Search results for: facial expression and mood recognition
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3918

Search results for: facial expression and mood recognition

2148 Nonmedical Determinants of Congenital Heart Diseases in Children from the Perspective of Mothers: A Qualitative Study in Iran

Authors: Maryam Borjali

Abstract:

Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

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2147 Detonating Culture, Statistic and Developmenet in Imo State of Nigeria

Authors: Ejikeme Ugiri

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In an executive summary, UNESCO describes Framework for Cultural Statistics as a tool for organizing cultural statistics both nationally and internationally. This is based on conceptual foundation and a common understanding of culture that will enable the measurement of a wide range of cultural expressions. This means therefore that cultural expression in whatever guise has the potentiality of contributing reasonably to the development of a given society. The paper looked into the various tangible and intangible cultures in Imo State of Nigeria. Due to government’s insensitivity, there is need to remind ourselves of the need to pay adequate attention to the cultural heritage bequeathed to us by our forefathers for the sake of posterity. Documenting this information in written form therefore becomes imperative. The study concludes that culture if developed, could reasonably contribute to economic and social growth of the society.

Keywords: culture, detonation, development, statistics

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2146 The Quantitative Optical Modulation of Dopamine Receptor-Mediated Endocytosis Using an Optogenetic System

Authors: Qiaoyue Kuang, Yang Li, Mizuki Endo, Takeaki Ozawa

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G protein-coupled receptors (GPCR) are the largest family of receptor proteins that detect molecules outside the cell and activate cellular responses. Of the GPCRs, dopamine receptors, which recognize extracellular dopamine, are essential to mammals due to their roles in numerous physiological events, including autonomic movement, hormonal regulation, emotions, and the reward system in the brain. To precisely understand the physiological roles of dopamine receptors, it is important to spatiotemporally control the signaling mediated by dopamine receptors, which is strongly dependent on their surface expression. Conventionally, chemical-induced interactions were applied to trigger the endocytosis of cell surface receptors. However, these methods were subjected to diffusion and therefore lacked temporal and special precision. To further understand the receptor-mediated signaling and to control the plasma membrane expression of receptors, an optogenetic tool called E-fragment was developed. The C-terminus of a light-sensitive photosensory protein cyptochrome2 (CRY2) was attached to β-Arrestin, and the E-fragment was generated by fusing the C-terminal peptide of vasopressin receptor (V2R) to CRY2’s binding partner protein CIB. The CRY2-CIB heterodimerization triggered by blue light stimulation brings β-Arrestin to the vicinity of membrane receptors and results in receptor endocytosis. In this study, the E-fragment system was applied to dopamine receptors 1 and 2 (DRD1 and DRD2) to control dopamine signaling. First, confocal fluorescence microscope observation qualitatively confirmed the light-induced endocytosis of E-fragment fused receptors. Second, NanoBiT bioluminescence assay verified quantitatively that the surface amount of E-fragment labeled receptors decreased after light treatment. Finally, GloSensor bioluminescence assay results suggested that the E-fragment-dependent receptor light-induced endocytosis decreased cAMP production in DRD1 signaling and attenuated the inhibition effect of DRD2 on cAMP production. The developed optogenetic tool was able to induce receptor endocytosis by external light, providing opportunities to further understand numerous physiological activities by controlling receptor-mediated signaling spatiotemporally.

Keywords: dopamine receptors, endocytosis, G protein-coupled receptors, optogenetics

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2145 Effect of a Synthetic Platinum-Based Complex on Autophagy Induction in Leydig TM3 Cells

Authors: Ezzati Givi M., Hoveizi E., Nezhad Marani N.

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Platinum-based anticancer therapeutics are the most widely used drugs in clinical chemotherapy but have major limitations and various side effects in clinical applications. Gonadotoxicity and sterility is one of the most common complications for cancer survivors, which seem to be drug-specific and dose-related. Therefore, many efforts have been dedicated to discovering a new structure of platinum-based anticancer agents with improved therapeutic index, fewer side effects. In this regard, new Pt(II)-phosphane complexes containing heterocyclic thionate ligands (PCTL) have been synthesized, which show more potent antitumor activities in comparison to cisplatin. Cisplatin, the best leading metal-based antitumor drug in the field, induces testicular toxicity on Leydig and Sertoli cells leading to serious side effects such as azoospermia and infertility. Therefore in the present study, we aimed to investigate the cytotoxicity effect of PCTL on mice TM4 Sertoli cells with particular emphasis on the role of autophagy in comparison to cisplatin. In this study, an MTT assay was performed to evaluate the IC50 of PCTL and to analyze the TM3 Leydig cell's viability. Cells morphology was evaluated via invert microscope and Changing in morphology for nuclei swelling or autophagic vacuoles formation were assessed by DAPI and MDC staining. Testosterone production in the culture medium was measured using an ELISA kit. Finally, the expression of Autophagy-related genes, Atg5, Beclin1 and p62, were analyzed by qPCR. Based on the obtained results by MTT, the IC50 value of PCTL was 50 μM in TM3 cells and cytotoxic effects was in a dose- and time-dependent manner. Cells morphological changes investigated by inverted microscopy, DAPI, and MDC staining which showed the cytotoxic concentrations of PCTL was significantly higher than cisplatin in the treated TM3 Leydig cells. The results of PCR showed a lack of expression of the p62, Atg5 and Beclin1 gene in TM3 cells treated with PCTL in comparison to cisplatin and control groups. It should be noted that the effects of 25 μM PCTL concentration on TM3 cells have been associated with increased testosterone production and secretion, which requires further study to explain the possible causes and involved molecular mechanisms. The results of the study showed that the PCTL had less-lethal effects on TM3 cells in comparison to cisplatin and probably did not induce autophagy in TM3 cells.

