Search results for: double sample selection
Commenced in January 2007
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Edition: International
Paper Count: 9353

Search results for: double sample selection

593 Acceptance and Commitment Therapy for Social Anxiety Disorder in Adolescence: A Manualized Online Approach

Authors: Francisca Alves, Diana Figueiredo, Paula Vagos, Luiza Lima, Maria do Céu Salvador, Daniel Rijo

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In recent years, Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of numerous anxiety disorders, including social anxiety disorder (SAD). However, limited evidence exists on its therapeutic gains for adolescents with SAD. The current work presents a weekly 10-session manualized online ACT approach to adolescent SAD, being the first study to do so in a clinical sample of adolescents. The intervention ACT@TeenSAD addresses the six proposed processes of psychological inflexibility (i.e., experiential avoidance, cognitive fusion, lack of values clarity, unworkable action, dominance of the conceptualized past and future, attachment to the conceptualized self) in social situations relevant to adolescents (e.g., doing a presentation). It is organized into four modules. The first module explores the role of psychological (in)flexibility in SAD (session 1 and 2), addressing psychoeducation (i.e., functioning of the mind) according to ACT, the development of an individualized model, and creative hopelessness. The second module focuses on the foundation of psychological flexibility (session 3, 4, and 5), specifically on the development and practice of strategies to promote clarification of values, contact with the present moment, the observing self, defusion, and acceptance. The third module encompasses psychological flexibility in action (sessions 6, 7, 8, and 9), encouraging committed action based on values in social situations relevant to the adolescents. The fourth modules’ focus is the revision of gains and relapse prevention (session 10). This intervention further includes two booster sessions after therapy has ended (3 and 6-month follow-up) that aim to review the continued practice of learned abilities and to plan for their future application to potentially anxious social events. As part of an ongoing clinical trial, the intervention will be assessed on its feasibility with adolescents diagnosed with SAD and on its therapeutic efficacy based on a longitudinal design including pretreatment, posttreatment, 3 and 6-month follow-up. If promising, findings may support the online delivery of ACT interventions for SAD, contributing to increased treatment availability to adolescents. This availability of an effective therapeutic approach will be helpful not only in relation to adolescents who face obstacles (e.g., distance) when attending to face-to-face sessions but also particularly to adolescents with SAD, who are usually more reluctant to look for specialized treatment in public or private health facilities.

Keywords: acceptance and commitment therapy, social anxiety disorder, adolescence, manualized online approach

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592 A Non-Invasive Method for Assessing the Adrenocortical Function in the Roan Antelope (Hippotragus equinus)

Authors: V. W. Kamgang, A. Van Der Goot, N. C. Bennett, A. Ganswindt

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The roan antelope (Hippotragus equinus) is the second largest antelope species in Africa. These past decades, populations of roan antelope are declining drastically throughout Africa. This situation resulted in the development of intensive breeding programmes for this species in Southern African, where they are popular game ranching herbivores in with increasing numbers in captivity. Nowadays, avoidance of stress is important when managing wildlife to ensure animal welfare. In this regard, a non-invasive approach to monitor the adrenocortical function as a measure of stress would be preferable, since animals are not disturbed during sample collection. However, to date, a non-invasive method has not been established for the roan antelope. In this study, we validated a non-invasive technique to monitor the adrenocortical function in this species. Herein, we performed an adrenocorticotropic hormone (ACTH) stimulation test at Lapalala reserve Wilderness, South Africa, using adult captive roan antelopes to determine the stress-related physiological responses. Two individually housed roan antelope (a male and a female) received an intramuscular injection with Synacthen depot (Norvatis) loaded into a 3ml syringe (Pneu-Dart) at an estimated dose of 1 IU/kg. A total number of 86 faecal samples (male: 46, female: 40) were collected 5 days before and 3 days post-injection. All samples were then lyophilised, pulverized and extracted with 80% ethanol (0,1g/3ml) and the resulting faecal extracts were analysed for immunoreactive faecal glucocorticoid metabolite (fGCM) concentrations using five enzyme immunoassays (EIAs); (i) 11-oxoaetiocholanolone I (detecting 11,17 dioxoandrostanes), (ii) 11-oxoaetiocholanolone II (detecting fGCM with a 5α-pregnane-3α-ol-11one structure), (iii) a 5α-pregnane-3β-11β,21-triol-20-one (measuring 3β,11β-diol CM), (iv) a cortisol and (v) a corticosterone. In both animals, all EIAs detected an increase in fGCM concentration 100% post-ACTH administration. However, the 11-oxoaetiocholanolone I EIA performed best, with a 20-fold increase in the male (baseline: 0.384 µg/g, DW; peak: 8,585 µg/g DW) and a 17-fold in the female (baseline: 0.323 µg/g DW, peak: 7,276 µg/g DW), measured 17 hours and 12 hours post-administration respectively. These results are important as the ability to assess adrenocortical function non-invasively in roan can now be used as an essential prerequisite to evaluate the effects of stressful circumstances; such as variation of environmental conditions or reproduction in other to improve management strategies for the conservation of this iconic antelope species.

Keywords: adrenocorticotropic hormone challenge, adrenocortical function, captive breeding, non-invasive method, roan antelope

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591 Communication Skills Training in Continuing Nursing Education: Enabling Nurses to Improve Competency and Performance in Communication

Authors: Marzieh Moattari Mitra Abbasi, Masoud Mousavinasab, Poorahmad

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Background: Nurses in their daily practice need to communicate with patients and their families as well as health professional team members. Effective communication contributes to patients’ satisfaction which is a fundamental outcome of nursing practice. There are some evidences in support of patients' dissatisfaction with nurses’ performance in communication process. Therefore improving nurses’ communication skills is a necessity for nursing scholars and nursing administrators. Objective: The aim of the present study was to evaluate the effect of a 2-days workshop on nurses’ competencies and performances in communication in a central hospital located in the sought of Iran. Materials and Method: This is a randomized controlled trial which comprised of a convenient sample of 70 eligible nurses, working in a central hospital. They were randomly divided into 2 experimental and control groups. Nurses’ competencies was measured by an Objective Structured Clinical Examination (OSCE) and their performance was measured by asking eligible patients hospitalized in the nurses work setting during a one month period to evaluate nurses' communication skills before and 2 months after intervention. The experimental group participated in a 2 day workshop on communication skills. Content included in this workshop were: the importance of communication (verbal and non verbal), basic communication skills such as initiating the communication, active listening and questioning technique. Other subjects were patient teaching, problem solving, and decision making, cross cultural communication and breaking bad news. Appropriate teaching strategies such as brief didactic sessions, small group discussion and reflection were applied to enhance participants learning. The data was analyzed using SPSS 16. Result: A significant between group differences was found in nurses’ communication skills competencies and performances in the posttest. The mean scores of the experimental group was higher than that of the control group in the total score of OSCE as well as all stations of OSCE (p<0.003). Overall posttest mean scores of patient satisfaction with nurse's communication skills and all of its four dimensions significantly differed between the two groups of the study (p<0.001). Conclusion: This study shows that the education of nurses in communication skills, improves their competencies and performances. Measurement of Nurses’ communication skills as a central component of efficient nurse patient relationship by valid and reliable methods of evaluation is recommended. Also it is necessary to integrate teaching of communication skills in continuing nursing education programs. Trial Registration Number: IRCT201204042621N11

Keywords: communication skills, simulation, performance, competency, objective structure, clinical evaluation

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590 High Throughput LC-MS/MS Studies on Sperm Proteome of Malnad Gidda (Bos Indicus) Cattle

Authors: Kerekoppa Puttaiah Bhatta Ramesha, Uday Kannegundla, Praseeda Mol, Lathika Gopalakrishnan, Jagish Kour Reen, Gourav Dey, Manish Kumar, Sakthivel Jeyakumar, Arumugam Kumaresan, Kiran Kumar M., Thottethodi Subrahmanya Keshava Prasad

