Search results for: vertical total electron content
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16799

Search results for: vertical total electron content

4829 Correlation of Spirometry with Six Minute Walk Test and Grading of Dyspnoea in COPD Patients

Authors: Anand K. Patel

Abstract:

Background: Patients with COPD have decreased pulmonary functions, which in turn reflect on their day-to-day activities. Objectives: To assess the correlation between functional vital capacity (FVC) and forced expiratory volume in one second (FEV1) with 6 minutes walk test (6MWT). To correlate the Borg rating for perceived exertion scale (Borg scale) and Modified medical research council (MMRC) dyspnea scale with the 6MWT, FVC and FEV1. Method: In this prospective study total 72 patients with COPD diagnosed by the GOLD guidelines were enrolled after taking written consent. They were first asked to rate physical exertion on the Borg scale as well as the modified medical research council dyspnea scale and then were subjected to perform pre and post bronchodilator spirometry followed by 6 minute walk test. The findings were correlated by calculating the Pearson coefficient for each set and obtaining the p-values, with a p < 0.05 being clinically significant. Result: There was a significant correlation between spirometry and 6MWT suggesting that patients with lower measurements were unable to walk for longer distances. However, FVC had the stronger correlation than FEV1. MMRC scale had a stronger correlation with 6MWT as compared to the Borg scale. Conclusion: The study suggests that 6MWT is a better test for monitoring the patients of COPD. In spirometry, FVC should be used in monitoring patients with COPD, instead of FEV1. MMRC scale shows a stronger correlation than the Borg scale, and we should use it more often.

Keywords: spirometry, 6 minute walk test, MMRC, Borg scale

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4828 Product Development of Standard Multi-Layer Sweet (Khanom- Chan) Recipe to Healthy for Thai Dessert

Authors: Tidarat Sanphom

Abstract:

Aim of this research is to development of Standard Layer pudding (Khanom-Chan) recipe to healthy Thai dessert. The objective are to study about standard recipe in multi-layer sweet. It was found that the appropriate recipe in multi-layer sweet, was consisted of rice starch 56 grams, tapioca starch 172 grams, arrowroot flour 98 grams, mung been-flour 16 grams, coconut milk 774 grams, fine sugar 374 grams, pandan leaf juice 47 grams and oil 5 grams.Then the researcher studied about the ratio of rice-berries flour to rice starch in multi-layer sweet at level of 30:70, 50:50, and only rice-berry flour 100 percentage. Result sensory evaluation, it was found the ratio of rice-berry flour to rice starch 30:70 had well score. The result of multi-layer sweet with rice-berry flour reduced sugar 20, 40 and 60 percentage found that 20 percentage had well score. Calculated total calories and calories from fat in Sweet layer cake with rice-berry flour reduced sugar 20 percentage had 250.04 kcal and 65.16 kcal.

Keywords: multi-layer sweet (Khanom-Chan), rice-berry flour, leaf juice, desert

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4827 Nurse's Use of Power to Standardize Nursing Terminology in Electronic Health Record

Authors: Samira Ali

Abstract:

Aim: The purpose of this study was to describe nurses’ potential use of power levels to influence the standardization of nursing terminology (SNT) in electronic health records. Also, to examine the relationship between nurses’ use of power levels and variables such as position, communication and the potential goal of achieving SNT in electronic health records. Background: In an era of evidence-based nursing care, with an emphasis on nursing’s ability to measure the care rendered and improve outcomes of care, little is known about the nurse’s potential use of their power to SNT in electronic health records and lack of use of an SNT in electronic health records. Method: This descriptive, correlational, and cross-sectional study was conducted using survey methodology to assess the nurse’s use of power to influence the SNT in electronic health records. The Theory of Group Power within Organizations (TGPO) provided the conceptual framework for this study. A total of (n=232) nurses responded to the survey, posted on three nursing organizations’ websites. Results revealed the mean Cronbach’s alpha of the subscales was .94, suggesting high internal consistency. The mean power capability score was moderately high, at 134.22 (SD = 18.49). Power Capacity was significantly correlated with Power Capability (r = .96, p < .001). Power Capacity subscales were significantly correlated with Power Capacity and Power Capability. Conclusion: The mean Cronbach’s alpha of the subscales was .94 suggestive of reliability of the instrument. Nurses could potentially use power to achieve their goals, such as the implementation of SNT in electronic health records.

Keywords: nurses, power, actualized power, nursing terminology, electronic health records

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4826 Flexible Feedstock Concept in Gasification Process for Carbon-Negative Energy Technology: A Case Study in Malaysia

Authors: Zahrul Faizi M. S., Ali A., Norhuda A. M.

Abstract:

Emission of greenhouse gases (GHG) from solid waste treatment and dependency on fossil fuel to produce electricity are the major concern in Malaysia as well as global. Innovation in downdraft gasification with combined heat and power (CHP) systems has the potential to minimize solid waste and reduce the emission of anthropogenic GHG from conventional fossil fuel power plants. However, the efficiency and capability of downdraft gasification to generate electricity from various alternative fuels, for instance, agriculture residues (i.e., woodchip, coconut shell) and municipal solid waste (MSW), are still controversial, on top of the toxicity level from the produced bottom ash. Thus this study evaluates the adaptability and reliability of the 20 kW downdraft gasification system to generate electricity (while considering environmental sustainability from the bottom ash) using flexible local feedstock at 20, 40, and 60% mixed ratio of MSW: agriculture residues. Feedstock properties such as feed particle size, moisture, and ash contents are also analyzed to identify optimal characteristics for the combination of feedstock (feedstock flexibility) to obtain maximum energy generation. Results show that the gasification system is capable to flexibly accommodate different feedstock compositions subjected to specific particle size (less than 2 inches) at a moisture content between 15 to 20%. These values exhibit enhance gasifier performance and provide a significant effect to the syngas composition utilizes by the internal combustion engine, which reflects energy production. The result obtained in this study is able to provide a new perspective on the transition of the conventional gasification system to a future reliable carbon-negative energy technology. Subsequently, promoting commercial scale-up of the downdraft gasification system.

