Search results for: negative pressure wound therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10236

Search results for: negative pressure wound therapy

936 Overcoming Mistrusted Masculinity: Analyzing Muslim Men and Their Aspirations for Fatherhood in Denmark

Authors: Anne Hovgaard Jorgensen

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This study investigates how Muslim fathers in Denmark are struggling to overcome notions of mistrust from teachers and educators. Starting from school-home-cooperation (parent conferences, school-home communication, etc.), the study finds that many Muslim fathers do not feel acknowledged as a resource in the upbringing of their children. To explain these experiences further, the study suggest the notion of ‘mistrusted masculinity’ to grasp the controlling image these fathers meet in various schools and child-care-institutions in the Danish Welfare state. The paper is based on 9 months of fieldwork in a Danish school, a social housing area and in various ‘father groups’ in Denmark. Additional, 50 interviews were conducted with fathers, children, mothers, schoolteachers, and educators. By using Connell's concepts 'hegemonic' and 'marginalized' masculinity as steppingstones, the paper argues that these concepts might entail a too static and dualistic picture of gender. By applying the concepts of 'emergent masculinity' and 'emergent fatherhood' the paper brings along a long needed discussion of how Muslim men in Denmark are struggling to overcome and change the controlling images of them as patriarchal and/or ignorant fathers regarding the upbringing of their children. As such, the paper shows how Muslim fathers are taking action to change this controlling image, e.g. through various ‘father groups’. The paper is inspired by the phenomenological notions of ‘experience´ and in the light of this notion, the paper tells the fathers’ stories about their upbringing of their children and aspirations for fatherhood. These stories share light on how these fathers take care of their children in everyday life. The study also shows that the controlling image of these fathers have affected how some Muslim fathers are actually being fathers. The study shows that fear of family-interventions from teachers or social workers e.g. have left some Muslim fathers in a limbo, being afraid of scolding their children, and being confused of ‘what good parenting in Denmark is’. This seems to have led to a more lassie fair upbringing than these fathers actually wanted. This study is important since anthropologists generally have underexposed the notion of fatherhood, and how fathers engage in the upbringing of their children. Over more, the vast majority of qualitative studies of fatherhood have been on white middleclass fathers, living in nuclear families. In addition, this study is crucial at this very moment due to the major refugee crisis in Denmark and in the Western world in general. A crisis, which has resulted in a vast number of scare campaigns against Islam from different nationalistic political parties, which enforces the negative controlling image of Muslim fathers.

Keywords: fatherhood, Muslim fathers, mistrust, education

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935 Principal Well-Being at Hong Kong: A Quantitative Investigation

Authors: Junjun Chen, Yingxiu Li

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The occupational well-being of school principals has played a vital role in the pursuit of individual and school wellness and success. However, principals’ well-being worldwide is under increasing threat because of the challenging and complex nature of their work and growing demands for school standardisation and accountability. Pressure is particularly acute in the post-pandemicfuture as principals attempt to deal with the impact of the pandemic on top of more regular demands. This is particularly true in Hong Kong, as school principals are increasingly wedged between unparalleled political, social, and academic responsibilities. Recognizing the semantic breadth of well-being, scholars have not determined a single, mutually agreeable definition but agreed that the concept of well-being has multiple dimensions across various disciplines. The multidimensional approach promises more precise assessments of the relationships between well-being and other concepts than the ‘affect-only’ approach or other single domains for capturing the essence of principal well-being. The multiple-dimension well-being concept is adopted in this project to understand principal well-being in this study. This study aimed to understand the situation of principal well-being and its influential drivers with a sample of 670 principals from Hong Kong and Mainland China. An online survey was sent to the participants after the breakout of COVID-19 by the researchers. All participants were well informed about the purposes and procedure of the project and the confidentiality of the data prior to filling in the questionnaire. Confirmatory factor analysis and structural equation modelling performed with Mplus were employed to deal with the dataset. The data analysis procedure involved the following three steps. First, the descriptive statistics (e.g., mean and standard deviation) were calculated. Second, confirmatory factor analysis (CFA) was used to trim principal well-being measurement performed with maximum likelihood estimation. Third, structural equation modelling (SEM) was employed to test the influential factors of principal well-being. The results of this study indicated that the overall of principal well-being were above the average mean score. The highest ranking in this study given by the principals was to their psychological and social well-being (M = 5.21). This was followed by spiritual (M = 5.14; SD = .77), cognitive (M = 5.14; SD = .77), emotional (M = 4.96; SD = .79), and physical well-being (M = 3.15; SD = .73). Participants ranked their physical well-being the lowest. Moreover, professional autonomy, supervisor and collegial support, school physical conditions, professional networking, and social media have showed a significant impact on principal well-being. The findings of this study will potentially enhance not only principal well-being, but also the functioning of an individual principal and a school without sacrificing principal well-being for quality education in the process. This will eventually move one step forward for a new future - a wellness society advocated by OECD. Importantly, well-being is an inside job that begins with choosing to have wellness, whilst supports to become a wellness principal are also imperative.

Keywords: well-being, school principals, quantitative, influential factors

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934 Quantification and Detection of Non-Sewer Water Infiltration and Inflow in Urban Sewer Systems

Authors: M. Beheshti, S. Saegrov, T. M. Muthanna

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Separated sewer systems are designed to transfer the wastewater from houses and industrial sections to wastewater treatment plants. Unwanted water in the sewer systems is a well-known problem, i.e. storm-water inflow is around 50% of the foul sewer, and groundwater infiltration to the sewer system can exceed 50% of total wastewater volume in deteriorated networks. Infiltration and inflow of non-sewer water (I/I) into sewer systems is unfavorable in separated sewer systems and can trigger overloading the system and reducing the efficiency of wastewater treatment plants. Moreover, I/I has negative economic, environmental, and social impacts on urban areas. Therefore, for having sustainable management of urban sewer systems, I/I of unwanted water into the urban sewer systems should be considered carefully and maintenance and rehabilitation plan should be implemented on these water infrastructural assets. This study presents a methodology to identify and quantify the level of I/I into the sewer system. Amount of I/I is evaluated by accurate flow measurement in separated sewer systems for specified isolated catchments in Trondheim city (Norway). Advanced information about the characteristics of I/I is gained by CCTV inspection of sewer pipelines with high I/I contribution. Achieving enhanced knowledge about the detection and localization of non-sewer water in foul sewer system during the wet and dry weather conditions will enable the possibility for finding the problem of sewer system and prioritizing them and taking decisions for rehabilitation and renewal planning in the long-term. Furthermore, preventive measures and optimization of sewer systems functionality and efficiency can be executed by maintenance of sewer system. In this way, the exploitation of sewer system can be improved by maintenance and rehabilitation of existing pipelines in a sustainable way by more practical cost-effective and environmental friendly way. This study is conducted on specified catchments with different properties in Trondheim city. Risvollan catchment is one of these catchments with a measuring station to investigate hydrological parameters through the year, which also has a good database. For assessing the infiltration in a separated sewer system, applying the flow rate measurement method can be utilized in obtaining a general view of the network condition from infiltration point of view. This study discusses commonly used and advanced methods of localizing and quantifying I/I in sewer systems. A combination of these methods give sewer operators the possibility to compare different techniques and obtain reliable and accurate I/I data which is vital for long-term rehabilitation plans.

Keywords: flow rate measurement, infiltration and inflow (I/I), non-sewer water, separated sewer systems, sustainable management

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933 Characterization of Dota-Girentuximab Conjugates for Radioimmunotherapy

Authors: Tais Basaco, Stefanie Pektor, Josue A. Moreno, Matthias Miederer, Andreas Türler

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Radiopharmaceuticals based in monoclonal anti-body (mAb) via chemical linkers have become a potential tool in nuclear medicine because of their specificity and the large variability and availability of therapeutic radiometals. It is important to identify the conjugation sites and number of attached chelator to mAb to obtain radioimmunoconjugates with required immunoreactivity and radiostability. Girentuximab antibody (G250) is a potential candidate for radioimmunotherapy of clear cell carcinomas (RCCs) because it is reactive with CAIX antigen, a transmembrane glycoprotein overexpressed on the cell surface of most ( > 90%) (RCCs). G250 was conjugated with the bifunctional chelating agent DOTA (1,4,7,10-Tetraazacyclododecane-N,N’,N’’,N’’’-tetraacetic acid) via a benzyl-thiocyano group as a linker (p-SCN-Bn-DOTA). DOTA-G250 conjugates were analyzed by size exclusion chromatography (SE-HPLC) and by electrophoresis (SDS-PAGE). The potential site-specific conjugation was identified by liquid chromatography–mass spectrometry (LC/MS-MS) and the number of linkers per molecule of mAb was calculated using the molecular weight (MW) measured by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The average number obtained in the conjugates in non-reduced conditions was between 8-10 molecules of DOTA per molecule of mAb. The average number obtained in the conjugates in reduced conditions was between 1-2 and 3-4 molecules of DOTA per molecule of mAb in the light chain (LC) and heavy chain (HC) respectively. Potential DOTA modification sites of the chelator were identified in lysine residues. The biological activity of the conjugates was evaluated by flow cytometry (FACS) using CAIX negative (SKRC-18) and CAIX positive (SKRC-52). The DOTA-G250 conjugates were labelled with 177Lu with a radiochemical yield > 95% reaching specific activities of 12 MBq/µg. The stability in vitro of different types of radioconstructs was analyzed in human serum albumin (HSA). The radiostability of 177Lu-DOTA-G250 at high specific activity was increased by addition of sodium ascorbate after the labelling. The immunoreactivity was evaluated in vitro and in vivo. Binding to CAIX positive cells (SK-RC-52) at different specific activities was higher for conjugates with less DOTA content. Protein dose was optimized in mice with subcutaneously growing SK-RC-52 tumors using different amounts of 177Lu- DOTA-G250.

