) 2010-11 cohort involving 2047 men and women aged 50–69 years. Self-reported assessments included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale), and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by the subtypes abuse, neglect, and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors that were selected using the Directed Acyclic Graph (DAG) approach. We also tested whether the estimated associations varied across levels of PSS (poor, moderate, and good). Results: 23.7% of participants reported at least one ACE (95% CI: 21.9% to 25.6%). ACE exposures (overall or subtype) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. For example, exposure to any ACE (vs. none) was associated with 3 times the odds of depressive symptoms (Adjusted OR 2.97; 95% CI 1.63 to 5.40) among individuals reporting poor PSS, while among those reporting moderate PSS, the adjusted OR was 1.18 (95% CI 0.72 to 1.94). Discussion: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms among those also reporting poor PSS. Interventions that enhance perception of social support following ACE exposure may help reduce the burden of depression in older populations.

Keywords: adverse childhood experiences, depression, later-life, perceived social support

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Authors: Ayse Ozbil, Gorsev Argin, Demet Yesiltepe

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Data for this cross-sectional study were drawn from questionnaires conducted in 10 elementary schools (1000 students, ages 12-14) located in Istanbul, Turkey. School environments (1600 meter buffers around the school) were evaluated through GIS-based land-use data (parcel level land use density) and street-level topography. Street networks within the same buffers were evaluated by using angular segment analysis (Integration and Choice) implemented in Depthmap as well as two segment-based connectivity measures, namely Metric and Directional Reach implemented in GIS. Segment Angular Integration measures how accessible each space from all the others within the radius using the least angle measure of distance. Segment Angular Choice which measures how many times a space is selected on journeys between all pairs of origins and destinations. Metric Reach captures the density of streets and street connections accessible from each individual road segment. Directional Reach measures the extent to which the entire street network is accessible with few direction changes. In addition, socio-economic characteristics (annual income, car ownership, education-level) of parents, obtained from parental questionnaires, were also included in the analysis. It is shown that surrounding street network configuration is strongly associated with both walk-mode shares and average walking distances to/from schools when controlling for parental socio-demographic attributes as well as land-use compositions and topographic features in school environments. More specifically, findings suggest that the scale at which urban form has an impact on pedestrian travel is considerably larger than a few blocks around the school.

Keywords: Istanbul, street network layout, urban form, walking to/from school

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Authors: Sweeti, Anoop Kant Godiyal, Neha Singh, Sneh Anand, B. K. Panigrahi, Jayasree Santhosh

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This work is about developing a tool for visualization and segmentation of Electroencephalograph (EEG) signals based on frequency domain features. Change in the frequency domain characteristics are correlated with change in mental state of the subject under study. Proposed algorithm provides a way to represent the change in the mental states using the different frequency band powers in form of segmented EEG signal. Many segmentation algorithms have been suggested in literature having application in brain computer interface, epilepsy and cognition studies that have been used for data classification. But the proposed method focusses mainly on the better presentation of signal and that’s why it could be a good utilization tool for clinician. Algorithm performs the basic filtering using band pass and notch filters in the range of 0.1-45 Hz. Advanced filtering is then performed by principal component analysis and wavelet transform based de-noising method. Frequency domain features are used for segmentation; considering the fact that the spectrum power of different frequency bands describes the mental state of the subject. Two sliding windows are further used for segmentation; one provides the time scale and other assigns the segmentation rule. The segmented data is displayed second by second successively with different color codes. Segment’s length can be selected as per need of the objective. Proposed algorithm has been tested on the EEG data set obtained from University of California in San Diego’s online data repository. Proposed tool gives a better visualization of the signal in form of segmented epochs of desired length representing the power spectrum variation in data. The algorithm is designed in such a way that it takes the data points with respect to the sampling frequency for each time frame and so it can be improved to use in real time visualization with desired epoch length.

Keywords: de-noising, multi-channel data, PCA, power spectra, segmentation

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Authors: Nayak Amar, Turner Naomi, Gobina Edward

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The Scottish Higher Education Institutes must report their scope 1 & 2 emissions, whereas reporting scope 3 is optional. Scope 3 is indirect emissions which embodies a significant component of total carbon footprint and therefore it is important to record, measure and report it accurately. Robert Gordon University (RGU) reported only business travel, grid transmission and distribution, water supply and transport, and recycling scope 3 emissions. This study estimates the RGUs total scope 3 emissions by comparing it with a similar HEI in scale. The scope 3 emission reporting of sixteen Scottish HEI was studied. Glasgow Caledonian University was identified as the nearest neighbour by comparing its students' full time equivalent, staff full time equivalent, research-teaching split, budget, and foundation year. Apart from the peer, data was also collected from the Higher Education Statistics Agency database. RGU reported emissions from business travel, grid transmission and distribution, water supply, and transport and recycling. This study estimated RGUs scope 3 emissions from procurement, student-staff commute, and international student trip. The result showed that RGU covered only 11% of the scope 3 emissions. The major contributor to scope 3 emissions were procurement (48%), student commute (21%), international student trip (16%), and staff commute (4%). The estimated scope 3 emission was more than 14 times the reported emissions. This study has shown the relative importance of each scope 3 emissions source, which gives a guideline for the HEIs, on where to focus their attention to capture maximum scope 3 emissions. Moreover, it has demonstrated that it is possible to estimate the scope 3 emissions with limited data.

Keywords: HEI, university, emission calculations, scope 3 emissions, emissions reporting

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Authors: Khiari Nor El Houda, Hiouani Amira Sarra

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Many EFL students with high capacities are hidden because they suffer from speaking anxiety (SA). Most of them find public speaking much demanding. They feel unable to communicate, they fear to make mistakes and they fear negative evaluation or being called on. With the growing number of the learners who suffer from foreign language speaking anxiety (FLSA), it is becoming increasingly difficult to ignore its harmful outcomes on their performance and success, especially during their first contact with the pupils, as they will be teaching in the near future. Different researchers suggested different ways to minimize the negative effects of FLSA. The present study sheds light on emotional intelligence skills training as an effective strategy not only to influence public speaking success but also to help pre-service EFL teachers lessen their speaking anxiety and eventually to prepare them for their professional career. A quasi-experiment was used in order to examine the research hypothesis. We worked with two groups of third-year EFL students at Oum El Bouaghi University. The Foreign Language Classroom Anxiety Scale (FLCAS) and the Emotional Quotient Inventory (EQ-i) were used to collect data about the participants’ FLSA and EI levels. The analysis of the data has yielded that the assumption that there is a negative correlation between EI and FLSA was statistically validated by the Pearson Correlation Test, concluding that, the more emotionally intelligent the individual is the less anxious s/he will be. In addition, the lack of amelioration in the results of the control group and the noteworthy improvement in the experimental group results led us to conclude that EI skills training was an effective strategy in minimizing the FLSA level and therefore, we confirmed our research hypothesis.