Keywords: carbon-negative energy, feedstock flexibility, gasification, renewable energy

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4825 Non-Steroidal Microtubule Disrupting Analogues Induce Programmed Cell Death in Breast and Lung Cancer Cell Lines

Authors: Marcel Verwey, Anna M. Joubert, Elsie M. Nolte, Wolfgang Dohle, Barry V. L. Potter, Anne E. Theron

Abstract:

A tetrahydroisoquinolinone (THIQ) core can be used to mimic the A,B-ring of colchicine site-binding microtubule disruptors such as 2-methoxyestradiol in the design of anti-cancer agents. Steroidomimeric microtubule disruptors were synthesized by introducing C'2 and C'3 of the steroidal A-ring to C'6 and C'7 of the THIQ core and by introducing a decorated hydrogen bond acceptor motif projecting from the steroidal D-ring to N'2. For this in vitro study, four non-steroidal THIQ-based analogues were investigated and comparative studies were done between the non-sulphamoylated compound STX 3450 and the sulphamoylated compounds STX 2895, STX 3329 and STX 3451. The objective of this study was to investigate the modes of cell death induced by these four THIQ-based analogues in A549 lung carcinoma epithelial cells and metastatic breast adenocarcinoma MDA-MB-231 cells. Cytotoxicity studies to determine the half maximal growth inhibitory concentrations were done using spectrophotometric quantification via crystal violet staining and lactate dehydrogenase (LDH) assays. Microtubule integrity and morphologic changes of exposed cells were investigated using polarization-optical transmitted light differential interference contrast microscopy, transmission electron microscopy and confocal microscopy. Flow cytometric quantification was used to determine apoptosis induction and the effect that THIQ-based analogues have on cell cycle progression. Signal transduction pathways were elucidated by quantification of the mitochondrial membrane integrity, cytochrome c release and caspase 3, -6 and -8 activation. Induction of autophagic cell death by the THIQ-based analogues was investigated by morphological assessment of fluorescent monodansylcadaverine (MDC) staining of acidic vacuoles and by quantifying aggresome formation via flow cytometry. Results revealed that these non-steroidal microtubule disrupting analogues inhibited 50% of cell growth at nanomolar concentrations. Immunofluorescence microscopy indicated microtubule depolarization and the resultant mitotic arrest was further confirmed through cell cycle analysis. Apoptosis induction via the intrinsic pathway was observed due to depolarization of the mitochondrial membrane, induction of cytochrome c release as well as, caspase 3 activation. Potential involvement of programmed cell death type II was observed due to the presence of acidic vacuoles and aggresome formation. Necrotic cell death did not contribute significantly, indicated by stable LDH levels. This in vitro study revealed the induction of the intrinsic apoptotic pathway as well as possible involvement of autophagy after exposure to these THIQ-based analogues in both MDA-MB-231- and A549 cells. Further investigation of this series of anticancer drugs still needs to be conducted to elucidate the temporal, mechanistic and functional crosstalk mechanisms between the two observed programmed cell deaths pathways.

Keywords: apoptosis, autophagy, cancer, microtubule disruptor

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4824 From an Elderly Middle-Aged Man to ‘a Scientist May Be Anyone’: Draw-A-Scientist-Test in Nepalese Context

Authors: Pragya Paneru, Prativa Paneru

Abstract:

This paper explores the attitude of high school Nepalese students toward scientists using a famous method named as Draw-A-Scientist-Test (DAST). A total of 145 students from Grade 11 and Grade 12 took part in this research and drew images of scientists. The findings indicated gender imbalance with male dominance in the images of scientists. The result also showed some usual stereotypes relating to hair, equipment, objects, use of eyeglasses, and lab coat in the drawings of scientists. Moreover, the influence of some mainstream western male scientists was widely seen in the drawings implying the exposure of limited male scientists to the students. In contrast to this, no real-life female scientists were mentioned by the participants demonstrating limited exposure of female scientists contributing to the gendered attitude toward the scientists. However, some of the findings also challenged the previous findings and depicted scientists with local features, positive expression, and working outdoors. Moreover, participants’ awareness that scientists could be anyone with an inquisitive mind was indicated by the variations in the characters in their drawings. The drawings indicated that scientists could be someone like a mother, themselves, a fashion icon, Buddha, or a crazy-looking person. This study recommends the inclusion of participants’ interviews, and exploration of their textbooks’ depiction of scientists to uncover additional details regarding their understanding of scientists. Also, a critical discussion of the stereotypical attitudes about scientists in class could help challenge the stereotypical assumptions of scientists.

Keywords: scientists, drawings, stereotypes, gender, high school students

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4823 Adolescent and Adult Hip Dysplasia on Plain Radiographs. Analysis of Measurements and Attempt for Optimization of Diagnostic and Performance Approaches for Patients with Periacetabular Osteotomy (PAO).

Authors: Naum Simanovsky MD, Michael Zaidman MD, Vladimir Goldman MD.

Abstract:

105 plain AP radiographs of normal adult pelvises (210 hips) were evaluated. Different measurements of normal and dysplastic hip joints in 45 patients were analyzed. Attempt was made to establish reproducible, easy applicable in practice approach for evaluation and follow up of patients with hip dysplasia. The youngest of our patients was 11 years and the oldest was 47 years. Only one of our patients needed conversion to total hip replacement (THR) during ten years of follow-up. It was emphasized that selected set of measurements was built for purpose to serve, especially those who’s scheduled or undergone PAO. This approach was based on concept of acetabulum-femoral head complex and importance of reliable reference points of measurements. Comparative analysis of measured parameters between normal and dysplastic hips was performed. Among 10 selected parameters, we use already well established such as lateral center edge angle and head extrusion index, but to serve specific group of patients with PAO, new parameters were considered such as complex lateralization and complex proximal migration. By our opinion proposed approach is easy applicable in busy clinical practice, satisfactorily delineate hip pathology and give to surgeon who’s going to perform PAO guidelines in condensed form. It is also useful tools for postoperative follow up after PAO.

Keywords: periacetabular osteotomy, plain radiograph’s measurements, adolescents, adult

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4822 Impact of Green Marketing Mix Strategy and CSR on Organizational Performance: An Empirical Study of Manufacturing Sector of Pakistan

Authors: Syeda Shawana Mahasan, Muhammad Farooq Akhtar

Abstract:

The objective of this study is to analyze the influence of the green marketing mix strategy and corporate social responsibility (CSR) on the performance of an organization, taking into account the mediating effect of corporate image. The impact of frugal innovation and corporate activism is being examined. The data was gathered from executives at various levels of management, including top, middle, and lower-level managers, from a total of 550 manufacturing enterprises of different sizes, ranging from small to medium to large. The collected replies are processed and analyzed using SMART PLS version 4.0.0.0. The application of PLS-SEM demonstrates that the green marketing mix strategy and corporate social responsibility have a significant impact on organizational performance. Therefore, it is imperative for organizations to effectively adopt environmentally sustainable and socially conscious methods within their operations. The results indicate that the corporate image has a key role in mediating the relationship between the green marketing mix strategy, corporate social responsibility, and organizational performance. This demonstrates the imperative for organizations to actively enhance their favorable reputation among stakeholders. The combination of frugal innovation and corporate activism enhances the connection between corporate image and organizational performance. The current study assists managers in recognizing the significance of these particular constructs in maintaining the long-term performance of the organization.