Keywords: platinum-based anticancer agents, cisplatin, Leydig TM3 cells, autophagy

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2144 Targeting Basic Leucine Zipper Transcription Factor ATF-Like Mediated Immune Cells Regulation to Reduce Crohn’s Disease Fistula Incidence

Authors: Mohammadjavad Sotoudeheian, Soroush Nematollahi

Abstract:

Crohn’s disease (CD) is a chronic gastrointestinal segment inflammation encompassing immune dysregulation in a genetically susceptible individual in response to the environmental triggers and interaction between the microbiome and immune system. Uncontrolled inflammation leads to long-term complications, including fibrotic strictures and enteric fistulae. Increased production of Th1 and Th17-cell cytokines and defects in T-regulatory cells have been associated with CD. Th17-cells are essential for protection against extracellular pathogens, but their atypical activity can cause autoimmunity. Intrinsic defects in the control of programmed cell death in the mucosal T-cell compartment are strongly implicated in the pathogenesis of CD. The apoptosis defect in mucosal T-cells in CD has been endorsed as an imbalance of the Bcl-2 and the Bax. The immune system encounters foreign antigens through microbial colonization of mucosal surfaces or infections. In addition, FOSL downregulated IL-26 expression, a cytokine that marks inflammatory Th17-populations in patients suffering from CD. Furthermore, the expression of IL-23 is associated with the transcription factor primary leucine zipper transcription factor ATF-like (Batf). Batf-deficiency demonstrated the crucial role of Batf in colitis development. Batf and IL-23 mediate their effects by inducing IL-6 production. Strong association of IL-23R, Stat3, and Stat4 with IBD susceptibility point to a critical involvement of T-cells. IL-23R levels in transfer fistula were dependent on the AP-1 transcription factor JunB that additionally controlled levels of RORγt by facilitating DNA binding of Batf. T lymphocytes lacking JunB failed to induce IL-23- and Th17-mediated experimental colitis highlighting the relevance of JunB for the IL-23/ Th17 pathway. The absence of T-bet causes unrestrained Th17-cell differentiation. T-cells are central parts of immune-mediated colon fistula. Especially Th17-cells were highly prevalent in inflamed IBD tissues, as RORγt is effective in preventing colitis. Intraepithelial lymphocytes (IEL) contain unique T-cell subsets, including cells expressing RORγt. Increased activated Th17 and decreased T-regulatory cells in inflamed intestinal tissues had been seen. T-cells differentiate in response to many cytokines, including IL-1β, IL-6, IL-23, and TGF-β, into Th17-cells, a process which is critically dependent on the Batf. IL-23 promotes Th17-cell in the colon. Batf manages the generation of IL-23 induced IL-23R+ Th17-cells. Batf is necessary for TGF-β/IL-6-induced Th17-polarization. Batf-expressing T-cells are the core of T-cell-mediated colitis. The human-specific parts of three AP-1 transcription factors, FOSL1, FOSL2, and BATF, are essential during the early stages of Th17 differentiation. BATF supports the Th17 lineage. FOSL1, FOSL2, and BATF make possession of regulatory loci of genes in the Th17 lineage cascade. The AP1 transcription factor Batf is identified to control intestinal inflammation and seems to regulate pathways within lymphocytes, which could theoretically control the expression of several genes. It shows central regulatory properties over Th17-cell development and is intensely upregulated within IBD-affected tissues. Here, we demonstrated that targeting Batf in IBD appears as a therapeutic approach that reduces colitogenic T-cell activities during fistula formation while aiming to affect inflammation in the gut epithelial cells.

Keywords: immune system, Crohn’s Disease, BATF, T helper cells, Bcl, interleukin, FOSL

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2143 Early Depression Detection for Young Adults with a Psychiatric and AI Interdisciplinary Multimodal Framework

Authors: Raymond Xu, Ashley Hua, Andrew Wang, Yuru Lin

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During COVID-19, the depression rate has increased dramatically. Young adults are most vulnerable to the mental health effects of the pandemic. Lower-income families have a higher ratio to be diagnosed with depression than the general population, but less access to clinics. This research aims to achieve early depression detection at low cost, large scale, and high accuracy with an interdisciplinary approach by incorporating clinical practices defined by American Psychiatric Association (APA) as well as multimodal AI framework. The proposed approach detected the nine depression symptoms with Natural Language Processing sentiment analysis and a symptom-based Lexicon uniquely designed for young adults. The experiments were conducted on the multimedia survey results from adolescents and young adults and unbiased Twitter communications. The result was further aggregated with the facial emotional cues analyzed by the Convolutional Neural Network on the multimedia survey videos. Five experiments each conducted on 10k data entries reached consistent results with an average accuracy of 88.31%, higher than the existing natural language analysis models. This approach can reach 300+ million daily active Twitter users and is highly accessible by low-income populations to promote early depression detection to raise awareness in adolescents and young adults and reveal complementary cues to assist clinical depression diagnosis.

