Search results for: children’s support group

Authors: Choon Seong Ng, P. Petrick, C. L. Lau

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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.

Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital

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Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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Authors: Miguel Limbert Ramos, Joseph Amado Galvez

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Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

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Authors: Muhammad Kashif Fida

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In the bank, teller’s job (cash officer) is highly important and critical as at one end it requires soft and brisk customer services and on the other side, handling cash with integrity. It is always challenging for recruiters to hire competent and trustworthy tellers. According to author’s knowledge, there is no comprehensive test available that may provide assistance in recruitment in Pakistan. So there is a dire need of a psychometric battery that could provide support in recruitment of potential candidates for the teller’ position. So, the aim of the present study was to construct ABL-Teller Aptitude Test (ABL-TApT). Three major phases have been designed by following American Psychological Association’s guidelines. The first phase was qualitative, indicators of the test have been explored by content analysis of the a) teller’s job descriptions (n=3), b) interview with senior tellers (n=6) and c) interview with HR personals (n=4). Content analysis of above yielded three border constructs; i). Personality, ii). Integrity/honesty, iii). Professional Work Aptitude. Identified indicators operationalized and statements (k=170) were generated using verbatim. It was then forwarded to the five experts for review of content validity. They finalized 156 items. In the second phase; ABL-TApT (k=156) administered on 323 participants through a computer application. The overall reliability of the test shows significant alpha coefficient (α=.81). Reliability of subscales have also significant alpha coefficients. Confirmatory Factor Analysis (CFA) performed to estimate the construct validity, confirms four main factors comprising of eight personality traits (Confidence, Organized, Compliance, Goal-oriented, Persistent, Forecasting, Patience, Caution), one Integrity/honesty factor, four factors of professional work aptitude (basic numerical ability and perceptual accuracy of letters, numbers and signature) and two factors for customer services (customer services, emotional maturity). Values of GFI, AGFI, NNFI, CFI, RFI and RMSEA are in recommended range depicting significant model fit. In third phase concurrent validity evidences have been pursued. Personality and integrity part of this scale has significant correlations with ‘conscientiousness’ factor of NEO-PI-R, reflecting strong concurrent validity. Customer services and emotional maturity have significant correlations with ‘Bar-On EQI’ showing another evidence of strong concurrent validity. It is concluded that ABL-TAPT is significantly reliable and valid battery of tests, will assist in objective recruitment of tellers and help recruiters in finding a more suitable human resource.

Keywords: concurrent validity, construct validity, content validity, reliability, teller aptitude test, objective recruitment

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Authors: Ronit Even Zahav

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Objectives: Mother-daughter relationships are often portrayed as one of the most constitutive ties that shape women's identities throughout their lives. Yet, to the best of author’s knowledge, only few studies examine mother-daughter relationships in adulthood in the context of cross-cultural transition. Most of them focus on the mother-daughter relationship among one origin group. Hence, the existing knowledge about these relationships in adulthood, in the context of intercultural transition and encounters between different cultures, remain limited. Based on a critical feminist approach critical and cultural perspectives the current study focuses on a cross-cultural comparison of adult mother-daughter relationships among three groups of origin: Ethiopia, Russia, and Israel. The study aimed to: Explore the voices of women participating in a mother-daughter discourse in the context of gender and ethnicity; examine the differences in the mother-daughter relationship through number of factors (e.g. expectations of similarity and difference, perceptions of gender roles, gender identity, emotional closeness, sharing and stress) and finally, to develop a gender informed tool for understanding the gender dialectic in mother-daughter relationship in the context of cross cultural transitions. Method: 37 dyads of mothers and adult daughters participated in a qualitative study. A semi-structured interview was conducted that included questions about socio-demographic characteristics, language proficiency, social distance, closeness, emotional stress, and expectations of similarity and difference in mother-daughter relationships. Results: Analysis of the findings yielded three relationship patterns of gender dialectic and expectations of similarity and difference that characterize the groups of origin. Ethiopian mothers reported more sharing their daughters, fewer expectations of similarity, and felt more stress in the relationship compered to women from the two other origin groups. Conclusions: The study highlighted the impact of intercultural transition and social exclusion on mother-daughter relationships in adulthood in the context of the gender dialectic and women’s status in society. The presentation will explore the findings that were brought up by participants. The discussion will focus on the practices related to gender dialectic and intersecting inequalities regarding diverse groups and discuss gender development reducing inequalities and promoting empowerment to transform oppressive conditions.

Keywords: gender informed perspectives, gender dialectic, mother-daughter relationships, multiculturalism

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Authors: Asena Biber, Ates Gul Ergun, Seda Bulut

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Based on the literature, there are large numbers of studies investigating the relationship between culture and leadership effectiveness. Although giving effective speeches is vital characteristic for a leader to be perceived as effective, to our knowledge, there is no research study the determinants of perceived effective leader speech. The aim of this study is to find the effects of both culture and voice pitch on perceptions of leader's speech effectiveness. Our hypothesis is that people from high power distance countries will perceive leaders' speech effective when the leader's voice pitch is high, comparing with people from relatively low power distance countries. The participants of the study were 36 undergraduate students (12 Pakistanis, 12 Nigerians, and 12 Turks) who are studying in Turkey. National power distance scores of Nigerians ranked as first, Turks ranked as second and Pakistanis ranked as third. There are two independent variables in this study; three nationality groups that representing three levels of power distance and voice pitch of the leader which is manipulated as high and low levels. Researchers prepared an audio to manipulate high and low conditions of voice pitch. A professional whose native language is English read the predetermined speech in high and low voice pitch conditions. Voice pitch was measured using Hertz (Hz) and Decibel (dB). Each nationality group (Pakistan, Nigeria, and Turkey) were divided into groups of six students who listened to either the low or high pitch conditions in the cubicles of the laboratory. It was expected from participants to listen to the audio and fill in the questionnaire which was measuring the leadership effectiveness on a response scale ranging from 1 to 5. To determine the effects of nationality and voice pitch on perceived effectiveness of leader' voice pitch, 3 (Pakistani, Nigerian, and Turk) x 2 (low voice pitch and high voice pitch) two way between subjects analysis of variances was carried out. The results indicated that there was no significant main effect of voice pitch and interaction effect on perceived effectiveness of the leader’s voice pitch. However, there was a significant main effect of nationality on perceived effectiveness of the leader's voice pitch. Based on the results of Turkey’s HSD post-hoc test, only the perceived effectiveness of the leader's speech difference between Pakistanis and Nigerians was statistically significant. The results show that the hypothesis of this study was not supported. As limitations of the study, it is of importance to mention that the sample size should be bigger. Also, the language of the questionnaire and speech should be in the participant’s native language in further studies.

