Search results for: health care workers' knowledge

Authors: Abonyi, Emmanuel Ebuka, Amina Jafaru O.

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Background: Illicit substance use among students is a phenomenon that has been widely studied, but it remains of interest due to its high prevalence and potential consequences. It is a major mental health concern among university students which may result in behavioral and academic problems, psychiatric disorders, and infectious diseases. Thus, this study was done to ascertain the prevalence and factors associated with the use of illicit drugs among these groups of people. Methods: A cross-sectional and descriptive survey was conducted among undergraduate students of the University of Lagos for the duration of three(3) months (August to October 2021). A total number of 938 undergraduate students were selected from seventeen faculties in the university. Pretested questionnaires were administered, completed, and returned. The data were analyzed using descriptive statistics and multivariate regression analysis. Results: From the data collected, it was observed that out of 938 undergraduate students of the University of Lagos that completed and returned the questionnaires, 56.3% were female and 43.7% were male. No gender differences were observed in the prevalence of use of any of the illicit substances. The result showed that the majority of the students that participated in the research were females(56.6%); it was observed that there were a total of 541 2nd-year students(57.7%) and 397 final-year students(42.3). Students between the age brackets of 20- 24 years had the highest frequency of 648(69.1%) of illicit drug use and students in none health-related disciplines. The result also showed that the majority of the students reported that they use Marijuana (31.7%), while lifetime use of LSD (6.3%), Heroin(4.8%), Cocaine (4.7%), and Ecstasy(4.5), Ketamine (3.4%). Besides, the use of alcohol was below average(44.1%). Additionally, Marijuana was among the ones that were mostly taken by students having a higher percentage and most of these respondents had experienced relationship problems with their family and intentions (50.9%). From the responses obtained, major reasons students indulge in illicit drug use were; curiosity to experiment, relief of stress after rigorous academic activities, social media influence, and peer pressure. Most Undergraduate students are in their most hyperactive stage in life, which makes them vulnerable to always want to explore practically every adventure. Hence, individual factors and social media influence are identified as major contributors to the prevalence of illicit drug use among undergraduate students at the University of Lagos, Nigeria. Conclusion: Control programs are most needed among the students. They should be comprehensive and focused on students' psycho-education about substances and their related negative consequences, plus the promotion of students' life skills, and integration into the family – and peer-based preventive interventions.

Keywords: illicit drugs, addiction, undergraduate students, prevalence, substances

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Authors: Mine Koyaz, M. Cem Altun

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Selection of the materials satisfying the expected performances is significantly important for any design. Today, with the constantly evolving and developing technologies, the material options are so wide that the necessity of the use of some support tools in the selection process is arising. Therefore, as a sub process of building element design, a systematic material selection tool is developed, that defines four main steps of the material selection; definition, research, comparison and decision. The main purpose of the tool is being an educational instrument that would show a methodic way of material selection in architectural detailing for the use of architecture students. The tool predefines the possible uses of various material databases and other sources of information on material properties. Hence, it is to be used as a guidance for designers, especially with a limited material knowledge and experience. The material selection tool not only embraces technical properties of materials related with building elements’ functional requirements, but also its sensual properties related with the identity of design and its environmental impacts with respect to the sustainability of the design. The method followed in the development of the tool has two main sections; first the examination and application of the existing methods and second the development of trial versions and their applications. Within the scope of the existing methods; design support tools, methodic approaches for the building element design and material selection process, material properties, material databases, methodic approaches for the decision making process are examined. The existing methods are applied by architecture students and newly graduate architects through different design problems. With respect to the results of these applications, strong and weak sides of the existing material selection tools are presented. A main flow chart of the material selection tool has been developed with the objective to apply the strong aspects of the existing methods and develop their weak sides. Through different stages, a different aspect of the material selection process is investigated and the tool took its final form. Systematic material selection tool, within the building element design process, guides the users with a minimum background information, to practically and accurately determine the ideal material that is to be chosen, satisfying the needs of their design. The tool has a flexible structure that answers different needs of different designs and designers. The trial version issued in this paper shows one of the paths that could be followed and illustrates its application over a design problem.

Keywords: architectural education, building element design, material selection tool, systematic approach

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Authors: Gayatri Swarnakar

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Paramphistomiasis and fascioliasis diseases have been prevalent due to presence of trematode parasites in the rumen and liver of domestic buffalo (Bubalus bubalis) in Udaipur, India. The trematode parasites such as Paramphistomum cervi, Gastrothylax crumenifer, Cotylophoron cotylophorum, Orthocoelium scoliocoelium, Fasciola hepatica and Fasciola gigantica were collected from infected rumen and liver of the freshly slaughtered buffaloes (Bubalus bubalis) at local zoo abattoir in Udaipur. Live trematodes were washed in normal saline, fixed in 0.2M cacodylate fixative, post fixed in osmium tetraoxide, dehydrated, dried, coated with gold sputter and observed under scanning electronic microscope (SEM). The surface tegument of Paramphistomum cervi was spineless with transverse folds, discontinuous with ridges and grooves. Two types of sensory papillae such as knob like and button shaped were also observed. The oral opening of Cotylophoron cotylophorum was surrounded by wrinkled and ridged tegument which formed concentric elevated rings. Tegument of Cotylophoron cotylophorum in acetabulum region was observed to be rough and bee-comb like structure. Genital sucker of this worm was surrounded by a tyre- shaped elevation of the tegument. Orthocoelium scoliocoelium showed circular and concentric rings of tegumental folds around the oral sucker. Genital pore had knob like papillae with radial tegumental folds. Surface topography of Fasciola gigantica and Fasciola hepatica were found to be rough due to occurrence of different types of spines, three types of sensory papillae, transverse folds and grooves. Oral and ventral suckers were spineless and covered with thick rims of transverse folds. Genital pore showed small scattered spines. Present research work would provide knowledge for ultrastructural characteristics of trematode parasites for chemotherapeutic measures and help us to evolve suitable strategy for the eradication of trematode parasites from the domestic buffalo (Bubalus bubalis).