Keywords: emotional intelligence, emotional intelligence skills training, EQ-I, FLCAS, foreign language speaking anxiety, pre-service EFL teachers

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Authors: Khairul Abid Awang

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Happiness and life satisfaction are the vital components in assessing the well-being of the societies and their social progress. These components varies and changes within communities and across time. Thus, due to low level of happiness and life satisfaction, it might affect mental health status psychologically and generally disrupt the health pattern of the individual. Hence, this present study aims to identify the happiness determinants, assessing the happiness and life satisfaction level, as well as examine the relation between happiness among Kampung Jaya Bakti adult community. Quantitative and cross-sectional study with total of 100 observations of 18 years old and above was participated in this study. The study was done in a semi-rural village which is geocentric towards river that branched from South East Asia Sea. Several happiness and life satisfaction instruments was used, inclusive of Individual Determinants of Happiness Scale (IDoHS) that had been developed in this study, in order to identify the determinants of happiness in the area based on the listed determinants. The listed determinants in IDoHS are: i) Daily activities. ii) Adaptation. iii) Goals. iv) Life Events. v) Living condition. vi) Self-confidence. vii) Personality traits. viii) Religion. The results revealed that 98% of the respondents agreed that the listed determinants in IDoHS are statistically significant in determining the happiness. The happiness level revealed that 71 percent (%) of the respondents are ‘very happy’, followed by 26% (‘moderately happy’) and 3% (‘neutral’), while life satisfaction level revealed that 70% of the respondents are ‘very highly satisfied’, followed by 29% (‘highly satisfied’) and 1% (‘moderately satisfied’). Pearson Correlation (Pearson’s r) shows that; happiness determinants listed in IDoHS are affecting happiness level (Pearson’s r: .514, p < 0.01) and life satisfaction level (Pearson’s r: .504, p < 0.01) respectively, as well as happiness that are statistically significant in affecting life satisfaction (Pearson’s r: .653, p < 0.01; Pearson’s r; .546, p < 0.01). It is concluded that the listed determinants in IDoHS are the determinants that affecting happiness and it is also noted that happiness are affecting life satisfaction and vice versa.

Keywords: adult community, determinants, happiness, life satisfaction, subjective well-being

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Authors: Kaiwen Zheng, Wanting Zhou, Nan Tang, Lei Li, Yuanhang He

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The integrated circuit industry has become a cornerstone of the information society, finding widespread application in areas such as industry, communication, medicine, and aerospace. However, with the increasing complexity of integrated circuits, Hardware Trojans (HTs) implanted by attackers have become a significant threat to their security. In this paper, we proposed a hardware trojan detection method for large-scale circuits. As HTs introduce physical characteristic changes such as structure, area, and power consumption as additional redundant circuits, we proposed a machine-learning-based hardware trojan detection method based on the physical characteristics of gate-level netlists. This method transforms the hardware trojan detection problem into a machine-learning binary classification problem based on physical characteristics, greatly improving detection speed. To address the problem of imbalanced data, where the number of pure circuit samples is far less than that of HTs circuit samples, we used the SMOTETomek algorithm to expand the dataset and further improve the performance of the classifier. We used three machine learning algorithms, K-Nearest Neighbors, Random Forest, and Support Vector Machine, to train and validate benchmark circuits on Trust-Hub, and all achieved good results. In our case studies based on AES encryption circuits provided by trust-hub, the test results showed the effectiveness of the proposed method. To further validate the method’s effectiveness for detecting variant HTs, we designed variant HTs using open-source HTs. The proposed method can guarantee robust detection accuracy in the millisecond level detection time for IC, and FPGA design flows and has good detection performance for library variant HTs.

Keywords: hardware trojans, physical properties, machine learning, hardware security

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Authors: Choki, Supatchai Boonpratham, Suwannee Luppanapornlarp

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The objective of this study was to find a correlation between cephalometric measurements and visual perception of facial profile in skeletal type II patients. In this study, 250 lateral cephalograms of female patients from age, 20 to 22 years were analyzed. The profile outlines of all the samples were hand traced and transformed into silhouettes by the principal investigator. Profile ratings were done by 9 orthodontists on Visual Analogue Scale from score one to ten (increasing level of convexity). 37 hard issue and soft tissue cephalometric measurements were analyzed by the principal investigator. All the measurements were repeated after 2 weeks interval for error assessment. At last, the rankings of visual perceptions were correlated with cephalometric measurements using Spearman correlation coefficient (P < 0.05). The results show that the increase in facial convexity was correlated with higher values of ANB (A point, nasion and B point), AF-BF (distance from A point to B point in mm), L1-NB (distance from lower incisor to NB line in mm), anterior maxillary alveolar height, posterior maxillary alveolar height, overjet, H angle hard tissue, H angle soft tissue and lower lip to E plane (absolute correlation values from 0.277 to 0.711). In contrast, the increase in facial convexity was correlated with lower values of Pg. to N perpendicular and Pg. to NB (mm) (absolute correlation value -0.302 and -0.294 respectively). From the soft tissue measurements, H angles had a higher correlation with visual perception than facial contour angle, nasolabial angle, and lower lip to E plane. In conclusion, the findings of this study indicated that the correlation of cephalometric measurements with visual perception was less than expected. Only 29% of cephalometric measurements had a significant correlation with visual perception. Therefore, diagnosis based solely on cephalometric analysis can result in failure to meet the patient’s esthetic expectation.

