Search results for: sum of ranking differences
Commenced in January 2007
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Edition: International
Paper Count: 4636

Search results for: sum of ranking differences

3466 Mobile App versus Website: A Comparative Eye-Tracking Case Study of Topshop

Authors: Zofija Tupikovskaja-Omovie, David Tyler, Sam Dhanapala, Steve Hayes

Abstract:

The UK is leading in online retail and mobile adoption. However, there is a dearth of information relating to mobile apparel retail, and developing an understanding about consumer browsing and purchase behavior in m-retail channel would provide apparel marketers, mobile website and app developers with the necessary understanding of consumers’ needs. Despite the rapid growth of mobile retail businesses, no published study has examined shopping behaviour on fashion mobile websites and apps. A mixed method approach helped to understand why fashion consumers prefer websites on mobile devices, when mobile apps are also available. The following research methods were employed: survey, eye-tracking experiments, observation, and interview with retrospective think aloud. The mobile gaze tracking device by SensoMotoric Instruments was used to understand frustrations in navigation and other issues facing consumers in mobile channel. This method helped to validate and compliment other traditional user-testing approaches in order to optimize user experience and enhance the development of mobile retail channel. The study involved eight participants - females aged 18 to 35 years old, who are existing mobile shoppers. The participants used the Topshop mobile app and website on a smart phone to complete a task according to a specified scenario leading to a purchase. The comparative study was based on: duration and time spent at different stages of the shopping journey, number of steps involved and product pages visited, search approaches used, layout and visual clues, as well as consumer perceptions and expectations. The results from the data analysis show significant differences in consumer behaviour when using a mobile app or website on a smart phone. Moreover, two types of problems were identified, namely technical issues and human errors. Having a mobile app does not guarantee success in satisfying mobile fashion consumers. The differences in the layout and visual clues seem to influence the overall shopping experience on a smart phone. The layout of search results on the website was different from the mobile app. Therefore, participants, in most cases, behaved differently on different platforms. The number of product pages visited on the mobile app was triple the number visited on the website due to a limited visibility of products in the search results. Although, the data on traffic trends held by retailers to date, including retail sector breakdowns for visits and views, data on device splits and duration, might seem a valuable source of information, it cannot explain why consumers visit many product pages, stay longer on the website or mobile app, or abandon the basket. A comprehensive list of pros and cons was developed by highlighting issues for website and mobile app, and recommendations provided. The findings suggest that fashion retailers need to be aware of actual consumers’ behaviour on the mobile channel and their expectations in order to offer a seamless shopping experience. Added to which is the challenge of retaining existing and acquiring new customers. There seem to be differences in the way fashion consumers search and shop on mobile, which need to be explored in further studies.

Keywords: consumer behavior, eye-tracking technology, fashion retail, mobile app, m-retail, smart phones, topshop, user experience, website

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3465 Identification of COVID-SARS Variants Based on Lactate Test Results

Authors: Zoltan Horvath, Dora Nagy

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In this research, it was examined whether individual COVID variants cause differences in the lactate curve of cyclists. After all, the virus variants attacked different organs in our body during the infections. During our tests, we used a traditional lactate step test, the results of which were compared with the values before the infection. In the tests, it has been proven that different virus variants show unique lactate curves. In this way, based on the lactate curve, it is possible to identify which variant caused the disease. Thanks to this, it has been shorten the return time, because we can apply the best return protocol after infection to the competitors.

Keywords: COVID-Sars19, lactate, virus mutation, lactate profile

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3464 Health Psychology Intervention: Identifying Early Symptoms in Neurological Disorders

Authors: Simon B. N. Thompson

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Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: cortisol, electromyography, neurology, yawning

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3463 Impact of Cultural Intelligence on Decision Making Styles of Managers: A Turkish Case

Authors: Fusun Akdag

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Today, as business becomes increasingly global, managers/leaders of multinational companies or local companies work with employees or customers from a variety of cultural backgrounds. To do this effectively, they need to develop cultural competence. Therefore, cultural intelligence (CQ) becomes a vitally important aptitude and skill, especially for leaders. The organizational success or failure depends upon the way, the kind of leadership which has been provided to its members. The culture we are born into deeply effects our values, beliefs, and behavior. Cultural intelligence (CQ) focuses on how well individuals can relate and work across cultures. CQ helps minimize conflict and maximize performance of a diverse workforce. The term 'decision,' refers to a commitment to a course of action that is intended to serve the interests and values of particular people. One dimension of culture that has received attention is individualism-collectivism or, independence-interdependence. These dimensions are associated with different conceptualizations of the 'self.' Individualistic cultures tend to value personal goal pursuit as opposed to pursuit of others’ goals. Collectivistic cultures, by contrast, view the 'self' as part of a whole. Each person is expected to work with his or her in-group toward goals, generally pursue group harmony. These differences underlie cross-cultural variation in decision-making, such as the decision modes people use, their preferences, negotiation styles, creativity, and more. The aim of this study is determining the effect of CQ on decision making styles of male and female managers in Turkey, an emergent economy framework. The survey is distributed to gather data from managers at various companies. The questionnaire consists of three parts: demographics, The Cultural Intelligence Scale (CQS) to measure the four dimensions of cultural intelligence and General Decision Making Style (GMDS) Inventory to measure the five subscales of decision making. The results will indicate the Turkish managers’ score at metacognitive, cognitive, motivational and behavioral aspects of cultural intelligence and to what extent these scores affect their rational, avoidant, dependent, intuitive and spontaneous decision making styles since business leaders make dozens of decisions every day that influence the success of the company and also having an impact on employees, customers, shareholders and the market.