Keywords: mass spectrometry, monoclonal antibody, radiopharmaceuticals, radioimmunotheray, renal cancer

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932 A New Approach for Preparation of Super Absorbent Polymers: In-Situ Surface Cross-Linking

Authors: Reyhan Özdoğan, Mithat Çelebi, Özgür Ceylan, Mehmet Arif Kaya

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Super absorbent polymers (SAPs) are defined as materials that can absorb huge amount of water or aqueous solution in comparison to their own mass and retain in their lightly cross-linked structure. SAPs were produced from water soluble monomers via polymerization subsequently controlled crosslinking. SAPs are generally used for water absorbing applications such as baby diapers, patient or elder pads and other hygienic product industries. Crosslinking density (CD) of SAP structure is an essential factor for water absortion capacity (WAC). Low internal CD leads to high WAC values and vice versa. However, SAPs have low CD and high swelling capacities and tend to disintegrate when pressure is applied upon them, so SAPs under load cannot absorb liquids effectively. In order to prevent this undesired situation and to obtain suitable SAP structures having high swelling capacity and ability to work under load, surface crosslinking can be the answer. In industry, these superabsorbent gels are mostly produced via solution polymerization and then they need to be dried, grinded, sized, post polymerized and finally surface croslinked (involves spraying of a crosslinking solution onto dried and grinded SAP particles, and then curing by heat). It can easily be seen that these steps are time consuming and should be handled carefully for the desired final product. If we could synthesize desired final SAPs using less processes it will help reducing time and production costs which are very important for any industries. In this study, synthesis of SAPs were achieved successfully by inverse suspension (Pickering type) polymerization and subsequently in-situ surface cross-linking via using proper surfactants in high boiling point solvents. Our one-pot synthesis of surface cross-linked SAPs invovles only one-step for preparation, thus it can be said that this technique exhibits more preferable characteristic for the industry in comparison to conventional methods due to its one-step easy process. Effects of different surface crosslinking agents onto properties of poly(acrylic acid-co-sodium acrylate) based SAPs are investigated. Surface crosslink degrees are evaluated by swelling under load (SUL) test. It was determined water absorption capacities of obtained SAPs decrease with the increasing surface crosslink density while their mechanic properties are improved.

Keywords: inverse suspension polymerization, polyacrylic acid, super absorbent polymers (SAPs), surface crosslinking, sodium polyacrylate

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931 The Aromaticity of P-Substituted O-(N-Dialkyl)Aminomethylphenols

Authors: Khodzhaberdi Allaberdiev

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Aromaticity, one of the most important concepts in organic chemistry, has attracted considerable interest from both experimentalists and theoreticians. The geometry optimization of p-substituted o-(N-dialkyl)aminomethylphenols, o-DEAMPH XC₆ H₅CH ₂Y (X=p-OCH₃, CH₃, H, F, Cl, Br, COCH₃, COOCH₃, CHO, CN and NO₂, Y=o-N (C₂H₅)₂, o-DEAMPHs have been performed in the gas phase using the B3LYP/6-311+G(d,p) level. Aromaticities of the considered molecules were investigated using different indices included geometrical (HOMA and Bird), electronic (FLU, PDI and SA) magnetic (NICS(0), NICS(1) and NICS(1)zz indices. The linear dependencies were obtained between some aromaticity indices. The best correlation is observed between the Bird and PDI indices (R² =0.9240). However, not all types of indices or even different indices within the same type correlate well among each other. Surprisingly, for studied molecules in which geometrical and electronic cannot correctly give the aromaticity of ring, the magnetism based index successfully predicts the aromaticity of systems. 1H NMR spectra of compounds were obtained at B3LYP/6–311+G(d,p) level using the GIAO method. Excellent linear correlation (R²= 0.9996) between values the chemical shift of hydrogen atom obtained experimentally of 1H NMR and calculated using B3LYP/6–311+G(d,p) demonstrates a good assignment of the experimental values chemical shift to the calculated structures of o-DEAMPH. It is found that the best linear correlation with the Hammett substituent constants is observed for the NICS(1)zz index in comparison with the other indices: NICS(1)zz =-21.5552+1,1070 σp- (R²=0.9394). The presence intramolecular hydrogen bond in the studied molecules also revealed changes the aromatic character of substituted o-DEAMPHs. The HOMA index predicted for R=NO2 the reduction in the π-electron delocalization of 3.4% was about double that observed for p-nitrophenol. The influence intramolecular H-bonding on aromaticity of benzene ring in the ground state (S0) are described by equations between NICS(1)zz and H-bond energies: experimental, Eₑₓₚ, predicted IR spectroscopical, Eν and topological, EQTAIM with correlation coefficients R² =0.9666, R² =0.9028 and R² =0.8864, respectively. The NICS(1)zz index also correlates with usual descriptors of the hydrogen bond, while the other indices do not give any meaningful results. The influence of the intramolecular H-bonding formation on the aromaticity of some substituted o-DEAMPHs is criteria to consider the multidimensional character of aromaticity. The linear relationships as well as revealed between NICS(1)zz and both pyramidality nitrogen atom, ΣN(C₂H₅)₂ and dihedral angle, φ CAr – CAr -CCH₂ –N, to characterizing out-of-plane properties.These results demonstrated the nonplanar structure of o-DEAMPHs. Finally, when considering dependencies of NICS(1)zz, were excluded data for R=H, because the NICS(1) and NICS(1)zz values are the most negative for unsubstituted DEAMPH, indicating its highest aromaticity; that was not the case for NICS(0) index.

Keywords: aminomethylphenols, DFT, aromaticity, correlations

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930 Frequency Interpretation of a Wave Function, and a Vertical Waveform Treated as A 'Quantum Leap'

Authors: Anthony Coogan

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Born’s probability interpretation of wave functions would have led to nearly identical results had he chosen a frequency interpretation instead. Logically, Born may have assumed that only one electron was under consideration, making it nonsensical to propose a frequency wave. Author’s suggestion: the actual experimental results were not of a single electron; rather, they were groups of reflected x-ray photons. The vertical waveform used by Scrhödinger in his Particle in the Box Theory makes sense if it was intended to represent a quantum leap. The author extended the single vertical panel to form a bar chart: separate panels would represent different energy levels. The proposed bar chart would be populated by reflected photons. Expansion of basic ideas: Part of Scrhödinger’s ‘Particle in the Box’ theory may be valid despite negative criticism. The waveform used in the diagram is vertical, which may seem absurd because real waves decay at a measurable rate, rather than instantaneously. However, there may be one notable exception. Supposedly, following from the theory, the Uncertainty Principle was derived – may a Quantum Leap not be represented as an instantaneous waveform? The great Scrhödinger must have had some reason to suggest a vertical waveform if the prevalent belief was that they did not exist. Complex wave forms representing a particle are usually assumed to be continuous. The actual observations made were x-ray photons, some of which had struck an electron, been reflected, and then moved toward a detector. From Born’s perspective, doing similar work the years in question 1926-7, he would also have considered a single electron – leading him to choose a probability distribution. Probability Distributions appear very similar to Frequency Distributions, but the former are considered to represent the likelihood of future events. Born’s interpretation of the results of quantum experiments led (or perhaps misled) many researchers into claiming that humans can influence events just by looking at them, e.g. collapsing complex wave functions by 'looking at the electron to see which slit it emerged from', while in reality light reflected from the electron moved in the observer’s direction after the electron had moved away. Astronomers may say that they 'look out into the universe' but are actually using logic opposed to the views of Newton and Hooke and many observers such as Romer, in that light carries information from a source or reflector to an observer, rather the reverse. Conclusion: Due to the controversial nature of these ideas, especially its implications about the nature of complex numbers used in applications in science and engineering, some time may pass before any consensus is reached.