Keywords: culture, leadership effectiveness, power distance, voice pitch

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Authors: Jimmy K. C. Lam, Carrie Wong

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One of the key goals on Learning and Teaching as documented in the University strategic plan 2012/13 – 2017/18 is to encourage active learning, the use of innovative teaching approaches and technology, and promoting the adoption of flexible and varied teaching delivery methods. This research reported the recent visited to Prof Eric Mazur at Harvard University on Peer Instruction: Collaborative learning in large class and innovative use of technology to enable new mode of learning. Peer Instruction is a research-based, interactive teaching method developed by Prof. Eric Mazur at Harvard University in the 1990s. It has been adopted across the disciplines, institutional type and throughout the world. One problem with conventional teaching lies in the presentation of the material. Frequently, it comes straight out of textbook/notes, giving students little incentive to attend class. This traditional presentation is always delivered as monologue in front of passive audience. Only exceptional lecturers are capable of holding students’ attention for an entire lecture period. Consequently, lectures simply reinforce students’ feelings that the most important step in mastering the material is memorizing a zoo of unrelated examples. In order to address these misconceptions about learning, Prof Mazur’s Team developed “Peer Instruction”, a method which involves students in their own learning during lectures and focuses their attention on underling concepts. Lectures are interspersed with conceptual questions called Concept Tests, designed to expose common difficulties in understanding the material. The students are given one or two minutes to think about the question and formulate their own answers; they then spend two or three minutes discussing their answers in a group of three or four, attempting to reach consensus on the correct answer. This process forces the students to think through the arguments being developed, and enable them to assess their understanding concepts before they leave the classroom. The findings from Peer Instruction and innovative use of technology on teaching at Harvard University were applied to the first year Textiles and Fashion students in Hong Kong. Survey conducted from 100 students showed that over 80% students enjoyed the flexibility of peer instruction and 70% of them enjoyed the instant feedback from the Clicker system (Student Response System used at Harvard University). Further work will continue to explore the possibility of peer instruction to art and fashion students.

Keywords: peer instruction, education, technology, fashion

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Authors: Girija Madhavanprabhakaran, Frincy Franacis, Sheeba Elizabeth John

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Introduction: A wide range of prenatal genetic screening is introduced with increasing incidences of congenital anomalies even in low-risk pregnancies and is an emerging standard of care. Being frontline caretakers, the role and responsibilities of nurses and midwives are critical as they are working along with couples to provide evidence-based supportive educative care. The increasing genetic disorders and advances in prenatal genetic screening with limited genetic counselling facilities urge nurses and midwifery nurses with essential competencies to help couples to take informed decision. Objective: This integrative literature review aimed to explore nurse midwives’ knowledge and role in prenatal screening and genetic counselling competency and the challenges faced by them to cater to all pregnant women to empower their autonomy in decision making and ensuring psychological comfort. Method: An electronic search using keywords prenatal screening, genetic counselling, prenatal counselling, nurse midwife, nursing education, genetics, and genomics were done in the PUBMED, SCOPUS and Medline, Google Scholar. Finally, based on inclusion criteria, 8 relevant articles were included. Results: The main review results suggest that nurses and midwives lack essential support, knowledge, or confidence to be able to provide genetic counselling and help the couples ethically to ensure client autonomy and decision making. The majority of nurses and midwives reported inadequate levels of knowledge on genetic screening and their roles in obtaining family history, pedigrees, and providing genetic information for an affected client or high-risk families. The deficiency of well-recognized and influential clinical academic midwives in midwifery practice is also reported. Evidence recommended to update and provide sound educational training to improve nurse-midwife competence and confidence. Conclusion: Overcoming the challenges to achieving informed choices about fetal anomaly screening globally is a major concern. Lack of adequate knowledge and counselling competency, communication insufficiency, need for education and policy are major areas to address. Prenatal nurses' and midwives’ knowledge on prenatal genetic screening and essential counselling competencies can ensure services to the majority of pregnant women around the globe to be better-informed decision-makers and enhances their autonomy, and reduces ethical dilemmas.

Keywords: challenges, genetic counselling, prenatal screening, prenatal counselling

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Authors: Martin Hagan

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Teacher identity has been recognised as a crucial field of research which supports understanding of the ways in which teachers navigate the complexities of professional life in order to grow in competence, knowledge and practice. As a field of study, teacher identity is concerned with understanding: how identity is defined; how it develops; how teachers make sense of their emerging identity; and how the act of teaching is mediated through the individual teacher’s values, beliefs and sense of professional self. By comparing two particular, socially constructed learning contexts or ‘learning milieu’, one in Northern Ireland and the other in the United States of America, this study aims specifically, to gain better understanding of how teacher identity develops during the initial phase of teacher education. The comparative approach was adopted on the premise that experiences are constructed through interactive, socio-historical and cultural negotiations with others within particular environments, situations and contexts. As such, whilst the common goal is to ‘become’ a teacher, the nuances emerging from the different learning milieu highlight variance in discourse, priorities, practice and influence. A qualitative, interpretative research design was employed to understand the world-constructions of the participants through asking open-ended questions, seeking views and perspectives, examining contexts and eventually deducing meaning. Data were collected using semi structured interviews from a purposive sample of student teachers (n14) in either the first or second year of study in their respective institutions. In addition, a sample of teacher educators (n5) responsible for the design, organisation and management of the programmes were also interviewed. Inductive thematic analysis was then conducted, which highlighted issues related to: the participants’ personal dispositions, prior learning experiences and motivation; the influence of the teacher education programme on the participants’ emerging professional identity; and the extent to which the experiences of working with teachers and pupils in schools in the context of the practicum, challenged and changed perspectives on teaching as a professional activity. The study also highlights the varying degrees of influence exercised by the different roles (tutor, host teacher/mentor, student) within the teacher-learning process across the two contexts. The findings of the study contribute to the understanding of teacher identity development in the early stages of professional learning. By so doing, the research makes a valid contribution to the discourse on initial teacher preparation and can help to better inform teacher educators and policy makers in relation to appropriate strategies, approaches and programmes to support professional learning and positive teacher identity formation.