Keywords: Domestic buffalo, tegument, trematode parasites, ultrastructure

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Authors: Dohun Kim

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Technological innovations have stimulated flipped learning in many disciplines, including language teaching. It is a specific type of blended learning, which combines onsite (i.e. face-to-face) with online experiences to produce effective, efficient and flexible learning. Flipped learning literally ‘flips’ conventional teaching and learning activities upside down: it leverages technologies to deliver a lecture and direct instruction—other asynchronous activities as well—outside the classroom to reserve onsite time for interaction and activities in the upper cognitive realms: applying, analysing, evaluating and creating. Unlike the conventional flipped approaches, which focused on video lecture, followed by face-to-face or on-site session, new innovative methods incorporate various means and structures to serve the needs of different academic disciplines and classrooms. In the light of such innovations, this study adopted ‘student-engaged’ approaches to interpreter training and contrasts them with traditional classrooms. To this end, students were also encouraged to engage in asynchronous activities online, and innovative technologies, such as Telepresence, were employed. Based on the class implementation, a thorough examination was conducted to examine how we can structure and implement flipped classrooms for language and interpreting training while actively engaging learners. This study adopted a quantitative research method, while complementing it with a qualitative one. The key findings suggest that the significance of the instructor’s role does not dwindle, but his/her role changes to a moderator and a facilitator. Second, we can apply flipped learning to both theory- and practice-oriented modules. Third, students’ integration into the community of inquiry is of significant importance to foster active and higher-order learning. Fourth, cognitive presence and competence can be enhanced through strengthened and integrated teaching and social presences. Well-orchestrated teaching presence stimulates students to find out the problems and voices the convergences and divergences, while fluid social presence facilitates the exchanges of knowledge and the adjustment of solutions, which eventually contributes to consolidating cognitive presence—a key ingredient that enables the application and testing of the solutions and reflection thereon.

Keywords: blended learning, Community of Inquiry, flipped learning, interpreter training, student-centred learning

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Authors: Ashleigh Hillier, Jody Goldstein, Lauren Tornatore, Emily Byrne

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As individuals with disabilities attend higher education in greater numbers, universities are seeking ways to support the retention and success of these students, beyond the academically based accommodations. Although mentoring programs for this population are being implemented more frequently, there is a lack of empirically validated outcomes which could promote program replication. The research objective of this exploratory study was to examine outcomes for students with disabilities participating in a peer-to-peer mentoring program. Mentees (students with disabilities) met with their mentor (trained upperclassman) once a week for an hour for one semester (14-weeks). Mentors followed a curriculum structured by monthly and weekly goals to guide the sessions. Curriculum topics included socializing on campus, peer pressure, time management, communicating with peers and professors, classroom etiquette, study skills, and seeking help and campus resources. Data was collected over a period of seven semesters resulting in seven separate cohorts (n=46). The impact of the program was measured using quantitative self-report measures as well as qualitative content analysis of focus groups. Academic outcomes (retention, credits earned, and GPA) were compared between those in the mentoring program and a matched group of students registered with Disability Services who did not receive mentoring. In addition, a one-year follow up was conducted to examine the longer term impact of participation. Findings indicated that mentoring had the most impact in knowing how things work at the university, knowing how and where to find opportunities to meet people on campus, and knowing how to access supports. Mentors also provided a supportive relationship to the mentees and helped with social skills. There were no significant differences in academic outcomes between those who were mentored and those in the comparison group. Most mentees reported continuing to benefit from the program one year on, providing support for the retention of knowledge gained and maintenance of positive outcomes over time. In conclusion, while a range of positive outcomes were evidenced, the model was limited in its impact more broadly, particularly with regards to academic success and impacting more complex challenges.

Keywords: mentor, outcomes, students with disabilities, university

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Authors: Mamochana, A. Ramatea, Fumane, P. Khanare

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Enabling the learning environment is a significant and adaptive technique necessary to navigate learners’ educational challenges. However, research has indicated that quality provision of education in the environments that are enabling, especially to learners with visual impairments (LVIs, hereafter) in rural schools, remain an ongoing challenge globally. Hence, LVIs often have a lower level of academic performance as compared to their peers. To balance this gap and fulfill learners'fundamentalhuman rights¬ of receiving an equal quality education, appropriate measures and structures that make enabling learning environment a better place to learn must be better understood. This paper, therefore, intends to find possible means that rural schools of Lesotho can employ to make the learning environment for LVIs enabling. The present study aims to determine suitable assets that can be drawn to make the learning environment for LVIs enabling. The study is also informed by the transformative paradigm and situated within a qualitative research approach. Data were generated through focus group discussions with twelve teachers who were purposefully selected from two rural primary schools in Lesotho. The generated data were then analyzed thematically using Braun and Clarke's six-phase framework. The findings of the study indicated that participating teachers do have an understanding that rural schools boast of assets (existing and hidden) that have a positive influence in responding to the special educational needs of LVIs. However, the participants also admitted that although their schools boast of assets, they still experience limited knowledge about the use of the existing assets and thus, realized a need for improved collaboration, involvement of the existing assets, and enhancement of academic resources to make LVIs’ learning environment enabling. The findings of this study highlight the significance of the effective use of assets. Additionally, coincides with literature that shows recognizing and tapping into the existing assets enable learning for LVIs. In conclusion, the participants in the current study indicated that for LVIs’ learning environment to be enabling, there has to be sufficient use of the existing assets. The researchers, therefore, recommend that the appropriate use of assets is good, but may not be sufficient if the existing assets are not adequately managed. Hence,VILs experience a vicious cycle of vulnerability. It was thus, recommended that adequate use of assets and teachers' engagement as active assets should always be considered to make the learning environment a better place for LVIs to learan in the future

Keywords: assets, enabling learning environment, rural schools, learners with visual impairments

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Authors: Ya-Hui Wang

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Lower speech therapy rate of tracheostomized patient was noted in comparison with previous researches. This study is aim to shed light on the referral status of speech therapy in those patients in Taiwan. This study developed an analysis for the size and key characteristics of the population of tracheostomized in-patient in the Taiwan. Method: We analyzed National Healthcare Insurance data (The Collaboration Center of Health Information Application, CCHIA) from Jan 1 2010 to Dec 31 2010. Result: over ages 3, number of tracheostomized in-patient is directly proportional to age. A high service loading was observed in North region in comparison with other regions. Only 4.87% of the tracheostomized in-patients were referred for speech therapy, and 1.9% for swallow examination, 2.5% for communication evaluation.