Keywords: cephalometric measurements, facial profile, skeletal type II, visual perception

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Authors: Agnieszka Markowska-Radomska, Ewa Dluska

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Maintaining a bioactive substances dense diet is important for the elderly, especially to prevent diseases and to support healthy ageing. Adequate bioactive substances intake can reduce the risk of developing chronic diseases (e.g. cardiovascular, osteoporosis, neurodegenerative syndromes, diseases of the oral cavity, gastrointestinal (GI) disorders, diabetes, and cancer). This can be achieved by introducing a comprehensive supplementation of components necessary for the proper functioning of the ageing body. The paper proposes the multiple emulsions of the W1/O/W2 (water-in-oil-in-water) type as carriers for effective co-encapsulation and co-delivery of bioactive substances in supplementation of the elderly. Multiple emulsions are complex structured systems ("drops in drops"). The functional structure of the W1/O/W2 emulsion enables (i) incorporation of one or more bioactive components (lipophilic and hydrophilic); (ii) enhancement of stability and bioavailability of encapsulated substances; (iii) prevention of interactions between substances, as well as with the external environment, delivery to a specific location; and (iv) release in a controlled manner. The multiple emulsions were prepared by a one-step method in the Couette-Taylor flow (CTF) contactor in a continuous manner. In general, a two-step emulsification process is used to obtain multiple emulsions. The paper contains a proposal of emulsion functionalization by introducing pH-responsive biopolymer—carboxymethylcellulose sodium salt (CMC-Na) to the external phase, which made it possible to achieve a release of components controlled by the pH of the gastrointestinal environment. The membrane phase of emulsions was soybean oil. The W1/O/W2 emulsions were evaluated for their characteristics (drops size/drop size distribution, volume packing fraction), encapsulation efficiency and stability during storage (to 30 days) at 4ºC and 25ºC. Also, the in vitro multi-substance co-release process were investigated in a simulated gastrointestinal environment (different pH and composition of release medium). Three groups of stable multiple emulsions were obtained: emulsions I with co-encapsulated vitamins B12, B6 and resveratrol; emulsions II with vitamin A and β-carotene; and emulsions III with vitamins C, E and D3. The substances were encapsulated in the appropriate emulsion phases depending on the solubility. For all emulsions, high encapsulation efficience (over 95%) and high volume packing fraction of internal droplets (0.54-0.76) were reached. In addition, due to the presence of a polymer (CMC-Na) with adhesive properties, high encapsulation stability during emulsions storage were achieved. The co-release study of encapsulated bioactive substances confirmed the possibility to modify the release profiles. It was found that the releasing process can be controlled through the composition, structure, physicochemical parameters of emulsions and pH of the release medium. The results showed that the obtained multiple emulsions might be used as potential liquid complex carriers for controlled/modified/site-specific co-delivery of bioactive substances in dietary supplementation in the elderly.

Keywords: bioactive substance co-release, co-encapsulation, elderly supplementation, multiple emulsion

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Authors: Ayodele James Akinola

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This study investigated the use of English in doctor-patient interaction in a university teaching hospital from a southwestern state in Nigeria with the aim of identifying the role of communication in an L2, patterns of communication, discourse strategies, pragmatic acts, and contexts that shape the interaction. Jacob Mey’s Pragmatic Acts notion complemented with Emanuel and Emanuel’s model of doctor-patient relationship provided the theoretical standpoint. Data comprising 7 audio-recorded doctors-patient interactions were collected from a University Hospital in Oyo state, Nigeria. Interactions involving the use of English language were purposefully selected. These were supplemented with patients’ case notes and interviews conducted with doctors. Transcription was patterned alongside modified Arminen’s notations of conversation analysis. In the study, interaction in English between doctor and patients has the preponderance of direct-translation, code-mixing and switching, Nigerianism and use of cultural worldviews to express medical experience. Irrespective of these, three patterns communication, namely the paternalistic, interpretive, and deliberative were identified. These were exhibited through varying discourse strategies. The paternalistic model reflected slightly casual conversational conventions and registers. These were achieved through the pragmemic activities of situated speech acts, psychological and physical acts, via patients’ quarrel-induced acts, controlled and managed through doctors’ shared situation knowledge. All these produced empathising, pacifying, promising and instructing practs. The patients’ practs were explaining, provoking, associating and greeting in the paternalistic model. The informative model reveals the use of adjacency pairs, formal turn-taking, precise detailing, institutional talks and dialogic strategies. Through the activities of the speech, prosody and physical acts, the practs of declaring, alerting and informing were utilised by doctors, while the patients exploited adapting, requesting and selecting practs. The negotiating conversational strategy of the deliberative model featured in the speech, prosody and physical acts. In this model, practs of suggesting, teaching, persuading and convincing were utilised by the doctors. The patients deployed the practs of questioning, demanding, considering and deciding. The contextual variables revealed that other patterns (such as phatic and informative) are also used and they coalesced in the hospital within the situational and psychological contexts. However, the paternalistic model was predominantly employed by doctors with over six years in practice, while the interpretive, informative and deliberative models were found among registrar and others below six years of medical practice. Doctors’ experience, patients’ peculiarities and shared cultural knowledge influenced doctor-patient communication in the study.

Keywords: pragmatics, communication pattern, doctor-patient interaction, Nigerian hospital situation

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Authors: Ruslin, R. E. Kartasasmita, M. S. Wibowo, S. Ibrahim

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An aphrodisiac is a substance contained in food or drug that can arouse sexual instinct and increase pleasure while working, these substances derived from plants, animals, and minerals. When consuming substances that have aphrodisiac activity and duration can improve the sexual instinct. The natural aphrodisiac effect can be obtained through plants, animals, and minerals. Leonurine compound has aphrodisiac activity, these compounds can be isolated from plants of Leonurus Sp, Sundanese people is known as deundereman, this plant is empirical has aphrodisiac activity and based on the isolation of active compounds from plants known to contain compounds leonurine, so that the compound is expected to have activity aphrodisiac. Leonurine compound can be isolated from plants or synthesized chemically with material dasa siringat acid. Leonurine compound can be obtained commercial and derivatives of these compounds can be synthesized in an effort to increase its activity. This study aims to obtain derivatives leonurine better aphrodisiac activity compared with the parent compound, modified the structure of the compounds in the form leonurin guanidino butyl ester group with butyl amin and bromoetanol. ArgusLab program version 4.0.1 is used to determine the binding energy, hydrogen bonds and amino acids involved in the interaction of the compound PDE5 receptor. The in vivo test leonurine compounds and derivatives as an aphrodisiac ingredients and hormone testosterone levels using 27 male rats Wistar strain and 9 female mice of the same species, ages ranged from 12 weeks rats weighing + 200 g / tail. The test animal is divided into 9 groups according to the type of compounds and the dose given. Each treatment group was orally administered 2 ml per day for 5 days. On the sixth day was observed male rat sexual behavior and taking blood from the heart to measure testosterone levels using ELISA technique. Statistical analysis was performed in this study is the ANOVA test Least Square Differences (LSD) using the program Statistical Product and Service Solutions (SPSS). Aphrodisiac efficacy of the leonurine compound and its derivatives have proven in silico and in vivo test, the in silico testing leonurine derivatives have smaller binding energy derivatives leonurine so that activity better than leonurine compounds. Testing in vivo using rats of wistar strain that better leonurine derivative of this compound shows leonurine that in silico studies in parallel with in vivo tests. Modification of the structure in the form of guanidine butyl ester group with butyl amin and bromoethanol increase compared leonurine compound for aphrodisiac activity, testosterone derivatives of compounds leonurine experienced a significant improvement especial is 1RD compounds especially at doses of 100 and 150 mg/bb. The results showed that the compound leonurine and its compounds contain aphrodisiac activity and increase the amount of testosterone in the blood. The compound test used in this study acts as a steroid precursor resulting in increased testosterone.