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Spermatozoa are the highly specialized transcriptionally and translationally inactive haploid male gamete. The understanding of proteome of sperm is indispensable to explore the mechanism of sperm motility and fertility. Though there is a large number of human sperm proteomic studies, in-depth proteomic information on Bos indicus spermatozoa is not well established yet. Therefore, we illustrated the profile of sperm proteome in indigenous cattle, Malnad gidda (Bos Indicus), using high-resolution mass spectrometry. In the current study, two semen ejaculates from 3 breeding bulls were collected employing the artificial vaginal method. Using 45% percoll purification, spermatozoa cells were isolated. Protein was extracted using lysis buffer containing 2% Sodium Dodecyl Sulphate (SDS) and protein concentration was estimated. Fifty micrograms of protein from each individual were pooled for further downstream processing. Pooled sample was fractionated using SDS-Poly Acrylamide Gel Electrophoresis, which is followed by in-gel digestion. The peptides were subjected to C18 Stage Tip clean-up and analyzed in Orbitrap Fusion Tribrid mass spectrometer interfaced with Proxeon Easy-nano LC II system (Thermo Scientific, Bremen, Germany). We identified a total of 6773 peptides with 28426 peptide spectral matches, which belonged to 1081 proteins. Gene ontology analysis has been carried out to determine the biological processes, molecular functions and cellular components associated with sperm protein. The biological process chiefly represented our data is an oxidation-reduction process (5%), spermatogenesis (2.5%) and spermatid development (1.4%). The highlighted molecular functions are ATP, and GTP binding (14%) and the prominent cellular components most observed in our data were nuclear membrane (1.5%), acrosomal vesicle (1.4%), and motile cilium (1.3%). Seventeen percent of sperm proteins identified in this study were involved in metabolic pathways. To the best of our knowledge, this data represents the first total sperm proteome from indigenous cattle, Malnad Gidda. We believe that our preliminary findings could provide a strong base for the future understanding of bovine sperm proteomics.

Keywords: Bos indicus, Malnad Gidda, mass spectrometry, spermatozoa

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589 British Female Muslim Converts: An Investigation into Their De-Conversions from Islam

Authors: Mona Alyedreessy

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This study, which is based on a qualitative study sample of thirty-four British converts from different ages, ethnicities, social classes, areas and religious backgrounds in London, investigates the common challenges, problems and abuse in the name of Islam that many British female Muslim converts experienced during their time as Muslims, which caused them to leave the faith. It is an important study, as it creates an awareness of the weaknesses found in western Muslim societies and in various Islamic educational programs that causes people to leave Islam and contribute towards its negative reputation in the media. The women in this study shared common problems regarding gender and racial discrimination, identity development, feminism, marriage, parenting, Muslim culture, isolation, extremism, belonging and practising Islam in both Muslim and non-Muslim societies with differing sacrifices and consequences that caused them to de-convert. The study argues that many of the personal, religious and social problems female Muslim converts experience are due to a lack of knowledge about Islam and their rights as Muslim women, which often results in them being vulnerable and influenced by the opinions, attitudes and actions of uneducated, abusive, non-practising and extremist Muslims. For example, it was found that young female converts in particular were often taken advantage of and manipulated into believing that many negative actions displayed by patriarchal Muslim husbands were a part of Islam. This created much confusion, especially when their husbands used specific Quran texts and Hadiths to justify their abuse, authority and attitudes that made them miserable. As a result and based on the positive experiences of some converts, the study found that obtaining a broad Islamic education that started with an intimate study of the Prophet Muhammad’s biography alongside being guided by the teachings of western Muslim scholars contributed greatly towards a more enjoyable conversion journey, as women were able to identify and avoid problematic Muslims and abuse in the name of Islam. This in turn helped to create a healthier family unit and Muslim society. Those who enjoyed being Muslims were able to create a balanced western Muslim identity by negotiating and applying their own morals and western values to their understanding of The Prophet’s biography and The Quran and integrated Islamic values into their own secular western environments that were free from foreign cultural practices. The outcomes of the study also highlight some effective modern approaches to da’wah based on the teachings of The Prophet Mohammad and other prophets for young Arab and Asian Muslims who marry, study and live among non-Muslims and converts.

Keywords: abuse, apostasy, converts, Muslims

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588 Machine Learning Prediction of Diabetes Prevalence in the U.S. Using Demographic, Physical, and Lifestyle Indicators: A Study Based on NHANES 2009-2018

Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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To develop a machine learning model to predict diabetes (DM) prevalence in the U.S. population using demographic characteristics, physical indicators, and lifestyle habits, and to analyze how these factors contribute to the likelihood of diabetes. We analyzed data from 23,546 participants aged 20 and older, who were non-pregnant, from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). The dataset included key demographic (age, sex, ethnicity), physical (BMI, leg length, total cholesterol [TCHOL], fasting plasma glucose), and lifestyle indicators (smoking habits). A weighted sample was used to account for NHANES survey design features such as stratification and clustering. A classification machine learning model was trained to predict diabetes status. The target variable was binary (diabetes or non-diabetes) based on fasting plasma glucose measurements. The following models were evaluated: Logistic Regression (baseline), Random Forest Classifier, Gradient Boosting Machine (GBM), Support Vector Machine (SVM). Model performance was assessed using accuracy, F1-score, AUC-ROC, and precision-recall metrics. Feature importance was analyzed using SHAP values to interpret the contributions of variables such as age, BMI, ethnicity, and smoking status. The Gradient Boosting Machine (GBM) model outperformed other classifiers with an AUC-ROC score of 0.85. Feature importance analysis revealed the following key predictors: Age: The most significant predictor, with diabetes prevalence increasing with age, peaking around the 60s for males and 70s for females. BMI: Higher BMI was strongly associated with a higher risk of diabetes. Ethnicity: Black participants had the highest predicted prevalence of diabetes (14.6%), followed by Mexican-Americans (13.5%) and Whites (10.6%). TCHOL: Diabetics had lower total cholesterol levels, particularly among White participants (mean decline of 23.6 mg/dL). Smoking: Smoking showed a slight increase in diabetes risk among Whites (0.2%) but had a limited effect in other ethnic groups. Using machine learning models, we identified key demographic, physical, and lifestyle predictors of diabetes in the U.S. population. The results confirm that diabetes prevalence varies significantly across age, BMI, and ethnic groups, with lifestyle factors such as smoking contributing differently by ethnicity. These findings provide a basis for more targeted public health interventions and resource allocation for diabetes management.

Keywords: diabetes, NHANES, random forest, gradient boosting machine, support vector machine

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587 The Diagnostic Utility and Sensitivity of the Xpert® MTB/RIF Assay in Diagnosing Mycobacterium tuberculosis in Bone Marrow Aspirate Specimens

Authors: Nadhiya N. Subramony, Jenifer Vaughan, Lesley E. Scott

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In South Africa, the World Health Organisation estimated 454000 new cases of Mycobacterium tuberculosis (M.tb) infection (MTB) in 2015. Disseminated tuberculosis arises from the haematogenous spread and seeding of the bacilli in extrapulmonary sites. The gold standard for the detection of MTB in bone marrow is TB culture which has an average turnaround time of 6 weeks. Histological examinations of trephine biopsies to diagnose MTB also have a time delay owing mainly to the 5-7 day processing period prior to microscopic examination. Adding to the diagnostic delay is the non-specific nature of granulomatous inflammation which is the hallmark of MTB involvement of the bone marrow. A Ziehl-Neelson stain (which highlights acid-fast bacilli) is therefore mandatory to confirm the diagnosis but can take up to 3 days for processing and evaluation. Owing to this delay in diagnosis, many patients are lost to follow up or remain untreated whilst results are awaited, thus encouraging the spread of undiagnosed TB. The Xpert® MTB/RIF (Cepheid, Sunnyvale, CA) is the molecular test used in the South African national TB program as the initial diagnostic test for pulmonary TB. This study investigates the optimisation and performance of the Xpert® MTB/RIF on bone marrow aspirate specimens (BMA), a first since the introduction of the assay in the diagnosis of extrapulmonary TB. BMA received for immunophenotypic analysis as part of the investigation into disseminated MTB or in the evaluation of cytopenias in immunocompromised patients were used. Processing BMA on the Xpert® MTB/RIF was optimised to ensure bone marrow in EDTA and heparin did not inhibit the PCR reaction. Inactivated M.tb was spiked into the clinical bone marrow specimen and distilled water (as a control). A volume of 500mcl and an incubation time of 15 minutes with sample reagent were investigated as the processing protocol. A total of 135 BMA specimens had sufficient residual volume for Xpert® MTB/RIF testing however 22 specimens (16.3%) were not included in the final statistical analysis as an adequate trephine biopsy and/or TB culture was not available. Xpert® MTB/RIF testing was not affected by BMA material in the presence of heparin or EDTA, but the overall detection of MTB in BMA was low compared to histology and culture. Sensitivity of the Xpert® MTB/RIF compared to both histology and culture was 8.7% (95% confidence interval (CI): 1.07-28.04%) and sensitivity compared to histology only was 11.1% (95% CI: 1.38-34.7%). Specificity of the Xpert® MTB/RIF was 98.9% (95% CI: 93.9-99.7%). Although the Xpert® MTB/RIF generates a faster result than histology and TB culture and is less expensive than culture and drug susceptibility testing, the low sensitivity of the Xpert® MTB/RIF precludes its use for the diagnosis of MTB in bone marrow aspirate specimens and warrants alternative/additional testing to optimise the assay.