Keywords: initial teacher education, professional learning, professional growth, teacher identity

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Authors: Michal Lach, Maria Hebdowska-Krupa, Justyna Stefanek, Artur Stanek, Anna Stefanska, Janusz Mikula, Marek Hebda

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Limited resources of raw materials determine the necessity of obtaining materials from other sources. In this area, the most known and widespread are recycling processes, which are mainly focused on the reuse of material. Another possible solution used in various companies to achieve improvement in sustainable development is waste-free production. It involves the production exclusively from such materials, whose waste is included in the group of renewable raw materials. This means that they can: (i) be recycled directly during the manufacturing process of further products or (ii) be raw material obtained by other companies for the production of alternative products. The article presents the possibility of using post-production clay from the Jurassic limestone deposit "Raciszyn II" as a raw material for the production of alkali activated materials (AAM). Such products are currently increasingly used, mostly in various building applications. However, their final properties depend significantly on many factors; the most important of them are: chemical composition of the raw material, particle size, specific surface area, type and concentration of the activator and the temperature range of the heat treatment. Conducted mineralogical and chemical analyzes of clay from the “Raciszyn II” deposit confirmed that this material, due to its high content of aluminosilicates, can be used as raw material for the production of AAM. In order to obtain the product with the best properties, the optimization of the clay calcining process was also carried out. Based on the obtained results, it was found that this process should occur in the range between 750 oC and 800 oC. The use of a lower temperature causes getting a raw material with low metakaolin content which is the main component of materials suitable for alkaline activation processes. On the other hand, higher heat treatment temperatures cause thermal dissociation of large amounts of calcite, which is associated with the release of large amounts of CO2 and the formation of calcium oxide. This compound significantly accelerates the binding process, which consequently often prevents the correct formation of geopolymer mass. The effect of the use of various activators: (i) NaOH, (ii) KOH and (iii) a mixture of KOH to NaOH in a ratio of 10%, 25% and 50% by volume on the compressive strength of the AAM was also analyzed. Obtained results depending on the activator used were in the range from 25 MPa to 40 MPa. These values are comparable with the results obtained for materials produced on the basis of Portland cement, which is one of the most popular building materials.

Keywords: alkaline activation, aluminosilicates, calcination, compressive strength

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Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

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Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

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Authors: Arkadiusz Gut, Robert Mirski

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The nativist-constructivist debate constitutes a considerable part of current research on mindreading. Peter Carruthers and his colleagues are known for their nativist position in the debate and take issue with constructivist views proposed by other researchers, with Henry Wellman, Alison Gopnik, and Ian Apperly at the forefront. More specifically, Carruthers together with Evan Westra propose a nativistic explanation of Theory of Mind Scale study results that Wellman et al. see as supporting constructivism. While allowing for development of the innate mindreading system, Westra and Carruthers base their argumentation essentially on a competence-performance gap, claiming that cross-cultural differences in Theory of Mind Scale progression as well as discrepancies between infants’ and toddlers’ results on verbal and non-verbal false-belief tasks are fully explainable in terms of acquisition of other, pragmatic, cognitive developments, which are said to allow for an expression of the innately present Theory of Mind understanding. The goal of the present paper is to bring together arguments against the view offered by Westra and Carruthers. It will be shown that even though Carruthers et al.’s interpretation has not been directly controlled for in Wellman et al.’s experiments, there are serious reasons to dismiss such nativistic views which Carruthers et al. advance. The present paper discusses the following issues that undermine Carruthers et al.’s nativistic conception: (1) The concept of innateness is argued to be developmentally inaccurate; it has been dropped in many biological sciences altogether and many developmental psychologists advocate for doing the same in cognitive psychology. Reality of development is a complex interaction of changing elements that is belied by the simplistic notion of ‘the innate.’ (2) The purported innate mindreading conceptual system posited by Carruthers ascribes adult-like understanding to infants, ignoring the difference between first- and second-order understanding, between what can be called ‘presentation’ and ‘representation.’ (3) Advances in neurobiology speak strongly against any inborn conceptual knowledge; neocortex, where conceptual knowledge finds its correlates, is said to be largely equipotential at birth. (4) Carruthers et al.’s interpretations are excessively charitable; they extend results of studies done with 15-month-olds to conclusions about innateness, whereas in reality at that age there has been plenty of time for construction of the skill. (5) Looking-time experiment paradigm used in non-verbal false belief tasks that provide the main support for Carruthers’ argumentation has been criticized on methodological grounds. In the light of the presented arguments, nativism in theory of mind research is concluded to be an untenable position.

Keywords: development, false belief, mindreading, nativism, theory of mind

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Authors: Alan Ruiz-Padilla, Brando Villalobos-Villalobos, Yeniley Ruiz-Noa, Claudia Mendoza-Macías, Claudia Palafox-Sánchez, Miguel Marín-Rosales, Álvaro Cruz, Rubén Rangel-Salazar

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Introduction: In patients with rheumatoid arthritis, resistance or poor response to disease modifying antirheumatic drugs (DMARD) may be a reflection of the increase in g-P. The expression of g-P may be important in mediating the effluence of DMARD from the cell. In addition, P-glycoprotein is involved in the transport of cytokines, IL-1, IL-2 and IL-4, from normal lymphocytes activated to the surrounding extracellular matrix, thus influencing the activity of RA. The involvement of P-glycoprotein in the transmembrane transport of cytokines can serve as a modulator of the efficacy of DMARD. It was shown that a number of lymphocytes with glycoprotein P activity is increased in patients with RA; therefore, P-glycoprotein expression could be related to the activity of RA and could be a predictor of poor response to therapy. Objective: To evaluate in RA patients, if the G2677T/A MDR1 polymorphisms is associated with differences in the rate of therapeutic response to disease-modifying antirheumatic agents in patients with rheumatoid arthritis. Material and Methods: A prospective cohort study was conducted. Fifty seven patients with RA were included. They had an active disease according to DAS-28 (score >3.2). We excluded patients receiving biological agents. All the patients were followed during 6 months in order to identify the rate of therapeutic response according to the American College of Rheumatology (ACR) criteria. At the baseline peripheral blood samples were taken in order to identify the G2677T/A MDR1 polymorphisms using PCR- Specific allele. The fragment was identified by electrophoresis in polyacrylamide gels stained with ethidium bromide. For statistical analysis, the genotypic and allelic frequencies of MDR1 gene polymorphism between responders and non-responders were determined. Chi-square tests as well as, relative risks with 95% confidence intervals (95%CI) were computed to identify differences in the risk for achieving therapeutic response. Results: RA patients had a mean age of 47.33 ± 12.52 years, 87.7% were women with a mean for DAS-28 score of 6.45 ± 1.12. At the 6 months, the rate of therapeutic response was 68.7 %. The observed genotype frequencies were: for G/G 40%, T/T 32%, A/A 19%, G/T 7% and for A/A genotype 2%. Patients with G allele developed at 6 months of treatment, higher rate for therapeutic response assessed by ACR20 compared to patients with others alleles (p=0.039). Conclusions: Patients with G allele of the - G2677T/A MDR1 polymorphisms had a higher rate of therapeutic response at 6 months with DMARD. These preliminary data support the requirement for a deep evaluation of these and other genotypes as factors that may influence the therapeutic response in RA.