Keywords: cultural intelligence, decision making, gender differences, management styles,

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3462 Examining the Changes in Complexity, Accuracy, and Fluency in Japanese L2 Writing Over an Academic Semester

Authors: Robert Long

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The results of a one-year study on the evolution of complexity, accuracy, and fluency (CAF) in the compositions of Japanese L2 university students throughout a semester are presented in this study. One goal was to determine if any improvement in writing abilities over this academic term had occurred, while another was to examine methods of editing. Participants had 30 minutes to write each essay with an additional 10 minutes allotted for editing. As for editing, participants were divided into two groups, one of which utilized an online grammar checker, while the other half self-edited their initial manuscripts. From the three different institutions, there was a total of 159 students. Research questions focused on determining if the CAF had evolved over the previous year, identifying potential variations in editing techniques, and describing the connections between the CAF dimensions. According to the findings, there was some improvement in accuracy (fewer errors) in all three of the measures), whereas there was a marked decline in complexity and fluency. As for the second research aim relating to the interaction among the three dimensions (CAF) and of possible increases in fluency being offset by decreases in grammatical accuracy, results showed (there is a logical high correlation with clauses and word counts, and mean length of T-unit (MLT) and (coordinate phrase of T-unit (CP/T) as well as MLT and clause per T-unit (C/T); furthermore, word counts and error/100 ratio correlated highly with error-free clause totals (EFCT). Issues of syntactical complexity had a negative correlation with EFCT, indicating that more syntactical complexity relates to decreased accuracy. Concerning a difference in error correction between those who self-edited and those who used an online grammar correction tool, results indicated that the variable of errors-free clause ratios (EFCR) had the greatest difference regarding accuracy, with fewer errors noted with writers using an online grammar checker. As for possible differences between the first and second (edited) drafts regarding CAF, results indicated there were positive changes in accuracy, the most significant change seen in complexity (CP/T and MLT), while there were relatively insignificant changes in fluency. Results also indicated significant differences among the three institutions, with Fujian University of Technology having the most fluency and accuracy. These findings suggest that to raise students' awareness of their overall writing development, teachers should support them in developing more complex syntactic structures, improving their fluency, and making more effective use of online grammar checkers.

Keywords: complexity, accuracy, fluency, writing

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3461 Comparison between RILM, JSTOR, and WorldCat Used to Search for Secondary Literature

Authors: Stacy Jarvis

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Databases such as JSTOR, RILM and WorldCat have been the main source and storage of literature in the music orb. The Reference Index to Music Literature is a bibliographic database of over 2.6 million citations to writings about music from over 70 countries. The Research Institute produces RILM for the Study of Music at the University of Buffalo. JSTOR is an e-library of academic journals, books, and primary sources. Database JSTOR helps scholars find, utilise, and build upon a vast range of literature through a powerful teaching and research platform. Another database, WorldCat, is the world's biggest library catalogue, assisting scholars in finding library materials online. An evaluation of these databases in the music sphere is conducted by looking into the description and intended use and finding similarities and differences among them. Through comparison, it is found that these aim to serve different purposes, though they have the same goal of providing and storing literature. Also, since each database has different parts of literature that it majors on, the intended use of the three databases is evaluated. This can be found in the description, scope, and intended uses section. These areas are crucial to the research as it addresses the functional or literature differences among the three databases. It is also found that these databases have different quantitative potentials. This is determined by addressing the year each database began collecting literature and the number of articles, periodicals, albums, conference proceedings, music, dissertations, digital media, essays collections, journal articles, monographs, online resources, reviews, and reference materials that can be found in each one of them. This can be found in the sections- description, scope and intended uses and the importance of the database in identifying literature on different topics. To compare the delivery of services to the users, the importance of databases in identifying literature on different topics is also addressed in the section -the importance of databases in identifying literature on different topics. Even though these databases are used in research, they all have disadvantages and advantages. This is addressed in the sections on advantages and disadvantages. This will be significant in determining which of the three is the best. Also, it will help address how the shortcomings of one database can be addressed by utilising two databases together while conducting research. It is addressed in the section- a combination of RILM and JSTOR. All this information revolves around the idea that a huge amount of quantitative and qualitative data can be found in the presented databases on music and digital content; however, each of the given databases has a different construction and material features contributing to the musical scholarship in its way.

Keywords: RILM, JSTOR, WorldCat, database, literature, research

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3460 Management and Marketing Implications of Tourism Gravity Models

Authors: Clive L. Morley

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Gravity models and panel data modelling of tourism flows are receiving renewed attention, after decades of general neglect. Such models have quite different underpinnings from conventional demand models derived from micro-economic theory. They operate at a different level of data and with different theoretical bases. These differences have important consequences for the interpretation of the results and their policy and managerial implications. This review compares and contrasts the two model forms, clarifying the distinguishing features and the estimation requirements of each. In general, gravity models are not recommended for use to address specific management and marketing purposes.

Keywords: gravity models, micro-economics, demand models, marketing

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3459 Screening of Wheat Wild Relatives as a Gene Pool for Improved Photosynthesis in Wheat Breeding

Authors: Amanda J. Burridge, Keith J. Edwards, Paul A. Wilkinson, Tom Batstone, Erik H. Murchie, Lorna McAusland, Ana Elizabete Carmo-Silva, Ivan Jauregui, Tracy Lawson, Silvere R. M. Vialet-Chabrand

Abstract:

The rate of genetic progress in wheat production must be improved to meet global food security targets. However, past selection for domestication traits has reduced the genetic variation in modern wheat cultivars, a fact that could severely limit the future rate of genetic gain. The genetic variation in agronomically important traits for the wild relatives and progenitors of wheat is far greater than that of the current domesticated cultivars, but transferring these traits into modern cultivars is not straightforward. Between the elite cultivars of wheat, photosynthetic capacity is a key trait for which there is limited variation. Early screening of wheat wild relative and progenitors has shown differences in photosynthetic capacity and efficiency not only between wild relative species but marked differences between the accessions of each species. By identifying wild relative accessions with improved photosynthetic traits and characterising the genetic variation responsible, it is possible to incorporate these traits into advanced breeding programmes by wide crossing and introgression programmes. To identify the potential variety of photosynthetic capacity and efficiency available in the secondary and tertiary genepool, a wide scale survey was carried out for over 600 accessions from 80 species including those from the genus Aegilops, Triticum, Thinopyrum, Elymus, and Secale. Genotype data were generated for each accession using a ‘Wheat Wild Relative’ Single Nucleotide Polymorphism (SNP) genotyping array composed of 35,000 SNP markers polymorphic between wild relatives and elite hexaploid wheat. This genotype data was combined with phenotypic measurements such as gas exchange (CO₂, H₂O), chlorophyll fluorescence, growth, morphology, and RuBisCO activity to identify potential breeding material with enhanced photosynthetic capacity and efficiency. The data and associated analysis tools presented here will prove useful to anyone interested in increasing the genetic diversity in hexaploid wheat or the application of complex genotyping data to plant breeding.