Keywords: bone marrow aspirate , extrapulmonary TB, low sensitivity, Xpert® MTB/RIF

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586 Measurement of Fatty Acid Changes in Post-Mortem Belowground Carcass (Sus-scrofa) Decomposition: A Semi-Quantitative Methodology for Determining the Post-Mortem Interval

Authors: Nada R. Abuknesha, John P. Morgan, Andrew J. Searle

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Information regarding post-mortem interval (PMI) in criminal investigations is vital to establish a time frame when reconstructing events. PMI is defined as the time period that has elapsed between the occurrence of death and the discovery of the corpse. Adipocere, commonly referred to as ‘grave-wax’, is formed when post-mortem adipose tissue is converted into a solid material that is heavily comprised of fatty acids. Adipocere is of interest to forensic anthropologists, as its formation is able to slow down the decomposition process. Therefore, analysing the changes in the patterns of fatty acids during the early decomposition process may be able to estimate the period of burial, and hence the PMI. The current study concerned the investigation of the fatty acid composition and patterns in buried pig fat tissue. This was in an attempt to determine whether particular patterns of fatty acid composition can be shown to be associated with the duration of the burial, and hence may be used to estimate PMI. The use of adipose tissue from the abdominal region of domestic pigs (Sus-scrofa), was used to model the human decomposition process. 17 x 20cm piece of pork belly was buried in a shallow artificial grave, and weekly samples (n=3) from the buried pig fat tissue were collected over an 11-week period. Marker fatty acids: palmitic (C16:0), oleic (C18:1n-9) and linoleic (C18:2n-6) acid were extracted from the buried pig fat tissue and analysed as fatty acid methyl esters using the gas chromatography system. Levels of the marker fatty acids were quantified from their respective standards. The concentrations of C16:0 (69.2 mg/mL) and C18:1n-9 (44.3 mg/mL) from time zero exhibited significant fluctuations during the burial period. Levels rose (116 and 60.2 mg/mL, respectively) and fell starting from the second week to reach 19.3 and 18.3 mg/mL, respectively at week 6. Levels showed another increase at week 9 (66.3 and 44.1 mg/mL, respectively) followed by gradual decrease at week 10 (20.4 and 18.5 mg/mL, respectively). A sharp increase was observed in the final week (131.2 and 61.1 mg/mL, respectively). Conversely, the levels of C18:2n-6 remained more or less constant throughout the study. In addition to fluctuations in the concentrations, several new fatty acids appeared in the latter weeks. Other fatty acids which were detectable in the time zero sample, were lost in the latter weeks. There are several probable opportunities to utilise fatty acid analysis as a basic technique for approximating PMI: the quantification of marker fatty acids and the detection of selected fatty acids that either disappear or appear during the burial period. This pilot study indicates that this may be a potential semi-quantitative methodology for determining the PMI. Ideally, the analysis of particular fatty acid patterns in the early stages of decomposition could be an additional tool to the already available techniques or methods in improving the overall processes in estimating PMI of a corpse.

Keywords: adipocere, fatty acids, gas chromatography, post-mortem interval

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585 From Servicescape to Servicespace: Qualitative Research in a Post-Cartesian Retail Context

Authors: Chris Houliez

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This study addresses the complex dynamics of the modern retail environment, focusing on how the ubiquitous nature of mobile communication technologies has reshaped the shopper experience and tested the limits of the conventional "servicescape" concept commonly used to describe retail experiences. The objective is to redefine the conceptualization of retail space by introducing an approach to space that aligns with a retail context where physical and digital interactions are increasingly intertwined. To offer a more shopper-centric understanding of the retail experience, this study draws from phenomenology, particularly Henri Lefebvre’s work on the production of space. The presented protocol differs from traditional methodologies by not making assumptions about what constitutes a retail space. Instead, it adopts a perspective based on Lefebvre’s seminal work, which posits that space is not a three-dimensional container commonly referred to as “servicescape” but is actively produced through shoppers’ spatial practices. This approach allows for an in-depth exploration of the retail experience by capturing the everyday spatial practices of shoppers without preconceived notions of what constitutes a retail space. The designed protocol was tested with eight participants during 209 hours of day-long field trips, immersing the researcher into the shopper's lived experience by combining multiple data collection methods, including participant observation, videography, photography, and both pre-fieldwork and post-fieldwork interviews. By giving equal importance to both locations and connections, this study unpacked various spatial practices that contribute to the production of retail space. These findings highlight the relative inadequacy of some traditional retail space conceptualizations, which often fail to capture the fluid nature of contemporary shopping experiences. The study's emphasis on the customization process, through which shoppers optimize their retail experience by producing a “fully lived retail space,” offers a more comprehensive understanding of consumer shopping behavior in the digital age. In conclusion, this research presents a significant shift in the conceptualization of retail space. By employing a phenomenological approach rooted in Lefebvre’s theory, the study provides a more efficient framework to understand the retail experience in the age of mobile communication technologies. Although this research is limited by its small sample size and the demographic profile of participants, it offers valuable insights into the spatial practices of modern shoppers and their implications for retail researchers and retailers alike.

Keywords: shopper behavior, mobile telecommunication technologies, qualitative research, servicescape, servicespace

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584 Development of Academic Software for Medial Axis Determination of Porous Media from High-Resolution X-Ray Microtomography Data

Authors: S. Jurado, E. Pazmino

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Determination of the medial axis of a porous media sample is a non-trivial problem of interest for several disciplines, e.g., hydrology, fluid dynamics, contaminant transport, filtration, oil extraction, etc. However, the computational tools available for researchers are limited and restricted. The primary aim of this work was to develop a series of algorithms to extract porosity, medial axis structure, and pore-throat size distributions from porous media domains. A complementary objective was to provide the algorithms as free computational software available to the academic community comprising researchers and students interested in 3D data processing. The burn algorithm was tested on porous media data obtained from High-Resolution X-Ray Microtomography (HRXMT) and idealized computer-generated domains. The real data and idealized domains were discretized in voxels domains of 550³ elements and binarized to denote solid and void regions to determine porosity. Subsequently, the algorithm identifies the layer of void voxels next to the solid boundaries. An iterative process removes or 'burns' void voxels in sequence of layer by layer until all the void space is characterized. Multiples strategies were tested to optimize the execution time and use of computer memory, i.e., segmentation of the overall domain in subdomains, vectorization of operations, and extraction of single burn layer data during the iterative process. The medial axis determination was conducted identifying regions where burnt layers collide. The final medial axis structure was refined to avoid concave-grain effects and utilized to determine the pore throat size distribution. A graphic user interface software was developed to encompass all these algorithms, including the generation of idealized porous media domains. The software allows input of HRXMT data to calculate porosity, medial axis, and pore-throat size distribution and provide output in tabular and graphical formats. Preliminary tests of the software developed during this study achieved medial axis, pore-throat size distribution and porosity determination of 100³, 320³ and 550³ voxel porous media domains in 2, 22, and 45 minutes, respectively in a personal computer (Intel i7 processor, 16Gb RAM). These results indicate that the software is a practical and accessible tool in postprocessing HRXMT data for the academic community.