Keywords: artificial intelligence, COVID-19, depression detection, psychiatric disorder

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2142 Spectrophotometric Detection of Histidine Using Enzyme Reaction and Examination of Reaction Conditions

Authors: Akimitsu Kugimiya, Kouhei Iwato, Toru Saito, Jiro Kohda, Yasuhisa Nakano, Yu Takano

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The measurement of amino acid content is reported to be useful for the diagnosis of several types of diseases, including lung cancer, gastric cancer, colorectal cancer, breast cancer, prostate cancer, and diabetes. The conventional detection methods for amino acid are high-performance liquid chromatography (HPLC) and liquid chromatography-mass spectrometry (LC-MS), but they have several drawbacks as the equipment is cumbersome and the techniques are costly in terms of time and costs. In contrast, biosensors and biosensing methods provide more rapid and facile detection strategies that use simple equipment. The authors have reported a novel approach for the detection of each amino acid that involved the use of aminoacyl-tRNA synthetase (aaRS) as a molecular recognition element because aaRS is expected to a selective binding ability for corresponding amino acid. The consecutive enzymatic reactions used in this study are as follows: aaRS binds to its cognate amino acid and releases inorganic pyrophosphate. Hydrogen peroxide (H₂O₂) was produced by the enzyme reactions of inorganic pyrophosphatase and pyruvate oxidase. The Trinder’s reagent was added into the reaction mixture, and the absorbance change at 556 nm was measured using a microplate reader. In this study, an amino acid-sensing method using histidyl-tRNA synthetase (HisRS; histidine-specific aaRS) as molecular recognition element in combination with the Trinder’s reagent spectrophotometric method was developed. The quantitative performance and selectivity of the method were evaluated, and the optimal enzyme reaction and detection conditions were determined. The authors developed a simple and rapid method for detecting histidine with a combination of enzymatic reaction and spectrophotometric detection. In this study, HisRS was used to detect histidine, and the reaction and detection conditions were optimized for quantitation of these amino acids in the ranges of 1–100 µM histidine. The detection limits are sufficient to analyze these amino acids in biological fluids. This work was partly supported by Hiroshima City University Grant for Special Academic Research (General Studies).

Keywords: amino acid, aminoacyl-tRNA synthetase, biosensing, enzyme reaction

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2141 UKIYO-E: User Knowledge Improvement Based on Youth Oriented Entertainment, Art Appreciation Support by Interacting with Picture

Authors: Haruya Tamaki, Tsugunosuke Sakai, Ryuichi Yoshida, Ryohei Egusa, Shigenori Inagaki, Etsuji Yamaguchi, Fusako Kusunoki, Miki Namatame, Masanori Sugimoto, Hiroshi Mizoguchi

Abstract:

Art appreciation is important as part of children education. Art appreciation can enrich sensibility and creativity. To enrich sensibility and creativity, the children have to learning knowledge of picture such as social and historical backgrounds and author intention. High learning effect can acquire by actively learning. In short, it is important that encourage learning of the knowledge about pictures actively. It is necessary that children feel like interest to encourage learning of the knowledge about pictures actively. In a general art museum, comments on pictures are done through writing. Thus, we expect that this method cannot arouse the interest of the children in pictures, because children feel like boring. In brief, learning about the picture information is difficult. Therefore, we are developing an art-appreciation support system that will encourage learning of the knowledge about pictures actively by children feel like interest. This system uses that Interacting with Pictures to learning of the knowledge about pictures. To Interacting with Pictures, children have to utterance by themselves. We expect that will encourage learning of the knowledge about pictures actively by Interacting with Pictures. To more actively learning, children can choose who talking with by information that location and movement of the children. This system must be able to acquire real-time knowledge of the location, movement, and voice of the children. We utilize the Microsoft’s Kinect v2 sensor and its library, namely, Kinect for Windows SDK and Speech Platform SDK v11 for this purpose. By using these sensor and library, we can determine the location, movement, and voice of the children. As the first step of this system, we developed ukiyo-e game that use ukiyo-e to appreciation object. Ukiyo-e is a traditional Japanese graphic art that has influenced the western society. Therefore, we believe that the ukiyo-e game will be appreciated. In this study, we applied talking to pictures to learn information about the pictures because we believe that learning information about the pictures by talking to the pictures is more interesting than commenting on the pictures using only texts. However, we cannot confirm if talking to the pictures is more interesting than commenting using texts only. Thus, we evaluated through EDA measurement whether the user develops an interest in the pictures while talking to them using voice recognition or by commenting on the pictures using texts only. Hence, we evaluated that children have interest to picture while talking to them using voice recognition through EDA measurement. In addition, we quantitatively evaluate that enjoyed this game or not and learning information about the pictures for primary schoolchildren. In this paper, we summarize these two evaluation results.