Keywords: wheat, wild relatives, pre-breeding, genomics, photosynthesis

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3458 Influence of Gender Inequality on Pre – Primary School Children’s Literacy Skills Development in Ojo Local Government Area, Lagos State

Authors: Morenikeji Aliu Balaji

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Gender inequality is seen as persistent discrimination of one group of people based gender, and it manifests itself differently according to race, culture, politics, country and economic situation. Multiple explanations have been offered for gender differences in literacy skill development. Three prominent explanations that precipitated the gender differences are; biological, where the assumption is that differential brain structures and hemispheric activation patterns cause the sexes to be hardwired differently for reading, with girls developing the cognitive skills associated with reading before boys. Secondly, schooling favour girls and ‘girly’ behaviour, and that boys are, as a result, lagging behind on several behavioural, social and academic measures and thirdly, cultural influences, where literacy is defined as a feminine characteristic – propagated by an overrepresentation of female teachers – and that modern culture steers boys towards activities such as sport and computers. Therefore the study investigated the influence of gender inequality on pre – primary school children literacy skills development in Ojo Local Government Area, Lagos State. Descriptive survey research design was adopted for the study. 100 pre-primary school teachers were involved in the study. A self-designed instrument was used for data collection titled ‘Influence of Gender Inequality on Literacy Skill Development in Children Questionnaire (IGILSDCQ)’. The instrument was validated and tested for reliability. The reliability index for IGILSDCQ (α = 0.79). Five research questions were answered using descriptive (frequency count, simple percentage, mean and standard deviation). The findings showed that that gender inequality to some extent influence children phonemic awareness (WA=1.76), the extent to which gender inequality influence children awareness of print is high (WA=2.8), gender inequality to some extent influence children vocabulary development (WA = 2.4), the extent to which gender inequality influence children speaking skill development is high (WA = 2.5) and lastly, the extent to which gender inequality influence children comprehension ability is high (WA = 2.5). It was recommended among others that effort by the school administrators is necessary in the provision of reading materials and literacy skill development packages that are both male-oriented and female-oriented.

Keywords: pre-primart, literacy, awareness, phonemic, gender

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3457 Indoor and Outdoor Health Risk Factors as a Result of Smoke Emission in Developing Countries: a Case of Nigeria

Authors: Beatrice Adeoye

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Background: One of the health challenges developing countries face is air pollution from indoor and outdoor activities. Smoke as a result of cooking, burning wastes and power generators litter the air space on a continual basis due to poverty and governance challenges. The short and long term implications of these actions are enormous and studies have attributed smoke as one of the leading preventable risk factors contributing to global burden of respiratory infections. Design/Methods: The issue at hand therefore includes an exploration of the existing policy frameworks regarding smoke, adherence to international conventions and practices, and more importantly the activities of the government in addressing these issues. Aside this, an understanding of the implications of smoke on peoples’ health and well-being also become crucial. Consequently, this article seeks to interrogate the effect of smoke on the health and well-being of Nigerians and the activities of the policy makers in addressing these challenges. Results (Main Argument): This study reviewed both primary and secondary data on poverty, smoke emission and attendant health risks coupled with existing policies on smoke and air pollution in the country. For instance, over 69% of Nigerians are poor, ranking third in the world; 2.9 billion people live in homes using wood, coal or dung as their primary cooking fuel; equally, 50.6% of Nigerians has no access to regular electricity supply. Further, sustainable policy regarding smoke emission is lacking in the country. This work further submitted that continued low standard of living as a result of governance challenges coupled with a lack of sustainable policy have aggravated the health risks related to smoke in the country. Conclusions: The implication on the health of the children, mothers and vulnerable groups for the future of the country is enormous and may continue if not addressed. Urgent attention therefore needs to be focused on this area considering what this portends for the nation now and in the future.

Keywords: air pollution, indoor, outdoor, respiratory infections

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3456 Early Age Behavior of Wind Turbine Gravity Foundations

Authors: Janet Modu, Jean-Francois Georgin, Laurent Briancon, Eric Antoinet

Abstract:

The current practice during the repowering phase of wind turbines is deconstruction of existing foundations and construction of new foundations to accept larger wind loads or once the foundations have reached the end of their service lives. The ongoing research project FUI25 FEDRE (Fondations d’Eoliennes Durables et REpowering) therefore serves to propose scalable wind turbine foundation designs to allow reuse of the existing foundations. To undertake this research, numerical models and laboratory-scale models are currently being utilized and implemented in the GEOMAS laboratory at INSA Lyon following instrumentation of a reference wind turbine situated in the Northern part of France. Sensors placed within both the foundation and the underlying soil monitor the evolution of stresses from the foundation’s early age to stresses during service. The results from the instrumentation form the basis of validation for both the laboratory and numerical works conducted throughout the project duration. The study currently focuses on the effect of coupled mechanisms (Thermal-Hydro-Mechanical-Chemical) that induce stress during the early age of the reinforced concrete foundation, and scale factor considerations in the replication of the reference wind turbine foundation at laboratory-scale. Using THMC 3D models on COMSOL Multi-physics software, the numerical analysis performed on both the laboratory-scale and the full-scale foundations simulate the thermal deformation, hydration, shrinkage (desiccation and autogenous) and creep so as to predict the initial damage caused by internal processes during concrete setting and hardening. Results show a prominent effect of early age properties on the damage potential in full-scale wind turbine foundations. However, a prediction of the damage potential at laboratory scale shows significant differences in early age stresses in comparison to the full-scale model depending on the spatial position in the foundation. In addition to the well-known size effect phenomenon, these differences may contribute to inaccuracies encountered when predicting ultimate deformations of the on-site foundation using laboratory scale models.