Keywords: green marketing mix strategy, CSR, corporate image, organizational performance, frugal innovation, corporate activism

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4821 Evaluation of the Shelf Life of Horsetail Stems Stored in Ecological Packaging

Authors: Rosana Goncalves Das Dores, Maira Fonseca, Fernando Finger, Vicente Casali

Abstract:

Equisetum hyemale L. (horsetail, Equisetaceae) is a medicinal plant used and commercialized in simple paper bags or non-ecological packaging in Brazil. The aim of this work was to evaluate the relation between the bioactive compounds of horsetail stems stored in ecological packages (multi-ply paper sacks) at room temperature. Stems in primary and secondary stage were harvested from an organic estate, on December 2016, selected, measured (length from the soil to the apex (cm), stem diameter at ground level (DGL mm) and breast height (DBH mm) and cut into 10 cm. For the post-harvest evaluations, stems were stored in multi-ply paper sacks and evaluated daily to the respiratory rate, fresh weight loss, pH, presence of fungi / mold, phenolic compounds and antioxidant activity. The analyses were done with four replicates, over time (regression) and compared at 1% significance (Tukey test). The measured heights were 103.7 cm and 143.5 cm, DGL was 2.5mm and 8.4 mm and DBH of 2.59 and 6.15 mm, respectively for primary and secondary stems stage. At both stages of development, in storage in multi-ply paper sacks, the greatest mass loss occurred at 48 h, decaying up to 120 hours, stabilizing at 192 hours. The peak respiratory rate increase occurred in 24 hours, coinciding with a change in pH (temperature and mean humidity was 23.5°C and 55%). No fungi or mold were detected, however, there was loss of color of the stems. The average yields of ethanolic extracts were equivalent (approximately 30%). Phenolic compounds and antioxidant activity were higher in secondary stems stage in up to 120 hours (AATt0 = 20%, AATt30 = 45%), decreasing at the end of the experiment (240 hours). The packaging used allows the commercialization of fresh stems of Equisetum for up to five days.

Keywords: paper sacks, phenolic content, antioxidant activity, medicinal plants, post-harvest, ecological packages, Equisetum

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4820 Oman’s Position in U.S. Tourists’ Mind: The Use of Importance-Performance Analysis on Destination Attributes

Authors: Mohammed Gamil Montasser, Angelo Battaglia

Abstract:

Tourism is making its presence felt across the Sultanate of Oman. The story is one of the most recognized phenomena as a sustainable solid growth and is considered a remarkable outcome for any destination. The competitive situation and challenges within the tourism industry worldwide entail a better understanding of the destination position and its image to achieve Oman’s aspiration to retain its international reputation as one of the most desirable destinations in the Middle East. To access general perceptions of Oman’s attributes, their importance and their influences among U.S. tourists, an online survey was conducted with 522 American travelers who have traveled internationally, including non-visitors, virtual-visitors and visitors to Oman. This research involved a total of 36 attributes in the survey. Participants were asked to rate their agreement on how each attribute represented Oman and how important each attribute was for selecting destinations on 5- point Likert Scale. They also indicated if each attribute has a positive, neutral or negative influence on their destination selection. Descriptive statistics and importance performance analysis (IPA) were conducted. IPA illustrated U.S. tourists’ perceptions of Oman’s destination attributes and their importance in destination selection on a matrix with four quadrants, divided by actual mean value in each grid for importance (M=3.51) and performance (M=3.57). Oman tourism organizations and destination managers may use these research findings for future marketing and management efforts toward the U.S. travel market.

Keywords: analysis of importance, performance, destination attributes, Oman's position, U.S. tourists

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4819 Properties Soft Cheese as Diversification of Dangke: A Natural Cheese of South Sulawesi Indonesia

Authors: Ratmawati Malaka, Effendi Abustam, Kusumandari Indah Prahesti, Sudirman Baco

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Dangke is natural cheese from Enrekang South Sulawesi, Indonesia produced through aglutination buffalo milk, cow, goat or sheep using the sap of papaya (Carica papaya). Dangke has been widely known in South Sulawesi but this soft cheese product diversification by using passion fruit juice as milk clotting agents has not been used. Passion fruit juice has a high acidity with a pH of around 4 - 4.5 and has a proteolytic enzyme, so that it can be used to agglutinate milk. The purpose of this study was to investigate the nature Dangke using passion fruit juice as coagulate milk. Dangke made by 10 lt of raw milk by heating at a temperature of 73oC with coagulant passion fruit juice (7.5% and 10%), and added 1% salt. Curd clot and then be formed using a coconut shell, is then pressed until the cheese is compact. The cheese is then observed for 28 days ripening at a temperature of about 5 ° C. Dangke then studied to violence, pH, fat levels and microstructure. Hardness is determined using CD-shear Force, pH is measured using a pH meter Hanna, and fat concentrations were analyzed with methods of proximate. Microstructure viewed using a light microscope with magnification 1000 x. The results showed that the levels of clotting material very significant influence on hardness, pH, and lipid levels. Maturation increase the hardness but lower the pH, the level of fat soft cheese with an average Dangke respectively 21.4% and 30.5% on 7.5% addition of passion fruit juice and 10%. Dangke violence is increasing with the increasing maturation time (1.38 to 3.73 kg / cm), but Dangke pH was decreased by the increase in storage maturation (5.34 to 4.1). Microktrukture cheeses coagulated with 10% of the passion fruit are very firmer and compact with a full globular fat of 7.5%. But the sensory properties of the soft cheese similar in both treatment. The manufacturing process with the addition of coagulant passion fruit juice on making Dangke affect hardness, pH, fat content and microstructure during storage at 5 ° C for 1 d - 28 d.