Keywords: actively learning, art appreciation, EDA, Kinect V2

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2140 Defect Modes in Multilayered Piezoelectric Structures

Authors: D. G. Piliposyan

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Propagation of electro-elastic waves in a piezoelectric waveguide with finite stacks and a defect layer is studied using a modified transfer matrix method. The dispersion equation for a periodic structure consisting of unit cells made up from two piezoelectric materials with metallized interfaces is obtained. An analytical expression, for the transmission coefficient for a waveguide with finite stacks and a defect layer, that is found can be used to accurately detect and control the position of the passband within a stopband. The result can be instrumental in constructing a tunable waveguide made of layers of different or identical piezoelectric crystals and separated by metallized interfaces.

Keywords: piezoelectric layered structure, periodic phononic crystal, bandgap, bloch waves

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2139 The Analysis of Deceptive and Truthful Speech: A Computational Linguistic Based Method

Authors: Seham El Kareh, Miramar Etman

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Recently, detecting liars and extracting features which distinguish them from truth-tellers have been the focus of a wide range of disciplines. To the author’s best knowledge, most of the work has been done on facial expressions and body gestures but only few works have been done on the language used by both liars and truth-tellers. This paper sheds light on four axes. The first axis copes with building an audio corpus for deceptive and truthful speech for Egyptian Arabic speakers. The second axis focuses on examining the human perception of lies and proving our need for computational linguistic-based methods to extract features which characterize truthful and deceptive speech. The third axis is concerned with building a linguistic analysis program that could extract from the corpus the inter- and intra-linguistic cues for deceptive and truthful speech. The program built here is based on selected categories from the Linguistic Inquiry and Word Count program. Our results demonstrated that Egyptian Arabic speakers on one hand preferred to use first-person pronouns and present tense compared to the past tense when lying and their lies lacked of second-person pronouns, and on the other hand, when telling the truth, they preferred to use the verbs related to motion and the nouns related to time. The results also showed that there is a need for bigger data to prove the significance of words related to emotions and numbers.

Keywords: Egyptian Arabic corpus, computational analysis, deceptive features, forensic linguistics, human perception, truthful features

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2138 Targeted Photodynamic Therapy for Intraperitoneal Ovarian Cancer, A Way to Stimulate Anti-Tumoral Immune Response

Authors: Lea Boidin, Martha Baydoun, Bertrand Leroux, Olivier Morales, Samir Acherar, Celine Frochot, Nadira Delhem

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Ovarian cancer (OC) is one of the most defying diseases in gynecologic oncology. Even though surgery remains crucial in the therapy of patients with primary ovarian cancer, recurrent recidivism calls for the development of new therapy protocols to propose for patients dealing with this cancer. FRα is described as a tumor‐associated antigen in OC, where FRα expression is usually linked with more poorly differentiated, aggressive tumors. The Photodynamic treatment (PDT) available data have shown improvements in the uptake of small tumors and in the induction of a proper anti-tumoral immune response. In order to target specifically peritoneal metastatis, which overexpress FRα, a new-patented PS coupled with folic acid has been developed in our team. Herein we propose PDT using this new patented PS for PDT applied in an in vivo mice model. The efficacy of the treatment was evaluated in mice without and with PBMC reconstitution. Mice were divided into four groups: Non-Treated, PS, Light Only, and PDT Treated and subjected to illumination by laser set at 668nm with a duration of illumination of 45 minutes (or 1 min of illumination followed by 2 minutes of pause repeated 45 times). When mice were not reconstituted and after fractionized PDT protocol, a significant decrease in the tumor volume was noticed. An induction in the anti-tumoral cytokine IFNγ chaperoned this decrease while a subsequent inhibition in the cytokine TGFβ. Even more crucial, when mice were reconstituted and upon PDT, the fold of tumor decrease was even higher. An immune response was activated decoded with an increase in NK, CD3 +, LT helper and Cytotoxic T cells. Thereafter, an increase in the expression of the cytokines IFNγ and TNFα were noticed while an inhibition in TGFβ, IL8 and IL10 accompanied this immune response activation. Therefore, our work has shown for the first time that a fractionized PDT protocol using a folate-targeted PDT is effective for treatment of ovarian cancer. The interest in using PDT in this case, goes beyond the local induction of tumor apoptosis only, but can promote subsequent anti-tumor response. Most of the therapies currently used to treat ovarian cancer, have an uncooperative outcomes on the host immune response. The readiness of a tumor adjuvant treatment like PDT adequate in eliminating the tumor and in concert stimulating anti-tumor immunity would be weighty.