Keywords: cement hydration, early age behavior, reinforced concrete, shrinkage, THMC 3D models, wind turbines

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3455 Morphological Differentiation and Temporal Variability in Essential Oil Yield and Composition among Origanum vulgare ssp. hirtum L., Origanum onites L. and Origanum x intercedens from Ikaria Island (Greece)

Authors: A.Assariotakis, P. Vahamidis, P. Tarantilis, G. Economou

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Greece, due to its geographical location and the particular climatic conditions, presents high biodiversity of Medicinal and Aromatic Plants. Among them, the genus Origanum not only presents a wide distribution, but it also has great economic importance. After extensive surveys in Ikaria Island (Greece), 3 species of the genus Origanum were identified, namely, Origanum vulgare ssp. hirtum (Greek oregano), Origanum onites (Turkish oregano) and Origanum x intercedens (hybrid), a naturally occurring hybrid between O. hirtum and O. onites. The purpose of this study was to determine their morphological as well as their temporal variability in essential oil yield and composition under field conditions. For this reason, a plantation of each species was created using vegetative propagation and was established at the experimental field of the Agricultural University of Athens (A.U.A.). From the establishment year and for the following two years (3 years of observations), several observations were taken during each growing season with the purpose of identifying the morphological differences among the studied species. Each year collected plant (at bloom stage) material was air-dried at room temperature in the shade. The essential oil content was determined by hydrodistillation using a Clevenger-type apparatus. The chemical composition of essential oils was investigated by Gas Chromatography-Mass Spectrometry (GC – MS). Significant differences were observed among the three oregano species in terms of plant height, leaf size, inflorescence features, as well as concerning their biological cycle. O. intercedens inflorescence presented more similarities with O. hirtum than with O. onites. It was found that calyx morphology could serve as a clear distinction feature between O. intercedens and O. hirtum. The calyx in O. hirtum presents five isometric teeth whereas in O. intercedens two high and three shorter. Essential oil content was significantly affected by genotype and year. O. hirtum presented higher essential oil content than the other two species during the first year of cultivation, however during the second year the hybrid (O. intercedens) recorded the highest values. Carvacrol, p-cymene and γ-terpinene were the main essential oil constituents of the three studied species. In O. hirtum carvacrol content varied from 84,28 - 93,35%, in O. onites from 86,97 - 91,89%, whereas in O. intercedens it was recorded the highest carvacrol content, namely from 89,25 - 97,23%.

Keywords: variability, oregano biotypes, essential oil, carvacrol

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3454 Housing Choices of Asian American Older Adults

Authors: Zoe Yang, Dena Shenk

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The goal of this research was to highlight stories from voices that are typically disregarded. Five older Asian Americans, who immigrated from Cambodia, Taiwan, and China, were interviewed in person, over Zoom, or through a phone call. Subjects were asked about their opinions towards aging and housing choices. Various Asian American stories reveal factors that contribute to the acceptance or rejection of aging. Through these interviews and research on cultural differences towards aging, findings indicate that personality, age, background, and health status affect one's relationship with housing choices and filial piety.

Keywords: assisted living, filial piety, housing choices, independent living

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3453 The Hansen Solubility Parameters of Some Lignosulfonates

Authors: Bernt O. Myrvold

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Lignosulfonates (LS) find widespread use as dispersants, binders, anti-oxidants, and fillers. In most of these applications LS is used in formulation together with a number of other components. To better understand the interactions between LS and water and possibly other components in a formulation, the Hansen solubility parameters have been determined for some LS. The Hansen solubility parameter splits the total solubility parameter into three components, the dispersive, polar and hydrogen bonding part. The Hansen solubility parameter was determined by comparing the solubility in a number of solvents and solvent mixtures. We have found clear differences in the solubility parameters, with softwood LS being closer to water than hardwood LS.

Keywords: Hansen solubility parameter, lignosulfonate (LS), solubility, solvent

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3452 Pregnancy - The Unique Immunological Paradigm

Authors: Husham Bayazed

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Purpose of presentation: Pregnancy represents the most important period for the conservation of the species. The immune system is one of the most important systems protecting the mother against the environment and preventing damage to the fetus. This presentation aims to review and discuss the role of the immune system during pregnancy, the evolutionary inflammatory process through pregnancy, infectious and environmental exposure influences on the mother and the fetus, and the impacts of sexual dimorphism of the placenta on offspring susceptibility to different disorders. Recent Findings: In 1960, Peter Medawar (Nobel Prize Winner) proposed that the fetus, a semi-allograft, is similar to a tissue graft that escapes rejection through a mechanism involving systemic immune suppression (Graft –Host response). However, recent researchers and studies have documented that implantation means inflammation, and the inflammatory process is considered a breach of tolerance in pregnancy with immune induction, which is necessary for the protection of the mother and the fetus against infections and environmental triggers. This inflammatory process should be maintained during different pregnancy phases till parturition, and any block at any phase will be associated with pregnancy complications, including pregnancy failure or loss, miscarriage, and preterm birth subsequently. Maternal immune activation following any trigger can have a positive effect on the fetus. The old concept of the placenta being asexual is inaccurate, and being with sexual dimorphism with clear differences in susceptibility to different factors that stimulate maternal immunity. Summary: The presence of different immune cells ((i.e., T cells, B cells, NK cells, etc.) at the implantation site is considered proof of a strong maternal immune response to the fetus. Therefore, human pregnancy is considered a unique immunological paradigm requiring maternal immune modulation rather than suppression. So Medawar's postulation of maternal systemic immunosuppression is wrong. Maternal immune system activation triggered by infections, stress, diet, and pollution can have a positive effect on the fetus, with the development of fetal-trained immunity necessary for survival. The sexual dimorphism of the placenta seems to have an impact on the differences in sex susceptible to the environment maternal risk stimuli. This link to why the incidence of autism is increasing more among boys than girls.