Keywords: dangke, passion fruits, microstructure, cheese

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4818 The Importance of Downstream Supply Chain in Supply Chain Risk Management: Multi-Objective Optimization

Authors: Zohreh Khojasteh-Ghamari, Takashi Irohara

Abstract:

One of the efficient ways in supply chain risk management is avoiding the interruption in Supply Chain (SC) before it occurs. Although the majority of the organizations focus on their first-tier suppliers to avoid risk in the SC, studies show that in only 60 percent of the disruption cases the reason is first tier suppliers. In the 40 percent of the SC disruptions, the reason is downstream SC, which is the second tier and lower. Due to the increasing complexity and interrelation of modern supply chains, the SC elements have become difficult to trace. Moreover, studies show that there is a vital need to better understand the integration of risk and visibility, especially in the context of multiple objectives. In this study, we propose a multi-objective programming model to avoid disruption in SC. The objective of this study is evaluating the effect of downstream SCV on managing supply chain risk. We propose a multi-objective mathematical programming model with the objective functions of minimizing the total cost and maximizing the downstream supply chain visibility (SCV). The decision variable is supplier selection. We assume there are several manufacturers and several candidate suppliers. For each manufacturer, our model proposes the best suppliers with the lowest cost and maximum visibility in downstream supply chain. We examine the applicability of the model by numerical examples. We also define several scenarios for datasets and observe the tendency. The results show that minimum visibility in downstream SC is needed to have a safe SC network.

Keywords: downstream supply chain, optimization, supply chain risk, supply chain visibility

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4817 Mother and Father Involvement and Students’ School Performance: A Study on Private Primary Schools in Bahir Dar City, Ethiopia

Authors: Alemayehu Belay Emagnaw

Abstract:

This study was conducted to investigate the relationship of mother and father involvement with students’ school performance and the effect of selected family demographic variables (mother and father education, family structure and sex of students) to the involvement of mothers and fathers in their children’s school performance. In addition, this study attempted to differentiate the level of involvement of mothers’ and fathers’ in their children’s school performance. The research was conducted in Bahirdar City, Ethiopia. A total of 175 students (boys were 85 and girls were 90) of grade 7th and 8th private primary schools were selected as respondents using stratified random sampling technique. The data were collected using a questionnaire. Analysis of the data showed that fathers and mothers have significant involvement in their children’s school performance. A significant difference was also found between mothers and fathers involvement in their children’s school performance. Mothers were better involved in their children school performance than fathers. The analysis of inter-correlation between variables showed that there is a statistically significant relationship between mother and father education, mother and father involvement, and school performance whereas, family structure and sex of the child had no significant relationship with school performance.

Keywords: family structure, parental education, parental involvement, school performance

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4816 Militating Factors Against Building Information Modeling Adoption in Quantity Surveying Practice in South Africa

Authors: Kenneth O. Otasowie, Matthew Ikuabe, Clinton Aigbavboa, Ayodeji Oke

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The quantity surveying (QS) profession is one of the professions in the construction industry, and it is saddled with the responsibility of measuring the number of materials as well as the workmanship required to get work done in the industry. This responsibility is vital to the success of a construction project as it determines if a project will be completed on time, within budget, and up to the required standard. However, the practice has been criticised severally for failure to accurately execute her responsibility. The need to reduce errors, inaccuracies and omissions has made the adoption of modern technologies such as building information modeling (BIM) inevitable in its practice. Nevertheless, there are barriers to the adoption of BIM in QS practice in South Africa (SA). Thus, this study aims to investigate these barriers. A survey design was adopted. A total number of one hundred and fifteen (115) questionnaires were administered to quantity surveyors in Guateng Province, SA, and ninety (90) were returned and found suitable for analysis. Collected data were analysed using percentage, mean item score, standard deviation, one-sample t-test, and Kruskal-Wallis. The findings show that lack of BIM expertise, lack of government enforcement, resistance to change, and no client demand for BIM are the most significant barriers to the adoption of BIM in QS practice. As a result, this study recommends that trainings on BIM technology be prioritised, and government must take the lead in BIM adoption in the country, particularly in public projects.

Keywords: barriers, BIM, quantity surveying practice, South Africa

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4815 Effect of Select Surfactants on Activities of Soil Enzymes Involved in Nutrient Cycling

Authors: Frieda Eivazi, Nikita L. Mullings

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Soils are recipient for surfactants in herbicide formulations. Surfactants entering the soil environment can possibly disrupt different chemical, physical and biological interactions. Therefore, it is critical that we understand the fate, behavior and transport of surfactants upon entering the soil. A comprehensive study was conducted to examine effect of surfactants on nutrient uptake, microbial community, and enzyme activity. The research was conducted in the greenhouse growing corn (Zea mays) as a test plant in a factorial experiment (three surfactants at two different rates with control, and three herbicides) organized as randomized blocked design. Surfactants evaluated were Activator 90, Agri-Dex, and Thrust; herbicides were glyphosate, atrazine, and bentazon. Treatments examined were surfactant only, herbicide only, and surfactant + herbicide combinations. Corn was planted in fertilized soils (silt loam and silty clay) with moisture content maintained at the field capacity for optimum growth. This paper will report results of above mentioned treatments on acid phosphatase, beta-glucosidase, arylsulfatase, beta-glucosaminidase, and dehydrogenase activities. In general, there were variations in the enzyme activities with some inhibition and some being enhanced by the treatments. Activator 90 appeared to have the highest inhibitory effect on enzymatic activities. Atrazine application significantly decreased the activities of acid phosphatase, beta-glucosidase, and dehydrogenase in both soils; however, combination of Atrazine + Agridex increased the acid phosphatase activity while significantly inhibiting the other enzyme activities in soils. It was concluded that long-term field studies are needed to validate changes in nutrient uptake, microbial community and enzyme activities due to surfactant-herbicide combination effects.