Keywords: aphrodisiac dysfunction erectile leonurine 1-RD 2-RD, dysfunction, erectile leonurine, 1-RD 2-RD

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Authors: Patricia Jayshree Jacob, Mas Jaffri Masarudinb, Mohd Zobir Hussein, Raha Abdul Rahim

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Iron based ferromagnetic nanoparticles (IONP) and silver nanostructures (AgNP) have found a wide range of application in antimicrobial therapy, cell targeting, and environmental applications. As such, the design of well-defined monodisperse IONPs and AgNPs have become an essential tool in nanotechnology. Fabrication of these nanostructures using conventional methods is not environmentally conducive and weigh heavily on energy and outlays. Selected microorganisms possess the innate ability to reduce metallic ions in colloidal aqueous solution to generate nanoparticles. Hence, harnessing this potential is a way forward in constructing microbial nano-factories, capable of churning out high yields of well-defined IONP’s and AgNP's with physicochemical characteristics on par with the best synthetically produced nanostructures. In this paper, we report the isolation and characterization of bacterial strains isolated from the tropical marine and freshwater ecosystems of Malaysia that demonstrated facile and rapid generation of ferromagnetic nanoparticles and silver nanostructures when precursors such as FeCl₃.6H₂O and AgNO₃ were added to the cell-free bacterial lysate in colloidal solution. Characterization of these nanoparticles was carried out using FESEM, UV Spectrophotometer, XRD, DLS and FTIR. This aerobic bioprocess was carried out at ambient temperature and humidity and has the potential to be developed for environmental friendly, cost effective large scale production of IONP’s. A preliminary bioprocess study on the harvesting time, incubation temperature and pH was also carried out to determine pertinent abiotic parameters contributing to the optimal production of these nanostructures.

Keywords: iron oxide nanoparticles, silver nanoparticles, biosynthesis, aquatic bacteria

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Authors: Hachaichi Mohamed Nour El-Islem, Baouni Tahar

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Environmental sustainability rather than a trans-disciplinary and a scientific issue, is the main problem that characterizes all modern cities nowadays. In developing countries, this concern is expressed in a plethora of critical urban ills: traffic congestion, air pollution, noise, urban decay, increase in energy consumption and CO₂ emissions which blemish cities’ landscape and might threaten citizens’ health and welfare. As in the same manner as developing world cities, the rapid growth of Algiers’ human population and increasing in city scale phenomena lead eventually to increase in daily trips, energy consumption and CO₂ emissions. In addition, the lack of proper and sustainable planning of the city’s infrastructure is one of the most relevant issues from which Algiers suffers. The aim of this contribution is to estimate the carbon deficit of the City of Algiers, Algeria, using the Ecological Footprint Model (carbon footprint). In order to achieve this goal, the amount of CO₂ from fuel combustion has been calculated and aggregated into five sectors (agriculture, industry, residential, tertiary and transportation); as well, Algiers’ biocapacity (CO₂ uptake land) has been calculated to determine the ecological overshoot. This study shows that Algiers’ transport system is not sustainable and is generating more than 50% of Algiers total carbon footprint which cannot be sequestered by the local forest land. The aim of this research is to show that the Carbon Footprint Assessment might be a relevant indicator to design sustainable strategies/policies striving to reduce CO₂ by setting in motion the energy consumption in the transportation sector and reducing the use of fossil fuels as the main energy input.

Keywords: biocapacity, carbon footprint, ecological footprint assessment, energy consumption

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Authors: Yaofei Jiang, Liangqing Wang, Yanjun Xu

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In recent years, geological explorations have been carried out on the Rumei hydropower station, China. After preliminary analysis of results, the mainly problem of slope in reservoir area is about the stability of accumulation body. It is found that there are 23 accumulations in various sizes in the reservoir area, and most of them are unfavorable geological bodies. Three typical (No. 1, 7, 17) accumulation body slopes were selected as subjects to investigate the stability of the slopes. Take No. 1 accumulation body slope as an example and basic geological condition investigation and formation mechanism analysis were carried out to study the stability and geological analysis of engineering influence of the slope. The accumulation body in the research area distributes along the river with natural slope of 32° ~ 37° which is the natural angle of repose of gravel. The formation mechanism is analyzed based on the composition and structure of the accumulation body. The middle and lower part of the body is dense full of gravel soil mixed with a small amount of sand gravel which is stable. In the upper part, gravel soil is interbedded with bad cemented gravel which as a weak surface is not conducive to slope stability. Under the natural condition before storing water, the underground water level is deep buried, mainly distributed in the bedrock, and the surface and groundwater discharge conditions of the accumulation body are good, which is beneficial to the stability of slope. The safety coefficient calculated by the limit equilibrium method is 1.14, which indicates the slope is basically stable. However, the safety coefficient drops to 1.02 when the normal storage level is 2895m, which is in a dangerous state. The accumulation body will be destabilized by a small-area instability to large-scale or overall instability.