Keywords: pregnancy, maternal immunity, implantation and inflammation, placenta sexual dimorphism

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3451 Coffee Consumption Has No Acute Effects on Glucose Metabolism in Healthy Men: A Randomized Crossover Clinical Trial

Authors: Caio E. G. Reis, Sara Wassell, Adriana L. Porto, Angélica A. Amato, Leslie J. C. Bluck, Teresa H. M. da Costa

Abstract:

Background: Multiple epidemiologic studies have consistently reported association between increased coffee consumption and a lowered risk of Type 2 Diabetes Mellitus. However, the mechanisms behind this finding have not been fully elucidated. Objective: We investigate the effect of coffee (caffeinated and decaffeinated) on glucose effectiveness and insulin sensitivity using the stable isotope minimal model protocol with oral glucose administration in healthy men. Design: Fifteen healthy men underwent 5 arms randomized crossover single-blinding (researchers) clinical trial. They consumed decaffeinated coffee, caffeinated coffee (with and without sugar), and controls – water (with and without sugar) followed 1 hour by an oral glucose tolerance test (75 g of available carbohydrate) with intravenous labeled dosing interpreted by the two compartment minimal model (225 minutes). One-way ANOVA with Bonferroni adjustment were used to compare the effects of the tested beverages on glucose metabolism parameters. Results: Decaffeinated coffee resulted in 29% and 85% higher insulin sensitivity compared with caffeinated coffee and water, respectively, and the caffeinated coffee showed 15% and 60% higher glucose effectiveness compared with decaffeinated coffee and water, respectively. However, these differences were not significant (p > 0.10). In overall analyze (0 – 225 min) there were no significant differences on glucose effectiveness, insulin sensitivity, and glucose and insulin area under the curve between the groups. The beneficial effects of coffee did not seem to act in the short-term (hours) on glucose metabolism parameters mainly on insulin sensitivity indices. The benefits of coffee consumption occur in the long-term (years) as has been shown in the reduction of Type 2 Diabetes Mellitus risk in epidemiological studies. The clinical relevance of the present findings is that there is no need to avoid coffee as the drink choice for healthy people. Conclusions: The findings of this study demonstrate that the consumption of caffeinated and decaffeinated coffee with or without sugar has no acute effects on glucose metabolism in healthy men. Further researches, including long-term interventional studies, are needed to fully elucidate the mechanisms behind the coffee effects on reduced risk for Type 2 Diabetes Mellitus.

Keywords: coffee, diabetes mellitus type 2, glucose, insulin

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3450 Effects of Macroprudential Policies on BankLending and Risks

Authors: Stefanie Behncke

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This paper analyses the effects of different macroprudential policy measures that have recently been implemented in Switzerland. Among them is the activation and the increase of the countercyclical capital buffer (CCB) and a tightening of loan-to-value (LTV) requirements. These measures were introduced to limit systemic risks in the Swiss mortgage and real estate markets. They were meant to affect mortgage growth, mortgage risks, and banks’ capital buffers. Evaluation of their quantitative effects provides insights for Swiss policymakers when reassessing their policy. It is also informative for policymakers in other countries who plan to introduce macroprudential instruments. We estimate the effects of the different macroprudential measures with a Differences-in-Differences estimator. Banks differ with respect to the relative importance of mortgages in their portfolio, their riskiness, and their capital buffers. Thus, some of the banks were more affected than others by the CCB, while others were more affected by the LTV requirements. Our analysis is made possible by an unusually informative bank panel data set. It combines data on newly issued mortgage loans and quantitative risk indicators such as LTV and loan-to-income (LTI) ratios with supervisory information on banks’ capital and liquidity situation and balance sheets. Our results suggest that the LTV cap of 90% was most effective. The proportion of new mortgages with a high LTV ratio was significantly reduced. This result does not only apply to the 90% LTV, but also to other threshold values (e.g. 80%, 75%) suggesting that the entire upper part of the LTV distribution was affected. Other outcomes such as the LTI distribution, the growth rates of mortgages and other credits, however, were not significantly affected. Regarding the activation and the increase of the CCB, we do not find any significant effects: neither LTV/LTI risk parameters nor mortgage and other credit growth rates were significantly reduced. This result may reflect that the size of the CCB (1% of relevant residential real estate risk-weighted assets at activation, respectively 2% at the increase) was not sufficiently high enough to trigger a distinct reaction between the banks most likely to be affected by the CCB and those serving as controls. Still, it might be have been effective in increasing the resilience in the overall banking system. From a policy perspective, these results suggest that targeted macroprudential policy measures can contribute to financial stability. In line with findings by others, caps on LTV reduced risk taking in Switzerland. To fully assess the effectiveness of the CCB, further experience is needed.

Keywords: banks, financial stability, macroprudential policy, mortgages

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3449 The Role of Piaget's Theory in Conjecture via Analogical Reasoning

Authors: Supratman Ahman Maedi

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The construction of knowledge is the goal of learning. The purpose of this research is to know how the role of Piaget theory in allegation via analogy reasoning. This study uses Think out loads when troubleshooting. To explore conjecturing via analogical reasoning is given the question of open analogy. The result: conjecture via analogical reasoning has been done by students in the construction of knowledge, in conjecture there are differences in thinking flow depending on the basic knowledge of the students, in the construction of knowledge occurs assimilation and accommodation problems, strategies and relationships.