Keywords: complex wave functions not necessary, frequency distributions instead of wave functions, information carried by light, sketch graph of uncertainty principle

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929 Development and Implementation of An "Electric Island" Monitoring Infrastructure for Promoting Energy Efficiency in Schools

Authors: Vladislav Grigorovitch, Marina Grigorovitch, David Pearlmutter, Erez Gal

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The concept of “electric island” is involved with achieving the balance between the self-power generation ability of each educational institution and energy consumption demand. Photo-Voltaic (PV) solar system installed on the roofs of educational buildings is a common way to absorb the available solar energy and generate electricity for self-consumption and even for returning to the grid. The main objective of this research is to develop and implement an “electric island” monitoring infrastructure for promoting energy efficiency in educational buildings. A microscale monitoring methodology will be developed to provide a platform to estimate energy consumption performance classified by rooms and subspaces rather than the more common macroscale monitoring of the whole building. The monitoring platform will be established on the experimental sites, enabling an estimation and further analysis of the variety of environmental and physical conditions. For each building, separate measurement configurations will be applied taking into account the specific requirements, restrictions, location and infrastructure issues. The direct results of the measurements will be analyzed to provide deeper understanding of the impact of environmental conditions and sustainability construction standards, not only on the energy demand of public building, but also on the energy consumption habits of the children that study in those schools and the educational and administrative staff that is responsible for providing the thermal comfort conditions and healthy studying atmosphere for the children. A monitoring methodology being developed in this research is providing online access to real-time data of Interferential Therapy (IFTs) from any mobile phone or computer by simply browsing the dedicated website, providing powerful tools for policy makers for better decision making while developing PV production infrastructure to achieve “electric islands” in educational buildings. A detailed measurement configuration was technically designed based on the specific conditions and restriction of each of the pilot buildings. A monitoring and analysis methodology includes a large variety of environmental parameters inside and outside the schools to investigate the impact of environmental conditions both on the energy performance of the school and educational abilities of the children. Indoor measurements are mandatory to acquire the energy consumption data, temperature, humidity, carbon dioxide and other air quality conditions in different parts of the building. In addition to that, we aim to study the awareness of the users to the energy consideration and thus the impact on their energy consumption habits. The monitoring of outdoor conditions is vital for proper design of the off-grid energy supply system and validation of its sufficient capacity. The suggested outcomes of this research include: 1. both experimental sites are designed to have PV production and storage capabilities; 2. Developing an online information feedback platform. The platform will provide consumer dedicated information to academic researchers, municipality officials and educational staff and students; 3. Designing an environmental work path for educational staff regarding optimal conditions and efficient hours for operating air conditioning, natural ventilation, closing of blinds, etc.

Keywords: sustainability, electric island, IOT, smart building

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928 Ayurvastra: A Study on the Ancient Indian Textile for Healing

Authors: Reena Aggarwal

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The use of textile chemicals in the various pre and post-textile manufacturing processes has made the textile industry conscious of its negative contribution to environmental pollution. Popular environmentally friendly fibers such as recycled polyester and organic cotton have been now increasingly used by fabrics and apparel manufacturers. However, after these textiles or the finished apparel are manufactured, they have to be dyed in the same chemical dyes that are harmful and toxic to the environment. Dyeing is a major area of concern for the environment as well as for people who have chemical sensitivities as it may cause nausea, breathing difficulties, seizures, etc. Ayurvastra or herbal medical textiles are one step ahead of the organic lifestyle, which supports the core concept of holistic well-being and also eliminates the impact of harmful chemicals and pesticides. There is a wide range of herbs that can be used not only for dyeing but also for providing medicinal properties to the textiles like antibacterial, antifungal, antiseptic, antidepressant and for treating insomnia, skin diseases, etc. The concept of herbal dyeing of fabric is to manifest herbal essence in every aspect of clothing, i.e., from production to end-use, additionally to eliminate the impact of harmful chemical dyes and chemicals which are known to result in problems like skin rashes, headache, trouble concentrating, nausea, diarrhea, fatigue, muscle and joint pain, dizziness, difficulty breathing, irregular heartbeat and seizures. Herbal dyeing or finishing on textiles will give an extra edge to the textiles as it adds an extra function to the fabric. The herbal extracts can be applied to the textiles by a simple process like the pad dry cure method and mainly acts on the human body through the skin for aiding in the treatment of disease or managing the medical condition through its herbal properties. This paper, therefore, delves into producing Ayurvastra, which is a perfect amalgamation of cloth and wellness. The aim of the paper is to design and create herbal disposable and non-disposable medical textile products acting mainly topically (through the skin) for providing medicinal properties/managing medical conditions. Keeping that in mind, a range of antifungal socks and antibacterial napkins treated with turmeric and aloe vera were developed, which are recommended for the treatment of fungal and bacterial infections, respectively. Both Herbal Antifungal socks and Antibacterial napkins have proved to be efficient enough in managing and treating fungal and bacterial infections of the skin, respectively.

Keywords: ayurvastra, ayurveda, herbal, pandemic, sustainable

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927 In vivo Evaluation of LAB Probiotic Potential with the Zebrafish Animal Model

Authors: Iñaki Iturria, Pasquale Russo, Montserrat Nacher-Vázquez, Giuseppe Spano, Paloma López, Miguel Angel Pardo

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Introduction: It is known that some Lactic Acid Bacteria (LAB) present an interesting probiotic effect. Probiotic bacteria stimulate host resistance to microbial pathogens and thereby aid in immune response, and modulate the host's immune responses to antigens with a potential to down-regulate hypersensitivity reactions. Therefore, probiotic therapy is valuable against intestinal infections and may be beneficial in the treatment of Inflammatory Bowel Disease (IBD). Several in vitro tests are available to evaluate the probiotic potential of a LAB strain. However, an in vivo model is required to understand the interaction between the host immune system and the bacteria. During the last few years, zebrafish (Danio rerio) has gained interest as a promising vertebrate model in this field. This organism has been extensively used to study the interaction between the host and the microbiota, as well as the host immune response under several microbial infections. In this work, we report on the use of the zebrafish model to investigate in vivo the colonizing ability and the immunomodulatory effect of probiotic LAB. Methods: Lactobacillus strains belonging to different LAB species were fluorescently tagged and used to colonize germ-free zebrafish larvae gastrointestinal tract (GIT). Some of the strains had a well-documented probiotic effect (L. acidophilus LA5); while others presented an exopolysaccharide (EPS) producing phenotype, thus allowing evaluating the influence of EPS in the colonization and immunomodulatory effect. Bacteria colonization was monitored for 72 h by direct observation in real time using fluorescent microscopy. CFU count per larva was also evaluated at different times. The immunomodulatory effect was assessed analysing the differential expression of several innate immune system genes (MyD88, NF-κB, Tlr4, Il1β and Il10) by qRT- PCR. The anti-inflammatory effect was evaluated using a chemical enterocolitis zebrafish model. The protective effect against a pathogen was also studied. To that end, a challenge test was developed using a fluorescently tagged pathogen (Vibrio anguillarum-GFP+). The progression of the infection was monitored up to 3 days using a fluorescent stereomicroscope. Mortality rates and CFU counts were also registered. Results and conclusions: Larvae exposed to EPS-producing bacteria showed a higher fluorescence and CFU count than those colonized with no-EPS phenotype LAB. In the same way, qRT-PCR results revealed an immunomodulatory effect on the host after the administration of the strains with probiotic activity. A downregulation of proinflammatory cytoquines as well as other cellular mediators of inflammation was observed. The anti-inflammatory effect was found to be particularly marked following exposure to LA% strain, as well as EPS producing strains. Furthermore, the challenge test revealed a protective effect of probiotic administration. As a matter of fact, larvae fed with probiotics showed a decrease in the mortality rate ranging from 20 to 35%. Discussion: In this work, we developed a promising model, based on the use of gnotobiotic zebrafish coupled with a bacterial fluorescent tagging in order to evaluate the probiotic potential of different LAB strains. We have successfully used this system to monitor in real time the colonization and persistence of exogenous LAB within the gut of zebrafish larvae, to evaluate their immunomodulatory effect and for in vivo competition assays. This approach could bring further insights into the complex microbial-host interactions at intestinal level.

Keywords: gnotobiotic, immune system, lactic acid bacteria, probiotics, zebrafish

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926 Sorghum Polyphenols Encapsulated by Spray Drying, Using Modified Starches as Wall Materials

Authors: Adriana Garcia G., Alberto A. Escobar P., Amira D. Calvo L., Gabriel Lizama U., Alejandro Zepeda P., Fernando Martínez B., Susana Rincón A.