Keywords: refer, speech therapy, training, rehabilitation

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Authors: Sedat Bilgili, Alper K. Demir

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The current Internet has become the dominant use with continuing growth in the home, medical, health, smart cities and industrial automation applications. Internet of Things (IoT) is an emerging technology to enable such applications in our lives. Moreover, Named Data Networking (NDN) is also emerging as a Future Internet architecture where it fits the communication needs of IoT networks. The aim of this study is to provide an NDN protocol stack implementation running on the Contiki operating system (OS). Contiki OS is an OS that is developed for constrained IoT devices. In this study, an NDN protocol stack that can work on top of IEEE 802.15.4 link and physical layers have been developed and presented.

Keywords: internet of things (IoT), named-data, named data networking (NDN), operating system

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Authors: Hsiu-Ling Hsu, En-Minh (John) Lan

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Pronunciation has received more and more language researchers’ and teachers’ attention because it is important for effective or even successful communication. How to consistently and correctly orally produce verbal morphology, such as English regular past tense inflection, has been a big challenge and troublesome for FL learners. The research aims to explore EFL (English as a foreign language) learners’ developmental trajectory of the inflectional morphology, that is, what mediating processes and strategies EFL learners use, to attain native-like prosodic structure of inflectional morphemes (e.g., –ed and –s suffixes) by comparing the differences among EFL learners at different English levels. This research adopted a self-repair analysis and Prosodic Transfer Hypothesis with three developmental stages as a theoretical framework. To answer the research questions, we conducted two experiments, grammatical tense test written production (Experiment 1) and read-aloud oral production (Experiment 2), and recruited 30 participants who were divided into three groups, low-, middle-, and advanced EFL learners. Experiment 1 was conducted to ensure that participants had learned the knowledge of forming the English regular past tense rules and Experiment 2 was carried out to compare the data across FL English learner groups at different English levels. The EFL learners’ self-repair data showed at least four interesting findings. First, low achievers were more sensitive to the plural suffix -s than the past tense suffix -ed. Middle achievers exhibited a greater responsiveness to the past tense suffix, while high achievers demonstrated equal sensitivity to both suffixes. Additionally, two strategies used by EFL English learners to produce verbs and nouns with inflectional morphemes were to delete internal syllable and to divide a four-syllable verb (e.g., ‘graduated’) into two prosodic structures (e.g., ‘gradu’ and ‘ated’ or ‘gradua’ and ‘ted’). Third, true vowel epenthesis was found only in the low EFL achievers. Moreover fortition (native-like sound) was observed in the low and middle EFL achievers. These findings and self-repair data disclosed mediating processes between the developmental stages and provided insight on how Taiwan EFL learners attained the adjunction prosodic structures of inflectional Morphemes in English.

Keywords: inflectional morphology, prosodic structure, developmental trajectory, strategies and mediating processes, English as a foreign language

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Authors: Ghada Abo-Zaid

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The main objective of this study was to examine the association between the elevated level of CRP and incidence of hypertension before and after adjusting by age, BMI, gender, SES, smoking, diabetes, cholesterol LDL and cholesterol HDL and to determine whether the association were differ by race. Method: Cross sectional data for participations from age 17 to age 74 years who included in The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analysed. CRP level was classified into three categories ( > 3mg/L, between 1mg/LL and 3mg/L, and < 3 mg/L). Blood pressure categorization was done using JNC 7 algorithm Hypertension defined as either systolic blood pressure (SBP) of 140 mmHg or more and disystolic blood pressure (DBP) of 90mmHg or greater, otherwise a self-reported prior diagnosis by a physician. Pre-hypertension was defined as (139 > SBP > 120 or 89 > DPB > 80). Multinominal regression model was undertaken to measure the association between CRP level and hypertension. Results: In univariable models, CRP concentrations > 3 mg/L were associated with a 73% greater risk of incident hypertension compared with CRP concentrations < 1 mg/L (Hypertension: odds ratio [OR] = 1.73; 95% confidence interval [CI], 1.50-1.99). Ethnic comparisons showed that American Mexican had the highest risk of incident hypertension (odds ratio [OR] = 2.39; 95% confidence interval [CI], 2.21-2.58).This risk was statistically insignificant, however, either after controlling by other variables (Hypertension: OR = 0.75; 95% CI, 0.52-1.08,), or categorized by race [American Mexican: odds ratio [OR] = 1.58; 95% confidence interval [CI], 0,58-4.26, Other Hispanic: odds ratio [OR] = 0.87; 95% confidence interval [CI], 0.19-4.42, Non-Hispanic white: odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.50-1.59, Non-Hispanic Black: odds ratio [OR] = 0.44; 95% confidence interval [CI], 0.22-0,87]. The same results were found for pre-hypertension, and the Non-Hispanic black showed the highest significant risk for Pre-Hypertension (odds ratio [OR] = 1.60; 95% confidence interval [CI], 1.26-2.03). When CRP concentrations were between 1.0-3.0 mg/L, in an unadjusted models prehypertension was associated with higher likelihood of elevated CRP (OR = 1.37; 95% CI, 1.15-1.62). The same relationship was maintained in Non-Hispanic white, Non-Hispanic black, and other race (Non-Hispanic white: OR = 1.24; 95% CI, 1.03-1.48, Non-Hispanic black: OR = 1.60; 95% CI, 1.27-2.03, other race: OR = 2.50; 95% CI, 1.32-4.74) while the association was insignificant with American Mexican and other Hispanic. In the adjusted model, the relationship between CRP and prehypertension were no longer available. In contrary, Hypertension was not independently associated with elevated CRP, and the results were the same after grouped by race or adjusted by the confounder variables. The same results were obtained when SBP or DBP were on a continuous measure. Conclusions: This study confirmed the existence of an association between hypertension, prehypertension and elevated level of CRP, however this association was no longer available after adjusting by other variables. Ethic group differences were statistically significant at the univariable models, while it disappeared after controlling by other variables.