Keywords: analogical reasoning, conjecturing, knowledge construction, Piaget's theory

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3448 Management Accounting Revolution: Developed and Developing Country

Authors: Puwanenthiren Pratheepkanth

Abstract:

The main aim of this paper is to analyse existing literature (1960 -2016) on management accounting revolution by firms in a comparative perspective to see whether any differences between developed and developing countries context. The significant role that management accounting practices play in corporate finance is well established by reams of research articles. The study reveals that there are clear limitations to the literature review, it suggests that a majority of management accounting practices’ studies are focused on developed markets and that there is a scarcity of serious analyses of the situation in emerging markets.

Keywords: developed countries, developing countries, literature review, management accounting practices

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3447 The Employer Brand as Perceived by Salespeople: A Study Based on Glassdoor Reviews

Authors: Juliet F. Poujol, Jeff John Tanner, Christophe Fournier

Abstract:

Employers desire a favorable brand as an employer. This research considers whether motivation theory is applied to identify universally desirable employer brand elements. Based on data from a website where employees give their opinion about their employer (N=200), this research examines what salespeople found positive and negative about their job. Results show that traditional motivators like opportunities of advancement, and 'hygiene' factors such as benefits and work conditions are a source of satisfaction for salespeople. We also found differences by sectors. Implications are related to sales force recruitment and management.

Keywords: employer brand, motivation, qualitative study, salespeople

Procedia PDF Downloads 365
3446 Effects of Covid-19 pandemic in Japan on Japanese People’s and Expatriates’ Lifestyles

Authors: Noriyuki Suyama

Abstract:

This paper looked into consumer behavioral changes by analyzing the data collected by ASMARKS Co., one of a research companies in Japan. The purpose of the paper is to understand the two differences of before vs. after COVID-19 pandemic and Japanese living in Japan. Subsequently, examining the analysis results helped obtain useful insights into new business models for business parties in Japan as a microlevel perspective. The paper also tried to explore future conditions of globalization by taking into consideration nation’s political and economic changes as a macro-level perspective. The COVID-19 has been continuing its spread across the world with more than 60 million confirmed cases in 190 countries. This pandemic with restricted scopes of behavior mandates have disrupted the consumer habits of their lifestyles. Consumers have tendency to learn new ways when they have trouble in taking routine action. For example, the government forces people to refrain from going out, they try to telecommute at home. If the situation come back to normal, people still change their lifestyles to fit in the best. Some of data show typical effects of COVID-19; forceful exposure to digitalized work-life styles; more flexible time at home; importance of trustful and useful information gathering between what's good and bad;etc. in comparison with before vs. after COVID-19 pandemic. In addition, Japanese have less changed their lifestyles than Expatriates living in Japan. For example, while 94% of the expatriates have decreased their outgo because of self-quarantine, only 55% of the Japanese have done. There are more differences in both comparisons in the analysis results. The economic downtrend resulting from COVID-19 is supposed to be at least as devastating if not more so than that of the financial crisis. With unemployment levels in the US taking two weeks to reach what took 6 months in the 2008 crisis, there is no doubt of a global recession some predict could reach 10% or above of GDP. As a result, globalization in the global supply chain of goods and services will end up with negative impact. A lot of governmental financial and economic policies are supposed to focus on their own profits and interests, exclusing other countries interests as is the case with the Recovery Act just after the global financial crisis from 2007 to 2008. Both micro- and macro-levels analysis successfully reveal important connotations and managerial implications of business in Japan for Japanese consumers as well as after COVID-19 global business.

Keywords: COVID-19, lifestyle in Japan, expatriates, consumer behavior

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3445 Academic Achievement in Argentinean College Students: Major Findings in Psychological Assessment

Authors: F. Uriel, M. M. Fernandez Liporace

Abstract:

In the last decade, academic achievement in higher education has become a topic of agenda in Argentina, regarding the high figures of adjustment problems, academic failure and dropout, and the low graduation rates in the context of massive classes and traditional teaching methods. Psychological variables, such as perceived social support, academic motivation and learning styles and strategies have much to offer since their measurement by tests allows a proper diagnose of their influence on academic achievement. Framed in a major research, several studies analysed multiple samples, totalizing 5135 students attending Argentinean public universities. The first goal was aimed at the identification of statistically significant differences in psychological variables -perceived social support, learning styles, learning strategies, and academic motivation- by age, gender, and degree of academic advance (freshmen versus sophomores). Thus, an inferential group differences study for each psychological dependent variable was developed by means of student’s T tests, given the features of data distribution. The second goal, aimed at examining associations between the four psychological variables on the one hand, and academic achievement on the other, was responded by correlational studies, calculating Pearson’s coefficients, employing grades as the quantitative indicator of academic achievement. The positive and significant results that were obtained led to the formulation of different predictive models of academic achievement which had to be tested in terms of adjustment and predictive power. These models took the four psychological variables above mentioned as predictors, using regression equations, examining predictors individually, in groups of two, and together, analysing indirect effects as well, and adding the degree of academic advance and gender, which had shown their importance within the first goal’s findings. The most relevant results were: first, gender showed no influence on any dependent variable. Second, only good achievers perceived high social support from teachers, and male students were prone to perceive less social support. Third, freshmen exhibited a pragmatic learning style, preferring unstructured environments, the use of examples and simultaneous-visual processing in learning, whereas sophomores manifest an assimilative learning style, choosing sequential and analytic processing modes. Despite these features, freshmen have to deal with abstract contents and sophomores, with practical learning situations due to study programs in force. Fifth, no differences in academic motivation were found between freshmen and sophomores. However, the latter employ a higher number of more efficient learning strategies. Sixth, freshmen low achievers lack intrinsic motivation. Seventh, models testing showed that social support, learning styles and academic motivation influence learning strategies, which affect academic achievement in freshmen, particularly males; only learning styles influence achievement in sophomores of both genders with direct effects. These findings led to conclude that educational psychologists, education specialists, teachers, and universities must plan urgent and major changes. These must be applied in renewed and better study programs, syllabi and classes, as well as tutoring and training systems. Such developments should be targeted to the support and empowerment of students in their academic pathways, and therefore to the upgrade of learning quality, especially in the case of freshmen, male freshmen, and low achievers.