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Different studies have recently been focused on the use of antioxidants such as polyphenols because of to its anticarcinogenic capacity. However, these compounds are highly sensible to environmental factors such as light and heat, so lose its long-term stability, besides possess an astringent and bitter taste. Nevertheless, the polyphenols can be protected by microcapsule formulation. In this sense, a rich source of polyphenols is sorghum, besides presenting a high starch content. Due to the above, the aim of this work was to obtain modified starches from sorghum by extrusion to encapsulate polyphenols the sorghum by spray drying. Polyphenols were extracted by ethanol solution from sorghum (Pajarero/red) and determined by the method of Folin-Ciocalteu, obtaining GAE at 30 mg/g. Moreover, was extracted starch of sorghum (Sinaloense/white) through wet milling (yield 32 %). The hydrolyzed starch was modified with three treatments: acetic anhydride (2.5g/100g), sodium tripolyphosphate (4g/100g), and sodium tripolyphosphate/ acetic anhydride (2g/1.25g by each 100 g) by extrusion. Processing conditions of extrusion were as follows: barrel temperatures were of 60, 130 and 170 °C at the feeding, transition, and high-pressure extrusion zones, respectively. Analysis of Fourier Transform Infrared spectroscopy (FTIR), showed bands exhibited of acetyl groups (1735 cm-1) and phosphates (1170 cm-1, 910 cm-1 and 525 cm-1), indicating the respective modification of starch. Besides, all modified starches not developed viscosity, which is a characteristic required for use in the encapsulation of polyphenols using the spray drying technique. As result of the modification starch, was obtained a water solubility index (WSI) from 33.8 to 44.8 %, and crystallinity from 8 to 11 %, indicating the destruction of the starch granule. Afterwards, microencapsulation of polyphenols was developed by spray drying, with a blend of 10 g of modified starch, 60 ml polyphenol extract and 30 ml of distilled water. Drying conditions were as follows: inlet air temperature 150 °C ± 1, outlet air temperature 80°C ± 5. As result of the microencapsulation: were obtained yields of 56.8 to 77.4 % and an efficiency of encapsulation from 84.6 to 91.4 %. The FTIR analysis showed evidence of microcapsules loaded with polyphenols in bands 1042 cm-1, 1038 cm-1 and 1148 cm-1. Analysis Differential scanning calorimetry (DSC) showed transition temperatures from 144.1 to 173.9 °C. For the order hand, analysis of Scanning Electron Microscopy (SEM), were observed rounded surfaces with concavities, typical feature of microcapsules produced by spray drying, how result of rapid evaporation of water. Finally, the modified starches were obtained by extrusion with good characteristics for use as cover materials by spray drying, where the phosphorylated starch was the best treatment in this work, according to the encapsulation yield, efficiency, and transition temperature.

Keywords: encapsulation, extrusion, modified starch, polyphenols, spray drying

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925 Unveiling Adorno’s Concern for Revolutionary Praxis and Its Enduring Significance: A Philosophical Analysis of His Writings on Sociology and Philosophy

Authors: Marie-Josee Lavallee

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Adorno’s reputation as an abstract and pessimistic thinker who indulged in a critic of capitalist society and culture without bothering himself with opening prospects for change, and who has no interest in political activism, recently begun to be questioned. This paper, which has a twofold objective, will push revisionist readings a step further by putting forward the thesis that revolutionary praxis has been an enduring concern for Adorno, surfacing throughout his entire work. On the other hand, it will hold that his understanding of the relationships between theory and praxis, which will be explained by referring to Ernst Bloch’s distinction between the warm and cold currents of Marxism, can help to interpret the paralysis of revolutionary practice in our own time under a new light. Philosophy and its tasks have been an enduring topic of Adorno’s work from the 1930s to Negativ Dialektik. The writings in which he develops these ideas stand among his most obscure and abstract so that their strong ties to the political have remained mainly overlooked. Adorno’s undertaking of criticizing and ‘redeeming’ philosophy and metaphysics is inseparable from a care for retrieving the capacity to act in the world and to change it. Philosophical problems are immanent to sociological problems, and vice versa, he underlines in his Metaphysik. Begriff and Problem. The issue of truth cannot be severed from the contingent context of a given idea. As a critical undertaking extracting its contents from reality, which is what philosophy should be from Adorno's perspective, the latter has the potential to fully reveal the reification of the individual and consciousness resulting from capitalist economic and cultural domination, thus opening the way to resistance and revolutionary change. While this project, according to his usual method, is sketched mainly in negative terms, it also exhibits positive contours which depict a socialist society. Only in the latter could human suffering end, and mutilated individuals experiment with reconciliation in an authentic way. That Adorno’s continuous plea for philosophy’s self-critic and renewal hides an enduring concern for revolutionary praxis emerges clearly from a careful philosophical analysis of his writings on philosophy and a selection of his sociological work, coupled with references to his correspondences. This study points to the necessity of a serious re-evaluation of Adorno’s relationship to the political, which will impact on the interpretation of his whole oeuvre, is much needed. In the second place, Adorno's dialectical conception of theory and praxis is enlightening for our own time, since it suggests that we are experiencing a phase of creative latency rather an insurmountable impasse.

Keywords: Frankfurt school, philosophy and revolution, revolutionary praxis, Theodor W. Adorno

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924 Cultural Routes: A Study of Anatolian Seljuks Madrasahs

Authors: Zeynep İnan Ocak, Gülsün Tanyeli

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One of the most important architectural types of Islamic architecture is madrasah used as educational institutions, hospital or observatory. This type of buildings has one or two storeys, central open or closed courtyards, four iwans and students cells located among the iwans. The main characteristic of the designs featured in the portals. The Islamic art features and adornments are seen well on these buildings made of stone. The earliest examples date to late 12th century in Anatolia after the Battle of Manzikert. Under the Seljuks rule over the one thousand facilities were built in 12th and 13th centuries and there are one hundred thirty five madrasah in total list. But today no all of them are conserved only forty percent are remained. The Seljuks madrasah located in many Anatolian were registered as immovable cultural property in several times by Turkish Culture and Tourism Ministry. The first Turkish buildings inscribed on the World Heritage List are the Great Mosque and Hospital of Divriği in 1985. Also the nominated site named as Anatolian Seljuks Madrasah is in the tentative list of UNESCO World Heritage in 2014. The property is composed some of notable madrasah such as İnce Minareli Madrasah and Karatay Madrasah in Konya; Çifte Madrasah and Sahibiye Madrasah in Kayseri; Buruciye Madrasah, Çifte Minareli Madrasah and Gök Madrasah in Sivas; Çifte Minareli Madrasah and Yakutiye Madrasah in Erzurum; Cacabey Madrasah in Kirşehir. Certainly the advantage of tourism is important for conducting the preservation of heritage. It offers much kind of cultural heritage products by means of visiting monuments. In spite of advantage of tourism, it can be the negative effects of tourism on sites and places of cultural significance. While assisting and guiding the conservation works of madrasah, it should be get reference to international charters and other doctrinal texts about the relation between heritage and tourism. Thereby the monuments will be conserved in good condition promoting by tourism. It should be plan a project about the correlation of visitors and heritage to focus on theme of Seljuks architecture. This study aims to set out the principles about the conservation of madrasah as world heritage taking advantages of tourism. The madrasah as a heritage should be evaluated not only a monument but also cultural route. So the cultural route for madrasah is determined by means of a journey through space and time, how the heritage of the different Anatolian cities. Also the cultural route is created visiting both the madrasah and the other medieval structures. In this study, the route, the principles, relation of tourism are represented considering the conservation of Seljuks madrasah.

Keywords: architectural heritage, cultural routes, Seljuks madrasah, Anatolia

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923 Transport Mode Selection under Lead Time Variability and Emissions Constraint

Authors: Chiranjit Das, Sanjay Jharkharia

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This study is focused on transport mode selection under lead time variability and emissions constraint. In order to reduce the carbon emissions generation due to transportation, organization has often faced a dilemmatic choice of transport mode selection since logistic cost and emissions reduction are complementary with each other. Another important aspect of transportation decision is lead-time variability which is least considered in transport mode selection problem. Thus, in this study, we provide a comprehensive mathematical based analytical model to decide transport mode selection under emissions constraint. We also extend our work through analysing the effect of lead time variability in the transport mode selection by a sensitivity analysis. In order to account lead time variability into the model, two identically normally distributed random variables are incorporated in this study including unit lead time variability and lead time demand variability. Therefore, in this study, we are addressing following questions: How the decisions of transport mode selection will be affected by lead time variability? How lead time variability will impact on total supply chain cost under carbon emissions? To accomplish these objectives, a total transportation cost function is developed including unit purchasing cost, unit transportation cost, emissions cost, holding cost during lead time, and penalty cost for stock out due to lead time variability. A set of modes is available to transport each node, in this paper, we consider only four transport modes such as air, road, rail, and water. Transportation cost, distance, emissions level for each transport mode is considered as deterministic and static in this paper. Each mode is having different emissions level depending on the distance and product characteristics. Emissions cost is indirectly affected by the lead time variability if there is any switching of transport mode from lower emissions prone transport mode to higher emissions prone transport mode in order to reduce penalty cost. We provide a numerical analysis in order to study the effectiveness of the mathematical model. We found that chances of stock out during lead time will be higher due to the higher variability of lead time and lad time demand. Numerical results show that penalty cost of air transport mode is negative that means chances of stock out zero, but, having higher holding and emissions cost. Therefore, air transport mode is only selected when there is any emergency order to reduce penalty cost, otherwise, rail and road transport is the most preferred mode of transportation. Thus, this paper is contributing to the literature by a novel approach to decide transport mode under emissions cost and lead time variability. This model can be extended by studying the effect of lead time variability under some other strategic transportation issues such as modal split option, full truck load strategy, and demand consolidation strategy etc.