Keywords: pharmacogenetics, MDR1, P-glycoprotein, therapeutic response, rheumatoid arthritis

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Authors: Djehich Mohamed Yousri

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The national sovereignty of states is now facing a dangerous situation that has witnessed a clear exacerbation of the restrictions that this sovereignty has known for quite some time, if not since the establishment of the sovereign national state in the first place, and things have reached this way to the extent that a group of analysts and commentators are talking about the demise or disappearance of the phenomenon of sovereignty Patriotism, a judgment that some consider exaggerated, although there is agreement on the seriousness of what has afflicted the national sovereignty of medium and small states in particular. In fact, the phenomenon of national sovereignty has not completely ended, as there is still a category of countries that are able to disagree with the American will without disappearing from the world map, as happened with the Soviet Union. China, some European countries, and some countries with leading regional roles are still able to deal with This administration, with rational and complex calculations, makes the restrictions on its sovereignty minimal, or at least draws a red line in front of the vital interests of those countries that the restrictions on sovereignty cannot cross, and it is certain that strengthening internal democratic development in countries will increase their ability to challenge external restrictions. On its sovereignty to the extent that this development creates a cohesive society in the face of external hegemony attempts, as well as to the extent that it eliminates some pretexts for interference in the internal affairs of states, including the claim of a lack of democracy or lack of respect for human rights in it. What led to transformations in the international arena in the wake of globalization and its effects on international aspects, including national sovereignty and the principle of state independence. Which was marred by several currents, which led to affecting it in a negative way, and this is what poor countries suffer from at the expense of rich countries, which led us to research the extent of the presence of national sovereignty on the international arena, and the extent to which the principle of non-interference in affairs is applied or existed. The internal affairs of states, which are stipulated in the Charter of the United Nations in the modern era, the theory of sovereignty has been subjected to substantial criticism and abandonment by many on the grounds that it is inconsistent with the current conditions of the international community. In fact, the theory of sovereignty has been misused to justify internal tyranny and international chaos. This theory has hindered the development of international law, the work of international organizations and the dominance of strong states over weak ones. At the present time, the concept of sovereignty has moved towards direction, as the transformations of the international system in the economic, political and military fields have led to the decline and erosion of the idea of the sovereignty of the national state.

Keywords: sovereignty, intervention, non-interference, globalization, humanitarian intervention

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Authors: Divya Kanchibhotla

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Of all the major health threats to emerge, none has challenged the very foundation of public health so profoundly as the rise of non-communicable diseases (NCD). Encouraging a holistic health approach encompasses the community’s well-being. Competent public health grounded with holistic health approach can lay a better foundation in the modern world. Yoga has been increasingly explored as an adjunct therapy to major disorders. This study explores the efficacy of Yoga as a tool for public health. A survey was administered to 5500 adults, and 300 teens were selected from 25 states of India. The study explored the differences in health, happiness, and sustainable living between Yoga-practitioners and Non-yoga practitioners. The study also explored the practice and habits of yoga practitioners (frequency, place, reasons to practice) and Health, Happiness, and Sustainable Living. The subjects were grouped based on age, education, experience in yoga (years of practice), and occupational background. The study population comprised of 54% males and 46% females. Majority of the respondents (59%) were from 18 to 30 years age group. The study indicated that 96.4% of the total respondents have heard of Yoga. However, only 46.8% of the total study population practice yoga (YP) and the rest 53.2% were non-practitioners (NP). From a perspective of how Yoga and health, 72.7% yoga practitioners asserted a peaceful and happy life, 71.9% yoga practitioners felt satisfaction in life, and 70.2 % yoga practitioners had satisfactory health. 61.9% of yoga practitioners report being vegetarian, not eating junk food, and not drinking alcohol than 38.1% Non-Practitioners population. 47% of yoga practitioners found themselves to be more sensitive to the environment compared to only 40% of non-practitioners. India has been witnessing an unprecedented rise in the NCDs, accounting for 61% deaths. The importance of yoga as an adjunct therapy for various disorders and diseases is gaining momentum across the globe. There are various studies on yoga that have indicated benefits of yoga as a unique holistic approach towards lifestyle and a consistent, complementary solution that could be adopted for long-term viability for a well being. The comprehensive study is the first of its kind that takes a holistic look at the prevalence of Yoga for public health in India. Our study is unique and stands out as it is detailed in its outlook with extensive coverage of almost the whole country (surveying 25 out of 29 states) and contemplates on the benefits to an individual at the grass-root level – physical, mental and social outlook. The insights from the study will enable the health care systems and grassroots organizations to make the holistic practice of Yoga accessible to spread sustainable living for a healthy community.

Keywords: non-communicable disease (NCD), sustainable development goal (SDG 3), public health, healthy living

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Authors: Petr Daniel Edward Kovarik, Malcolm Jackson, Charles Kelly, Rahul Patil, Shahid Iqbal

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Introduction: Recognition of the presence of extra capsular spread (ECS) has been a major change in the TNM 8th edition published by the American Joint Committee on Cancer in 2018. Irrespective of the size or number of lymph nodes, the presence of ECS makes N3b disease a stage IV disease. The objective of this retrospective observational study was to conduct a comparative analysis of survival outcomes in patients with lymph node-positive cutaneous head and neck squamous cell carcinoma (CHNSCC) based on their TNM 7th and TNM 8th editions classification. Materials and Methods: From January 2010 to December 2020, 71 patients with CHNSCC were identified from our centre’s database who were treated with radical surgery and adjuvant radiotherapy. All histopathological reports were reviewed, and comprehensive nodal mapping was performed. The data were collected retrospectively and survival outcomes were compared using TNM 7th and 8th editions. Results: The median age of the whole group of 71 patients was 78 years, range 54 – 94 years, 63 were male and 8 female. In total, 2246 lymph nodes were analysed; 195 were positive for cancer. ECS was present in 130 lymph nodes, which led to a change in TNM staging. The details on N-stage as per TNM 7th edition was as follows; pN1 = 23, pN2a = 14, pN2b = 32, pN2c = 0, pN3 = 2. After incorporating the TNM 8th edition criterion (presence of ECS), the details on N-stage were as follows; pN1 = 6, pN2a = 5, pN2b = 3, pN2c = 0, pN3a = 0, pN3b = 57. This showed an increase in overall stage. According to TNM 7th edition, there were 23 patients were with stage III and remaining 48 patients, stage IV. As per TNM 8th edition, there were only 6 patients with stage III as compared to 65 patients with stage IV. For all patients, 2-year disease specific survival (DSS) and overall survival (OS) were 70% and 46%. 5-year DSS and OS rates were 66% and 20% respectively. Comparing the survival between stage III and stage IV of the two cohorts using both TNM 7th and 8th editions, there is an obvious greater survival difference between the stages if TNM 8th staging is used. However, meaningful statistics were not possible as the majority of patients (n = 65) were with stage IV and only 6 patients were stage III in the TNM 8th cohort. Conclusion: Our study provides a comprehensive analysis on lymph node data mapping in this specific patient population. It shows a better differentiation between stage III and stage IV in the TNM 8th edition as compared to TNM 7th however meaningful statistics were not possible due to the imbalance of patients in the sub-cohorts of the groups.