Keywords: academic achievement, academic motivation, coping, learning strategies, learning styles, perceived social support

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3444 Impact of Land Ownership on Rangeland Condition in the Gauteng Province, South Africa

Authors: N. L. Letsoalo, H. T. Pule, J. T. Tjelele, N. R. Mkhize, K. R. Mbatha

Abstract:

Rangelands are major feed resource for livestock farming in South Africa, despite being subjected to different forms of degradation. These forms of degradation are as a result of inappropriate veld and livestock management practices such as excessive stocking rates. While information on judicious veld management is available, adoption of appropriate practices is still unsatisfactory and seems to depend partly on the type of land ownership of farmers. The objectives of this study were to; (I) compare rangeland condition (species richness, basal cover, veld condition score, and herbaceous biomass) among three land ownership types (leased land, communal land and private land), and (II) determine the relationships between veld condition score (%) and herbaceous biomass (kg DM/ha) production. Vegetation was assessed at fifty farms under different land use types using nearest plant technique. Grass species composition and forage value were estimated using PROC FREQ procedure of SAS 9.3. A one-way ANOVA was used to determine significant differences (P < 0.05) in species richness, basal cover, veld condition (%) large stock units, grazing capacity and herbaceous biomass production among the three grazing systems. A total of 28 grass species were identified, of which 95% and 5% were perennials and annuals, respectively. The most commonly distributed and highly palatable grass species, Digitaria eriantha had significantly higher frequency under private owned lands (32.3 %) compared to communal owned lands (12.3%). There were no significant difference on grass species richness and basal cover among land ownership types (P > 0.05). There were significant differences on veld condition score and biomass production (P < 0.05). Private lands had significantly higher (69.63%) veld condition score than leased (56.07%) and communal lands (52.55%). Biomass production was significantly higher (± S.E.) 2990.30 ± 214 kg DM/ha on private owned lands, compared to leased lands 2069.85 ± 196 kg DM/ha and communal lands 1331.04 ± 102 kg DM/ha. Biomass production was positively correlated with rangeland condition (r = 0.895; P < 0.005). These results suggest that rangeland conditions on communal and leased lands are in poor condition than those on private lands. More research efforts are needed to improve management of rangelands in communal and leased land in Gauteng province.

Keywords: grazing, herbaceous biomass, management practices, species richness

Procedia PDF Downloads 155
3443 Transformative Learning and the Development of Cultural Humility in Social Work Students

Authors: Ruilin Zhu, Katarzyna Olcoń, Rose M. Pulliam, Dorie J. Gilbert

Abstract:

Cultural humility is increasingly important in social work literature, given its emphasis on mitigating power imbalances in helping relationships, particularly across cultural differences. Consequently, there is a need to understand whether and how cultural humility can be taught in social work education. Relying on ethnographic observations and reflective journals from a cultural immersion program, this study identified the learning process required to develop cultural humility: confusion and discomfort, re-moulding, and humility in action.

Keywords: social work education, cultural humility, transformative learning theory, study abroad, ethnographic observations

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3442 The Effect Human Papilloma Virus on Pregnancy Outcome

Authors: Amrit Gupta, Suchi Rani, Vineeta Agarwal, Swast Tiwari, Anup Kumar, Sachin Sharma

Abstract:

Pregnancy is a unique state in which a balance of immune tolerance and suppression is necessary to protect the fetus without compromising the mother’s health. Human papilloma virus (HPV) is viral infection which mainly gets transmitted through sexual contact. The HPV infection can cause infections in the placenta and increase the inflammatory response in the mother, affecting pregnancy outcomes. This may result in adverse maternal and neonatal outcomes. The objectives of this research are to evaluate the effect on clinical course in pregnancy and maternal outcome in pregnant women with HPV infection and to evaluate the effect on neonatal health in terms of adverse clinical effects. Methodology: The prospective cohort study was done in a tertiary care institution over two years. In this study, 250 participants were recruited. The study included pregnant women who attended the antenatal clinic for routine check-ups. Written informed consent was obtained from each participant. Participants were asked to fill out a detailed questionnaire about their lifestyle, including demographic characteristics, sexual behaviors, past gynecological history, and medical and surgical history. HPV was the preliminary screening method, and a Pap smear was done in patients who came out to be HPV positive. Samples were collected with the cotton stick or HC2 sampler brush. Cyto-brush was rotated 3–5 times in the region of ecto-cervix. After the collection of the sample, it was dissolved in PBS buffer and stored at − 80° for HPV DNA analysis. HPV DNA was detected using a hybrid capture assay (marketed as Digene HC2 high-risk HPV DNA test; Cat. No./ID: 5199–1220). The cohort was divided into two study groups: 1) those who were HPV positive and 2) those who were HPV negative. The chi-square test is used to compare categorical variables across groups. AQ5 Unpaired t-tests and independent sample tests are used to test the statistical significance of intergroup mean differences. P-values are considered significant if they are less than 0.05. In MS Windows, SPSS20 (IBM Corporation; NY, USA) was used for statistical analysis of all data. Results: Out of 228 pregnant women, 27.63% (n=63) of pregnant women were found positive for the HPV DNA test. In comparing the HPV-positive (N=63) and HPV-negative (N=165) groups using chi-square tests, several demographic variables exhibited statistically significant differences. Habitat distribution shows a significant difference (p<0.001), with 28.6% of HPV-positive individuals residing in rural areas compared to 8.5% of HPV-negative individuals. The presence of morbidity besides HPV infection differed significantly (p<0.001), with HPV-positive participants more likely to have additional morbidities (54%) compared to HPV-negative participants (32.1%). The mode of delivery showed significant differences (p<0.05), particularly in emergency lower segment cesarean section (HPV+: 41.3%, HPV-: 23.6%). Gestational age at delivery was significantly lower in the HPV-positive group (median 37.28 weeks, IQR 36.43-37.85) compared to the HPV-negative group (median 37.71 weeks, IQR 37.14-38.42), with a P-value of 0.003. Finally, birth weight was significantly lower in the HPV-positive group (median 2.75 kg, IQR 2.5-2.9425) compared to the HPV-negative group (median 2.9 kg, IQR 2.67-3.25) with a P-value of 0.001. Conclusion: In summary, our study offers valuable insights into the relationship between HPV infection during pregnancy, basic demographic factors and maternal and neonatal health outcomes.