Keywords: medial axis, pore-throat distribution, porosity, porous media

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583 Impact of Reproductive Technologies on Women's Lives in New Delhi: A Study from Feminist Perspective

Authors: Zairunisha

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This paper is concerned with the ways in which Assisted Reproductive Technologies (ARTs) affect women’s lives and perceptions regarding their infertility, contraception and reproductive health. Like other female animals, nature has ordained human female with the biological potential of procreation and becoming mother. However, during the last few decades, this phenomenal disposition of women has become a technological affair to achieve fertility and contraception. Medical practices in patriarchal societies are governed by male scientists, technical and medical professionals who try to control women as procreator instead of providing them choices. The use of ARTs presents innumerable waxed ethical questions and issues such as: the place and role of a child in a woman’s life, freedom of women to make their choices related to use of ARTs, challenges and complexities women face at social and personal levels regarding use of ARTs, effect of ARTs on their life as mothers and other relationships. The paper is based on a survey study to explore and analyze the above ethical issues arising from the use of Assisted Reproductive Technologies (ARTs) by women in New Delhi, the capital of India. A rapid rate of increase in fertility clinics has been noticed recently. It is claimed that these clinics serve women by using ARTs procedures for infertile couples and individuals who want to have child or terminate a pregnancy. The study is an attempt to articulate a critique of ARTs from a feminist perspective. A qualitative feminist research methodology has been adopted for conducting the survey study. An attempt has been made to identify the ways in which a woman’s life is affected in terms of her perceptions, apprehensions, choices and decisions regarding new reproductive technologies. A sample of 18 women of New Delhi was taken to conduct in-depth interviews to investigate their perception and response concerning the use of ARTs with a focus on (i) successful use of ARTs, (ii) unsuccessful use of ARTs, (iii) use of ARTs in progress with results yet to be known. The survey was done to investigate the impact of ARTs on women’s physical, emotional, psychological conditions as well as on their social relations and choices. The complexities and challenges faced by women in the voluntary and involuntary (forced) use of ARTs in Delhi have been illustrated. A critical analysis of interviews revealed that these technologies are used and developed for making profits at the cost of women’s lives through which economically privileged women and individuals are able to purchase services from lesser ones. In this way, the amalgamation of technology and cultural traditions are redefining and re-conceptualising the traditional patterns of motherhood, fatherhood, kinship and family relations within the realm of new ways of reproduction introduced through the use of ARTs.

Keywords: reproductive technologies, infertilities, voluntary, involuntary

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582 Systematic Identification of Noncoding Cancer Driver Somatic Mutations

Authors: Zohar Manber, Ran Elkon

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Accumulation of somatic mutations (SMs) in the genome is a major driving force of cancer development. Most SMs in the tumor's genome are functionally neutral; however, some cause damage to critical processes and provide the tumor with a selective growth advantage (termed cancer driver mutations). Current research on functional significance of SMs is mainly focused on finding alterations in protein coding sequences. However, the exome comprises only 3% of the human genome, and thus, SMs in the noncoding genome significantly outnumber those that map to protein-coding regions. Although our understanding of noncoding driver SMs is very rudimentary, it is likely that disruption of regulatory elements in the genome is an important, yet largely underexplored mechanism by which somatic mutations contribute to cancer development. The expression of most human genes is controlled by multiple enhancers, and therefore, it is conceivable that regulatory SMs are distributed across different enhancers of the same target gene. Yet, to date, most statistical searches for regulatory SMs have considered each regulatory element individually, which may reduce statistical power. The first challenge in considering the cumulative activity of all the enhancers of a gene as a single unit is to map enhancers to their target promoters. Such mapping defines for each gene its set of regulating enhancers (termed "set of regulatory elements" (SRE)). Considering multiple enhancers of each gene as one unit holds great promise for enhancing the identification of driver regulatory SMs. However, the success of this approach is greatly dependent on the availability of comprehensive and accurate enhancer-promoter (E-P) maps. To date, the discovery of driver regulatory SMs has been hindered by insufficient sample sizes and statistical analyses that often considered each regulatory element separately. In this study, we analyzed more than 2,500 whole-genome sequence (WGS) samples provided by The Cancer Genome Atlas (TCGA) and The International Cancer Genome Consortium (ICGC) in order to identify such driver regulatory SMs. Our analyses took into account the combinatorial aspect of gene regulation by considering all the enhancers that control the same target gene as one unit, based on E-P maps from three genomics resources. The identification of candidate driver noncoding SMs is based on their recurrence. We searched for SREs of genes that are "hotspots" for SMs (that is, they accumulate SMs at a significantly elevated rate). To test the statistical significance of recurrence of SMs within a gene's SRE, we used both global and local background mutation rates. Using this approach, we detected - in seven different cancer types - numerous "hotspots" for SMs. To support the functional significance of these recurrent noncoding SMs, we further examined their association with the expression level of their target gene (using gene expression data provided by the ICGC and TCGA for samples that were also analyzed by WGS).

Keywords: cancer genomics, enhancers, noncoding genome, regulatory elements

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581 To Compare the Visual Outcome, Safety and Efficacy of Phacoemulsification and Small-Incision Cataract Surgery (SICS) at CEITC, Bangladesh

Authors: Rajib Husain, Munirujzaman Osmani, Mohammad Shamsal Islam

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Purpose: To compare the safety, efficacy and visual outcome of phacoemulsification vs. manual small-incision cataract surgery (SICS) for the treatment of cataract in Bangladesh. Objectives: 1. To assess the Visual outcome after cataract surgery 2. To understand the post-operative complications and early rehabilitation 3. To identified which surgical procedure more attractive to the patients 4. To identify which surgical procedure is occurred fewer complications. 5. To find out the socio-economic and demographic characteristics of study patients Setting: Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: Retrospective, randomised comparison of 300 patients with visually significant cataracts. Method: The present study was designed as a retrospective hospital-based research. The sample size was 300 and study period was from July, 2012 to July, 2013 and assigned randomly to receive either phacoemulsification or manual small-incision cataract surgery (SICS). Preoperative and post-operative data were collected through a well designed collection format. Three follow-up were done; i) during discharge ii) 1-3 weeks & iii) 4-11 weeks post operatively. All preoperative and surgical complications, uncorrected and best-corrected visual acuity (BCVA) and astigmatism were taken into consideration for comparison of outcome Result: Nearly 95% patients were more than 40 years of age. About 52% patients were female, and 48% were male. 52% (N=157) patients came to operate their first eye where 48% (N=143) patients were visited again to operate their second eye. Postoperatively, five eyes (3.33%) developed corneal oedema with >10 Descemets folds, and six eyes (4%) had corneal oedema with <10 Descemets folds for Phacoemulsification surgeries. For SICS surgeries, seven eyes (4.66%) developed corneal oedema with >10 Descemets folds and eight eyes (5.33%) had corneal oedema with < 10 descemets folds. However, both the uncorrected and corrected (4-11 weeks) visual acuities were better in the eyes that had phacoemulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at 4-11 weeks in the eye that had phacoemulsification. Best-corrected visual acuity (BCVA) of final follow-up 95% (N=253) had a good outcome, borderline 3.10% (N=40) and poor outcome was 1.6% (N=7). The individual surgeon outcome were closer, 95% (BCVA) in SICS and 96% (BCVA) in Phacoemulsification at 4-11 weeks follow-up respectively. Conclusion: outcome of cataract surgery both Phacoemulsification and SICS in CEITC was more satisfactory according to who norms. Both Phacoemulsification and manual small-incision cataract surgery (SICS) shows excellent visual outcomes with low complication rates and good rehabilitation. Phacoemulsification is significantly faster, and modern technology based surgical procedure for cataract treatment.