Keywords: CRP, hypertension, ethnicity, NHANES, blood pressure

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Authors: Aistis ZekevicIus

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Biopolitical theory, which was first developed by Michel Foucault, takes into consideration the administration of life by implying a style of government based on the regulation of populations as its subject. The intensification of the #BlackLivesMatter movement and popular outcries against racial discrimination in the US health system have prompted us to reconsider the relationship between biopolitics and race in the face of the COVID-19 pandemic. Based on works by Foucault, Achille Mbembe and Nicholas Mirzoeff that transcend the boundaries of poststructuralism, critical theory and postcolonial studies, the paper suggests that the global pandemic has highlighted new aspects of the interplay between biopower and race by encouraging the search for scapegoats, deepening the structural racial inequality, and thus producing necropolitical regimes of exclusion.

Keywords: biopolitics, biopower, necropolitics, pandemic, race

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Authors: Joel F. Campbell, Bing Lin, Michael Obland, Susan Kooi, Tai-Fang Fan, Byron Meadows, Edward Browell, Wayne Erxleben, Doug McGregor, Jeremy Dobler, Sandip Pal, Christopher O'Dell, Ken Davis

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The Active Sensing of CO₂ Emissions over Nights, Days, and Seasons (ASCENDS) CarbonHawk Experiment Simulator (ACES) is a NASA Langley Research Center instrument funded by NASA’s Science Mission Directorate that seeks to advance technologies critical to measuring atmospheric column carbon dioxide (CO₂ ) mixing ratios in support of the NASA ASCENDS mission. The ACES instrument, an Intensity-Modulated Continuous-Wave (IM-CW) lidar, was designed for high-altitude aircraft operations and can be directly applied to space instrumentation to meet the ASCENDS mission requirements. The ACES design demonstrates advanced technologies critical for developing an airborne simulator and spaceborne instrument with lower platform consumption of size, mass, and power, and with improved performance. The Atmospheric Carbon and Transport – America (ACT-America) is an Earth Venture Suborbital -2 (EVS-2) mission sponsored by the Earth Science Division of NASA’s Science Mission Directorate. A major objective is to enhance knowledge of the sources/sinks and transport of atmospheric CO₂ through the application of remote and in situ airborne measurements of CO₂ and other atmospheric properties on spatial and temporal scales. ACT-America consists of five campaigns to measure regional carbon and evaluate transport under various meteorological conditions in three regional areas of the Continental United States. Regional CO₂ distributions of the lower atmosphere were observed from the C-130 aircraft by the Harris Corp. Multi-Frequency Fiber Laser Lidar (MFLL) and the ACES lidar. The airborne lidars provide unique data that complement the more traditional in situ sensors. This presentation shows the applications of CO₂ lidars in support of these science needs.

Keywords: CO₂ measurement, IMCW, CW lidar, laser spectroscopy

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Authors: Rodrique Watong Tchounkeu

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This paper investigated the implementation and impact of inclusive education practices in early childhood settings (ages 3-6) with the overarching aim of fostering a diverse learning environment. The primary objectives were to assess the then-current state of inclusive practices, identify effective methodologies for accommodating diverse learning needs, and evaluate the outcomes of implementing inclusive education in early childhood settings. To achieve these objectives, a mixed-methods approach was employed, combining qualitative interviews with early childhood educators and parents, along with quantitative surveys distributed to a diverse sample of participants. The qualitative phase involved semi-structured interviews with 30 educators and 50 parents, selected through purposive sampling. The interviews aimed to gather insights into the challenges faced in implementing inclusive education, the strategies employed, and the perceived benefits and drawbacks. The quantitative phase included surveys administered to 300 early childhood educators across various settings, measuring their familiarity with inclusive practices, their perceived efficacy, and their willingness to adapt teaching methods. The results revealed a significant gap between the theoretical understanding and practical implementation of inclusive education in early childhood settings. While educators demonstrated a high level of theoretical knowledge, they faced challenges in effectively translating these concepts into practice. Parental perspectives highlighted the importance of collaboration between educators and parents in supporting inclusive education. The surveys indicated a positive correlation between educators' familiarity with inclusive practices and their willingness to adapt teaching methods, emphasizing the need for targeted professional development. The implications of this study suggested the necessity for comprehensive training programs for early childhood educators focused on the practical implementation of inclusive education strategies. Additionally, fostering stronger partnerships between educators and parents was crucial for creating a supportive learning environment for all children. By addressing these findings, this research contributed to the advancement of inclusive education practices in early childhood settings, ultimately leading to more inclusive and effective learning environments for diverse groups of young learners.

Keywords: inclusive education, early childhood settings, diverse learning, young learners, practical implementation, parental collaboration

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Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Predicting the risk of diabetic retinopathy (DR) in Indian type 2 diabetes patients is immensely necessary. India, being the second largest country after China in terms of a number of diabetic patients, to the best of our knowledge not a single risk score for complications has ever been investigated. Diabetic retinopathy is a serious complication and is the topmost reason for visual impairment across countries. Any type or form of DR has been taken as the event of interest, be it mild, back, grade I, II, III, and IV DR. A sample was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of DR. Cox proportional hazard regression is used to design risk scores for the prediction of retinopathy. Model calibration and discrimination are assessed from Hosmer Lemeshow and area under receiver operating characteristic curve (ROC). Overfitting and underfitting of the model are checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Optimal cut off point is chosen by Youden’s index. Five-year probability of DR is predicted by both survival function, and Markov chain two state model and the better technique is concluded. The risk scores developed can be applied by doctors and patients themselves for self evaluation. Furthermore, the five-year probabilities can be applied as well to forecast and maintain the condition of patients. This provides immense benefit in real application of DR prediction in T2DM.