Keywords: carbon emissions, inventory theoretic model, lead time variability, transport mode selection

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922 Stimulus-Response and the Innateness Hypothesis: Childhood Language Acquisition of “Genie”

Authors: Caroline Kim

Abstract:

Scholars have long disputed the relationship between the origins of language and human behavior. Historically, behaviorist psychologist B. F. Skinner argued that language is one instance of the general stimulus-response phenomenon that characterizes the essence of human behavior. Another, more recent approach argues, by contrast, that language is an innate cognitive faculty and does not arise from behavior, which might develop and reinforce linguistic facility but is not its source. Pinker, among others, proposes that linguistic defects arise from damage to the brain, both congenital and acquired in life. Much of his argument is based on case studies in which damage to the Broca’s and Wernicke’s areas of the brain results in loss of the ability to produce coherent grammatical expressions when speaking or writing; though affected speakers often utter quite fluent streams of sentences, the words articulated lack discernible semantic content. Pinker concludes on this basis that language is an innate component of specific, classically language-correlated regions of the human brain. Taking a notorious 1970s case of linguistic maladaptation, this paper queries the dominant materialist paradigm of language-correlated regions. Susan “Genie” Wiley was physically isolated from language interaction in her home and beaten by her father when she attempted to make any sort of sound. Though without any measurable resulting damage to the brain, Wiley was never able to develop the level of linguistic facility normally achieved in adulthood. Having received a negative reinforcement of language acquisition from her father and lacking the usual language acquisition period, in adulthood Wiley was able to develop language only at a quite limited level in later life. From a contemporary behaviorist perspective, this case confirms the possibility of language deficiency without brain pathology. Wiley’s potential language-determining areas in the brain were intact, and she was exposed to language later in her life, but she was unable to achieve the normal level of communication skills, deterring socialization. This phenomenon and others like it in the case limited literature on linguistic maladaptation pose serious clinical, scientific, and indeed philosophical difficulties for both of the major competing theories of language acquisition, innateness, and linguistic stimulus-response. The implications of such cases for future research in language acquisition are explored, with a particular emphasis on the interaction of innate capacity and stimulus-based development in early childhood.

Keywords: behaviorism, innateness hypothesis, language, Susan "Genie" Wiley

Procedia PDF Downloads 280
921 Assessing Adaptive Capacity to Climate Change and Agricultural Productivity of Farming Households of Makueni County in Kenya

Authors: Lilian Mbinya Muasa

Abstract:

Climate change is inevitable and a global challenge with long term implications to the sustainable development of many countries today. The negative impacts of climate change are creating far reaching social, economic and environmental problems threatening lives and livelihoods of millions of people in the world. Developing countries especially sub-Saharan countries are more vulnerable to climate change due to their weak ecosystem, low adaptive capacity and high dependency on rain fed agriculture. Countries in Sub-Saharan Africa are more vulnerable to climate change impacts due to their weak adaptive capacity and over-reliance on rain fed agriculture. In Kenya, 78% of the rural communities are poor farmers who heavily rely on rain fed agriculture thus are directly affected by climate change impacts.Currently, many parts of Kenya are experiencing successive droughts which are contributing to persistently unstable and declining agricultural productivity especially in semi arid eastern Kenya. As a result, thousands of rural communities repeatedly experience food insecurity which plunge them to an ever over-reliance on relief food from the government and Non-Governmental Organization In addition, they have adopted poverty coping strategies to diversify their income, for instance, deforestation to burn charcoal, sand harvesting and overgrazing which instead contribute to environmental degradation.This research was conducted in Makueni County which is classified as one of the most food insecure counties in Kenya and experiencing acute environmental degradation. The study aimed at analyzing the adaptive capacity to climate change across farming households of Makueni County in Kenya by, 1) analyzing adaptive capacity to climate change and agricultural productivity across farming households, 2) identifying factors that contribute to differences in adaptive capacity across farming households, and 3) understanding the relationship between climate change, agricultural productivity and adaptive capacity. Analytical Hierarchy Process (AHP) was applied to determine adaptive capacity and Total Factor Productivity (TFP) to determine Agricultural productivity per household. Increase in frequency of prolonged droughts and scanty rainfall. Preliminary findings indicate a magnanimous decline in agricultural production in the last 10 years in Makueni County. In addition, there is an over reliance of households on indigenous knowledge which is no longer reliable because of the unpredictability nature of climate change impacts. These findings on adaptive capacity across farming households provide the first step of developing and implementing action-oriented climate change policies in Makueni County and Kenya.

Keywords: adaptive capacity, agricultural productivity, climate change, vulnerability

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920 The Integration of Prosecutorial Discretion in the Anti-Money Laundering Regime in Nigeria: A Focus on Politically Exposed Persons

Authors: Chineduum Okpala

Abstract:

Nigeria, since her independence, has been engulfed in financial crimes of different forms. From embezzlement and conversion of public funds by public servants to stealing, contract inflation, and money laundering. Money laundering in Nigeria, particularly by political exposed persons, has been an issue of concern since independence. Corruption has been endemic, and Nigeria needs to integrate pro-active measures to show to the international community that it is ready to move against this vice. This paper discusses the negative effect of corruption and its effect on prosecutorial discretion. It also takes cognisance of the policy and aims of the anti-money laundering (AML) policy as enacted in Nigeria. It also takes as valid the assumption that the effective application of the rule of law will improve the efficacy of the Nigerian regime. In this regard, the perspective is internal to the Nigerian regime and its internal policy discourse which also reflect its policy discourse at international level. This paper takes notice of the typology of money laundering (ML) offences that most affect Nigeria, which hinges on corruption and abuse of office by a specific type of person, politically exposed persons (PEP). This typology of money laundering offence appears to be the most prevalent in developing nations like Nigeria. The application of essential principles of law provides an opportunity for the internalisation of the rule of law in the anti-money laundering regime in Nigeria, which could aid the successful prosecution of politically exposed persons on money laundering offences. The rule of law and how well the Nigerian legal system manages to deal with the interface between high level politics and the criminal justice system in Nigeria cannot be understood from internal sources but must be developed as a genuine but critical account informed by perspectives external to the Nigerian regime. If the efficacy of the regime is to be assessed in view of notorious failures of the regime, an external assessment is needed. Hence the paper discusses the need to integrate the essential principles of law in the application of prosecutorial discretion in the anti-money laundering regime in Nigeria, particularly with politically exposed persons. The paper highlights jurisdiction where prosecutorial discretion is integrated into the anti-money laundering regime in accordance to the rule of law which forms a basis for comparative analysis of the success of the anti-money laundering regime in Nigeria. This paper discusses why the application of prosecutorial discretion should not be used as a tool to extricate or avail the rich and powerful in the society from justice. The paper aims to argue that the successful prosecution of politically exposed persons, will raise the confidence of the citizens and the international community in the anti-money laundering regime in Nigeria.

Keywords: money laundering, politically exposed persons, corruption, Nigeria

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919 Li2S Nanoparticles Impact on the First Charge of Li-ion/Sulfur Batteries: An Operando XAS/XES Coupled With XRD Analysis

Authors: Alice Robba, Renaud Bouchet, Celine Barchasz, Jean-Francois Colin, Erik Elkaim, Kristina Kvashnina, Gavin Vaughan, Matjaz Kavcic, Fannie Alloin

Abstract:

With their high theoretical energy density (~2600 Wh.kg-1), lithium/sulfur (Li/S) batteries are highly promising, but these systems are still poorly understood due to the complex mechanisms/equilibria involved. Replacing S8 by Li2S as the active material allows the use of safer negative electrodes, like silicon, instead of lithium metal. S8 and Li2S have different conductivity and solubility properties, resulting in a profoundly changed activation process during the first cycle. Particularly, during the first charge a high polarization and a lack of reproducibility between tests are observed. Differences observed between raw Li2S material (micron-sized) and that electrochemically produced in a battery (nano-sized) may indicate that the electrochemical process depends on the particle size. Then the major focus of the presented work is to deepen the understanding of the Li2S material charge mechanism, and more precisely to characterize the effect of the initial Li2S particle size both on the mechanism and the electrode preparation process. To do so, Li2S nanoparticles were synthetized according to two ways: a liquid path synthesis and a dissolution in ethanol, allowing Li2S nanoparticles/carbon composites to be made. Preliminary chemical and electrochemical tests show that starting with Li2S nanoparticles could effectively suppress the high initial polarization but also influence the electrode slurry preparation. Indeed, it has been shown that classical formulation process - a slurry composed of Polyvinylidone Fluoride polymer dissolved in N-methyle-2-pyrrolidone - cannot be used with Li2S nanoparticles. This reveals a complete different Li2S material behavior regarding polymers and organic solvents when going at the nanometric scale. Then the coupling between two operando characterizations such as X-Ray Diffraction (XRD) and X-Ray Absorption and Emission Spectroscopy (XAS/XES) have been carried out in order to interpret the poorly understood first charge. This study discloses that initial particle size of the active material has a great impact on the working mechanism and particularly on the different equilibria involved during the first charge of the Li2S based Li-ion batteries. These results explain the electrochemical differences and particularly the polarization differences observed during the first charge between micrometric and nanometric Li2S-based electrodes. Finally, this work could lead to a better active material design and so to more efficient Li2S-based batteries.