Keywords: herbicides, nutrient cycling, soil enzymes, surfactant

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4814 The Role of Digital Technology in Crime Prevention: A Case Study of Cellular Forensics Unit, Capital City Police Peshawar

Authors: Muhammad Ashfaq

Abstract:

Main theme: This prime focus of this study is on the role of digital technology in crime prevention, with special focus on Cellular Forensic Unit, Capital City Police Peshawar-Khyber Pakhtunkhwa-Pakistan. Objective(s) of the study: The prime objective of this study is to provide statistics, strategies, and pattern of analysis used for crime prevention in Cellular Forensic Unit of Capital City Police Peshawar, Khyber Pakhtunkhwa-Pakistan. Research Method and Procedure: Qualitative method of research has been used in the study for obtaining secondary data from research wing and Information Technology (IT) section of Peshawar police. Content analysis was the method used for the conduction of the study. This study is delimited to Capital City Police and Cellular Forensic Unit Peshawar-KP, Pakistan. information technologies. Major finding(s): It is evident that the old traditional approach will never provide solutions for better management in controlling crimes. The best way to control crimes and promotion of proactive policing is to adopt new technologies. The study reveals that technology have transformed police more effective and vigilant as compared to traditional policing. The heinous crimes like abduction, missing of an individual, snatching, burglaries, and blind murder cases are now traceable with the help of technology. Recommendation(s): From the analysis of the data, it is reflected that Information Technology (IT) expert should be recruited along with research analyst to timely assist and facilitate operational as well as investigation units of police. A mobile locator should be Provided to Cellular Forensic Unit to timely apprehend the criminals. Latest digital analysis software should be provided to equip the Cellular Forensic Unit.

Keywords: criminology-pakistan, crime prevention-KP, digital forensics, digital technology-pakistan

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4813 E-Learning Approach for Improving Classroom Teaching to Enhance Students' Learning in Secondary Schools in Nigeria

Authors: Chika Ethel Esege

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Electronic learning is learning facilitated by technology which has basically altered approaches globally, including the field of education. This trend is compelling educators to focus on approaches that improve classroom practices in order to enhance students’ learning and participation in a global digital society. However, e-learning is not fully utilized across subject disciplines particularly in the field of humanities, in the context of Nigerian secondary education. This study focused on the use of e-learning to enhance the development of digital skills, particularly, collaboration and communication in secondary school students in Nigeria. The study adopted an ‘action research’ involving 210 students and 7 teachers, who utilised the e-learning platform designed by the researcher for the survey. Mixed methods- qualitative and quantitative- were used for data collection including questionnaire, observation, interview, and analysis of statutory documents. The data were presented using frequency counts for questionnaire responses and figures of screenshots for learning tasks. The VOD Burner software was also used to analyse interviews and video recordings. The study showed that the students acquired collaboration and communication skills through e-learning intervention lesson, and demonstrated satisfaction with this approach. However, the study further revealed that the traditional teaching approach could not provide digital education or develop the digital skills of the students. Based on these findings, recommendations were made that the Nigerian Government should incorporate digital content across subject disciplines into secondary school education curricular and provide adequate infrastructure in order to enable educators to adopt relevant approaches necessary for the enhancement of students’ learning especially in a technologically evolving and advancing world.

Keywords: developing collaboration and communication skills, electronic learning, improving classroom teaching, secondary schools in Nigeria

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4812 A Prospective Study of a Modified Pin-In-Plaster Technique for Treatment of Distal Radius Fractures

Authors: S. alireza Mirghasemi, Shervin Rashidinia, Mohammadsaleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, S. Shahin Eftekhari, Sara Shahmoradi

Abstract:

Purpose: There are various pin-in-plaster methods for treating distal radius fractures. This study is meant to introduce a modified technique of pin-in-plaster. Materials and methods: Fifty-four patients with distal radius fractures were followed up for one year. Patients were excluded if they had type B fractures according to AO classification, multiple injuries or pathological fractures, and were treated more than 7 days after injury. Range of motion and functional results were evaluated. Radiographic parameters including radial inclination, tilt, and height, were measured preoperatively and postoperatively. Results: The average radial tilt was 10.6° and radial height was 10.2 mm at the sixth month postoperatively. Three cases of pin tract infection were recorded, who were treated totally with oral antibiotics. There was no case of pin loosening. Of total 73 patients underwent surgery, three cases of radial nerve irritation were recorded at the time of cast removal. All of them resolved at the 6th month follow up. No median nerve compression and carpal tunnel syndrome have found. We also had no case of tendon injury. Conclusion: Our modified technique is effective to restore anatomic congruity and maintain reduction.

Keywords: distal radius fracture, percutaneous pinning, pin-in-plaster, modified method of pin-in-plaster, operative treatment

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4811 An Analysis of Twitter Use of Slow Food Movement in the Context of Online Activism

Authors: Kubra Sultan Yuzuncuyil, Aytekin İsman, Berkay Bulus

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With the developments of information and communication technologies, the forms of molding public opinion have changed. In the presence of Internet, the notion of activism has been endowed with digital codes. Activists have engaged the use of Internet into their campaigns and the process of creating collective identity. Activist movements have been incorporating the relevance of new communication technologies for their goals and opposition. Creating and managing activism through Internet is called Online Activism. In this main, Slow Food Movement which was emerged within the philosophy of defending regional, fair and sustainable food has been engaging Internet into their activist campaign. This movement supports the idea that a new food system which allows strong connections between plate and planet is possible. In order to make their voices heard, it has utilized social networks and develop particular skills in the framework online activism. This study analyzes online activist skills of Slow Food Movement (SFM) develop and attempts to measure its effectiveness. To achieve this aim, it adopts the model proposed by Sivitandies and Shah and conduct both qualitiative and quantiative content analysis on social network use of Slow Food Movement. In this regard, the sample is chosen as the official profile and analyzed between in a three month period respectively March-May 2017. It was found that SFM develops particular techniques that appeal to the model of Sivitandies and Shah. The prominent skill in this regard was found as hyperlink abbreviation and use of multimedia elements. On the other hand, there are inadequacies in hashtag and interactivity use. The importance of this study is that it highlights and discusses how online activism can be engaged into a social movement. It also reveals current online activism skills of SFM and their effectiveness. Furthermore, it makes suggestions to enhance the related abilities and strengthen its voice on social networks.

Keywords: slow food movement, Twitter, internet, online activism

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4810 Vehicle Routing Problem with Mixed Fleet of Conventional and Heterogenous Electric Vehicles and Time Dependent Charging Costs

Authors: Ons Sassi, Wahiba Ramdane Cherif-Khettaf, Ammar Oulamara

Abstract:

In this paper, we consider a new real-life Heterogenous Electric Vehicle Routing Problem with Time Dependant Charging Costs and a Mixed Fleet (HEVRP-TDMF), in which a set of geographically scattered customers have to be served by a mixed fleet of vehicles composed of a heterogenous fleet of Electric Vehicles (EVs), having different battery capacities and operating costs, and Conventional Vehicles (CVs). We include the possibility of charging EVs in the available charging stations during the routes in order to serve all customers. Each charging station offers charging service with a known technology of chargers and time-dependent charging costs. Charging stations are also subject to operating time windows constraints. EVs are not necessarily compatible with all available charging technologies and a partial charging is allowed. Intermittent charging at the depot is also allowed provided that constraints related to the electricity grid are satisfied. The objective is to minimize the number of employed vehicles and then minimize the total travel and charging costs. In this study, we present a Mixed Integer Programming Model and develop a Charging Routing Heuristic and a Local Search Heuristic based on the Inject-Eject routine with three different insertion strategies. All heuristics are tested on real data instances.