Keywords: Cox proportional hazard regression, diabetic retinopathy, ROC curve, type 2 diabetes mellitus

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Authors: A. Kouloumpis, P. Zygouri, G. Potsi, K. Spyrou, D. Gournis

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Much of the research effort on graphene focuses on its use as building block for the development of new hybrid nanostructures with well-defined dimensions and behavior suitable for applications among else in gas storage, heterogeneous catalysis, gas/liquid separations, nanosensing and biology. Towards this aim, here we describe a new bottom-up approach, which combines the self-assembly with the Langmuir Schaefer technique, for the production of fullerene-intercalated graphene hybrid materials. This new method uses graphene nanosheets as a template for the grafting of various fullerene C60 molecules (pure C60, bromo-fullerenes, C60Br24, and fullerols, C60(OH)24) in a bi-dimensional array, and allows for perfect layer-by-layer growth with control at the molecular level. Our film preparation approach involves a bottom-up layer-by-layer process that includes the formation of a hybrid organo-graphene Langmuir film hosting fullerene molecules within its interlayer spacing. A dilute water solution of chemically oxidized graphene (GO) was used as subphase on the Langmuir-Blodgett deposition system while an appropriate amino surfactant (that binds covalently with the GO) was applied for the formation of hybridized organo-GO. After the horizontal lift of a hydrophobic substrate, a surface modification of the GO platelets was performed by bringing the surface of the transferred Langmuir film in contact with a second amino surfactant solution (capable to interact strongly with the fullerene derivatives). In the final step, the hybrid organo-graphene film was lowered in the solution of the appropriate fullerene derivative. Multilayer films were constructed by repeating this procedure. Hybrid fullerene-based thin films deposited on various hydrophobic substrates were characterized by X-ray diffraction (XRD) and X-ray reflectivity (XRR), FTIR, and Raman spectroscopies, Atomic Force Microscopy, and optical measurements. Acknowledgments. This research has been co‐financed by the European Union (European Social Fund – ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF)‐Research Funding Program: THALES. Investing in knowledge society through the European Social Fund (no. 377285).

Keywords: hybrids, graphene oxide, fullerenes, langmuir-blodgett, intercalated structures

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Authors: Stephens Oluyemi Adetunji, Nel Norma Margaret, Naidu Narainsamy

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Empathy has been identified by researchers to be a crucial factor in helping adolescents to refrain from delinquent behavior. Adolescent delinquent behavior is a social problem that has become a source of concern to parents, psychologists, educators, correctional services, researchers as well as governments of nations. Empathy is a social skill that enables an individual to understand and to share another’s emotional state. An individual with a high level of empathy will avoid any act or behavior that will affect another person negatively. The need for this study is predicated on the fact that delinquent adolescent behavior could lead to adult criminality. This, in the long run, has the potential of resulting in an increase in crime rate thereby threatening public safety. It has therefore become imperative to explore the level of empathy of delinquent adolescents who have committed crime and are awaiting trial. It is the conjecture of this study that knowledge of the empathy level of delinquent adolescents will provide an opportunity to design an intervention strategy to remediate the deficit. This study was therefore designed to determine the level of empathy of delinquent adolescents. In addition, this study provides a better understanding of factors that may prevent adolescents from developing delinquent behavior, in this case, delinquents’ empathy levels. In the case of participants who have a low level of empathy, remediation strategies to improve their empathy level would be designed. Two research questions were raised to guide this study. A mixed methods research design was employed for the study. The sample consists of fifteen male adolescents who are between 13-18 years old with a mean age of 16.5 years old. The participants are adolescents who are awaiting trial. The non-probability sampling technique was used to obtain the sample for the quantitative study while purposive sampling was used in the case of the qualitative study. A self–report questionnaire and structured interview were used to assess the level of empathy of participants. The data obtained was analysed using the simple percentages for the quantitative data and transcribing the qualitative data. The result indicates that most of the participants have low level of empathy. It is also revealed that there is a difference in the empathy level on the basis of whether they are from parents living together and those whose parents are separated. Based on the findings of this study, it is recommended that the level of empathy of participants be improved through training and emphasizing the importance of stimulating family environment for children. It is also recommended that programs such as youth mentoring and youth sheltering be established by the government of South Africa to address the menace of delinquent adolescents.

Keywords: adolescents, behavior, delinquents, empathy

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Authors: Yi-Hsuan Gloria Lo

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The educational objective of vocational high schools (VHSs) is to equip VHS students with practical skills and knowledge that can be applied in the job-related market. However, with the increasing number of technological universities over the past two decades, the majority of VHS students have chosen to receive higher education rather than enter the job market. VHS English education has been confronting a dilemma: Should an English for specific purposes (ESP) approach, which aligns with the educational goal of VHS education, be taken or should an English for general purposes (EGP) approach, which prepares VHS students for advanced studies in universities, be followed? While ESP theorists proposed that that ESP can be taught to secondary learners, little was known about VHS students’ perspective on this ESP-versus-EGP dilemma. Scant research has investigated different facets of students’ needs (necessities, wants, and lacks) for both ESP and EGP in terms of the four language skills and the factors that contribute to any differences. To address the gap in the literature, 100 VHS students responded to statements related to their necessities, wants, and lacks in learning ESP and EGP on a 6-point Likert scale. Six VHS students were interviewed to tap into the reasons for different facets of the needs for learning EGP and ESP. The statistical analysis indicates that at this stage of learning English, VHS subjects believed that EGP was more necessary than ESP; EGP was more desirable than ESP. However, they reported that they were more lacking in ESP than in EGP learning. Regarding EGP, the results show that the VHS subjects rated speaking as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference was found between perceived learning necessities and lacks and between perceived wants and lacks. No statistical difference was found between necessities and wants. In the aspect of ESP, the results indicate that the VHS subjects marked reading as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference exists between their perceived necessities and lacks and between their wants and lacks. However, there is no statistically significant difference between their perceived lacks and wants. Despite the lack of a significant difference between learning necessities and wants, the qualitative interview data reveal that the reasons for their perceived necessities and wants were different. The findings of the study confirm previous research that demonstrates that ‘needs’ is a multiple and conflicting construct. What VHS students felt most lacking was not necessarily what they believed they should learn or would like to learn. Although no statistical difference was found, different reasons were attributed to their perceived necessities and wants. Both theoretical and practical implications have been drawn and discussed for ESP research in general and teaching ESP in VHSs in particular.