Keywords: cutaneous head and neck squamous cell carcinoma, extra capsular spread, neck lymphadenopathy, TNM 7th and 8th editions

Procedia PDF Downloads 100

Authors: L. Gómez-Limia, I. Franco, T. Blanco, S. Martínez

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European eels (Anguilla anguilla) belong to Anguilliformes order and Anguillidae family. They are generally classified as warm-water fish. Eels have a great commercial value in Europe and Asian countries. Eels can reach high weights, although their commercial size is relatively low in some countries. The capture of larger eels would facilitate the recovery of the species, as well as having a greater number of either glass eels or elvers for aquaculture. In the last years, the demand and the price of eels have increased significantly. However, European eel is considered critically endangered by the International Union for the Conservation of Nature (IUCN) Red List. The biochemical composition of fishes is an important aspect of quality and affects the nutritional value and consumption quality of fish. In addition, knowing this composition can help predict an individual’s condition for their recovery. Fish is known to be important source of protein rich in essential amino acids. However, there is very little information about changes in amino acids composition of European eels with increase in size. The aim of this study was to evaluate the effect of two different weight categories on the amino acids content in muscle tissue of wild European eels. European eels were caught in River Ulla (Galicia, NW Spain), during winter. The eels were slaughtered in ice water immersion. Then, they were purchased and transferred to the laboratory. The eels were subdivided into two groups, according to the weight. The samples were kept frozen (-20 °C) until their analysis. Frozen eels were defrosted and the white muscle between the head and the anal hole. was extracted, in order to obtain amino acids composition. Thirty eels for each group were used. Liquid chromatography was used for separation and quantification of amino a cids. The results conclude that the eels are rich in glutamic acid, leucine, lysine, threonine, valine, isoleucine and phenylalanine. The analysis showed that there are significant differences (p < 0.05) among the eels with different sizes. Histidine, threonine, lysine, hydroxyproline, serine, glycine, arginine, alanine and proline were higher in small eels. European eels muscle presents between 45 and 46% of essential amino acids in the total amino acids. European eels have a well-balanced and high quality protein source in the respect of E/NE ratio. However, eels with higher weight showed a better ratio of essential and non-essential amino acid.

Keywords: European eels, amino acids, HPLC, body size

Procedia PDF Downloads 97

Authors: Derek Wardle, Tarik Al-Shemmeri, Neil Packer

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This paper presents a small tube/wire type electrostatic precipitator (ESP). In the ESPs present form, particle charging and collecting voltages and airflow rates were individually varied throughout 200 ambient temperature test runs ranging from 10 to 30 kV in increments on 5 kV and 0.5 m/s to 1.5 m/s, respectively. It was repeatedly observed that, at input air velocities of between 0.5 and 0.9 m/s and voltage settings of 20 kV to 30 kV, the collection efficiency remained above 95%. The outcomes of preliminary tests at combustion flue temperatures are, at present, inconclusive although indications are that there is little or no drop in comparable performance during ideal test conditions. A limited set of similar tests was carried out during which the collecting electrode was grounded, having been disconnected from the static generator. The collecting efficiency fell significantly, and for that reason, this approach was not pursued further. The collecting efficiencies during ambient temperature tests were determined by mass balance between incoming and outgoing dry PM. The efficiencies of combustion temperature runs are determined by analysing the difference in opacity of the flue gas at inlet and outlet compared to a reference light source. In addition, an array of Leit tabs (carbon coated, electrically conductive adhesive discs) was placed at inlet and outlet for a number of four-day continuous ambient temperature runs. Analysis of the discs’ contamination was carried out using scanning electron microscopy and ImageJ computer software that confirmed collection efficiencies of over 99% which gave unequivocal support to all the previous tests. The average efficiency for these runs was 99.409%. Emissions collected from a woody biomass combustion unit, classified to a diameter of 100 µm, were used in all ambient temperature trials test runs apart from two which collected airborne dust from within the laboratory. Sawdust and wood pellets were chosen for laboratory and field combustion trials. Video recordings were made of three ambient temperature test runs in which the smoke from a wood smoke generator was drawn through the precipitator. Although these runs were visual indicators only, with no objective other than to display, they provided a strong argument for the device’s claimed efficiency, as no emissions were visible at exit when energised.  The theoretical performance of ESPs, when applied to the geometry and configuration of the tested model, was compared to the actual performance and was shown to be in good agreement with it.

Keywords: electrostatic precipitators, air quality, particulates emissions, electron microscopy, image j

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Authors: Dial Tassadit Rania, Figueiredo De Oliveira Gabriel

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In this paper, we investigate the relationship between ports and their hinterland and foreland environments and the competitive relationship between the ports themselves. These two environments are changing, evolving and introducing new challenges for commercial and economic development at the regional, national and international levels. Because of the rise of the containerization phenomenon, shipping costs and port handling costs have considerably decreased due to economies of scale. The volume of maritime trade has increased substantially and the markets served by the ports have expanded. On these bases, overlapping hinterlands can give rise to the phenomenon of competition between ports. Our main contribution comparing to the existing literature on this issue, is to build a set of hinterland, foreland and competition indicators. Using these indicators? we investigate the effect of hinterland accessibility, foreland connectivity and inter-ports competition on containerized traffic of Europeans ports. For this, we have a 10-year panel database from 2004 to 2014. Our hinterland indicators are given by two indicators of accessibility; they describe the market potential of a port and are calculated using information on population and wealth (GDP). We then calculate population and wealth for different neighborhoods within a distance from a port ranging from 100 to 1000km. For the foreland, we produce two indicators: port connectivity and number of partners for each port. Finally, we compute the two indicators of inter-port competition and a market concentration indicator (Hirshmann-Herfindhal) for different neighborhood-distances around the port. We then apply a fixed-effect model to test the relationship above. Again, with a fixed effects model, we do a sensitivity analysis for each of these indicators to support the results obtained. The econometric results of the general model given by the regression of the accessibility indicators, the LSCI for port i, and the inter-port competition indicator on the containerized traffic of European ports show a positive and significant effect for accessibility to wealth and not to the population. The results are positive and significant for the two indicators of connectivity and competition as well. One of the main results of this research is that the port development given here by the increase of its containerized traffic is strongly related to the development of its hinterland and foreland environment. In addition, it is the market potential, given by the wealth of the hinterland that has an impact on the containerized traffic of a port. However, accessibility to a large population pool is not important for understanding the dynamics of containerized port traffic. Furthermore, in order to continue to develop, a port must penetrate its hinterland at a deep level exceeding 100 km around the port and seek markets beyond this perimeter. The port authorities could focus their marketing efforts on the immediate hinterland, which can, as the results shows, not be captive and thus engage new approaches of port governance to make it more attractive.