Keywords: phacoemulsification, SICS, cataract, Bangladesh, visual outcome of SICS

Procedia PDF Downloads 350
580 Reintegrating Forensic Mental Health Service Users into Communities in the Western Cape, South Africa

Authors: Zolani Metu

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The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

Procedia PDF Downloads 167
579 Gendered Experiences of the Urban Space in India as Portrayed by Hindi Cinema: A Quantitative Analysis

Authors: Hugo Ribadeau Dumas

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In India, cities represent intense battlefields where patriarchal norms are simultaneously defied and reinforced. While Indian metropolises have witnessed numerous initiatives where women boldly claimed their right to the city, urban spaces still remain disproportionately unfriendly to female city-dwellers. As a result, the presence of strees (women, in Hindi) in the streets remains a socially and politically potent phenomenon. This paper explores how, in India, women engage with the city as compared to men. Borrowing analytical tools from urban geography, it uses Hindi cinema as a medium to map the extent to which activities, attitudes and experiences in urban spaces are highly gendered. The sample consists of 30 movies, both mainstream and independent, which were released between 2010 and 2020, were set in an urban environment and comprised at least one pivotal female character. The paper adopts a quantitative approach, consisting of the scrutiny of close to 3,000 minutes of footage, the labeling and time count of every scene, and the computation of regressions to identify statistical relationships between characters and the way they navigate the city. According to the analysis, female characters spend half less time in the public space than their male counterparts. When they do step out, women do it mostly for utilitarian reasons; inversely, in private spaces or in pseudo-public commercial places – like malls – they indulge in fun activities. For male characters, the pattern is the exact opposite: fun takes place in public and serious work in private. The characters’ attitudes in the streets are also greatly gendered: men spend a significant amount of time immobile, loitering, while women are usually on the move, displaying some sense of purpose. Likewise, body language and emotional expressiveness betray differentiated gender scripts: while women wander in the streets either smiling – in a charming role – or with a hostile face – in a defensive mode – men are more likely to adopt neutral facial expressions. These trends were observed across all movies, although some nuances were identified depending on the character's age group, social background, and city, highlighting that the urban experience is not the same for all women. The empirical pieces of evidence presented in this study are helpful to reflect on the meaning of public space in the context of contemporary Indian cities. The paper ends with a discussion on the link between universal access to public spaces and women's empowerment.

Keywords: cinema, Indian cities, public space, women empowerment

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578 Predicting Reading Comprehension in Spanish: The Evidence for the Simple View Model

Authors: Gabriela Silva-Maceda, Silvia Romero-Contreras

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Spanish is a more transparent language than English given that it has more direct correspondences between sounds and letters. It has become important to understand how decoding and linguistic comprehension contribute to reading comprehension in the framework of the widely known Simple View Model. This study aimed to identify the level of prediction by these two components in a sample of 1st to 4th grade children attending two schools in central Mexico (one public and one private). Within each school, ten children were randomly selected in each grade level, and their parents were asked about reading habits and socioeconomic information. In total, 79 children completed three standardized tests measuring decoding (pseudo-word reading), linguistic comprehension (understanding of paragraphs) and reading comprehension using subtests from the Clinical Evaluation of Language Fundamentals-Spanish, Fourth Edition, and the Test de Lectura y Escritura en Español (LEE). The data were analyzed using hierarchical regression, with decoding as a first step and linguistic comprehension as a second step. Results showed that decoding accounted for 19.2% of the variance in reading comprehension, while linguistic comprehension accounted for an additional 10%, adding up to 29.2% of variance explained: F (2, 75)= 15.45, p <.001. Socioeconomic status derived from parental questionnaires showed a statistically significant association with the type of school attended, X2 (3, N= 79) = 14.33, p =.002. Nonetheless when analyzing the Simple View components, only decoding differences were statistically significant (t = -6.92, df = 76.81, p < .001, two-tailed); reading comprehension differences were also significant (t = -3.44, df = 76, p = .001, two-tailed). When socioeconomic status was included in the model, it predicted a 5.9% unique variance, even when already accounting for Simple View components, adding to a 35.1% total variance explained. This three-predictor model was also significant: F (3, 72)= 12.99, p <.001. In addition, socioeconomic status was significantly correlated with the amount of non-textbook books parents reported to have at home for both adults (rho = .61, p<.001) and children (rho= .47, p<.001). Results converge with a large body of literature finding socioeconomic differences in reading comprehension; in addition this study suggests that these differences were also present in decoding skills. Although linguistic comprehension differences between schools were expected, it is argued that the test used to collect this variable was not sensitive to linguistic differences, since it came from a test to diagnose clinical language disabilities. Even with this caveat, results show that the components of the Simple View Model can predict less than a third of the variance in reading comprehension in Spanish. However, the results also suggest that a fuller model of reading comprehension is obtained when considering the family’s socioeconomic status, given the potential differences shown by the socioeconomic status association with books at home, factors that are particularly important in countries where inequality gaps are relatively large.

Keywords: decoding, linguistic comprehension, reading comprehension, simple view model, socioeconomic status, Spanish

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577 Iranian English as Foreign Language Teachers' Psychological Well-Being across Gender: During the Pandemic

Authors: Fatemeh Asadi Farsad, Sima Modirkhameneh

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The purpose of this study was to explore the pattern of Psychological Well-Being (PWB) of Iranian male and female EFL teachers during the pandemic. It was intended to see if such a drastic change in the context and mode of teaching affects teachers' PWB. Furthermore, the possible difference between the six elements of PWB of Iranian EFL male vs. female teachers during the pandemic was investigated. The other purpose was to find out the EFL teachers’ perceptions of any modifications, and factors leading to such modifications in their PWB during pandemic. For the purpose of this investigation, a total of 81 EFL teachers (59 female, 22 male) with an age range of 25 to 35 were conveniently sampled from different cities in Iran. Ryff’s PWB questionnaire was sent to participant teachers through online platforms to elicit data on their PWB. As for their perceptions on the possible modifications and the factors involved in PWB during pandemic, a set of semi-structured interviews were run among both sample groups. The findings revealed that male EFL teachers had the highest mean on personal growth, followed by purpose of life, and self-acceptance and the lowest mean on environmental mastery. With a slightly similar pattern, female EFL teachers had the highest mean on personal growth, followed by purpose in life, and positive relationship with others with the lowest mean on environmental mastery. However, no significant difference was observed between the male and female groups’ overall means on elements of PWB. Additionally, participants perceived that their anxiety level in online classes altered due to factors like (1) Computer literacy skills, (2) Lack of social communications and interactions with colleagues and students, (3) Online class management, (4) Overwhelming workloads, and (5) Time management. The study ends with further suggestions as regards effective online teaching preparation considering teachers PWB, especially at severe situations such as covid-19 pandemic. The findings offer to determine the reformations of educational policies concerning enhancing EFL teachers’ PWB through computer literacy courses and stress management courses. It is also suggested that to proactively support teachers’ mental health, it is necessary to provide them with advisors and psychologists if possible for free. Limitations: One limitation is the small number of participants (81), suggesting that future replications should include more participants for reliable findings. Another limitation is the gender imbalance, which future studies should address to yield better outcomes. Furthermore, Limited data gathering tools suggest using observations, diaries, and narratives for more insights in future studies. The study focused on one model of PWB, calling for further research on other models in the literature. Considering the wide effect of the COVID-19 pandemic, future studies should consider additional variables (e.g., teaching experience, age, income) to understand Iranian EFL teachers’ vulnerabilities and strengths better.