Keywords: vocational high schools (VHSs), English for General Purposes (EGP), English for Specific Purposes (ESP), needs analysis

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Authors: Matthew Baucum

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With the increasing popularity of fMRI as an experimental method, psychology and neuroscience can greatly benefit from advanced techniques for summarizing and synthesizing large amounts of data from brain imaging studies. One promising avenue is automated meta-analyses, in which natural language processing methods are used to identify the brain regions consistently associated with certain semantic concepts (e.g. “social”, “reward’) across large corpora of studies. This study builds on this approach by demonstrating how, in fMRI meta-analyses, individual voxels can be treated as vectors in a semantic space and evaluated for their “proximity” to terms of interest. In this technique, a low-dimensional semantic space is built from brain imaging study texts, allowing words in each text to be represented as vectors (where words that frequently appear together are near each other in the semantic space). Consequently, each voxel in a brain mask can be represented as a normalized vector sum of all of the words in the studies that showed activation in that voxel. The entire brain mask can then be visualized in terms of each voxel’s proximity to a given term of interest (e.g., “vision”, “decision making”) or collection of terms (e.g., “theory of mind”, “social”, “agent”), as measured by the cosine similarity between the voxel’s vector and the term vector (or the average of multiple term vectors). Analysis can also proceed in the opposite direction, allowing word cloud visualizations of the nearest semantic neighbors for a given brain region. This approach allows for continuous, fine-grained metrics of voxel-term associations, and relies on state-of-the-art “open vocabulary” methods that go beyond mere word-counts. An analysis of over 11,000 neuroimaging studies from an existing meta-analytic fMRI database demonstrates that this technique can be used to recover known neural bases for multiple psychological functions, suggesting this method’s utility for efficient, high-level meta-analyses of localized brain function. While automated text analytic methods are no replacement for deliberate, manual meta-analyses, they seem to show promise for the efficient aggregation of large bodies of scientific knowledge, at least on a relatively general level.

Keywords: FMRI, machine learning, meta-analysis, text analysis

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Authors: Caroline Provost, Francois Dumont

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Production of insects for human and animal consumption is an increasingly important activity in Canada. Protein production is more efficient and less harmful to the environment using insect rearing compared to the impact of traditional livestock, poultry and fish farms. Insects are rich in essential amino acids, essential fatty acids and trace elements. Thus, insect-based products could be used as a food supplement for livestock and domestic animals and may even find their way into the diets of high performing athletes or fine dining. Nevertheless, several parameters remain to be determined to ensure efficient and profitable production that meet the potential of these sectors. This project proposes to improve the production processes, rearing diets and processing methods for three species with valuable gastronomic and nutritional potential: the common mealworms (Tenebrio molitor), the small mealworm (Alphitobius diaperinus), and the giant mealworm (Zophobas morio). The general objective of the project is to acquire specific knowledge for mass rearing of insects dedicated to animal and human consumption in order to respond to current market opportunities and meet a growing demand for these products. Mass rearing of the three species of mealworm was produced to provide the individuals needed for the experiments. Mealworms eat flour from different cereals (e.g. wheat, barley, buckwheat). These cereals vary in their composition (protein, carbohydrates, fiber, vitamins, antioxidant, etc.), but also in their purchase cost. Seven different diets were compared to optimize the yield of the rearing. Diets were composed of cereal flour (e.g. wheat, barley) and were either mixed or left alone. Female fecundity, larvae mortality and growing curves were observed. Some flour diets have positive effects on female fecundity and larvae performance while each mealworm was found to have specific diet requirements. Trade-offs between mealworm performance and costs need to be considered. Experiments on the effect of flour composition on several parameters related to performance and nutritional and gastronomic value led to the identification of a more appropriate diet for each mealworm.

Keywords: mass rearing, mealworm, human consumption, diet

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Authors: Mannar R. Maurya, Bithika Sarkar, Fernando Avecilla

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Peroxidase activity is possibly successfully used for different industrial processes in medicine, chemical industry, food processing and agriculture. However, they bear some intrinsic drawback associated with denaturation by proteases, their special storage requisite and cost factor also. Now a day’s artificial enzyme mimics are becoming a research interest because of their significant applications over conventional organic enzymes for ease of their preparation, low price and good stability in activity and overcome the drawbacks of natural enzymes e.g serine proteases. At present, a large number of artificial enzymes have been synthesized by assimilating a catalytic center into a variety of schiff base complexes, ligand-anchoring, supramolecular complexes, hematin, porphyrin, nanoparticles to mimic natural enzymes. Although in recent years a several number of vanadium complexes have been reported by a continuing increase in interest in bioinorganic chemistry. To our best of knowledge, the investigation of artificial enzyme mimics of vanadium complexes is very less explored. Recently, our group has reported synthetic vanadium schiff base complexes capable of mimicking peroxidases. Herein, we have synthesized monoidovanadium(IV) and dioxidovanadium(V) complexes of pyrazoleone derivateis ( extensively studied on account of their broad range of pharmacological appication). All these complexes are characterized by various spectroscopic techniques like FT-IR, UV-Visible, NMR (1H, 13C and 51V), Elemental analysis, thermal studies and single crystal analysis. The peroxidase mimic activity has been studied towards oxidation of pyrogallol to purpurogallin with hydrogen peroxide at pH 7 followed by measuring kinetic parameters. The Michaelis-Menten behavior shows an excellent catalytic activity over its natural counterparts, e.g. V-HPO and HRP. The obtained kinetic parameters (Vmax, Kcat) were also compared with peroxidase and haloperoxidase enzymes making it a promising mimic of peroxidase catalyst. Also, the catalytic activity has been studied towards the oxidation of 1-phenylethanol in presence of H2O2 as an oxidant. Various parameters such as amount of catalyst and oxidant, reaction time, reaction temperature and solvent have been taken into consideration to get maximum oxidative products of 1-phenylethanol.