Keywords: folate receptor, ovarian cancer, photodynamic therapy, humanized mice model

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2137 A Phenomenological Expression for Self-Attractive Energy of Singlelayer Graphene Sheets

Authors: Bingjie Wu, C. Q. Ru

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The present work studies several reasonably expected candidate integral forms for self-attractive potential energy of a free monolayer graphene sheet. The admissibility of a specific integral form for ripple formation is verified, while all others most of the candidate integral forms are rejected based on the non-existence of stable periodic ripples. Based on the selected integral form of self-attractive potential energy, some mechanical behavior, including ripple formation and buckling, of a free monolayer grapheme sheet are discussed in details

Keywords: graphene, monolayer, ripples, van der Waals energy

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2136 Multilingualism in Medieval Romance: A French Case Study

Authors: Brindusa Grigoriu

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Inscribing itself in the field of the history of multilingual communities with a focus on the evolution of language didactics, our paper aims at providing a pragmatic-interactional approach on a corpus proposing to scholars of the international scientific community a relevant text of early modern European literature: the first romance in French, The Conte of Flore and Blanchefleur by Robert d’Orbigny (1150). The multicultural context described by the romance is one in which an Arab-speaking prince, Floire, and his Francophone protégée, Blanchefleur, learn Latin together at the court of Spain and become fluent enough to turn it into the language of their love. This learning process is made up of interactional patterns of affective relevance, in which the proficiency of the protagonists in the domain of emotive acts becomes a matter of linguistic and pragmatic emulation. From five to ten years old, the pupils are efficiently stimulated by their teacher of Latin, Gaidon – a Moorish scholar of the royal entourage – to cultivate their competencies of oral expression and reading comprehension (of Antiquity classics), while enjoying an ever greater freedom of written expression, including the composition of love poems in this second language of culture and emotional education. Another relevant parameter of the educational process at court is that Latin shares its prominent role as a language of culture with French, whose exemplary learner is the (Moorish) queen herself. Indeed, the adult 'First lady' strives to become a pupil benefitting from lifelong learning provided by a fortuitous slave-teacher with little training, her anonymous chambermaid and Blanchefleur’s mother, who, despite her status of a war trophy, enjoys her Majesty’s confidence as a cultural agent of change in linguistic and theological fields. Thus, the two foreign languages taught at Spains’s court, Latin and French – as opposed to Arabic -, suggest a spiritual authority allowing the mutual enrichment of intercultural pioneers of cross-linguistic communication, in the aftermath of religious wars. Durably, and significantly – if not everlastingly – the language of physical violence rooted in intra-cultural solipsism is replaced by two Romance languages which seem to embody, together and yet distinctly, the parlance of peace-making.

Keywords: multilingualism, history of European language learning, French and Latin learners, multicultural context of medieval romance

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2135 Effective Learning and Testing Methods in School-Aged Children

Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf, Kamal Kharrazi

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When we teach, we have two critical elements at our disposal to help students: learning styles as well as testing styles. There are many different ways in which educators can effectively teach their students; verbal learning and experience-based learning. Lecture as a form of verbal learning style is a traditional arrangement in which teachers are more active and share information verbally with students. In experienced-based learning as the process of through, students learn actively through hands-on learning materials and observing teachers or others. Meanwhile, standard testing or assessment is the way to determine progress toward proficiency. Teachers and instructors mainly use essay (requires written responses), multiple choice questions (includes the correct answer and several incorrect answers as distractors), or open-ended questions (respondents answers it with own words). The current study focused on exploring an effective teaching style and testing methods as the function of age over school ages. In the present study, totally 410 participants were selected randomly from four grades (2ⁿᵈ, 4ᵗʰ, 6ᵗʰ, and 8ᵗʰ). Each subject was tested individually in one session lasting around 50 minutes. In learning tasks, the participants were presented three different instructions for learning materials (learning by doing, learning by observing, and learning by listening). Then, they were tested via different standard assessments as free recall, cued recall, and recognition tasks. The results revealed that generally students remember more of what they do and what they observe than what they hear. The age effect was more pronounced in learning by doing than in learning by observing, and learning by listening, becoming progressively stronger in the free-recall, cued-recall, and recognition tasks. The findings of this study indicated that learning by doing and free recall task is more age sensitive, suggesting that both of them are more strategic and more affected by developmental differences. Pedagogically, these results denoted that learning by modeling and engagement in program activities have the special role for learning. Moreover, the findings indicated that the multiple-choice questions can produce the best performance for school-aged children but is less age-sensitive. By contrast, the essay as essay can produce the lowest performance but is more age-sensitive. It will be very helpful for educators to know that what types of learning styles and test methods are most effective for students in each school grade.