Keywords: Li-ion/Sulfur batteries, Li2S nanoparticles effect, Operando characterizations, working mechanism

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918 Impact of Youth Corners and Knowledge about Human Sexuality among Young Adults and Adolescents of Nigerian Population in the Prevention of Sexually Transmitted Diseases

Authors: Gabriel I. Oke, Faremi O. Ayodeji

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Background: Access to youth Friendly Health Corners is vital for ensuring sexual reproductive health and total well being of young Adults since human sexuality has been widely misunderstood. Meanwhile, behavior of young people towards it remains at variance with the alarm. This study attempt to access the impact of youth corners also called Adolescent Friendly Health Corners on manifestation of human sexual behavior among Nigerian adolescent and young adults. Description: Hundred young adults and adolescents of both sex between the Age range of 12-25years were randomly selected from 5 secondary schools and 3 prominent universities in Southwestern Nigeria and focal group discussions (FGD) were conducted among them. Fifty secondary and primary health facilities were visited between February and June 2017 to conduct interviews for health workers and to ascertain the presence or absence of youth corners. Results: 95% of the health facilities visited lack Youth Corners section neither are they willing to make provision for it due to lack of workmanship and sponsorship. However, 5% with Youth corners does not have well-trained Counselors or a Health Educator but health professionals from nursing profession. 90% of the respondents of which 16-17 years of Age is the mean age had their first sexual exposure with no use of protection even before been introduced to what Sexuality is all about. Virtually, none of the respondents had ever visited a Youth Corner before or heard the term before. 86% have heard about the term STI before of which 60% are using protection, 10% care less about any information attached to the term STI, 4% have not heard of the term STI before even when translated to their local dialect. 20% are abstaining as at the time the study was conducted and they attribute their sexual decision to religion and parental influence. Of the age group 20-25, 45% claimed they have had symptoms of one STI or the other and 40% claimed they have been tested positive for an STI before of which 12% have positive HIV status. Promiscuous behaviors were found among them before they reach the age 16years with pornography ranking the highest, followed by masturbation. Respondents blame this on peer pressure, the lack of Youth Friendly Centers in their locality and lack of proper Sexual Orientation on time. About half of the respondents make use of contraceptives while others have varying views. We found out that inability to access Youth Friendly Centers amongst the respondents might be one of the singular reasons of their early experimentation of their sex life and lack of healthy sexual lifestyle. (95% CI, P=0.922) Conclusion: The study reveals that a connection between youth Friendly Centers and Prevention of Sexually Transmitted Diseases, therefore more sustainable Friendly Youth Corners with well-trained educators are needed in various Health facilities to checkmate the numerous risks of Young People along the path of adulthood.

Keywords: adolescents, sexually transmitted infections, reproductive health, youth corners

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917 A Comparison between Five Indices of Overweight and Their Association with Myocardial Infarction and Death, 28-Year Follow-Up of 1000 Middle-Aged Swedish Employed Men

Authors: Lennart Dimberg, Lala Joulha Ian

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Introduction: Overweight (BMI 25-30) and obesity (BMI 30+) have consistently been associated with cardiovascular (CV) risk and death since the Framingham heart study in 1948, and BMI was included in the original Framingham risk score (FRS). Background: Myocardial infarction (MI) poses a serious threat to the patient's life. In addition to BMI, several other indices of overweight have been presented and argued to replace FRS as more relevant measures of CV risk. These indices include waist circumference (WC), waist/hip ratio (WHR), sagittal abdominal diameter (SAD), and sagittal abdominal diameter to height (SADHtR). Specific research question: The research question of this study is to evaluate the interrelationship between the various body measurements, BMI, WC, WHR, SAD, and SADHtR, and which measurement is strongly associated with MI and death. Methods: In 1993, 1,000 middle-aged Caucasian, randomly selected working men of the Swedish Volvo-Renault cohort were surveyed at a nurse-led health examination with a questionnaire, EKG, laboratory tests, blood pressure, height, weight, waist, and sagittal abdominal diameter measurements. Outcome data of myocardial infarction over 28 years come from Swedeheart (the Swedish national myocardial infarction registry) and the Swedish death registry. The Aalen-Johansen and Kaplan–Meier methods were used to estimate the cumulative incidences of MI and death. Multiple logistic regression analyses were conducted to compare BMI with the other four body measurements. The risk for the various measures of obesity was calculated with outcomes of accumulated first-time myocardial infarction and death as odds ratios (OR) in quartiles. The ORs between the 4th and the 1st quartile of each measure were calculated to estimate the association between the body measurement variables and the probability of cumulative incidences of myocardial infarction (MI) over time. Double-sided P values below 0.05 will be considered statistically significant. Unadjusted odds ratios were calculated for obesity indicators, MI, and death. Adjustments for age, diabetes, SBP, and the ratio of total cholesterol/HDL-C and blue/white collar status were performed. Results: Out of 1000 people, 959 subjects had full information about the five different body measurements. Of those, 90 participants had a first MI, and 194 persons died. The study showed that there was a high and significant correlation between the five different body measurements, and they were all associated with CVD risk factors. All body measurements were significantly associated with MI, with the highest (OR=3.6) seen for SADHtR and WC. After adjustment, all but SADHtR remained significant with weaker ORs. As for all-cause mortality, WHR (OR=1.7), SAD (OR=1.9), and SADHtR (OR=1.6) were significantly associated, but not WC and BMI. However, after adjustment, only WHR and SAD were significantly associated with death, but with attenuated ORs.

Keywords: BMI, death, epidemiology, myocardial infarction, risk factor, sagittal abdominal diameter, sagittal abdominal diameter to height, waist circumference, waist-hip ratio

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916 Prevalence, Median Time, and Associated Factors with the Likelihood of Initial Antidepressant Change: A Cross-Sectional Study

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

Abstract:

Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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915 Using Fractal Architectures for Enhancing the Thermal-Fluid Transport

Authors: Surupa Shaw, Debjyoti Banerjee

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Enhancing heat transfer in compact volumes is a challenge when constrained by cost issues, especially those associated with requirements for minimizing pumping power consumption. This is particularly acute for electronic chip cooling applications. Technological advancements in microelectronics have led to development of chip architectures that involve increased power consumption. As a consequence packaging, technologies are saddled with needs for higher rates of power dissipation in smaller form factors. The increasing circuit density, higher heat flux values for dissipation and the significant decrease in the size of the electronic devices are posing thermal management challenges that need to be addressed with a better design of the cooling system. Maximizing surface area for heat exchanging surfaces (e.g., extended surfaces or “fins”) can enable dissipation of higher levels of heat flux. Fractal structures have been shown to maximize surface area in compact volumes. Self-replicating structures at multiple length scales are called “Fractals” (i.e., objects with fractional dimensions; unlike regular geometric objects, such as spheres or cubes whose volumes and surface area values scale as integer values of the length scale dimensions). Fractal structures are expected to provide an appropriate technology solution to meet these challenges for enhanced heat transfer in the microelectronic devices by maximizing surface area available for heat exchanging fluids within compact volumes. In this study, the effect of different fractal micro-channel architectures and flow structures on the enhancement of transport phenomena in heat exchangers is explored by parametric variation of fractal dimension. This study proposes a model that would enable cost-effective solutions for thermal-fluid transport for energy applications. The objective of this study is to ascertain the sensitivity of various parameters (such as heat flux and pressure gradient as well as pumping power) to variation in fractal dimension. The role of the fractal parameters will be instrumental in establishing the most effective design for the optimum cooling of microelectronic devices. This can help establish the requirement of minimal pumping power for enhancement of heat transfer during cooling. Results obtained in this study show that the proposed models for fractal architectures of microchannels significantly enhanced heat transfer due to augmentation of surface area in the branching networks of varying length-scales.

Keywords: fractals, microelectronics, constructal theory, heat transfer enhancement, pumping power enhancement

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914 Liquid Food Sterilization Using Pulsed Electric Field

Authors: Tanmaya Pradhan, K. Midhun, M. Joy Thomas

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Increasing the shelf life and improving the quality are important objectives for the success of packaged liquid food industry. One of the methods by which this can be achieved is by deactivating the micro-organisms present in the liquid food through pasteurization. Pasteurization is done by heating, but some serious disadvantages such as the reduction in food quality, flavour, taste, colour, etc. were observed because of heat treatment, which leads to the development of newer methods instead of pasteurization such as treatment using UV radiation, high pressure, nuclear irradiation, pulsed electric field, etc. In recent years the use of the pulsed electric field (PEF) for inactivation of the microbial content in the food is gaining popularity. PEF uses a very high electric field for a short time for the inactivation of microorganisms, for which we require a high voltage pulsed power source. Pulsed power sources used for PEF treatments are usually in the range of 5kV to 50kV. Different pulse shapes are used, such as exponentially decaying and square wave pulses. Exponentially decaying pulses are generated by high power switches with only turn-on capacity and, therefore, discharge the total energy stored in the capacitor bank. These pulses have a sudden onset and, therefore, a high rate of rising but have a very slow decay, which yields extra heat, which is ineffective in microbial inactivation. Square pulses can be produced by an incomplete discharge of a capacitor with the help of a switch having both on/off control or by using a pulse forming network. In this work, a pulsed power-based system is designed with the help of high voltage capacitors and solid-state switches (IGBT) for the inactivation of pathogenic micro-organism in liquid food such as fruit juices. The high voltage generator is based on the Marx generator topology, which can produce variable amplitude, frequency, and pulse width according to the requirements. Liquid food is treated in a chamber where pulsed electric field is produced between stainless steel electrodes using the pulsed output voltage of the supply. Preliminary bacterial inactivation tests were performed by subjecting orange juice inoculated with Escherichia Coli bacteria. With the help of the developed pulsed power source and the chamber, the inoculated orange has been PEF treated. The voltage was varied to get a peak electric field up to 15kV/cm. For a total treatment time of 200µs, a 30% reduction in the bacterial count has been observed. The detailed results and analysis will be presented in the final paper.