Keywords: oxovanadium(IV)/dioxidovanadium(V) complexes, NMR spectroscopy, Crystal structure, peroxidase mimic activity towards oxidation of pyrogallol, Oxidation of 1-phenylethanol

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Authors: Mónika Ditta Tóth, Ádám Fritz, Balázs Hankó, György Purebl

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Communication training about depression and suicide prevention for pharmacists – A Hungarian pilot study Mónika Ditta Tóth1, Ádám Fritz2, Balázs Hankó2, György Purebl1 1: Semmelweis University, Institute of Behavioural Sciences 2: Semmelweis University, University Pharmacy Department of Pharmacy Administration Background: Suicide rates in Hungary have been one of the highest in the European Union. Depression is one of the main risk factors for suicide and recognizing and treating depression is an effective way to prevent suicidal behaviour. In their daily practice, pharmacists meet patients with high risk of mental health problems. Therefore they have a key role in the prevention of depression and suicide. Aim: The main aim of this study is to raise pharmacists’ awareness about depression and suicide to enable better recognation of verbal and non-verbal signs of these deseases. Another important objective is to reduce their stigma about depression and increase their confidence in communication with depressed and/or suicidal patients. Methods: A 3-hour communication workshop has been delivered in this pilot study about the reasons, trigger factors, verbal and non-verbal signs of depression and suicide. The training includes communication techniques which have been developed to patients needs, as well as role-playing scenarios. Depression Stigma and Morris Confidence Scales were applied before, after and 6 weeks following the training. The results of the training group are then compared with two of the following pharmacist groups: 1. written material only (N=15), 2. no material (N=15). Results: One-way ANOVA revealed significant differences in the training group regarding the level of confidence in treating and communicating with patients with depression and/or suicide following the training, and after 6 weeks (F(2, 24)= 7,135, p=,004; baseline: 20,37, after training: 30,00, follow up: 27,66). After the 3-hour workshop the personal stigma about depression decreased (baselin: 19,75 after training: 17,00, p=0,075) in the training group (N=9), whilst the perceived stigma did not change (before: 33.54, after: 33,44, p=NS). Trainees assessed the workshop as ‘useful’ and ‘gap filling’. No significant differences was found in the group of pharmacisists who got written material only. Conclusions: Despite the high rates of depression and suicide in Hungary, pharmacists do not receive lectures or seminars about mental health during their university studies. Such half-day workshops could fill this gap and give practical help to recognize and communicate with depressed and/or suicidal patients in a more effective way. This way pharmacists, as community gate-keepers, could contribute to a more effective suicide prevention program in Hungary.

Keywords: communication training, pharmacists, depression, suicide

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Authors: Karthiyayini J., Arpita Chowdary Vantipalli, Darshana Sailu Tanti, Malvika Ravi Kudari, Krtin Kannan

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This paper is propelled from the generally existing undertaking of the smart water quality management, which addresses an IoT (Internet of things) based brilliant water quality observing (SWQM) framework which we call it AquaSwach that guides in the ceaseless estimation of water conditions dependent on five actual boundaries i.e., temperature, pH, electric conductivity and turbidity properties and water virtue estimation each time you drink water. Six sensors relate to Arduino-Mega in a discrete way to detect the water parameters. Extracted data from the sensors are transmitted to a desktop application developed in the NET platform and compared with the WHO (World Health Organization) standard values.

Keywords: AquaSwach, IoT, WHO, water quality

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Authors: Perizat Balkhimbekova

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Evolutionary changes in cognitive world view taking place in the last decades are followed by changes in perception of the key concepts which are related to the certain lingua-cultural sphere. Also, such concepts reflect the person’s attitude to essential processes in the sphere of concepts, e.g. the opposite operations like creation and destruction. These changes in people’s life and thinking are displayed in a language world view. In order to open the maintenance of mental structures and concepts we should use language means as observable results of people’s cognitive activity. Semantics of words, free phrases and idioms should be considered as an authoritative source of information concerning concepts. The regularized set of concepts in people consciousness forms the sphere of concepts. Cognitive linguistics widely discusses the sphere of concepts as its crucial category defining it as the field of knowledge which is made of concepts. It is considered that a sphere of concepts comprises the various types of association and forms conceptual fields. As a material for the given research, the data from Russian National Corpus and British National Corpus were used. In is necessary to point out that data provided by computational studies, are intrinsic and verifiable; so that we have used them in order to get the reliable results. The procedure of study was based on such techniques as extracting of the context containing concepts of creation|destruction from the Russian National Corpus (RNC), and British National Corpus (BNC); analyzing and interpreting of those context on the basis of cognitive approach; finding of correspondence between the given concepts in the Russian and English world view. The key problem of our study is to find the correspondence between the elements of world view represented by opposite concepts such as creation and destruction. Findings: The concept of "destruction" indicates a process which leads to full or partial destruction of an object. In other words, it is a loss of the object primary essence: structures, properties, distinctive signs and its initial integrity. The concept of "creation", on the contrary, comprises positive characteristics, represents the activity aimed at improvement of the certain object, at the creation of ideal models of the world. On the other hand, destruction is represented much more widely in RNC than creation (1254 cases of the first concept by comparison to 192 cases for the second one). Our hypothesis consists in the antinomy represented by the aforementioned concepts. Being opposite both in respect of semantics and pragmatics, and from the point of view of axiology, they are at the same time complementary and interrelated concepts.

Keywords: creation, destruction, concept, world view

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Authors: Jamal A. Mayouf, Hashim Salih Al Bayati

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Green tea is one of the most common drinks in all cities of Libyan. Heavy metal contents such as cadmium (Cd), lead (Pb), nickel (Ni) and zinc (Zn) were determined in four green tea samples collected from Libyan market and their tea infusions by using atomic emission spectrophotometry after acid digestion. The results obtained indicate that the concentrations of Cd, Pb, Ni, and Zn in tea infusions samples ranged from 0.07-0.12, 0.19-0.28, 0.09-0.15, 0.18-0.43 mg/l after boiling for 5 min., 0.06-0.08, 0.18-0.23, 0.08-0.14, 0.17-0.27 mg/l after boiling for 10 min., 0.07-0.11, 0.18-0.24, 0.08-0.14, 0.21-0.34 mg/l after boiling for 15 min. respectively. On the other hand, the concentrations of the same element mentioned above obtained in tea leaves ranged from 6.0-18.0, 36.0-42.0, 16.0-20.0, 44.0-132.0 mg/kg respectively. The concentrations of Cd, Pb, Ni and Zn in tea leaves samples were higher than Prevention of Food Adulteration (PFA) limit and World Health Organization(WHO) permissible limit.