Keywords: experience-based learning, learning style, school-aged children, testing methods, verbal learning

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2134 Cognitive Translation and Conceptual Wine Tasting Metaphors: A Corpus-Based Research

Authors: Christine Demaecker

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Many researchers have underlined the importance of metaphors in specialised language. Their use of specific domains helps us understand the conceptualisations used to communicate new ideas or difficult topics. Within the wide area of specialised discourse, wine tasting is a very specific example because it is almost exclusively metaphoric. Wine tasting metaphors express various conceptualisations. They are not linguistic but rather conceptual, as defined by Lakoff & Johnson. They correspond to the linguistic expression of a mental projection from a well-known or more concrete source domain onto the target domain, which is the taste of wine. But unlike most specialised terminologies, the vocabulary is never clearly defined. When metaphorical terms are listed in dictionaries, their definitions remain vague, unclear, and circular. They cannot be replaced by literal linguistic expressions. This makes it impossible to transfer them into another language with the traditional linguistic translation methods. Qualitative research investigates whether wine tasting metaphors could rather be translated with the cognitive translation process, as well described by Nili Mandelblit (1995). The research is based on a corpus compiled from two high-profile wine guides; the Parker’s Wine Buyer’s Guide and its translation into French and the Guide Hachette des Vins and its translation into English. In this small corpus with a total of 68,826 words, 170 metaphoric expressions have been identified in the original English text and 180 in the original French text. They have been selected with the MIPVU Metaphor Identification Procedure developed at the Vrije Universiteit Amsterdam. The selection demonstrates that both languages use the same set of conceptualisations, which are often combined in wine tasting notes, creating conceptual integrations or blends. The comparison of expressions in the source and target texts also demonstrates the use of the cognitive translation approach. In accordance with the principle of relevance, the translation always uses target language conceptualisations, but compared to the original, the highlighting of the projection is often different. Also, when original metaphors are complex with a combination of conceptualisations, at least one element of the original metaphor underlies the target expression. This approach perfectly integrates into Lederer’s interpretative model of translation (2006). In this triangular model, the transfer of conceptualisation could be included at the level of ‘deverbalisation/reverbalisation’, the crucial stage of the model, where the extraction of meaning combines with the encyclopedic background to generate the target text.

Keywords: cognitive translation, conceptual integration, conceptual metaphor, interpretative model of translation, wine tasting metaphor

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2133 Constitutive Flo1p Expression on Strains Bearing Deletions in Genes Involved in Cell Wall Biogenesis

Authors: Lethukuthula Ngobese, Abin Gupthar, Patrick Govender

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The ability of yeast cell wall-derived mannoproteins (glycoproteins) to positively contribute to oenological properties has been a key factor that stimulates research initiatives into these industrially important glycoproteins. In addition, and from a fundamental research perspective, yeast cell wall glycoproteins are involved in a wide range of biological interactions. To date, and to the best of our knowledge, our understanding of the fine molecular structure of these mannoproteins is fairly limited. Generally, the amino acid sequences of their protein moieties have been established from structural and functional analysis of the genomic sequence of these yeasts whilst far less information is available on the glycosyl moieties of these mannoproteins. A novel strategy was devised in this study that entails the genetic engineering of yeast strains that over-express and release cell wall-associated glycoproteins into the liquid growth medium. To this end, the Flo1p mannoprotein was overexpressed in Saccharomyces cerevisiae laboratory strains bearing a specific deletion in KNR4 and GPI7 genes involved in cell wall biosynthesis that have been previously shown to extracellularly hyper-secrete cell wall-associated glycoproteins. A polymerase chain reaction (PCR) -based cloning strategy was employed to generate transgenic yeast strains in which the native cell wall FLO1 glycoprotein-encoding gene is brought under transcriptional control of the constitutive PGK1 promoter. The modified Helm’s flocculation assay was employed to assess flocculation intensities of a Flo1p over-expressing wild type and deletion mutant as an indirect measure of their abilities to release the desired mannoprotein. The flocculation intensities of the transformed strains were assessed and all the strains showed similar intensities (>98% flocculation). To assess if mannoproteins were released into the growth medium, the supernatant of each strain was subjected to the BCA protein assay and the transformed Δknr4 strain showed a considerable increase in protein levels. This study has the potential to produce mannoproteins in sufficient quantities that may be employed in future investigations to understand their molecular structures and mechanisms of interaction to the benefit of both fundamental and industrial applications.

Keywords: glycoproteins, genetic engineering, flocculation, over-expression

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2132 Nondestructive Prediction and Classification of Gel Strength in Ethanol-Treated Kudzu Starch Gels Using Near-Infrared Spectroscopy

Authors: John-Nelson Ekumah, Selorm Yao-Say Solomon Adade, Mingming Zhong, Yufan Sun, Qiufang Liang, Muhammad Safiullah Virk, Xorlali Nunekpeku, Nana Adwoa Nkuma Johnson, Bridget Ama Kwadzokpui, Xiaofeng Ren

Abstract:

Enhancing starch gel strength and stability is crucial. However, traditional gel property assessment methods are destructive, time-consuming and resource intensive. Thus, understanding ethanol treatment effects on kudzu starch gel strength and developing a rapid, nondestructive gel strength assessment method is essential for optimizing the treatment process and ensuring product quality consistency. This study investigated the effects of different ethanol concentrations on the microstructure of kudzu starch gels using a comprehensive microstructural analysis. We also developed a nondestructive method for predicting gel strength and classifying treatment levels using near-infrared (NIR) spectroscopy, and advanced data analytics. Scanning electron microscopy revealed progressive network densification and pore collapse with increasing ethanol concentration, correlating with enhanced mechanical properties. NIR spectroscopy, combined with various variable selection methods (CARS, GA, and UVE) and modeling algorithms (PLS, SVM, and ELM), was employed to develop predictive models for gel strength. The UVE-SVM model demonstrated exceptional performance, with the highest R² values (Rc = 0.9786, Rp = 0.9688) and lowest error rates (RMSEC = 6.1340, RMSEP = 6.0283). Pattern recognition algorithms (PCA, LDA, and KNN) successfully classified gels based on ethanol treatment levels, achieving near-perfect accuracy. This integrated approach provided a multiscale perspective on ethanol-induced starch gel modification, from molecular interactions to macroscopic properties. Our findings demonstrate the potential of NIR spectroscopy, coupled with advanced data analysis, as a powerful tool for rapid, nondestructive quality assessment in starch gel production. This study contributes significantly to the understanding of starch modification processes and opens new avenues for research and industrial applications in food science, pharmaceuticals, and biomaterials

Keywords: kudzu starch gel, near-infrared spectroscopy, gel strength prediction, support vector machine (SVM), pattern recognition algorithms, ethanol treatment

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2131 Leukocyte Transcriptome Analysis of Patients with Obesity-Related High Output Heart Failure

Authors: Samantha A. Cintron, Janet Pierce, Mihaela E. Sardiu, Diane Mahoney, Jill Peltzer, Bhanu Gupta, Qiuhua Shen

Abstract:

High output heart failure (HOHF) is characterized a high output state resulting from an underlying disease process and is commonly caused by obesity. As obesity levels increase, more individuals will be at risk for obesity-related HOHF. However, the underlying pathophysiologic mechanisms of obesity-related HOHF are not well understood and need further research. The aim of the study was to describe the differences in leukocyte transcriptomes of morbidly obese patients with HOHF and those with non-HOHF. In this cross-sectional study, the study team collected blood samples, demographics, and clinical data of six patients with morbid obesity and HOHF and six patients with morbid obesity and non-HOHF. The study team isolated the peripheral blood leukocyte RNA and applied stranded total RNA sequencing. Differential gene expression was calculated, and Ingenuity Pathway Analysis software was used to interpret the canonical pathways, functional changes, upstream regulators, and mechanistic and causal networks that were associated with the significantly different leukocyte transcriptomes. The study team identified 116 differentially expressed genes; 114 were upregulated, and 2 were downregulated in the HOHF group (Benjamini-Hochberg adjusted p-value ≤ 0.05 and log2(fold-change) of ±1). The differentially expressed genes were involved with cell proliferation, mitochondrial function, erythropoiesis, erythrocyte stability, and apoptosis. The top upregulated canonical pathways associated with differentially expressed genes were autophagy, adenosine monophosphate-activated protein kinase signaling, and senescence pathways. Upstream regulator GATA Binding Protein 1 (GATA1) and a network associated with nuclear factor kappa-light chain-enhancer of activated B cells (NF-kB) were also identified based on the different leukocyte transcriptomes of morbidly obese patients with HOHF and non-HOHF. To the author’s best knowledge, this is the first study that reported the differential gene expression in patients with obesity-related HOHF and demonstrated the unique pathophysiologic mechanisms underlying the disease. Further research is needed to determine the role of cellular function and maintenance, inflammation, and iron homeostasis in obesity-related HOHF.

Keywords: cardiac output, heart failure, obesity, transcriptomics

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2130 Optimization of Black-Litterman Model for Portfolio Assets Allocation

Authors: A. Hidalgo, A. Desportes, E. Bonin, A. Kadaoui, T. Bouaricha

Abstract:

Present paper is concerned with portfolio management with Black-Litterman (B-L) model. Considered stocks are exclusively limited to large companies stocks on US market. Results obtained by application of the model are presented. From analysis of collected Dow Jones stock data, remarkable explicit analytical expression of optimal B-L parameter τ, which scales dispersion of normal distribution of assets mean return, is proposed in terms of standard deviation of covariance matrix. Implementation has been developed in Matlab environment to split optimization in Markovitz sense from specific elements related to B-L representation.

Keywords: Black-Litterman, Markowitz, market data, portfolio manager opinion

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2129 Brinkman Flow Past an Impervious Spheroid under Stokesian Assumption

Authors: D. Satish Kumar, T. K. V. Iyengar

Abstract:

In this paper, we study the Brinkman flow, under Stokesian assumption, past an impervious prolate spheroid and obtain the expressions for the velocity and pressure fields in terms of Legendre functions, Associated Legendre functions, prolate radial and angular spheroidal wave functions. We further obtain an expression for the drag experienced by the spheroid and numerically study its variation with respect to the flow parameters and display the results through graphs.