Keywords: charging problem, electric vehicle, heuristics, local search, optimization, routing problem

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4809 Developing a Toolkit of Undergraduate Nursing Student’ Desirable Characteristics (TNDC) : An application Item Response Theory

Authors: Parinyaporn Thanaboonpuang, Siridej Sujiva, Shotiga Pasiphul

Abstract:

The higher education reform that integration of nursing programmes into the higher education system. Learning outcomes represent one of the essential building blocks for transparency within higher education systems and qualifications. The purpose of this study is to develop a toolkit of undergraduate nursing student’desirable characteristics assessment on Thai Qualifications Framework for Higher education and to test psychometric property for this instrument. This toolkit seeks to improve on the Computer Multimedia test. There are three skills to be examined: Cognitive skill, Responsibility and Interpersonal Skill, and Information Technology Skill. The study was conduct in 4 phases. In Phase 1. Based on developed a measurement model and Computer Multimedia test. Phase 2 two round focus group were conducted, to determine the content validity of measurement model and the toolkit. In Phase 3, data were collected using a multistage random sampling of 1,156 senior undergraduate nursing student were recruited to test psychometric property. In Phase 4 data analysis was conducted by descriptive statistics, item analysis, inter-rater reliability, exploratory factor analysis and confirmatory factor analysis. The resulting TNDC consists of 74 items across the following four domains: Cognitive skill, Interpersonal Skill, Responsibility and Information Technology Skill. The value of Cronbach’ s alpha for the four domains were .781, 807, .831, and .865, respectively. The final model in confirmatory factor analysis fit quite well with empirical data. The TNDC was found to be appropriate, both theoretically and statistically. Due to these results, it is recommended that the toolkit could be used in future studies for Nursing Program in Thailand.

Keywords: toolkit, nursing student’ desirable characteristics, Thai qualifications framework

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4808 Improving Graduate Student Writing Skills: Best Practices and Outcomes

Authors: Jamie Sundvall, Lisa Jennings

Abstract:

A decline in writing skills and abilities of students entering graduate school has become a focus for university systems within the United States. This decline has become a national trend that requires reflection on the intervention strategies used to address the deficit and unintended consequences as outcomes in the profession. Social work faculty is challenged to increase written scholarship within the academic setting. However, when a large number of students in each course have writing deficits, there is a shift from focus on content, ability to demonstrate competency, and application of core social work concepts. This qualitative study focuses on the experiences of online faculty who support increasing scholarship through writing and are following best practices preparing students academically to see improvements in written presentation in classroom work. This study outlines best practices to improve written academic presentation, especially in an online setting. The research also highlights how a student’s ability to show competency and application of concepts may be overlooked in the online setting. This can lead to new social workers who are prepared academically, but may unable to effectively advocate and document thought presentation in their writing. The intended progression of writing across all levels of higher education moves from summary, to application, and into abstract problem solving. Initial findings indicate that it is important to reflect on practices used to address writing deficits in terms of academic writing, competency, and application. It is equally important to reflect on how these methods of intervention impact a student post-graduation. Specifically, for faculty, it is valuable to assess a social worker’s ability to engage in continuity of documentation and advocacy at micro, mezzo, macro, and international levels of practice.

Keywords: intervention, professional impact, scholarship, writing

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4807 Changes in Textural Properties of Zucchini Slices Under Effects of Partial Predrying and Deep-Fat-Frying

Authors: E. Karacabey, Ş. G. Özçelik, M. S. Turan, C. Baltacıoğlu, E. Küçüköner

Abstract:

Changes in textural properties of any food material during processing is significant for further consumer’s evaluation and directly affects their decisions. Thus any food material should be considered in terms of textural properties after any process. In the present study zucchini slices were partially predried to control and reduce the product’s final oil content. A conventional oven was used for partially dehydration of zucchini slices. Following frying was carried in an industrial fryer having temperature controller. This study was based on the effect of this predrying process on textural properties of fried zucchini slices. Texture profile analysis was performed. Hardness, elasticity, chewiness, cohesiveness were studied texture parameters of fried zucchini slices. Temperature and weight loss were monitored parameters of predrying process, whereas, in frying, oil temperature and process time were controlled. Optimization of two successive processes was done by response surface methodology being one of the common used statistical process optimization tools. Models developed for each texture parameters displayed high success to predict their values as a function of studied processes’ conditions. Process optimization was performed according to target values for each property determined for directly fried zucchini slices taking the highest score from sensory evaluation. Results indicated that textural properties of predried and then fried zucchini slices could be controlled by well-established equations. This is thought to be significant for fried stuff related food industry, where controlling of sensorial properties are crucial to lead consumer’s perception and texture related ones are leaders. This project (113R015) has been supported by TUBITAK.

Keywords: optimization, response surface methodology, texture profile analysis, conventional oven, modelling

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4806 Activation of Apoptosis in the Midgut Epithelium of Spodoptera exigua Hübner (Lepidoptera: Noctuidae) Exposed to Various Cadmium Concentration

Authors: Magdalena Maria Rost-Roszkowska, Alina Chachulska-Żymełka, Monika Tarnawska, Maria Augustyniak, Alina Kafel, Agnieszka Babczyńska

Abstract:

The digestive system of insects is composed of three distinct regions: fore-, mid- and hingut. The middle region (the midgut) is treated as one of the barriers which protects the organism against any stressors which originate from external environment, e.g. toxic metals. Such factors can activate the cell death in epithelial cells to preserve the entire tissue/organs against the degeneration. Different mechanisms involved in homeostasis maintenance have been described, but the studies of animals under field conditions do not give the opportunity to conclude about potential ability of subsequent generation to inherit the tolerance mechanisms. It is possible only by a multigenerational strain of an animal led under laboratory conditions, exposed to a selected toxic factor, present also in polluted ecosystems. The main purpose of the project was to check if changes, which appear in the midgut epithelium after Cd treatment, can be fixed during the following generations of insects with the special emphasis on apoptosis. As the animal for these studies we chose 5th larval stage of the beet armyworm Spodoptera exigua Hübner (Lepidoptera: Noctuidae), which is one of pest of many vegetable crops. Animals were divided into some experimental groups: K, Cd, KCd, Cd1, Cd2, Cd3. A control group (K) fed a standard diet, and was conducted for XX generations, a cadmium group (Cd), fed on standard diet supplemented with cadmium (44 mg Cd per kg of dry weight of food) for XXX generations. A reference Cd group (KCd) has been initiated: control insects were fed with Cd supplemented diet (44 mg Cd per kg of dry weight of food). Experimental groups Cd1, Cd2, Cd3 developed from the control one: 5 mg Cd per kg of dry weight of food, 10 mg Cd per kg of dry weight of food, 20 mg Cd per kg of dry weight of food. We were interested in the activation of apoptosis during following generations in all experimental groups. Therefore, during the 1st year of the experiment, the measurements were done for 6 generations in all experimental group. The intensity and the course of apoptosis have been examined using transmission electron microscope (TEM), confocal microscope and flow cytometry. During apoptosis the cell started to shrink, extracellular spaces appeared between digestive and neighboring cells, the nucleus achieved a lobular shape. Eventually, the apoptotic cells was discharged into the midgut lumen. A quantitative analysis revealed that the number of apoptotic cells depends significantly on the generation, tissue and cadmium concentration in the insect rearing medium. In the following 6 generations, we observed that the percentage of apoptotic cells in the midguts from cadmium-exposed groups decreased gradually according to the following order of strains: Cd1, Cd2, Cd3 and KCd. At the same time, it was still higher than the percentage of apoptotic cells in the same tissues of the insects from the control and multigenerational cadmium strain. The results of our studies suggest that changes caused by cadmium treatment were preserved during 6-generational development of lepidopteran larvae. The study has been financed by the National Science Centre Poland, grant no 2016/21/B/NZ8/00831.

Keywords: cadmium, cell death, digestive system, ultrastructure

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4805 Topical Negative Pressure for Autologous Fat Grafting in Breast Augmentation

Authors: Mohamed Eftal Bin Mohamed Ebrahim, Alexander Varey

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Aim: Topical negative pressure has been shown to enhance angiogenesis during wound healing, both for open and closed wounds. Since angiogenesis is a key requirement for successful fat grafting, there may be a role for topical negative pressure as a means of enhancing the take rate during autologous fat grafting to breasts. Here we present a systematic review of the literature on this topic. Methods: Ovid and Embase were utilized, with searches ranging between 1960 – 2019. Terms (“Liposculpting” OR “Fat grafting” OR “Lipofilling” OR “Lipograft” OR “Fat transfer”) AND (“Negative Pressure” OR “Brava” OR “Kiwi”) AND (“Breast”) were merged as keywords. Inclusion criteria were females, autologous fat graft to breast with topical negative pressure prior to the procedure. Studies were excluded if there was no primary endpoint or non-original article. Results: Upon reviewing 219 articles, 2 met inclusion criteria. A total of 565 and 46 breasts in each article were treated respectively using the negative pressure device BRAVA®, with each cohort having different pre-and post-operative pressure settings. Khouri et al. cohort had higher graft survival (79%) compared to Del Vecchio et al. cohort (64%); however, the latter had fewer complications compared to Khouri’s cohort, e.g., fat necrosis, pneumothorax and infection. Conclusion: There is limited evidence regarding the use of topical negative pressure for fat grafting to the breasts. However, in the two studies published, the reported rates of success are high, suggesting there may be a benefit. Consequently, a randomized controlled trial on this area is required.

Keywords: fat grafting, lipograft, negative pressure, breast, breast augmentation, brava

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4804 Ideal Posture in Regulating Legal Regulations in Indonesia

Authors: M Jeffri Arlinandes Chandra, Puwaningdyah Murti Wahyuni, Dewi Mutiara M Jeffri Arlinandes Chandra, Puwaningdyah Murti Wahyuni, Dewi Mutiara

Abstract:

Indonesia is a state of the law in accordance with article 1 paragraph 3 of the Constitution of the Republic of Indonesia (1945 Constitution), namely, 'the State of Indonesia is a state of law'. The consequences of the rule of law are making the law as the main commanding officer or making the law as a basis for carrying out an action taken by the state. The types of regulations and procedures for the formation of legislation in Indonesia are contained in Law Number 12 of 2011 concerning the Formation of Legislation. Various attempts were made to make quality regulations both in the formal hierarchy and material hierarchy such as synchronization and harmonization in the formation of laws and regulations so that there is no conflict between equal and hierarchical laws, but the fact is that there are still many conflicting regulations found between one another. This can be seen clearly in the many laws and regulations that were sued to judicial institutions such as the Constitutional Court (MK) and the Supreme Court (MA). Therefore, it is necessary to have a formulation regarding the governance of the formation of laws and regulations so as to minimize the occurrence of lawsuits to the court so that positive law can be realized which can be used today and for the future (ius constituendum). The research method that will be used in this research is a combination of normative research (library research) supported by empirical data from field research so that it can formulate concepts and answer the challenges being faced. First, the structuring of laws and regulations in Indonesia must start from the inventory of laws and regulations, whether they can be classified based on the type of legislation, what are they set about, the year of manufacture, etc. so that they can be clearly traced to the regulations relating to the formation of laws and regulations. Second, the search and revocation/revocation of laws and regulations that do not exist in the state registration system. Third, the periodic evaluation system is carried out at every level of the hierarchy of laws and regulations. These steps will form an ideal model of laws and regulations in Indonesia both in terms of content and material so that the instructions can be codified and clearly inventoried so that they can be accessed by the wider community as a concrete manifestation of the principle that all people know the law (presumptio iures de iure).

Keywords: legislation, review, evaluation, reconstruction

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4803 Defect Identification in Partial Discharge Patterns of Gas Insulated Switchgear and Straight Cable Joint

Authors: Chien-Kuo Chang, Yu-Hsiang Lin, Yi-Yun Tang, Min-Chiu Wu

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With the trend of technological advancement, the harm caused by power outages is substantial, mostly due to problems in the power grid. This highlights the necessity for further improvement in the reliability of the power system. In the power system, gas-insulated switches (GIS) and power cables play a crucial role. Long-term operation under high voltage can cause insulation materials in the equipment to crack, potentially leading to partial discharges. If these partial discharges (PD) can be analyzed, preventative maintenance and replacement of equipment can be carried out, there by improving the reliability of the power grid. This research will diagnose defects by identifying three different defects in GIS and three different defects in straight cable joints, for a total of six types of defects. The partial discharge data measured will be converted through phase analysis diagrams and pulse sequence analysis. Discharge features will be extracted using convolutional image processing, and three different deep learning models, CNN, ResNet18, and MobileNet, will be used for training and evaluation. Class Activation Mapping will be utilized to interpret the black-box problem of deep learning models, with each model achieving an accuracy rate of over 95%. Lastly, the overall model performance will be enhanced through an ensemble learning voting method.