Keywords: accumulation body slope, stability evaluation, geological engineering investigation, effect of storing water

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Authors: Wern Lin Yeo, Choo Kim Tan, Sook Ling Lew

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Mathematics anxiety refers to the feeling of anxious when one having difficulties in solving mathematical problem. Mathematics anxiety is the most common type of anxiety among other types of anxiety which occurs among the students. However, level of anxiety among males and females are different. There were few past study were conducted to determine the relationship of anxiety and gender but there were still did not have an exact results. Hence, the purpose of this study is to determine the relationship of anxiety level between male and female undergraduates at a private university in Malaysia. Convenient sampling method used in this study in which the students were selected based on the grouping assigned by the faculty. There were 214 undergraduates who registered the probability courses had participated in this study. Mathematics Anxiety Rating Scale (MARS) was the instrument used in study which used to determine students’ anxiety level towards probability. Reliability and validity of instrument was done before the major study was conducted. In the major study, students were given briefing about the study conducted. Participation of this study were voluntary. Students were given consent form to determine whether they agree to participate in the study. Duration of two weeks were given for students to complete the given online questionnaire. The data collected will be analyzed using Statistical Package for the Social Sciences (SPSS) to determine the level of anxiety. There were three anxiety level, i.e., low, average and high. Students’ anxiety level were determined based on their scores obtained compared with the mean and standard deviation. If the scores obtained were below mean and standard deviation, the anxiety level was low. If the scores were at below and above the mean and between one standard deviation, the anxiety level was average. If the scores were above the mean and greater than one standard deviation, the anxiety level was high. Results showed that both of the gender were having average anxiety level. Males having high frequency of three anxiety level which were low, average and high anxiety level as compared to females. Hence, the mean values obtained for males (M = 3.62) was higher than females (M = 3.42). In order to be significant of anxiety level among the gender, the p-value should be less than .05. The p-value obtained in this study was .117. However, this value was greater than .05. Thus, there was no significant difference of anxiety level among the gender. In other words, there was no relationship of anxiety level with the gender.

Keywords: anxiety level, gender, mathematics anxiety, probability and statistics

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Authors: B. Niez, B. Moulia, J. Dlouha, E. Badel

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Trees adjust their development to the environmental conditions they experience. Storms events of last decades showed that acclimation of trees to mechanical stresses due to wind is a very important process that allows the trees to sustain for long years. In the future, trees will experience new wind patterns, namely, more often strong winds and fewer daily moderate winds. Moreover, these patterns will go along with drought periods that may interact with the capacity of trees to adjust their growth to mechanical stresses due to wind. It is necessary to understand the mechanisms of wood functional acclimations to environmental conditions in order to predict their behaviour and in order to give foresters and breeders the relevant tools to adapt their forest management. This work aims to study how trees adjust the mechanical and hydraulic functions of their wood to environmental stresses and how this acclimation may be beneficial for the tree to resist to future stresses. In this work, young poplars were grown under controlled climatic conditions that include permanent environmental stress (daily mechanical stress of the stem by bending and/or hydric stress). Then, the properties of wood formed under these stressed conditions were characterized. First, hydraulic conductivity and sensibility to cavitation were measured at the tissue level in order to evaluate the changes in water transport capacity. Secondly, bending tests and Charpy impact tests were carried out at the millimetric scale to locally measure mechanical parameters such as elastic modulus, elastic limit or rupture energy. These experimental data allow evaluating the impacts of mechanical and water stress on the wood material. At the stem level, they will be merged in an integrative model in order to evaluate the beneficial aspect of wood acclimation for trees.

Keywords: acclimation, environmental stresses, hydraulics, mechanics, wood

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Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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Authors: Xin Chen, Xiao Yang, Rongrong Han, Lu Chen, Lingling Gao

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Background: Leisure time physical activity (LTPA) benefits both pregnant women and their fetuses. The guidelines recommended that pregnant women should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week. The aim of this study was to investigate the rate of LTPA participation among Chinese pregnant women and to identify its predictors based on the health belief model. Methods: A cross-sectional study was conducted from June 2019 to September 2019 in Changchun, China. A total of 225 pregnant women aged 18 years or older with no severe physical or mental disease were recruited in the obstetric clinic. Self-administered questionnaires were used to collect data. LTPA was assessed by a pregnant physical activity questionnaire (PPAQ). A revised pregnancy physical activity health belief scale and social-demographic and perinatal characteristics factors were collected and used to predict LTPA participation. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: The participants had a high level of perceived susceptibility, perceived severity, perceived benefits, and action clues, with mean item scores above 3.5. The predictors of LTPA in Chinese pregnant women were pre-pregnancy exercise habits [OR 3.236 (95% CI:1.632, 6.416)], perceived susceptibility score [OR 2.083 (95% CI:1.002, 4.331)], and perceived barriers score [OR 3.113 (95%CI:1.462, 6.626)]. Conclusions: The results of this study will lead to better identification of pregnant women who may not participate in LTPA. Healthcare professionals should be cognizant of issues that may affect LTPA participation among pregnant women, including pre-pregnancy exercise habits, perceived susceptibility, and perceived barriers.

Keywords: pregnancy, health belief model., leisure time physical activity, factors

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Authors: Hirokatsu Kawashima

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One important element of teaching/learning listening is intensive listening such as listening for precise sounds, words, grammatical, and semantic units. Several classroom-based investigations have been conducted to explore the usefulness of auditory recognition of phonological, grammatical and semantic errors in such a context. The current study reports the results of one such investigation, which targeted auditory recognition of phonological, grammatical, and semantic errors at the sentence level. 56 Japanese EFL learners participated in this investigation, in which their recognition performance of phonological, grammatical and semantic errors was measured on a 9-point scale by learners’ self-evaluation from the perspective of 1) two types of similar English sound (vowel and consonant minimal pair words), 2) two types of sentence word order (verb phrase-based and noun phrase-based word orders), and 3) two types of semantic consistency (verb-purpose and verb-place agreements), respectively, and their general listening proficiency was examined using standardized tests. A number of findings have been made about the interactive relationships between the three types of auditory error recognition and general listening proficiency. Analyses based on the OPLS (Orthogonal Projections to Latent Structure) regression model have disclosed, for example, that the three types of auditory error recognition are linked in a non-linear way: the highest explanatory power for general listening proficiency may be attained when quadratic interactions between auditory recognition of errors related to vowel minimal pair words and that of errors related to noun phrase-based word order are embraced (R2=.33, p=.01).