Keywords: online teaching, psychological well-being, female and male EFL teachers, pandemic

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576 Incidence of and Risk Factors for Post-Operative Cognitive Dysfunction (POCD) in Neurosurgical Patients: A Prospective Cohort Study

Authors: Suparna Bharadwaj, Sriganesh Kamath, Gopalakrishna K. N., Subhas Konar

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Introduction: Post-operative cognitive dysfunction (POCD) is a spectrum of clinical syndrome presenting as emergence delirium (ED) and/or post-operative delirium (POD). ED is a transient state (minutes to hours) of marked agitation after the discontinuation of general anesthesia, which does not respond to consoling measures. On the other hand, POD without identifiable etiology is not temporally related to emergence from anesthesia. These patients often emerge smoothly and may be lucid in the post-anesthesia care unit (PACU), but may develop fluctuating mental status, most commonly between postoperative days one and three. General anesthesia (GA) has been identified as a risk factor for POCD. Cranial surgeries involve brain handling in addition to exposure to GA. We hypothesize that the incidence of postoperative delirium after cranial surgery is twice that of spinal surgery. The primary objective of this study was to evaluate the incidence of emergence delirium and postoperative delirium in patients undergoing cranial and spinal neurosurgeries. The secondary objective was to identify the perioperative risk factors of ED and POD. Methods: This was a prospective cohort observation study conducted from March 2020 to September 2023 conducted at a tertiary neurocentre. After obtaining institutional ethics committee approval, adult patients undergoing cranial or spinal surgery with a Glasgow coma scale of 15 were included in the study. Patients undergoing cranial surgery are considered exposed to risk factors, while patients undergoing spinal surgery are considered unexposed. All study subjects received standard general anesthesia. About twenty perioperative parameters were identified as risk factors for POCD. ED was assessed using the Riker sedation agitation scale, and POD was assessed using the confusion assessment method. A sample size of 2000 patients was planned with 1000 each cranial and spinal cases. However, around 700 spinal patients could be recruited for this study. Results: In this study, about two thousand patients were screened for inclusion. However, 1185 cranial cases and 742 spinal cases were considered for final analysis. Both the groups were similar in terms of demographics. Incidence of ED was 25.8% after cranial surgery vs 10.24% after spinal surgery (relative risk 2.5). The incidence of POD after cranial surgery is 20.25% vs 2.15% after cranial surgery (relative risk 9.3). All the proposed risk factors were assessed using binomial logistic regression. Conclusion: Cranial cases expose patients to a nine times higher risk for the development of postoperative delirium. The presence of ED predisposes to POD representing a spectrum.

Keywords: post operative cognitive dysfunction, Neurosurgical patients cohort study, cohort study, emergence delirium

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575 The Study of Difficulties of Understanding Idiomatic Expressions Encountered by Translators 2021

Authors: Mohamed Elmogbail

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The present study aimed at investigating difficulties those Translators encounter in understanding idiomatic expressions between Arabic and English languages. To achieve this goal, the researcher raised the three questions are:(1) What are the major difficulties that translators encounter in translating idiomatic expressions? (2) What factors cause such difficulties that translators encountered in translating idiomatic expressions? (3) What are the possible techniques that should be followed to overcome these difficulties? To answer these questions, the researcher designed questionnaire Table (2) and mentioned tables related to Test Show the second question in the study is about the factors that stand behind the challenges. Translators encounter while translating idiomatic expressions. The translators asked Provided the following factors:1- Because of lack of exposure to the source culture, they do not know the connotations of the cultural words that are related to the environment, food, folklore 2- Misusing dictionaries made the participants unable to find a proper target language idiomatic expression. 3-Lack of using idiomatic expressions in daily life. Table (3): (Questionnaire) Results to the table (3) Questions Of the study are About suggestions that can be inferred to handle these challenges. The questioned translators provided the following solutions:1- translators must be exposed to source language culture, including religion, habits, and traditions.2- translators should also be exposed to source language idiomatic expressions by introducing English culture in textbooks and through participating in extensive English culture courses.3- translators should be familiar with the differences between source and target language cultures.4- translators should avoid literal translation that results in most cases in wrong or poor translation.5- Schools, universities, and institutions should introduce translators to English culture.6- translators should participate in cultural workshops at universities.7- translators should try to use idiomatic expressions in everyday situations.8- translators should read more idiomatic expressions books. And researcher also designed a translation test consisted of 40 excerpts given to a random sample of 100 Translators in Khartoum capital of Sudan to translate them. After Collected data for the study, the researcher proceeded to a more detailed analysis, the methodology used in the analysis of idiomatic expressions Is empirical and descriptive. This study is qualitative by nature, but the quantitative method used the analysis of the data. Some figure and statistics are used, such as (statistical package for the social sciences). The researcher calculated the percentage proportion of each translation expressions. And compared them to each other. The finding of the study showed that most translations are inadequate as the translators faced difficulties while communication, these difficulties were mostly due to their unfamiliarity with idiomatic expressions producing improper equivalence in the communication, and not being able to use translation techniques as required, and resorted to literal translation, furthermore, the study recommended that more comprehensive studies to executed on translating idiomatic expressions to enrich the translation field.

Keywords: translation, translators, idioms., expressions

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574 Impact of Financial and Nutrition Support on Blood Health, Dietary Intake, and Well-Being among Female Student-Athletes

Authors: Kaila A. Vento

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Within the field of sports science, financial situations have been reported as a key barrier in purchasing high-quality foods. A lack of proper nutrition leads to insecurities of health, impairs training, and diminishes optimal performances. Consequently, insufficient nutrient intake, disordered eating patterns, and eating disorders may arise, leading to poor health and well-being. Athletic scholarships, nutrition resources, and meal programs are available, yet are disproportionally allocated, favoring male sports, Caucasian athletes, and higher sport levels. Direct athlete finances towards nutrition at various sport levels and the role race influences aid received has yet to be examined. Additionally, a diverse female athlete population is missing in the sports science literature, specifically in nutrition. To address this gap, the current project assesses how financial and nutrition support and nutrition knowledge impacts physical health, dietary intake, and overall quality of life of a diverse sample of female athletes at the National Collegiate Athletic Association (NCAA), National Junior Collegiate Athletic Association (NJCAA), and cub sport levels. The project will identify differences in financial support in relation to race, as well. Approximately (N = 120) female athletes will participate in a single 30-minute lab visit. At this visit, body composition (i.e., height, weight, body mass index, and fat percent), blood health indicators (fasted blood glucose and lipids), and resting blood pressure are measured. In addition, three validated questionnaires pertaining to nutrition knowledge (Sports Nutrition Knowledge Questionnaire; SNKQ), dietary intake (Rapid Eating Assessment for Participants; REAP), and quality of life (World Health Organization Quality of Life Brief; WHOQL-B) are gathered. Body composition and blood health indicators will be compared with the results of self-reported sports nutrition knowledge, dietary intake, and quality of life questionnaires. It is hypothesized that 1) financial and nutrition support and nutrition knowledge will differ between the sport levels and 2) financial and nutrition support and nutrition knowledge will have a positive association with quality of dietary intake and blood health indicators, 3) financial and nutrition support will differ significantly among racial background across the various competition levels, and 4) dietary intake will influence blood health indicators and quality of life. The findings from this study could have positive implications on athletic associations' policies on equity of financial and nutrition support to improve the health and safety of all female athletes across several sport levels.

Keywords: athlete, equity, finances, health, resources

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573 Consultation Time and Its Impact on Length of Stay in the Emergency Department

Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

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Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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572 Exploring Faculty Attitudes about Grades and Alternative Approaches to Grading: Pilot Study