Keywords: partial discharge, gas-insulated switches, straight cable joint, defect identification, deep learning, ensemble learning

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4802 Performance and Structural Evaluation of the Torrefaction of Bamboo under a High Gravity (Higee) Environment Using a Rotating Packed Bed

Authors: Mark Daniel De Luna, Ma. Katreena Pillejera, Wei-Hsin Chen

Abstract:

The raw bamboo (Phyllostachys mankinoi), with a moisture content of 13.54 % and a higher heating value (HHV) of 17.657 MJ/kg, was subjected to torrefaction under a high gravity (higee) environment using a rotating packed bed. The performance of the higee torrefaction was explored in two parts: (1) effect of rotation and temperature and (2) effect of duration on the solid yield, HHV and energy yield. By statistical analyses, the results indicated that the rotation, temperature and their interaction has a significant effect on the three responses. Same remarks on the effect of duration where when the duration (temperature and rotation) increases, the HHV increases, while the solid yield and energy yield decreases. Graphical interpretations showed that at 300 °C, the rotating speed has no evident effect on the responses. At 30-min holding time, the highest HHV reached (28.389 MJ/kg) was obtained in the most severe torrefaction condition (the rotating speed at 1800 rpm and temperature at 300 °C) with an enhancement factor of HHV corresponding to 1.61 and an energy yield of 63.51%. Upon inspection, the recommended operating condition under a 30-min holding time is at 255 °C-1800 rpm since the enhancement factor of HHV (1.53), HHV (26.988 MJ/kg), and energy yield (65.21%) values are relatively close to that of the aforementioned torrefaction condition. The Van Krevelen diagram of the torrefied biomass showed that the ratios decrease as the torrefaction intensifies, hence improving the hydrophobicity of the product. The spreads of the results of the solid yield, enhancement factor (EF) of HHV, energy yield, and H/C and O/C ratios were in accordance with the trends of the responses. Overall, from the results presented, it can be concluded that the quality of the product from the process is at par to that of coal (i.e. HHV of coal is 21-35 MJ/kg). The Fourier transform infrared (FTIR) spectroscopy results indicated that cellulose and lignin may have been degraded at a lower temperature accompanied with a high rotating speed. The results suggested that torrefaction under higee environment indicates promising process for the utilization of bamboo.

Keywords: heat transfer, high gravity environment, FTIR, rotation, rotating speed, torrefaction

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4801 The Psychology of Virtual Relationships Provides Solutions to the Challenges of Online Learning: A Pragmatic Review and Case Study from the University of Birmingham, UK

Authors: Catherine Mangan, Beth Anderson

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There has been a significant drive to use online or hybrid learning in Higher Education (HE) over recent years. HEs with a virtual presence offer their communities a range of benefits, including the potential for greater inclusivity, diversity, and collaboration; more flexible learning packages; and more engaging, dynamic content. Institutions can also experience significant challenges when seeking to extend learning spaces in this way, as can learners themselves. For example, staff members’ and learners’ digital literacy varies (as do their perceptions of technologies in use), and there can be confusion about optimal approaches to implementation. Furthermore, the speed with which HE institutions have needed to shift to fully online or hybrid models, owing to the COVID19 pandemic, has highlighted the significant barriers to successful implementation. HE environments have been shown to predict a range of organisational, academic, and experiential outcomes, both positive and negative. Much research has focused on the social aspect of virtual platforms, as well as the nature and effectiveness of the technologies themselves. There remains, however, a relative paucity of synthesised knowledge on the psychology of learners’ relationships with their institutions; specifically, how individual difference and interpersonal factors predict students’ ability and willingness to engage with novel virtual learning spaces. Accordingly, extending learning spaces remains challenging for institutions, and wholly remote courses, in particular, can experience high attrition rates. Focusing on the last five years, this pragmatic review summarises evidence from the psychological and pedagogical literature. In particular, the review highlights the importance of addressing the psychological and relational complexities of students’ shift from offline to online engagement. In doing so, it identifies considerations for HE institutions looking to deliver in this way.

Keywords: higher education, individual differences, interpersonal relationships, online learning, virtual environment

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4800 Delayed Contralateral Prophylactic Mastectomy (CPM): Reasons and Rationale for Patients with Unilateral Breast Cancer

Authors: C. Soh, S. Muktar, C. M. Malata, J. R. Benson

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Introduction Reasons for requesting CPM include prevention of recurrence, peace of mind and moving on after breast cancer. Some women seek CPM as a delayed procedure but factors influencing this are poorly understood. Methods A retrospective analysis examined patients undergoing CPM as either an immediate or delayed procedure with or without breast reconstruction (BR) between January 2009 and December 2019. A cross-sectional survey based on validated questionnaires (5 point Likert scale) explored patients’ decision-making process in terms of timing of CPM and any BR. Results A total of 123 patients with unilateral breast cancer underwent CPM with 39 (32.5%) delayed procedures with or without BR. The response rate amongst patients receiving questionnaires (n=33) was 22/33 (66%). Within this delayed CPM cohort were three reconstructive scenarios 1) unilateral immediate BR with CPM (n=12); 2) delayed CPM with concomitant bilateral BR (n=22); 3) delayed bilateral BR after delayed CPM (n=3). Two patients had delayed CPM without BR. The most common reason for delayed CPM was to complete all cancer treatments (including radiotherapy) before surgery on the unaffected breast (score 2.91). The second reason was unavailability of genetic test results at the time of therapeutic mastectomy (score 2.64) whilst the third most cited reason was a subsequent change in family cancer history. Conclusion Factors for delayed CPM are patient-driven with few women spontaneously changing their mind having initially decided against immediate CPM for reasons also including surgical duration. CPM should be offered as a potentially delayed option with informed discussion of risks and benefits.

Keywords: Breast Cancer, CPM, Prophylactic, Rationale

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