Keywords: accessibility, connectivity, European containerization, European hinterland and foreland, inter-port competition

Procedia PDF Downloads 189

Authors: Dhouha Laribi Galalou, Najla Allani Bouhoula, Atef Hammouda

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This research delves into the fundamental question of the morphological restitution of built archaeology in order to place it in its paradigmatic context and to seek answers to it. Indeed, the understanding of the object of the study, its analysis, and the methodology of solving the morphological problem posed, are manageable aspects only by means of a thoughtful strategy that draws on well-defined epistemological scaffolding. In this stream, the crisis of natural reasoning in archaeology has generated multiple changes in this field, ranging from the use of new tools to the integration of an archaeological information system where urbanization involves the interplay of several disciplines. The built archaeological topic is also an architectural and morphological object. It is also a set of articulated elementary data, the understanding of which is about to be approached from a logicist point of view. Morphological restitution is no exception to the rule, and the inter-exchange between the different disciplines uses the capacity of each to frame the reflection on the incomplete elements of a given architecture or on its different phases and multiple states of existence. The logicist sequence is furnished by the set of scattered or destroyed elements found, but also by what can be called a rule base which contains the set of rules for the architectural construction of the object. The knowledge base built from the archaeological literature also provides a reference that enters into the game of searching for forms and articulations. The choice of the Roman Forum in North Africa is justified by the great urban and architectural characteristics of this entity. The research on the forum involves both a fairly large knowledge base but also provides the researcher with material to study - from a morphological and architectural point of view - starting from the scale of the city down to the architectural detail. The experimentation of the knowledge deduced on the paradigmatic level, as well as the deduction of an analysis model, is then carried out on the basis of a well-defined context which contextualises the experimentation from the elaboration of the morphological information container attached to the rule base and the knowledge base. The use of logicist analysis and artificial intelligence has allowed us to first question the aspects already known in order to measure the credibility of our system, which remains above all a decision support tool for the morphological restitution of Roman Fora in North Africa. This paper presents a first experimentation of the model elaborated during this research, a model framed by a paradigmatic discussion and thus trying to position the research in relation to the existing paradigmatic and experimental knowledge on the issue.

Keywords: classical reasoning, logicist reasoning, archaeology, architecture, roman forum, morphology, calculation

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Authors: Wee Tong Liaw, Elaine Wong Yee Sing

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The main objective and focus of this study are to establish the significance of a sustained health promoting workplace on stock and portfolio returns focusing on companies listed on the Singapore stock exchange, using a two-factor model comprising of the single factor CAPM and a 'health promoting workplace' factor. The 'health promoting workplace' factor represents the excess returns derived between two portfolios of component stocks that, when combined, would represent a top tier stock market index in Singapore, namely the STI index. The first portfolio represents companies that are independently assessed by the Singapore’s Health Award, SHA, to have a sustained and comprehensive health promoting workplace (SHA-STI portfolio) and the second portfolio represents companies that had not been independently assessed (Non-SHA STI portfolio). Since 2001, many companies in Singapore have voluntarily participated in the bi-annual Singapore HEALTH Award initiated by the Health Promotion Board of Singapore (HPB). The Singapore HEALTH Award (SHA), is an industry-wide award and assessment process. SHA assesses and recognizes employers in Singapore for implementing a comprehensive and sustainable health promotion programme at their workplaces. When using a ten year holding period instead of a one year holding period, excess returns in the SHA-STI portfolio over Non-SHA STI portfolio were consistently being observed over all test periods, during 2001 to 2013. In addition, when applied to the SHA-STI portfolio, results from the Two Factor Model consistently revealed higher explanatory powers across all test periods for the portfolio as well as all the individual component stocks in SHA-STI portfolio, than the single factor CAPM model. However, with respect to attaining higher level of achievement in the Singapore Health Award, this study did not show any incentive for selecting listed companies that have achieved a higher level of award. Results from this study would give further insights to investors and fund managers alike who intend to consider health promoting workplace as a risk factor in their stock or portfolio selection process, in particular for investors who have a preference for STI’s component stocks and with a longer investment horizon. Key micro factors like management abilities, business development strategies and production capabilities that meet the needs of market would create the demand for a company’s product(s) or service(s) and consequently contribute to its top line and profitability. Thereafter, the existence of a sustainable health promoting workplace would be a key catalytic factor in sustaining a productive workforce needed to support the continued success of a profitable business.

Keywords: asset pricing model, company's performance, stock returns, financial risk factor, sustained health promoting workplace

Procedia PDF Downloads 164

Authors: Byeongcheol Kang, Junyi Kim, Hyungsik Jung, Hyungjun Yang, Jaewoo An, Jonggeun Choe

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It is important to figure out reservoir properties for better production management. Due to the limited information, there are geological uncertainties on very heterogeneous or channel reservoir. One of the solutions is to generate multiple equi-probable realizations using geostatistical methods. However, some models have wrong properties, which need to be excluded for simulation efficiency and reliability. We propose a novel method of model selection scheme, based on distance-based clustering for reliable application of production optimization algorithm. Distance is defined as a degree of dissimilarity between the data. We calculate Hausdorff distance to classify the models based on their similarity. Hausdorff distance is useful for shape matching of the reservoir models. We use multi-dimensional scaling (MDS) to describe the models on two dimensional space and group them by K-means clustering. Rather than simulating all models, we choose one representative model from each cluster and find out the best model, which has the similar production rates with the true values. From the process, we can select good reservoir models near the best model with high confidence. We make 100 channel reservoir models using single normal equation simulation (SNESIM). Since oil and gas prefer to flow through the sand facies, it is critical to characterize pattern and connectivity of the channels in the reservoir. After calculating Hausdorff distances and projecting the models by MDS, we can see that the models assemble depending on their channel patterns. These channel distributions affect operation controls of each production well so that the model selection scheme improves management optimization process. We use one of useful global search algorithms, particle swarm optimization (PSO), for our production optimization. PSO is good to find global optimum of objective function, but it takes too much time due to its usage of many particles and iterations. In addition, if we use multiple reservoir models, the simulation time for PSO will be soared. By using the proposed method, we can select good and reliable models that already matches production data. Considering geological uncertainty of the reservoir, we can get well-optimized production controls for maximum net present value. The proposed method shows one of novel solutions to select good cases among the various probabilities. The model selection schemes can be applied to not only production optimization but also history matching or other ensemble-based methods for efficient simulations.