Keywords: auditory error recognition, intensive listening, interaction, investigation

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Authors: Veysel Çelik, Aynur Aker, Ebru Güç

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Developments in information and communication technologies have increased both the speed of producing information and the speed of accessing new information. Accordingly, the daily lives of individuals have started to change. New concepts such as e-mail, e-government, e-school, e-signature have emerged. For this reason, prospective teachers who will be future teachers or school administrators are expected to have a high awareness of digital data security. The aim of this study is to reveal the effect of the digital storytelling technique on the data security awareness of pre-service teachers of computer and instructional technology education departments. For this purpose, participants were selected based on the principle of volunteering among third-grade students studying at the Computer and Instructional Technologies Department of the Faculty of Education at Siirt University. In the research, the pretest/posttest half experimental research model, one of the experimental research models, was used. In this framework, a 6-week lesson plan on digital data security awareness was prepared in accordance with the digital narration technique. Students in the experimental group formed groups of 3-6 people among themselves. The groups were asked to prepare short videos or animations for digital data security awareness. The completed videos were watched and evaluated together with prospective teachers during the evaluation process, which lasted approximately 2 hours. In the research, both quantitative and qualitative data collection tools were used by using the digital data security awareness scale and the semi-structured interview form consisting of open-ended questions developed by the researchers. According to the data obtained, it was seen that the digital storytelling technique was effective in creating data security awareness and creating permanent behavior changes for computer and instructional technology students.

Keywords: digital storytelling, self-regulation, digital data security, teacher candidates, self-efficacy

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Authors: Hong Beom Hur

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Politics in America is polarized. The best illustration of this is the 2016 presidential election result map. States with megacities like California, New York, Illinois, Virginia, and others are marked blue to signify the color of the Democratic party. States located in inland and south like Texas, Florida, Tennesse, Kansas and others are marked red to signify the color of the Republican party. Such a stark difference between two colors, red and blue, combined with geolocations of each state with their borderline remarks one central message; America is divided into two colors between urban Democrats and rural Republicans. This paper seeks to defy the visualization by pointing out its limitations and search for alternative ways to visualize the 2016 election result. One such limitation is that geolocations of each state and state borderlines limit the visualization of population density. As a result, the election result map does not convey the fact that Clinton won the popular vote and only accentuates the voting patterns of urban and rural states. The paper seeks whether an alternative narrative can be observed by factoring in the population number into the size of each state and manipulating the state borderline according to the normalization. Yet another alternative narrative may be reached by factoring the size of each state by the number of the electoral college of each state by voting and visualize the number. Other alternatives will be discussed but are not implemented in visualization. Such methods include dividing the land of America into about 120 million cubes each representing a voter or by the number of whole population 300 million cubes. By exploring these alternative methods to visualize the politics of the 2016 election map, the public may be able to question whether it is possible to be free from the narrative of the divide-conquer when interpreting the election map and to look at both parties as a story of the United States of America.

Keywords: 2016 U.S. presidential election, data visualization, population scale, geo-political

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Authors: Sylvia Huang

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Contemporary Buddhist music has been emerged at the new forms of large-scale public Buddhist ritual ceremonies that may involve up to 10,000 participants at a time. Since 2007, the Buddha’s Birthday ceremony (Sanskrit, Vesak) by the Buddhist Tzu Chi Foundation has being held at major cities in Taiwan and many affiliated Tzu Chi offices around the world. Analysis of this modern and technologically-dependent ceremony sheds new light on the significance of music in contemporary Buddhist ritual, and also on recently enhanced and increasingly intimate connections between music and Buddhism. Through extensive ethnographic research of ten years (2007-2017), the research explores how the form of contemporary Buddhist music relates to the role of music in participants’ experience of the ritual and the way in which they construct meaning. The theoretical approach draws on both ethnomusicology and Buddhist teachings, Dharma. As soundscape is defined as the entire sonic energy produced by a landscape, the concept of soundscape is utilised to examine the contemporary ritual music in the Tzu Chi Vesak ceremony. The analysis opens new territory in exploring how analysis of Buddhist music can benefit from incorporating Buddhist philosophy within the methodological approach. Main findings are: 1) music becomes a method for Buddhist understanding through a focus in particular on how the ceremonial program is followed by music, and 2) participants engage with each other and entrain with music in the Vesak ceremony. As Buddhist sounding, such as scripture reading, liturgical chanting, and ceremonial music singing, is a sonic epistemological knowing of the conditions in which Buddhism is practiced, experienced, and transmigrated, the research concludes by showing that studies of Buddhist music have the potential to reveal distinctively Buddhist concepts, meaning, and values. Certain principles of Buddhist philosophy are adopted within ethnomusicological analysis to further enhance understandings of the crucial function of music within such a ritual context. Finally, the contemporary Buddhist music performance in the ceremony is possessed as a means of direct access to the spiritual experience in Buddhism.

Keywords: buddhist music, Taiwan, soundscape, Vesak ceremony

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Authors: M. Nerantzaki, I. Koliakou, D. Bikiaris

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This study evaluates the hypothesis that the incorporation of fibrous hydroxyapatite nanoparticles (nHA) with high crystallinity and high aspect ratio, synthesized by hydrothermal method, into Poly(butylene succinate) (PBSu), improves the bioactivity of the aliphatic polyester and affects new bone growth inhibiting resorption and enhancing bone formation. Hydroxyapatite nanorods were synthesized using a simple hydrothermal procedure. First, the HPO42- -containing solution was added drop-wise into the Ca2+-containing solution, while the molar ratio of Ca/P was adjusted at 1.67. The HA precursor was then treated hydrothermally at 200°C for 72 h. The resulting powder was characterized using XRD, FT-IR, TEM, and EDXA. Afterwards, PBSu nanocomposites containing 2.5wt% (nHA) were prepared by in situ polymerization technique for the first time and were examined as potential scaffolds for bone engineering applications. For comparison purposes composites containing either 2.5wt% micro-Bioglass (mBG) or 2.5wt% mBG-nHA were prepared and studied, too. The composite scaffolds were characterized using SEM, FTIR, and XRD. Mechanical testing (Instron 3344) and Contact Angle measurements were also carried out. Enzymatic degradation was studied in an aqueous solution containing a mixture of R. Oryzae and P. Cepacia lipases at 37°C and pH=7.2. In vitro biomineralization test was performed by immersing all samples in simulated body fluid (SBF) for 21 days. Biocompatibility was assessed using rat Adipose Stem Cells (rASCs), genetically modified by nucleofection with DNA encoding SB100x transposase and pT2-Venus-neo transposon expression plasmids in order to attain fluorescence images. Cell proliferation and viability of cells on the scaffolds were evaluated using fluoresce microscopy and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide) assay. Finally, osteogenic differentiation was assessed by staining rASCs with alizarine red using cetylpyridinium chloride (CPC) method. TEM image of the fibrous HAp nanoparticles, synthesized in the present study clearly showed the fibrous morphology of the synthesized powder. The addition of nHA decreased significantly the contact angle of the samples, indicating that the materials become more hydrophilic and hence they absorb more water and subsequently degrade more rapidly. In vitro biomineralization test confirmed that all samples were bioactive as mineral deposits were detected by X-ray diffractometry after incubation in SBF. Metabolic activity of rASCs on all PBSu composites was high and increased from day 1 of culture to day 14. On day 28 metabolic activity of rASCs cultured on samples enriched with bioceramics was significantly decreased due to possible differentiation of rASCs to osteoblasts. Staining rASCs with alizarin red after 28 days in culture confirmed our initial hypothesis as the presence of calcium was detected, suggesting osteogenic differentiation of rACS on PBSu/nHAp/mBG 2.5% and PBSu/mBG 2.5% composite scaffolds.