Keywords: tea, infusion, metals, Libya

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Authors: Naina Deshmukh

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With the wide production, consumption, and disposal of pesticides in the world, the concerns over their human and environmental health impacts are rapidly growing. Among developing treatment technologies, Ultrasonication, as an emerging and promising technology for the removal of pesticides in the aqueous environment, has attracted the attention of many researchers in recent years. The degradation of acephate in aqueous solutions was investigated under the influence of ultrasound irradiation (20 kHz) in the presence of heterogeneous catalysts titanium dioxide (TiO2) and Zinc oxide (ZnO). The influence of various factors such as amount of catalyst (0.25, 0.5, 0.75, 1.0, 1.25 g/l), initial acephate concentration (100, 200, 300, 400 mg/l), and pH (3, 5, 7, 9, 11) were studied. The optimum catalyst dose was found to be 1 g/l of TiO2 and 1.25 g/l of ZnO for acephate at 100 mg/l, respectively. The maximum percentage degradation of acephate was observed at pH 11 for catalysts TiO2 and ZnO, respectively.

Keywords: ultrasonic degradation, acephate, TiO2, ZnO, heterogeneous catalyst

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Authors: Mehdi Ketabchi, Shamsollah Alijanlou

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The flue gas from fossil fuels combustion contains harmful pollutants dangerous for human health and the environment. One of the air pollution control methods to restrict the emission of these pollutants is based on using the nanoparticle in the adsorption process. In the present research gamma, Nano-alumina particle is added to Polyacrylonitrile (PAN) polymer through simple loading method and the adsorption capacity of the wet spun fiber is investigated. The results of exposure the fiber to the acid gasses including SO2, CO, NO2, NO and CO2 show the noticeable increase of gas adsorption capacity on fiber contains nanoparticle. The research has been conducted in Acrylic II Plant of Polyacryl Iran Corporation.

Keywords: acrylic fiber, adsorbent, wet spun, nano gamma alumina

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Authors: Lindsey Carruthers, Alexandra Willis, Rory MacLean

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Introduction: It has been proposed that distractibility, a key diagnostic criterion of Attention Deficit Hyperactivity Disorder (ADHD), may be associated with higher creativity levels in some individuals. Anecdotal and empirical evidence has shown that ADHD is therefore beneficial to creative problem-solving, and the generation of new ideas and products. Previous studies have only used one or two measures of attention, which is insufficient given that it is a complex cognitive process. The current study aimed to determine in which ways performance on creative problem-solving tasks and a range of attention tests may be related, and if performance differs between adults with and without ADHD. Methods: 150 adults, 47 males and 103 females (mean age=28.81 years, S.D.=12.05 years), were tested at Edinburgh Napier University. Of this set, 50 participants had ADHD, and 100 did not, forming the control group. Each participant completed seven attention tasks, assessing focussed, sustained, selective, and divided attention. Creative problem-solving was measured using divergent thinking tasks, which require multiple original solutions for one given problem. Two types of divergent thinking task were used: verbal (requires written responses) and figural (requires drawn responses). Each task is scored for idea originality, with higher scores indicating more creative responses. Correlational analyses were used to explore relationships between attention and creative problem-solving, and t-tests were used to study the between group differences. Results: The control group scored higher on originality for figural divergent thinking (t(148)= 3.187, p< .01), whereas the ADHD group had more original ideas for the verbal divergent thinking task (t(148)= -2.490, p < .05). Within the control group, figural divergent thinking scores were significantly related to both selective (r= -.295 to -.285, p < .01) and divided attention (r= .206 to .290, p < .05). Alternatively, within the ADHD group, both selective (r= -.390 to -.356, p < .05) and divided (r= .328 to .347, p < .05) attention are related to verbal divergent thinking. Conclusions: Selective and divided attention are both related to divergent thinking, however the performance patterns are different between each group, which may point to cognitive variance in the processing of these problems and how they are managed. The creative differences previously found between those with and without ADHD may be dependent on task type, which to the author’s knowledge, has not been distinguished previously. It appears that ADHD does not specifically lead to higher creativity, but may provide explanation for creative differences when compared to those without the disorder.

Keywords: ADHD, attention, creativity, problem-solving

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Authors: Sophie Lemoussu, Jean-Charles Chaudemar, Robertus A. Vingerhoeds

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Many innovative projects exist in the field of aeronautics, each addressing specific areas so to reduce weight, increase autonomy, reduction of CO2, etc. In many cases, such innovative developments are being carried out by very small enterprises (VSE’s) or small and medium sized-enterprises (SME’s). A good example concerns airships that are being studied as a real alternative to passenger and cargo transportation. Today, no international regulations propose a precise and sufficiently detailed framework for the development and certification of airships. The absence of such a regulatory framework requires a very close contact with regulatory instances. However, VSE’s/SME’s do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses an additional challenge for those VSE’s/SME’s, in particular those that have system integration responsibilities and that must provide all the necessary evidence to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The main objective of this research is to provide a methodological framework enabling VSE’s/SME’s with limited resources to organize the development of airships while taking into account the constraints of safety, cost, time and performance. This paper proposes to provide a contribution to this problematic by proposing a Model-Based Systems Engineering approach. Through a comprehensive process modeling approach applied to the development processes, the regulatory constraints, existing best practices, etc., a good image can be obtained as to the process landscape that may influence the development of airships. To this effect, not only the necessary regulatory information is taken on board, also other international standards and norms on systems engineering and project management are being modeled and taken into account. In a next step, the model can be used for analysis of the specific situation for given developments, derive critical paths for the development, identify eventual conflicting aspects between the norms, standards, and regulatory expectations, or also identify those areas where not enough information is available. Once critical paths are known, optimization approaches can be used and decision support techniques can be applied so to better support VSE’s/SME’s in their innovative developments. This paper reports on the adopted modeling approach, the retained modeling languages, and how they all fit together.

Keywords: aeronautics, certification, process modeling, project management, regulation, SME, systems engineering, VSE

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Authors: Sabo Elizabeth

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Cowpea production is presently mainly done with inorganic insecticides, but the growing environmental problems linked with their use and the rising costs of the chemicals are stimulating all categories of stakeholders towards the adoption of less impacting practices. 611 respondents were interviewed between 2008 and 2009. Respondents are young adults and are fairly educated. Awareness is high about insecticide use, but is low for bio-pesticides and resistant varieties. Adoption of inorganic insecticides is related to age, educational level, and contacts with dealers. Low adoption rate for resistant varieties is associated with inadequate information and poor extension service. To adopt IPM techniques with limited health hazards and compatible with the environment, a properly designed extension program is consequently needed.

Keywords: Vigna unguiculata, IPM, bio-pesticides, resistant varieties, extension

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Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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