Keywords: distance-based clustering, geological uncertainty, particle swarm optimization (PSO), production optimization

Procedia PDF Downloads 141

Authors: Boris Nemzer, Tania Reyes-Izquierdo, Zbigniew Pietrzkowski

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Glucosinolate is a family of glucosides that can be found in a family of brassica vegetables. Upon the damage of the plant, glucosinolate breakdown by an internal enzyme myrosinase (thioglucosidase; EC 3.2.3.1) into isothiocyanates, such as sulforaphane. Sulforaphane is formed by glucoraphanin cleaving the sugar off by myrosinase and rearranged. Sulforaphane nitrile is formed in the same reaction as sulforaphane with the active of epithiospecifier protein (ESP). Most common food processing procedure would break the plant and mix the glucoraphanin and myrosinase together, and the formed sulforaphane would be further degraded. The purpose of this study is to understand the glucoraphanin/sulforaphane and the myrosinase activity of broccoli seeds germinated at a different time and technological processing conditions that keep the activity of the enzyme to form sulforaphane. Broccoli seeds were germinated in the house. Myrosinase activities were tested as the glucose content using glucose assay kit and measured UV-Vis spectrophotometer. Glucosinolates were measured by HPLC/DAD. Sulforaphane was measured using HPLC-DAD and GC/MS. The 6 hr germinated sprouts have a myrosinase activity 32.2 mg glucose/g, which is comparable with 12 and 24 hour germinated seeds and higher than dry seeds. The glucoraphanin content in 6 hour germinated sprouts is 13935 µg/g which is comparable to 24 hour germinated seeds and lower than the dry seeds. GC/MS results show that the amount of sulforaphane is higher than the amount of sulforaphane nitrile in seeds, 6 hour and 24 hour germinated seeds. The ratio of sulforaphane and sulforaphane nitrile is high in 6 hour germinated seeds, which indicates the inactivated ESP in the reaction. After evaluating the results, the short time germinated seeds can be used as the source of glucoraphanin and myrosinase supply to form potential higher sulforaphane content. Broccoli contains glucosinolates, glucoraphanin (4-methylsulfinylbutyl glucosinolate), which is an important metabolite with health-promoting effects. In the pilot clinical study, we observed the effects of a glucosinolates/glucoraphanin-rich extract from short time germinated broccoli seeds on blood adenosine triphosphate (ATP), reactive oxygen species (ROS) and lactate levels. A single dose of 50 mg of broccoli sprouts extract increased blood levels of ATP up to 61% (p=0.0092) during the first 2 hours after the ingestion. Interestingly, this effect was not associated with an increase in blood ROS or lactate. When compared to the placebo group, levels of lactate were reduced by 10% (p=0.006). These results indicate that broccoli germinated seed extract may positively affect the generation of ATP in humans. Due to the preliminary nature of this work and promising results, larger clinical trials are justified.

Keywords: broccoli glucosinolates, glucoraphanin, germinated seeds, myrosinase, adenosine triphosphate

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Authors: Zohar Manber, Ran Elkon

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

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

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Riteesh Bookun

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Patients with carotid stenosis, which may be asymptomatic or symptomatic in the form of transient ischaemic attack (TIA), amaurosis fugax, or stroke, often require an endarterectomy to reduce stroke risk. Risks of this procedure include stroke, death, myocardial infarction, and cranial nerve damage. Carotid endarterectomy is most commonly performed under general anaesthetic, however, it can also be undertaken with a regional anaesthetic approach. Our tertiary centre generally performs carotid endarterectomy under regional anaesthetic. Our major tertiary hospital mostly utilises regional anaesthesia for carotid endarterectomy. We completed a cross-sectional analysis of all cases of carotid endarterectomy performed under regional anaesthesia across a 10-year period between January 2010 to March 2020 at our institution. 350 patients were included in this descriptive analysis, and demographic details for patients, indications for surgery, procedural details, length of surgery, and complications were collected. Data was cross tabulated and presented in frequency tables to describe these categorical variables. 263 of the 350 patients in the analysis were male, with a mean age of 71 ± 9. 172 patients had a history of ischaemic heart disease, 104 had diabetes mellitus, 318 had hypertension, and 17 patients had chronic kidney disease greater than Stage 3. 13.1% (46 patients) were current smokers, and the majority (63%) were ex-smokers. Most commonly, carotid endarterectomy was performed conventionally with patch arterioplasty 96% of the time (337 patients). The most common indication was TIA and stroke in 64% of patients, 18.9% were classified as asymptomatic, and 13.7% had amaurosis fugax. There were few general complications, with 9 wound complications/infections, 7 postoperative haematomas requiring return to theatre, 3 myocardial infarctions, 3 arrhythmias, 1 exacerbation of congestive heart failure, 1 chest infection, and 1 urinary tract infection. Specific complications to carotid endarterectomy included 3 strokes, 1 postoperative TIA, and 1 cerebral bleed. There were no deaths in our cohort. This analysis of a large cohort of patients from a major tertiary centre who underwent carotid endarterectomy under regional anaesthesia indicates the safety of such an approach for these patients. Regional anaesthesia holds the promise of less general respiratory and cardiac events compared to general anaesthesia, and in this vulnerable patient group, calls for comparative research between local and general anaesthesia in carotid surgery.

Keywords: anaesthesia, carotid endarterectomy, stroke, carotid stenosis

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Authors: Lubna Naz, Munir Ahmad, G. M. Arif

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This study analyzes static and dynamic welfare impacts of food price changes for various landholding groups in Pakistan. The study uses three classifications of land ownership, landless, small landowners and large landowners, for analysis. The study uses Panel Survey, Pakistan Rural Household Survey (PRHS) of Pakistan Institute of Development Economics Islamabad, of rural households from two largest provinces (Sindh and Punjab) of Pakistan. The study uses all three waves (2001, 2004 and 2010) of PRHS. This research work makes three important contributions in literature. First, this study uses Quadratic Almost Ideal Demand System (QUAIDS) to estimate demand functions for eight food groups-cereals, meat, milk and milk products, vegetables, cooking oil, pulses and other food. The study estimates food demand functions with Nonlinear Seemingly Unrelated (NLSUR), and employs Lagrange Multiplier and test on the coefficient of squared expenditure term to determine inclusion of squared expenditure term. Test results support the inclusion of squared expenditure term in the food demand model for each of landholding groups (landless, small landowners and large landowners). This study tests for endogeneity and uses control function for its correction. The problem of observed zero expenditure is dealt with a two-step procedure. Second, it creates low price and high price periods, based on literature review. It uses elasticity coefficients from QUAIDS to analyze static and dynamic welfare effects (first and second order Tylor approximation of expenditure function is used) of food price changes across periods. The study estimates compensation variation (CV), money metric loss from food price changes, for landless, small and large landowners. Third, this study compares the findings on welfare implications of food price changes based on QUAIDS with the earlier research in Pakistan, which used other specification of the demand system. The findings indicate that dynamic welfare impacts of food price changes are lower as compared to static welfare impacts for all landholding groups. The static and dynamic welfare impacts of food price changes are highest for landless. The study suggests that government should extend social security nets to landless poor and categorically to vulnerable landless (without livestock) to redress the short-term impact of food price increase. In addition, the government should stabilize food prices and particularly cereal prices in the long- run.