Keywords: biomaterials, hydroxyapatite nanorods, poly(butylene succinate), scaffolds

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Authors: Erika Mattio

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The aim of this project is to study the Chinese presence in Ethiopia, in the area between the Saba River and the Coptic areas of the Tigray, with detailed documentation of the Danakil region, from which the salt pickers caravans departed; the study was created to understand the relationships and consequences of the Chinese advance in these areas, inhabited by tribes linked to ancient, still practiced religious rituals, and home to unique landscapes and archaeological sites. Official estimates of the number of Chinese in Africa vary widely; on the continent, there are increasingly diverse groups of Chinese migrants in terms of language, dialect, class, education, and employment. Based on this and on a very general state of the art, it was decided to increase the studies on this phenomenon, focusing the attention on one of the most interesting countries for its diversity, cultural wealth, and for strong Chinese presence: Ethiopia. The study will be integrated with interdisciplinary investigation methods, such as landscape archeology, historiographic research, participatory anthropology, geopolitics, and cultural anthropology and ethnology. There are two main objectives of the research. The first is to predict what will happen to these populations and how the territory will be modified, trying to monitor the growth of infrastructure in the country and the effects it will have on the population. Risk analyzes will be carried out to understand what the foreign presence may entail, such as the absence of sustenance for local populations, the ghettoization of foreigners, unemployment of natives and the exodus of the population to the capital; the relationships between families and the local population will be analyzed, trying to understand the dynamics of socialization and interaction. Thanks to the use of GIS, the areas affected by the Chinese presence will be geo-referenced and mapped, delimiting the areas most affected and creating a risk analysis, both in desert areas and in archaeologically and historically relevant areas. The second point is to document the life and rituals of Ethiopian populations in order not to lose the aspects of uniqueness that risk being lost. Local interviews will collect impressions and criticisms from the local population to understand if the Chinese presence is perceived as a threat or as a solution. Furthermore, Afar leaders in the Logya area will be interviewed, in truly exclusive research, to understand their links with the foreign presence. From the north, along the Saba river, we will move to the northwest, in the Tigray region, to know the impressions in the Coptic area, currently less threatened by the Chinese presence but still affected by urbanization proposals. There will also be documented the Coptic rituals of Gennà and Timkat, unique expressions of a millennial tradition. This will allow the understanding of whether the Maoist presence could influence the religious rites and forms of belief present in the country, or the country will maintain its cultural independence.

Keywords: Ethiopia, GIS, risk perceptions, salt caravans

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Authors: Hitesh Gupta, Surender Dabas

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TORS is increasingly gaining widespread use and has been explored as minimally invasive surgery for the treatment of supraglottic cancer (SGC). Being a central critical role of Supraglottis in deglutition, swallowing outcomes post TORS remain a most important factor. Available published studies show inconsistent swallowing outcomes and are deficient in standardized outcome measures, description of swallowing recovery and rehabilitation. So, the objective of this study is to find out swallowing outcomes in SGC patients after TORS provided with early dysphagia management using standardized measures. Prospectively 16 patients were recruited in the study who underwent TORS for primary tumor of Supraglottis, involving one or more sub-sites or invading to sites other than Supraglottis at the BLK Super Specialty Hospital, New Delhi from March 2019 to June 2020. All patients were evaluated for dysphagia with subsequent swallowing rehabilitation on post operative day 3 in the hospital or at the time of discharge, whichever was earlier. Functional oral intake scale (FOIS) and penetration-aspiration score (PAS) were used as outcome measures to quantify swallowing recovery at one month and six month post operatively. Post TORS, patients achieved functional swallow in less than one month, where resection was limited to Supraglottis, while the recovery was delayed in patients with extended resection to tongue base or hypopharynx. Overall, out of Total 16 cases including all supraglottis sub-catagories, 13 (81%) could remove their NG tube (FOIS ≥5 and PAS=1 ) within 6 months. In which 8 cases(62%) achieved functional swallow in less than one month. Swallowing outcomes post TORS supraglottic laryngectomy are favorable if provided with early dysphagia management (or swallowing rehabilitation).

Keywords: dysphagia, supraglottic cancer, swallowing, TORS

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Authors: Chantel Snyman, Chrizanne van Eeden, Marita Heyns

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Autism spectrum disorder (ASD) is one of the most common disabilities in schools, with up to50% of children displaying behaviors that challenge, bringing about demanding teaching circumstances. The teachers and teaching assistants of such learners often experience a negative impact on their own quality of life. Research globally and in South Africa about the teachers of ASD learners and teaching interventions, especially positive psychology approaches aimed at supporting learners with ASD, is limited. The primary research aim of this study was to investigate the feasibility as well as the effect of a strength-based intervention for teachers on the behavior of their learners with ASD and on the wellbeing and self-efficacy of teachers and assistants over time. This quantitative study used a pre-experimental group design with a pre-test-post-test method for the proposed school-based intervention. Teachers and teaching assistants completed the Difficult Behavior Self-Efficacy Scale, the Mental Health Questionnaire, and the short Behaviors That Challenge Checklist for learners with ASD. The six-week intervention on character strengths was delivered by the researcher as part of Teacher Staff Development. Results were generally significant on a practical level (based on practical effect sizes), which indicate that the intervention had a visible effect on behaviors that challenge. Research scores over time suggested a positive effect of the intervention in the well-being of participants and an overall positive effect on behaviors that challenge of ASD learners. Results showed that the character strengths intervention shows promise as a simple but effective intervention for teachers and teaching assistants, with positive effects for learners and teaching staff in the ASD classroom. It is recommended that this intervention should be repeated over a longer period of time and with a larger sample to determine its validity.