Authors: Scott Snyder

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Grading approaches in higher education have not changed meaningfully in over 100 years. While there is variation in the types of grades assigned across countries, most use approaches based on simple ordinal scales (e.g, letter grades). While grades are generally viewed as an indication of a student's performance, challenges arise regarding the clarity, validity, and reliability of letter grades. Research about grading in higher education has primarily focused on grade inflation, student attitudes toward grading, impacts of grades, and benefits of plus-minus letter grade systems. Little research is available about alternative approaches to grading, varying approaches used by faculty within and across colleges, and faculty attitudes toward grades and alternative approaches to grading. To begin to address these gaps, a survey was conducted of faculty in a sample of departments at three diverse colleges in a southeastern state in the US. The survey focused on faculty experiences with and attitudes toward grading, the degree to which faculty innovate in teaching and grading practices, and faculty interest in alternatives to the point system approach to grading. Responses were received from 104 instructors (21% response rate). The majority reported that teaching accounted for 50% or more of their academic duties. Almost all (92%) of respondents reported using point and percentage systems for their grading. While all respondents agreed that grades should reflect the degree to which objectives were mastered, half indicated that grades should also reflect effort or improvement. Over 60% felt that grades should be predictive of success in subsequent courses or real life applications. Most respondents disagreed that grades should compare students to other students. About 42% worried about their own grade inflation and grade inflation in their college. Only 17% disagreed that grades mean different things based on the instructor while 75% thought it would be good if there was agreement. Less than 50% of respondents felt that grades were directly useful for identifying students who should/should not continue, identify strengths/weaknesses, predict which students will be most successful, or contribute to program monitoring of student progress. Instructors were less willing to modify assessment than they were to modify instruction and curriculum. Most respondents (76%) were interested in learning about alternative approaches to grading (e.g., specifications grading). The factors that were most associated with willingness to adopt a new grading approach were clarity to students and simplicity of adoption of the approach. Follow-up studies are underway to investigate implementations of alternative grading approaches, expand the study to universities and departments not involved in the initial study, examine student attitudes about alternative approaches, and refine the measure of attitude toward adoption of alternative grading practices within the survey. Workshops about challenges of using percentage and point systems for determining grades and workshops regarding alternative approaches to grading are being offered.

Keywords: alternative approaches to grading, grades, higher education, letter grades

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571 Ultra-Sensitive Point-Of-Care Detection of PSA Using an Enzyme- and Equipment-Free Microfluidic Platform

Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

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570 Challenges & Barriers for Neuro Rehabilitation in Developing Countries

Authors: Muhammad Naveed Babur, Maria Liaqat

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Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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569 Assessment of Community Perceptions of Mangrove Ecosystem Services and Their Link to SDGs in Vanga, Kenya

Authors: Samson Obiene, Khamati Shilabukha, Geoffrey Muga, James Kairo

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Mangroves play a vital role in the achievement of multiple goals of global sustainable development (SDG’s), particularly SDG SDG 14 (life under water). Their management, however, is faced with several shortcomings arising from inadequate knowledge on the perceptions of their ecosystem services, hence a need to map mangrove goods and services within SDGs while interrogating the disaggregated perceptions. This study therefore aimed at exploring the parities and disparities in attitudes and perceptions of mangrove ecosystem services among community members of Vanga and the link of the ecosystem services (ESs) to specific SDG targets. The study was based at the Kenya-Tanzania transboundary area in Vanga; where a carbon-offset project on mangroves is being up scaled. Mixed methods approach employing surveys, focus group discussions (FGDs) and reviews of secondary data were used in the study. A two stage cluster samplings was used to select the study population and the sample size. FGDs were conducted purposively selecting active participants in mangrove related activities with distinct socio-demographic characteristics. Sampled respondents comprised of males and females of different occupations and age groups. Secondary data review was used to select specific SDG targets against which mangrove ecosystem services identified through a value chain analysis were mapped. In Vanga, 20 ecosystem services were identified and categorized under supporting, cultural and aesthetic, provisioning and regulating services. According to the findings of this study, 63.9% (95% ci 56.6-69.3) perceived of the ESs as very important for economic development, 10.3% (95% ci 0-21.3) viewed them as important for environmental and ecological development while 25.8% (95% ci 2.2-32.8) were not sure of any role they play in development. In the social-economic disaggregation, ecosystem service values were found to vary with the level of interaction with the ecosystem which depended on gender and other social-economic classes within the study area. The youths, low income earners, women and those with low education levels were also identified as the primary beneficiaries of mangrove ecosystem services. The study also found that of the 17 SDGs, mangroves have a potential of influencing the achievement 12, including, SDGs 1, 2, 3, 4, 6, 8 10, 12, 13, 14, 15 and 17 either directly or indirectly. Generally therefore, the local community is aware of the critical importance mangroves for enhanced livelihood and ecological services but challenges in sustainability still occur as a result the diverse values and of the services and the contradicting interests of the different actors around the ecosystem. It is therefore important to consider parities in values and perception to avoid a ‘tragedy of the commons’ while striving to enhance sustainability of the Mangrove ecosystem.

Keywords: sustainable development, community values, socio-demographics, Vanga, mangrove ecosystem services

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568 Examination of Calpurnia Aurea Seed Extract Activity Against Hematotoxicity and Hepatotoxicity in HAART Drug Induced Albino Wistar Rat

Authors: Haile Nega Mulata, Seifu Daniel, Umeta Melaku, Wendwesson Ergete, Natesan Gnanasekaran

Abstract:

Background: In Ethiopia, medicinal plants have been used for various human and animal diseases. In this study, we have examined the potential effect of hydroethanolic extract of Calpurnia aurea seed against hepatotoxicity and haematotoxicity induced by Highly Active Antiretroviral Therapy (HAART) drugs in Albino Wistar rats. Methods: We collected Matured dried seeds of Calpurnia aurea from northern Ethiopia (south Tigray and south Gondar) in June 2013. The powder of the dried seed sample was macerated with 70% ethanol and dried using rotavapor. We have investigated the Preliminary phytochemical tests and in-vitro antioxidant properties. Then, we induced toxicity with HAART drugs and gave the experimental animals different doses of the crude extract orally for thirty-five days. On the 35th day, the animals were fasted overnight and sacrificed by cervical dislocation. We collected the blood samples by cardiac puncture. We excised the liver and brain tissues for further histopathological studies. Subsequently, we analysed serum levels of the liver enzymes- Alanine Aminotransferase, Aspartate Aminotransferase, Alkaline Phosphatase, Total Bilirubin, and Serum Albumin, using commercial kits in Cobas Integra 400 Plus Roche Analyzer Germany. We have also assessed the haematological profile using an automated haematology Analyser (Sysmex KX-2IN). Results: A significant (P<0.05) decrease in serum enzymes (ALT and AST) and total bilirubin were observed in groups that received the highest dose (300mg/kg) of the seed extract. And significant (P<0.05) elevation of total red blood cell count, haemoglobin, and hematocrit percentage was observed in the groups that received the seed extract compared to the HAART-treated groups. The WBC count mean values showed a statistically significant increase (p<0.05) in groups that received HAART and 200 and 300mg/kg extract, respectively. The histopathological observations also showed that the oral administration of varying doses of the crude extract of the seed reversed to a normal state. Conclusion: The hydroethanolic extract of the Calpurnia aurea seed lowered the hepatotoxicity and haematotoxicity in a dose-dependent manner. The antioxidant properties of the Calpurnia aurea seed extract may have possible protective effects against the drug's toxicity.

Keywords: calpurnia aurea, hepatotoxicity, haematotoxicity, antioxidant, histopathology, HAART

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567 Employee Wellbeing: The Key to Organizational Success

Authors: Crystal Hoole

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Employee well-being has become an area of concern for top executives and organizations worldwide. In developing countries such as South Africa, and especially in the educational sector, employees have to deal with anxiety, stress, fear, student protests, political and economic turmoil and excessive work demands on a daily basis. Research has shown that workplaces with higher resilience and better well-being strategies also report higher productivity, increased innovation, better employee retention and better employee engagement. Many organisations offer standard employee assistance programs and once-off short interventions. However, most of these well-being initiatives are perceived as ineffective. Some of the criticism centers around a lack of holistic well-being approaches, no proof of the success of well-being initiatives, not being part of the organization’s strategies and a lack of genuine leadership support. This study attempts to illustrate how a holistic well-being intervention, over a period of 100 days, is far more effective in impacting organizational outcomes. A quasi-experimental design, with a pre-test and pro-test design with a randomization strategy, will be used. Measurements of organizational outcomes are taken at three-time points throughout the study, before, middle and after. The constructs that will be measured are employee engagement, psychological well-being, organizational culture and trust, and perceived stress. The well-being is imitative follows a salutogenesis approach and is aimed at building resilience through focusing on six focal areas, namely sleep, mindful eating, exercise, love, gratitude and appreciation, breath work and mindfulness, and finally, purpose. Certain organizational constructs, including employee engagement, psychological well-being, organizational culture and trust and perceived stress, will be measured at three-time points during the study, namely before, middle and after. A quasi-experimental, pre-test and post-test design will be applied, also using a randomization strategy to limit potential bias. Repeated measure ANCOVA will be used to determine whether any change occurred over the period of 100 days. The study will take place in a Higher Education institution in South Africa. The sample will consist of academic and administrative staff. Participants will be assigned to a test and control group. All participants will complete a survey measuring employee engagement, psychological well-being, organizational culture and trust, and perceived stress. Only the test group will undergo the well-being intervention. The study envisages contributing on several levels: Firstly, the study hopes to find a positive increase in the various well-being indicators of the participants who participated in the study and secondly to illustrate that a longer more holistic approach is successful in improving organisational success (as measured in the various organizational outcomes).