Keywords: QUAIDS, Lagrange multiplier, NLSUR, and Tylor approximation

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Authors: Begzod Nishanov, Farhod Karimov

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Globalization and the internet have completely changed the way in which businesses operate as well as has equipped customers with endless potential. Today, consumers’ product choice is not only affected by branding, price and quality of the product, but also by the country-of-origin information. Precisely, ‘Made In’ label is considered as one of the driving factors which directly impact on consumers’ preferences. Generally, it is obvious that products manufactured in less developed countries are considered to be of lower quality and riskier compared to the products made in developed countries. In this regard, it is worth to note that this phenomenon is mainly applicable to western developed countries. However, there is a lack of empirical research on underlying the influence of country-of-origin phenomenon in emerging economies such as Uzbekistan. Today, Uzbek market is being dominated by growing number of foreign made products. Uzbek manufacturers are facing intense competition not only from local producers but also from the availability of foreign goods suppliers. Consequently, consumers are given wider choice of products than ever before. In this regard, it is important to define the importance of country-of-origin information in order to understand Uzbek consumers’ preference. The methodology of the research is formulated based on the methodology of previous papers. A total 527 online questionnaires were completed. Data analysis was conducted using factor analysis and analysis of variance test (ANOVA). Findings of the research support the view that Uzbek consumers attach great importance to the country-of-origin information of products. Precisely, it can be stated that Uzbek people perceive product quality by its ‘Made in...’ label, especially when buying high involvement goods such as car or refrigerator. Another findings of the paper show that products manufactured in developed countries including Germany, Japan and USA are found to be of high quality, while products manufactured in less developed countries are considered to be of lower quality. Marketers can use this information for segmentation purposes. For example, products manufactured in less developed countries can be targeted for low-to-middle income families while goods manufactured in developed countries can be targeted for higher income families. In conclusion, it can be stated that perceived product quality of products that are made in Uzbekistan has slightly increased since 18 years. It implies that nowadays products under ‘Made in Uzbekistan’ label is continually becoming available to many consumers in foreign markets, especially among Commonwealth of Independent States (CIS) countries. Therefore, conducting further research to explore the phenomenon of country-of-origin information and perceived product quality in emerging markets is of paramount importance.

Keywords: country-of-origin, consumer behavior, product evaluation, perceived quality

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Authors: Samul Sahile Kebede

Abstract:

Back ground: -Immune hemolytic anemia commonly affects human immune deficiency, infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to the drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV, which accompanies the greatest percent from acquired hemolytic anemia. Objective: -The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at the university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. Methods: - An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination, and antihuman globulin test were performed to the diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. Result; - The overall prevalence of immune hemolytic anemia was 2.8 % (10 of 358 participants). Of these, 5 were males, and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40 % mild and 60 % moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). Conclusion and recommendation; Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.

Keywords: anemia, hemolytic, immune, auto immune, HIV/AIDS

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Authors: Bhaskar Basu

Abstract:

Universities and higher education institutes are finding it increasingly difficult to engage students fruitfully through traditional pedagogic tools. Web 2.0 technologies comprising social networking sites (SNSs) offer a platform for students to collaborate and share information, thereby enhancing their learning experience. Despite the potential and reach of SNSs, its use has been limited in academic settings promoting higher education. The purpose of this paper is to assess the perception of social networking sites among business school students in India and analyze its role in enhancing quality of student experiences in a business school leading to the proposal of an agenda for future research. In this study, more than 300 students of a reputed business school were involved in a survey of their preferences of different social networking sites and their perceptions and attitudes towards these sites. A questionnaire with three major sections was designed, validated and distributed among  a sample of students, the research method being descriptive in nature. Crucial questions were addressed to the students concerning time commitment, reasons for usage, nature of interaction on these sites, and the propensity to share information leading to direct and indirect modes of learning. It was further supplemented with focus group discussion to analyze the findings. The paper notes the resistance in the adoption of new technology by a section of business school faculty, who are staunch supporters of the classical “face-to-face” instruction. In conclusion, social networking sites like Facebook and LinkedIn provide new avenues for students to express themselves and to interact with one another. Universities could take advantage of the new ways  in which students are communicating with one another. Although interactive educational options such as Moodle exist, social networking sites are rarely used for academic purposes. Using this medium opens new ways of academically-oriented interactions where faculty could discover more about students' interests, and students, in turn, might express and develop more intellectual facets of their lives. hitherto unknown intellectual facets.  This study also throws up the enormous potential of mobile phones as a tool for “blended learning” in business schools going forward.

Keywords: business school, India, learning, social media, social networking, university

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Authors: Sudikshya Bhandari, Jonathan K. London

Abstract:

Barpak in northern Nepal represents a unique identity expressed through the local rituals, values, lifeways and the styles of vernacular architecture. The traditional residential buildings and construction practices adopted by the dominant ethnic groups: Ghales and Gurungs, reflect environmental, social, cultural and economic concerns. However, most of these buildings did not survive the Gorkha earthquake in 2015 that made many residents skeptical about their strength to resist future disasters. This led Barpak residents to prefer modern housing designs primarily for the strength but additionally for convenience and access to earthquake relief funds. Post-earthquake reconstruction has transformed the cohesive community, developed over hundreds of years into a haphazard settlement with the imposition of externally-driven building models. Housing guidelines provided for the community reconstruction and earthquake resilience have been used as a singular template, similar to other communities on different geographical locations. The design and construction of these buildings do not take into account the local, historical, environmental, social, cultural and economic context of Barpak. In addition to the physical transformation of houses and the settlement, the consequences continue to develop challenges to sustainability. This paper identifies the major challenges for environmental sustainability with the construction of new houses in post-earthquake Barpak. Mixed methods such as interviews, focus groups, site observation, and documentation, and analysis of housing and neighborhood design have been used for data collection. The discernible changing situation of this settlement due to the new housing has included reduced climatic adaptation and thermal comfort, increased consumption of agricultural land and water, minimized use of local building materials, and an increase in energy demand. The research has identified that reconstruction housing practices happening in Barpak, while responding to crucial needs for disaster recovery and resilience, are also leading this community towards an unsustainable future. This study has also integrated environmental, social, cultural and economic parameters into an assessment framework that could be used to develop place-based design guidelines in the context of other post-earthquake reconstruction efforts. This framework seeks to minimize the unintended repercussions of unsustainable reconstruction interventions, support the vitality of vernacular architecture and traditional lifeways and respond to context-based needs in coordination with residents.

Keywords: earthquake, environment, reconstruction, sustainability

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