Keywords: Escherichia coli bacteria, high voltage generator, microbial inactivation, pulsed electric field, pulsed forming line, solid-state switch

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913 Investigating Unplanned Applications and Admissions to Hospitals of Children with Cancer

Authors: Hacer Kobya Bulut, Ilknur Kahriman, Birsel C. Demirbag

Abstract:

Introduction and Purpose: The lives of children with cancer are affected by long term hospitalizations in a negative way due to complications arising from diagnosis or treatment. However, the children's parents are known to have difficulties in meeting their children’s needs and providing home care after cancer treatment or during remission process. Supporting these children and their parents by giving a planned discharge training starting from the hospital and home care leads to reducing hospital applications, hospitalizations, hospital costs, shortening the length of hospital stay and increasing the satisfaction of the children with cancer and their families. This study was conducted to investigate the status of children and their parents' unplanned application to hospital and re-hospitalization. Methods: The study was carried out with 65 children with hematological malignancy in 0-17 age group and their families in a hematology clinic and polyclinic of a university hospital in Trabzon. Data were collected with survey methodology between August-November, 2015 through face to face interview using numbers, percentage and chi-square test in the evaluation. Findings: Most of the children were leukemia (90.8%) and 49.2% had been ill over 13 months. Few of the parents (32.3%) stated that they had received discharge and home care training (24.6%) but most of them (69.2%) found themselves enough in providing home care. Very few parents (6.2%) received home care training after their children being discharged and the majority of parents (61.5%) faced difficulties in home care and had no one to call around them. The parents expressed that in providing care to their children with hematological malignance, they faced difficulty in feeding them (74.6%), explaining their disease (50.0%), giving their oral medication (47.5%), providing hygiene (43.5%) and providing oral care (39.3%). The question ‘What are the emergency situations in which you have to bring your children to a doctor immediately?' was replied as fever (89.2%), severe nausea and vomiting (87.7%), hemorrhage (86.2%) and pain (81.5%). The study showed that 50.8% of the children had unplanned applications to hospitals and 33.8% of them identified as unplanned hospitalization and the first causes of this were fever and pain. The study showed that the frequency of applications (%78.8) and hospitalizations (%81.8) was higher for boys and a statistically significant difference was found between gender and unplanned applications (X=4.779; p=0.02). Applications (48.5%) and hospitalizations (40.9%) were found lower for the parents who had received hospital discharge training, and a significant difference was determined between receiving training and unplanned hospitalizations (X=8.021; p=0.00). Similarly, applications (30.3%) and hospitalizations (40.9%) was found lower for the ones who had received home care training, and a significant difference was determined between receiving home care training and unplanned hospitalizations (X=4.758; p=0.02). Conclusion: It was found out that caregivers of children with cancer did not receive training related to home care and complications about treatment after discharging from hospital, so they faced difficulties in providing home care and this led to an increase in unplanned hospital applications and hospitalizations.

Keywords: cancer, children, unplanned application, unplanned hospitalization

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912 A Study of Evaporative Heat Loss from the Skin of Baby Elephants (Elephas maximus maximus) at Elephant Transit Home

Authors: G .D. B. N. Kulasaooriya, H. B. S. Ariyarathne, I. Abeygunawardene, A. A. J. Rafarathne, B. V. Perera

Abstract:

Elephant is the largest resident of the wild and has small surface to volume ratio as well as less number of sweat glands which cause challenges to the thermoregulation of this mammal. However, this megaherbivore has adopted specialised meachanisms to maintain its thermal balance through behavioral adaptations, ear flapping and well anastomosed arterioles and venules of the ear. Nevertheless, little is known on the involvement of the skin in the process of thermoregulation. The present study was undertaken to monitor the water evaporation rate from the skin of unrestrained wild elephant calves throughout the day and to understand its importance in the thermoregulation. Seven baby elephants housed in the elephant transit home, Udawalawe were used. Ambient temparature, relative humidity (RH) and radiation heat load was monitored throughout the day of the study period. Similarly, surface temparature of the skin was taken at six points including lateral ear pinna, lateral body and the rump during the same period. The skin water evaporation was also measured from the same sites using cobolt chloride method. The surface are of the skin was determined by assigning geometrical shapes to each body part. The results showed that the ambient temperature gradually increased with the day reaching maximum around 3.00 pm. The relative humidity was lowest early in the morning. The radiation heat load did not show any significant change in the study period. The skin temperature was different among lateral ear pinna, lateral body and the rump where the highest temperature was on the rump and the lowest on the lateral ear pinna. The skin temperature gradually increase with increasing ambient temperature but there was not a strong correlation (R2 =53.53) between these two. The skin temperature had strong correlation with RH (p<0.05 R2 =70.84% ) but a significant relationship was not considered since the radiation heat load was not varying in large scale. The skin evaporative water loss had a weak negative correlation with ambient temperature (correlation coefficient= -0.01) whereas strong positive correlation with RH (correlation coefficient= 25.275 ) and no corelation with radiation heat load. It also appeared that skin water loss increases as the skin temperature increased. In the present study, it was observed that on average, skin of the baby elephant looses 403 g/m2/h of water. Based on these observations it can be concluded that a large volume of water is evaporated from the skin of baby elephants and evaporative heat loss may be contributing significantly to the thermoregulation. However, further investigation on the influence of environmental factors on evaporative heat loss has to be conducted to understand the thermoregulatory mechanisms of the baby elephant.

Keywords: thermoregulation, behavioral adaptations, evaporation, elephant

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911 DPAGT1 Inhibitors: Discovery of Anti-Metastatic Drugs

Authors: Michio Kurosu

Abstract:

Alterations in glycosylation not only directly impact cell growth and survival but also facilitate tumor-induced immunomodulation and eventual metastasis. Identification of cell type-specific glycoconjugates (tumor markers) has led to the discovery of new assay systems for certain cancers via immunodetection reagents. N- and O-linked glycans are the most abundant forms of glycoproteins. Recent studies of cancer immunotherapy are based on the immunogenicity of truncated O-glycan chains (e.g., Tn, sTn, T, and sLea/x). The prevalence of N-linked glycan changes in the development of tumor cells is known; however, therapeutic antibodies against N-glycans have not yet been developed. This is due to the lack of specificity of N-linked glycans between normal/healthy and cancer cells. Abnormal branching of N-linked glycans has been observed, particularly in solid cancer cells. While the discovery of drug-like glycosyltransferase inhibitors that block the biosynthesis of specific branching has a very low likelihood of success, altered glycosylation levels can be exploited by suppressing N-glycan biosynthesis through the inhibition of dolichyl-phosphate N-acetylglucosaminephosphotransferase1 (DPAGT1) activity. Inhibition of DPAGT1 function leads to changes of O-glycosylation on proteins associated with mitochondria and zinc finger binding proteins (indirect effects). On the basis of dynamic crosstalk between DPAGT1 and Snail/Slung/ZEB1 (a family of transcription factors that promote the repression of the adhesion molecules), we have developed pharmacologically acceptable selective DPAGT1 inhibitors. Tunicamycin kills a wide range of cancer and healthy cells in a non-selective manner. In sharp contrast, our DPAGT1 inhibitors display strong cytostatic effects against 16 solid cancers, which require the overexpression of DPAGT1 in their progression but do not affect the cell viability of healthy cells. The identified DPAGT1 inhibitors possess impressive anti-metastatic ability in various solid cancer cell lines and induce their mitochondrial structural changes, resulting in apoptosis. A prototype DPAGT1 inhibitor, APPB has already been proven to shrink solid tumors (e.g., pancreatic cancers, triple-negative breast cancers) in vivo while suppressing metastases and has strong synergistic effects when combined with current cytotoxic drugs (e.g., paclitaxel). At this conference, our discovery of selective DPAGT1 inhibitors with drug-like properties and proof-of-pharmaceutical concept studies of a novel DPAGT1 inhibitor are presented.