Keywords: wellbeing, resilience, organizational success, intervention

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566 Comparison of Verb Complementation Patterns in Selected Pakistani and British English Newspaper Social Columns: A Corpus-Based Study

Authors: Zafar Iqbal Bhatti

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The present research aims to examine and evaluate the frequencies and practices of verb complementation patterns in English newspaper social columns published in Pakistan and Britain. The research will demonstrate that Pakistani English is a non-native variety of English having its own unique usual and logical characteristics, affected by way of the native languages and the culture, upon syntactic levels, making the variety users aware that any differences from British or American English that are systematic and regular, or another English language, are not even if they are unique, erroneous forms and typical characteristics of several kinds. The objectives are to examine the verb complementation patterns that British and Pakistani social columnists use in relation to their syntactic categories. Secondly, to compare the verb complementation patterns used in Pakistani and British English newspapers social columns. This study will figure out various verb complementation patterns in Pakistani and British English newspaper social columns and their occurrence and distribution. The word classes express different functions of words, such as action, event, or state of being. This research aims to evaluate whether there are any appreciable differences in the verb complementation patterns used in Pakistani and British English newspaper social columns. The results will show the number of varieties of verb complementation patterns in selected English newspapers social columns. This study will fill the gap of previous studies conducted in this field as they only explore a little about the differences between Pakistani and British English newspapers. It will also figure out a variety of languages used in Pakistani and British English journals, as well as regional and cultural values and variations. The researcher will use AntConc software in this study to extract the data for analysis. The researcher will use a concordance tool to identify verb complementation patterns in selected data. Then the researcher will manually categorize them because the same type of adverb can sometimes be used for various purposes. From 1st June 2022 to 30th Sep. 2022, a four-month written corpus of the social columns of PE and BE newspapers will be collected and analyzed. For the analysis of the research questions, 50 social columns will be selected from Pakistani newspapers and 50 from British newspapers. The researcher will collect a representative sample of data from Pakistani and British English newspaper social columns. The researcher will manually analyze the complementation patterns of each verb in each sentence, and then the researcher will determine how frequently each pattern occurs. The researcher will use syntactic characteristics of the verb complementation elements according to the description by Downing and Locke (2006). The researcher will examine all of the verb complementation patterns in the data, and the frequency and distribution of each verb complementation pattern will be evaluated using the software. The researcher will explore every possible verb complementation pattern in Pakistani and British English before calculating the occurrence and abundance of each verb pattern. The researcher will explore every possible verb complementation pattern in Pakistani English before calculating the frequency and distribution of each pattern.

Keywords: verb complementation, syntactic categories, newspaper social columns, corpus

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565 Social Entrepreneurship Core Dimensions and Influential Perspectives: An Exploratory Study

Authors: Filipa Lancastre, Carmen Lages, Filipe Santos

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The concept of social entrepreneurship (SE) remains ambiguous and deprived of a widely accepted operational definition. We argue that an awareness about the consensual constituent elements of SE from all key players from its ecosystem as well as a deeper understanding of apparently divergent perspectives will allow the different stakeholders (social entrepreneurs, corporations, investors, policymakers, the beneficiaries themselves) to bridge and cooperate for societal value co-creation in trying to solve our most pressing societal issues. To address our research question –what are the dimensions of SE that are consensual and controversial across existing perspectives? – We designed a two-step qualitative study. In a first step, we conducted an extensive literature review, collecting and analyzing 155 different SE definitions. From this initial step, we extracted and characterized three consensual and six controversial dimensions of the SE concept. In a second step, we conducted 20 semi-structured interviews with practitioners that are actively involved in the SE field. The goal of this second step was to verify if the literature did not capture any key dimension, understand how the dimensions related to each other and to understand the rationale behind them. The dimensions of the SE concept were extracted based on the relevance of each theme and on the theoretical relationship among them. To identify the relevance, we used as a proxy the frequency of each theme was referred to in our sample of definitions. To understand relationships, as identified in the previous section, we included concepts from both the management and psychology literature, such as the Entrepreneurial Orientation concept from the entrepreneurship literature, the Subjective Well Being construct from psychology literature, and the Resource-Based Theory from the strategy literature. This study has two main contributions; First, the identification of (consensual and controversial) dimensions of SE that exist across scattered definitions from the academic and practitioner literature. Second, a framework that parsimoniously synthesizes four dominant perspectives of SE and relates them with the SE dimensions. Assuming the contested nature of the SE concept, it is not expected that these views will be reconciled at the academic or practitioner field level. In future research, academics can, however, be aware of the existence of different understandings of SE and avoid bias towards a single view, developing holistic studies on SE phenomena or comparing differences by studying their underlying assumptions. Additionally, it is important that researchers make explicit the perspective they are embracing to ensure consistency among the research question, sampling procedures and implications of results. At the practitioner level, individuals or groups following different logics are predictably mutually suspicious and might benefit from taking stock of other perspectives on SE, building bridges and fostering cross-fertilization to the benefit of the SE ecosystem for which all contribute.

Keywords: social entrepreneurship, conceptualization, dimensions, perspectives

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564 The Relationship between Extremely High Levels of Testosterone in Blood and Chronic Diseases and Attention Disorders: A Study of Different Population Groups

Authors: Armin Taheri

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Testosterone levels can impact physical and mental health, with abnormal levels potentially leading to chronic diseases and attention disorders. Further exploration is needed to understand how extremely high testosterone levels affect different population groups. The primary aim of this study is to examine the impact of extremely high levels of testosterone in the blood on chronic diseases and attention disorders. The specific objectives are as follows: i. to compare testosterone levels in athletes and non-athletes, ii. to analyze the association between extremely high testosterone levels and the incidence of chronic diseases, iii. to evaluate the impact of testosterone on attention in hyperactive and typical students. This research was conducted as a cross-sectional study using advanced statistical and technological methods. The study population included male students from boys' schools and male athletes from sports clubs in Shiraz, Iran. Random sampling was performed from 10 schools and 5 sports clubs. The total sample size was 300 participants divided into three groups: 100 professional athletes from sports clubs, 100 non-athletes with no physical activity from boys' schools, 100 students (50 hyperactive and 50 typical) from boys' schools. Testosterone levels were measured using Liquid Chromatography-Mass Spectrometry (LC-MS/MS). This method provides high accuracy in determining hormone concentrations in blood. Data were analyzed using statistical tests, including ANOVA and linear regression, to examine differences and correlations. Professional athletes had significantly higher testosterone levels compared to non-athletes. This increase was associated with improved physical performance and a reduced risk of chronic diseases. Non-athletes with no physical activity generally exhibited lower testosterone levels, which were linked to a higher risk of diabetes and cardiovascular diseases. Hyperactive students had higher testosterone levels, which may be associated with attention disorders and impulsive behaviors. Typical students showed balanced testosterone levels, correlating with better cognitive performance and increased attention. The findings of this study indicate that extremely high levels of testosterone can have varying effects on physical and mental health. While athletes benefit from higher testosterone levels, such levels in hyperactive students may lead to attention disorders and unstable behaviors. The use of LC-MS/MS for precise testosterone measurement is a valuable tool for analyzing these effects. These results emphasize the importance of regulating physical activity and managing hormone levels to promote health.

Keywords: attention disorders, chronic diseases, different population groups, extremely high testosterone levels

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