Keywords: human papilloma virus, maternal health, fetal outcome, pregnancy

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3441 Effects of Caprine Arthritis-Encephalitis Virus (CAEV) Infection on the Expression of Cathelicidin Genes in Goat Blood Leukocytes

Authors: Daria Reczynska, Justyna Jarczak, Michal Czopowicz, Danuta Sloniewska, Karina Horbanczuk, Wieslaw Jarmuz, Jaroslaw Kaba, Emilia Bagnicka

Abstract:

Since people, animals and plants are constantly exposed to pathogens they have developed very complex systems of defense. Among ca. 1000 antimicrobial peptides from different families so far identified, approximately 30 belonging to cathelicidin family can be found in mammals. Cathelicidins probably constitute the first line of defense because they can act at a physiological salt concentration which is present in healthy tissues. Moreover, the low salt concentration which is present in infected tissues inhibits their activity. In goat bactenecin 7.5 (BAC7.5), bactenecin 5 (BAC5), myeloid antimicrobial peptide 28 (MAP28), myeloid antimicrobial peptide 34 (MAP34 A and B), goat bactenecin3.4 (ChBac3.4) were identified. Caprine arthritis-encephalitis (CAE) caused by small ruminant lentivirus (SRLV) is economic problem. The main CAE symptoms are weight loss, arthritis, pneumonia and mastitis (significant elevation of the somatic cell count and deterioration of some technological parameters). The study was conducted on 24 dairy goats. The animals were divided into two groups: experimental (SRLV-infected) and control (non-infected). The blood samples were collected five times: on the 1st, 7th, 30th, 90th and 150thday of lactation. The levels of transcripts of BAC7.5, BAC5, MAP28 and MAP34 genes in blood leucocytes were measured using qPCR method. There were no differences in mRNA levels of studied genes between stages of lactation. The differences were observed in expressions of BAC5, MAP28 and MAP34 genes with lower levels in the experimental group. There was no difference in BAC7.5 expression between groups. The decreased levels of transcripts of cathelicidin genes in blood leucocytes of SRLV-infected goats may indicate the disturbances of homeostasis in organisms. It can be concluded that SRLV infection seems to inhibit expression of cathelicidin genes. The study was financed by a grant from the National Scientific Center No. UMO-2013/09/B/NZ/03514.

Keywords: goat, CAEV, cathelicidins, blood leukocytes, gene expression

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3440 Value Engineering Change Proposal Application in Construction of Road-Building Projects

Authors: Mohammad Mahdi Hajiali

Abstract:

Many of construction projects estimated in Iran have been influenced by the limitations of financial resources. As for Iran, a country that is developing, and to follow this development-oriented approach which many numbers of projects each year run in, if we can reduce the cost of projects by applying a method we will help greatly to minimize the cost of major construction projects and therefore projects will finish faster and more efficiently. One of the components of transportation infrastructure are roads that are considered to have a considerable share of the country budget. In addition, major budget of the related ministry is spending to repair, improve and maintain roads. Value Engineering is a simple and powerful methodology over the past six decades that has been successful in reducing the cost of many projects. Specific solution for using value engineering in the stage of project implementation is called value engineering change proposal (VECP). It was tried in this research to apply VECP in one of the road-building projects in Iran in order to enhance the value of this kind of projects and reduce their cost. In this case study after applying VECP, an idea was raised. It was about use of concrete pavement instead of hot mixed asphalt (HMA) and also using fiber in order to improve concrete pavement performance. VE group team made a decision that for choosing the best alternatives, get expert’s opinions in pavement systems and use Fuzzy TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) for ranking opinions of the experts. Finally, Jointed Plain Concrete Pavement (JPCP) was selected. Group also experimented concrete samples with available fibers in Iran and the results of experiments showed a significant increment in concrete specifications such as flexural strength. In the end, it was shown that by using of fiber-reinforced concrete pavement instead of asphalt pavement, we can achieve a significant saving in cost, time and also increment in quality, durability, and longevity.

Keywords: road-building projects, value engineering change proposal (VECP), Jointed Plain Concrete Pavement (JPCP), Fuzzy TOPSIS, fiber-reinforced concrete

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3439 Investigation on Hydration Mechanism of Eco-Friendly Concrete

Authors: Aliakbar Sayadi, Thomas Neitzert, Charles Clifton

Abstract:

The hydration process of a green concrete with differences on fly ash and the poly-lactic acid ratio was investigated using electrical resistivity measurement. The results show that the hydration process of proposed concrete was significantly different with concrete containing petroleum aggregate. Moreover, a microstructure analysis corresponding to each hydration stage is conducted with scanning microscope for ploy-lactic acid and expanded polystyrene concrete. In addition, specific equations using the variables of this study were developed to understand and predict the relationship between setting time and resistivity development of proposed concrete containing eco-friendly aggregate.

Keywords: green concrete, SEM, hydration mechanism, eco-friendly aggregate

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3438 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

Abstract:

Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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3437 Efficacy and Safety of Sublingual Sufentanil for the Management of Acute Pain

Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

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Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

Procedia PDF Downloads 346