Keywords: DPAGT1 inhibitors, anti-metastatic drugs, natural product based drug designs, cytostatic effects

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910 School Refusal Behaviours: The Roles of Adolescent and Parental Factors

Authors: Junwen Chen, Celina Feleppa, Tingyue Sun, Satoko Sasagawa, Michael Smithson

Abstract:

School refusal behaviours refer to behaviours to avoid school attendance, chronic lateness in arriving at school, or regular early dismissal. Poor attendance in schools is highly correlated with anxiety, depression, suicide attempts, delinquency, violence, and substance use and abuse. Poor attendance is also a strong indicator of lower achievement in school, as well as problematic social-emotional development. Long-term consequences of school refusal behaviours include fewer opportunities for higher education, employment, and social difficulties, and high risks of later psychiatric illness. Given its negative impacts on youth educational outcomes and well-being, a thorough understanding of factors that are involved in the development of this phenomenon is warranted for developing effective management approaches. This study investigated parental and adolescent factors that may contribute to school refusal behaviours by specifically focusing on the role of parental and adolescents’ anxiety and depression, emotion dysregulation, and parental rearing style. Findings are expected to inform the identification of both parental and adolescents’ factors that may contribute to school refusal behaviours. This knowledge will enable novel and effective approaches that incorporate these factors to managing school refusal behaviours in adolescents, which in turn improve their school and daily functioning. Results are important for an integrative understanding of school refusal behaviours. Furthermore, findings will also provide information for policymakers to weigh the benefits of interventions targeting school refusal behaviours in adolescents. One-hundred-and-six adolescents aged 12-18 years (mean age = 14.79 years old, SD = 1.78, males = 44) and their parents (mean age = 47.49 years old, SD = 5.61, males = 27) completed an online questionnaire measuring both parental and adolescents’ anxiety, depression, emotion dysregulation, parental rearing styles, and adolescents’ school refusal behaviours. Adolescents with school refusal behaviours reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Parental emotion dysregulation and adolescents’ anxiety and depression predicted school refusal behaviours independently. To date, only limited studies have investigated the interplay between parental and youth factors in relation to youth school refusal behaviours. Although parental emotion dysregulation has been investigated in relation to youth emotion dysregulation, little is known about its role in the context of school refusal. This study is one of the very few that investigated both parental and adolescent factors in relation to school refusal behaviours in adolescents. The findings support the theoretical models that emphasise the role of youth and parental psychopathology in school refusal behaviours. Future management of school refusal behaviours should target adolescents’ anxiety and depression while incorporating training for parental emotion regulation skills.

Keywords: adolescents, school refusal behaviors, parental factors, anxiety and depression, emotion dysregulation

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909 Comparisons of Depressive Symptoms and Cognitive Appraisals in Different Age Groups under Abusive Leadership

Authors: Shao-Ying Wang, Shin-I Shih, Chi-Cheng Wu

Abstract:

Background: By following to the maturity theory about age, the manifestation of depression in different age groups under occupational stressors still remains unclear. Therefore, the aim of this study was to examine the depression within four main symptoms clusters: cognition, affect, physical complaints and interpersonal difficulty among the different age groups. Additionally, this study also used the stress appraisal theory, through the examination of challenge and hindrance appraisals, the effects of cognitive factors were expected to give therapeutic indication for the future treatment of depression under abusive leadership. Methods (Participants and Procedure): The data were collected in two waves from employees of local companies in Taiwan. The participants (58 males and 167 females) were native Chinese speakers, ranging in age from 20 to 59 years (M= 36.51). Up to 80% educational level of participants were above senior high. The married population was approximately at 43%. Measures; 1. Abusive Leadership: To measure abusive leadership, we used 15-item scale of abusive supervision which anchored on a 7-point Likert-type scale. (α= .96) 2. Depression: We used Taiwanese Depression Scale to measure the 4 clusters (cognition, affect, physical complaints and interpersonal difficulty) of symptoms. Participants responded for depression anchored on a 7-point Likert-type scale (α= .96). 3. Stress Appraisal Scale: To measure challenge and hindrance types of appraisal, participants responded to 33-item measure anchored on a 7-point Likert-type scale. (Challenge appraisal; α= .90; hindrance appraisal α= .87). Results: The results of correlation showed that there was a significant and negative correlation between abusive leadership and age (r = - .21, p < .01). Abusive leadership was positive correlated significantly with hindrance appraisal (r = .52, p < .01) and depression (r = .20, p < .01). The results also showed that hindrance appraisal was correlated to depression positively (r = .36, p < .01). A one-way ANOVA was conducted to compare the effect of lower/middle/order age groups on each cluster of depressive symptoms. The results showed that the effect of age groups on cognition was significant F (2, 157) =3.66, P < .05. Older age group (M=13.43 SD=6.84) reported less cognitive symptoms of depression than the middle (M=16.77 SD=7.49) and lower age (M=16.91 SD=6.97) groups. Besides, the effect of age groups on affect was also significant F (2,157)= 4.09 P < .05. Older age group (M=18.68 SD=8.98) reported less affective symptoms of depression than the middle (M=22.01 SD=7.96) and lower age (M=23.56 SD=7.67) groups. Moreover, the main effect of hindrance appraisal was found F (2, 157) =3.81, P < .05. Older age group (M=9.44 SD=2.89) reported fewer score on hindrance appraisals than the middle (M=11.06 SD=4.02) and lower age (M=9.62 SD=3.17) groups. To conclude, the severity of depression symptoms varies across different age groups. Maturity seems to be the protective factor to depression, accompanying with lower hindrance appraisals.

Keywords: abusive leadership, affective commitment, depression symptoms, psychological well-being

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908 Thinking Differently about Diversity: A Literature Review

Authors: Natalie Rinfret, Francine Tougas, Ann Beaton

Abstract:

Conventions No. 100 and 111 of the International Labor Organization, passed in 1951 and 1958 respectively, established the principles of equal pay for men and women for work of equal value and freedom from discrimination in employment. Governments of different countries followed suit. For example, in 1964, the Civil Rights Act was passed in the United States and in 1972, Canada ratified Convention 100. Thus, laws were enacted and programs were implemented to combat discrimination in the workplace and, over time, more than 90% of the member countries of the International Labour Organization have ratified these conventions by implementing programs such as employment equity in Canada aimed at groups recognized as being discriminated against in the labor market, including women. Although legislation has been in place for several decades, employment discrimination has not gone away. In this study, we pay particular attention to the hidden side of the effects of employment discrimination. This is the emergence of subtle forms of discrimination that often fly under the radar but nevertheless, have adverse effects on the attitudes and behaviors of members of targeted groups. Researchers have identified two forms of racial and gender bias. On the one hand, there are traditional prejudices referring to beliefs about the inferiority and innate differences of women and racial minorities compared to White men. They have the effect of confining these two groups to job categories suited to their perceived limited abilities and can result in degrading, if not violent and hateful, language and actions. On the other hand, more subtle prejudices are more suited to current social norms. However, this subtlety harbors a conflict between values of equality and remnants of negative beliefs and feelings toward women and racial minorities. Our literature review also takes into account an overlooked part of the groups targeted by the programs in place, senior workers, and highlights the quantifiable and observable effects of prejudice and discriminatory behaviors in employment. The study proposes a hybrid model of interventions, taking into account the organizational system (employment equity practices), discriminatory attitudes and behaviors, and the type of leadership to be advocated. This hybrid model includes, in the first instance, the implementation of initiatives aimed at both promoting employment equity and combating discrimination and, in the second instance, the establishment of practices that foster inclusion, the full and complete participation of all, including seniors, in the mission of their organization.

Keywords: employment discrimination, gender bias, the hybrid model of interventions, senior workers

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907 Preceptor Program: A Way to Reduce Absconding Rate and Increase Patient Satisfaction

Authors: Akanksha Dicholkar, Celin Jacob, Omkar More

Abstract:

Work force instability, as demonstrated by high rates of staff turnover and lingering vacancy rates, continues to be a major challenge faced by health care organizations. The impact is manifested in workflow inefficiencies, delays in delivering patient care, and dissatisfaction among patients and staff, all of which can have significant negative effects on quality of care and patient safety. In addition, the staggering administrative costs created by a transient work force threaten health care organizations financial viability. One nurse retention strategy is to have newly hired nurses partake in Preceptorship. Precepting is a way to enculturate new employees into their role. Also good professional, collegial relationship between an experienced nurse and a newly hired nurse relations was evidenced. This study demonstrates impact of preceptor program on absconding rate, employee satisfaction & Patient satisfaction. Purpose of study: To decrease absconding rate. Objective: 1. To reduce the high absconding rate among nurses in Aster Medcity (AMC). 2. To facilitate the acclimatization of the newly hired nurse into their role, focusing on professional growth, inter-professional relationships and clinical skills required for the job. Methodology: Descriptive study by Convenience sampling method and collect data by direct observation, questionnaire, interviews. Sample size as per Sample size statistical table at 95 % CI. We conducted a pre and post intervention analysis to assess the impact of Preceptorship at AMC, with a daily occupancy of approx. 300 patients. Result: Preceptor program has had a significant improvement positive impact on all measured parameters. Absconding rate came down from 20% to 0% (P= 0.001). Patient satisfaction scores rose from 85% to 95%. Employee satisfaction rose form 65% to 85%. Conclusion: The project proved that Preceptor Development Programme and the steps taken in hand holding of the new joinees were effective in reducing the absconding rate among nurses and improved the overall satisfaction of new nurses. Preceptee satisfaction with the preceptorship experience was correlated with favorable evaluation of the relationship between the preceptee and preceptor. These findings indicate that when preceptors and preceptees have the benefit of formal preceptorship programs that are well supported, and when the preceptors’ efforts are rewarded, satisfaction is enhanced for both participants, preceptor commitment to the role is reinforced.

Keywords: absconding rate, preceptor, employee satisfaction index, satisfaction index

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