Keywords: autism spectrum disorder (ASD), behavior that challenge, character strengths, disabilities, self-efficacy, teachers, teaching assistants, well-being

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Authors: Ainouna Bouziane

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The ability of Electron Tomography to recover the 3D structure of catalysts, with spatial resolution in the subnanometer scale, has been widely explored and reviewed in the last decades. A variety of experimental techniques, based either on Transmission Electron Microscopy (TEM) or Scanning Transmission Electron Microscopy (STEM) have been used to reveal different features of nanostructured catalysts in 3D, but High Angle Annular Dark Field imaging in STEM mode (HAADF-STEM) stands out as the most frequently used, given its chemical sensitivity and avoidance of imaging artifacts related to diffraction phenomena when dealing with crystalline materials. In this regard, our group has developed a methodology that combines image denoising by undecimated wavelet transforms (UWT) with automated, advanced segmentation procedures and parameter selection methods using CS-TVM (Compressed Sensing-total variation minimization) algorithms to reveal more reliable quantitative information out of the 3D characterization studies. However, evaluating the accuracy of the magnitudes estimated from the segmented volumes is also an important issue that has not been properly addressed yet, because a perfectly known reference is needed. The problem particularly complicates in the case of multicomponent material systems. To tackle this key question, we have developed a methodology that incorporates volume reconstruction/segmentation methods. In particular, we have established an approach to evaluate, in quantitative terms, the accuracy of TVM reconstructions, which considers the influence of relevant experimental parameters like the range of tilt angles, image noise level or object orientation. The approach is based on the analysis of material-realistic, 3D phantoms, which include the most relevant features of the system under analysis.

Keywords: electron tomography, supported catalysts, nanometrology, error assessment

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Authors: Soraia V. M. de Sá, Miguel A. Faria, José O. Fernandes, Sara C. Cunha

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Cereals play a vital role in fulfilling the nutritional needs of children, supplying essential nutrients crucial for their growth and development. However, concerns arise due to children's heightened vulnerability due to their unique physiology, specific dietary requirements, and relatively higher intake in relation to their body weight. This vulnerability exposes them to harmful food contaminants, particularly mycotoxins, prevalent in cereals. Because of the thermal stability of mycotoxins, conventional industrial food processing often falls short of eliminating them. Children, especially those aged 4 months to 12 years, frequently encounter mycotoxins through the consumption of specialized food products, such as instant foods, breakfast cereals, bars, cookie snacks, fruit puree, and various dairy items. A close monitoring of this demographic group's exposure to mycotoxins is essential, as toxins ingestion may weaken children’s immune systems, reduce their resistance to infectious diseases, and potentially lead to cognitive impairments. The severe toxicity of mycotoxins, some of which are classified as carcinogenic, has spurred the establishment and ongoing revision of legislative limits on mycotoxin levels in food and feed globally. While EU Commission Regulation 1881/2006 addresses well-known mycotoxins in processed cereal-based foods and infant foods, the absence of regulations specifically addressing emerging mycotoxins underscores a glaring gap in the regulatory framework, necessitating immediate attention. Emerging mycotoxins have gained mounting scrutiny in recent years due to their pervasive presence in various foodstuffs, notably cereals and cereal-based products. Alarmingly, exposure to multiple mycotoxins is hypothesized to exhibit higher toxicity than isolated effects, raising particular concerns for products primarily aimed at children. This study scrutinizes the presence of 22 mycotoxins of the diverse range of chemical classes in 148 processed cereal-based foods, including 39 breakfast cereals, 25 infant formulas, 27 snacks, 25 cereal bars, and 32 cookies commercially available in Portugal. The analytical approach employed a modified QuEChERS procedure followed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) analysis. Given the paucity of information on the risk assessment of children to multiple mycotoxins in cereal and cereal-based products consumed by children of Portugal pioneers the evaluation of this critical aspect. Overall, aflatoxin B1 (AFB1) and aflatoxin G2 (AFG2) emerged as the most prevalent regulated mycotoxins, while enniatin B (ENNB) and sterigmatocystin (STG) were the most frequently detected emerging mycotoxins.

Keywords: cereal-based products, children´s nutrition, food safety, UPLC-MS/MS analysis

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Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu

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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).

Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions

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Authors: William Thomas Worster

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Diplomatic assurances issued by states declaring that they will not mistreat individuals returned to them occupy a strange middle ground between being legal and non-legal obligations. States assert that they are non-binding, yet at other times that they are binding. However, this assertion may not be the end of the discussion. The International Court of Justice and other tribunals have concluded that similar instruments were binding, states have disagreed that certain similar instruments were binding, and the Vienna Convention on the Law of Treaties and its travaux prépératoires do not appear to contemplate non-binding instruments. This paper is a case study of diplomatic assurances but, by necessity, touches on the delicate question of whether certain texts are treaties, promises, or non-binding political statements. International law, and law in general, requires a binary approach to obligation. All communications must be binding or not, even if the fit is not precise. Through this study, we will find that some of the obligations in certain assurances can be understood as legal and some not. We will attempt to state the current methodology for determining which obligations are legal under the law of treaties and law on binding unilateral promises. The paper begins with some background of the legal environment of diplomatic assurances and their use in cases of expulsion. The paper then turns to discuss the legal nature of diplomatic assurances, proceeding to address various possibilities for legal value as treaties and as binding unilateral statements. This paper will not examine the legal value of diplomatic assurances solely under customary international law other than the way in which customary international law might further refine the treaty definition. In order to identify whether any assurances are contained in legal acts, this study identifies a pool of relevant assurances and qualitatively analyzes whether any of those are contained in treaties or binding unilateral statements. To the author’s best knowledge, this study is the first large-scale, qualitative qualitative analysis of assurances as a group of instruments that accounts for their heterogenous nature. It is also the first study to identify the indicators of whether an instrument is a treaty or promise.

Keywords: diplomatic assurances, deportation, extradition, expulsion, non-refoulement, torture, persecution, death penalty, human rights, memorandum of understanding, promises, secret, monitoring, compliance, enforcement

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