Keywords: prolate spheoid, porous medium, stokesian assumption, brinkman model, velocity, pressure, drag

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2128 Automatic Intelligent Analysis of Malware Behaviour

Authors: Hermann Dornhackl, Konstantin Kadletz, Robert Luh, Paul Tavolato

Abstract:

In this paper we describe the use of formal methods to model malware behaviour. The modelling of harmful behaviour rests upon syntactic structures that represent malicious procedures inside malware. The malicious activities are modelled by a formal grammar, where API calls’ components are the terminals and the set of API calls used in combination to achieve a goal are designated non-terminals. The combination of different non-terminals in various ways and tiers make up the attack vectors that are used by harmful software. Based on these syntactic structures a parser can be generated which takes execution traces as input for pattern recognition.

Keywords: malware behaviour, modelling, parsing, search, pattern matching

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2127 Preventing the Septic Shock in an Oncological Patient with Febrile Neutropenia Submitted to Chemotherapy: The Nurse's Responsibility

Authors: Hugo Reis, Isabel Rabiais

Abstract:

The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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2126 The Digital Unconscious: Exploring AI Potential to Decode the Human Subconscious

Authors: Khader I. Alkhouri

Abstract:

This paper explores the emerging intersection of artificial intelligence (AI) and subconscious research, examining how AI technologies may revolutionize our understanding of the human mind. We review key AI techniques being applied to decode subconscious processes, discuss potential applications and breakthroughs, and consider the ethical implications and societal impacts of this rapidly advancing field. By leveraging AI's powerful pattern recognition and data analysis capabilities, researchers aim to gain unprecedented insights into implicit memory, unconscious bias, and automatic behaviors. While promising, this research also raises important questions about cognitive privacy and the responsible development of these technologies.

Keywords: artificial intelligence, machine learning, neuroethics, psychological research, subconscious

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2125 The Perspective of British Politicians on English Identity: Qualitative Study of Parliamentary Debates, Blogs, and Interviews

Authors: Victoria Crynes

Abstract:

The question of England’s role in Britain is increasingly relevant due to the ongoing rise in citizens identifying as English. Furthermore, the Brexit Referendum was predominantly supported by constituents identifying as English. Few politicians appear to comprehend how Englishness is politically manifested. Politics and the media have depicted English identity as a negative and extremist problem - an inaccurate representation that ignores the breadth of English identifying citizens. This environment prompts the question, 'How are British Politicians Addressing the Modern English Identity Question?' Parliamentary debates, political blogs, and interviews are synthesized to establish a more coherent understanding of the current political attitudes towards English identity, the perceived nature of English identity, and the political manifestation of English representation and governance. Analyzed parliamentary debates addressed the democratic structure of English governance through topics such as English votes for English laws, devolution, and the union. The blogs examined include party-based, multi-author style blogs, and independently authored blogs by politicians, which provide a dynamic and up-to-date representation of party and politician viewpoints. Lastly, fourteen semi-structured interviews of British politicians provide a nuanced perspective on how politicians conceptualize Englishness. Interviewee selection was based on three criteria: (i) Members of Parliament (MP) known for discussing English identity politics, (ii) MPs of strongly English identifying constituencies, (iii) MPs with minimal English identity affiliation. Analysis of parliamentary debates reveals the discussion of English representation has gained little momentum. Many politicians fail to comprehend who the English are, why they desire greater representation and believe that increased recognition of the English would disrupt the unity of the UK. These debates highlight the disconnect of parliament from the disenfranchised English towns. A failure to recognize the legitimacy of English identity politics generates an inability for solution-focused debates to occur. Political blogs demonstrate cross-party recognition of growing English disenfranchisement. The dissatisfaction with British politics derives from multiple factors, including economic decline, shifting community structures, and the delay of Brexit. The left-behind communities have seen little response from Westminster, which is often contrasted to the devolved and louder voices of the other UK nations. Many blogs recognize the need for a political response to the English and lament the lack of party-level initiatives. In comparison, interviews depict an array of local-level initiatives reconnecting MPs to community members. Local efforts include town trips to Westminster, multi-cultural cooking classes, and English language courses. These efforts begin to rebuild positive, local narratives, promote engagement across community sectors, and acknowledge the English voices. These interviewees called for large-scale, political action. Meanwhile, several interviewees denied the saliency of English identity. For them, the term held only extremist narratives. The multi-level analysis reveals continued uncertainty on Englishness within British politics, contrasted with increased recognition of its saliency by politicians. It is paramount that politicians increase discussions on English identity politics to avoid increased alienation of English citizens and to rebuild trust in the abilities of Westminster.

Keywords: British politics, contemporary identity politics and its impacts, English identity, English nationalism, identity politics

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2124 Subtitled Based-Approach for Learning Foreign Arabic Language

Authors: Elleuch Imen

Abstract:

In this paper, it propose a new approach for learning Arabic as a foreign language via audio-visual translation, particularly subtitling. The approach consists of developing video sequences appropriate to different levels of learning (from A1 to C2) containing conversations, quizzes, games and others. Each video aims to achieve a specific objective, such as the correct pronunciation of Arabic words, the correct syntactic structuring of Arabic sentences, the recognition of the morphological characteristics of terms and the semantic understanding of statements. The subtitled videos obtained can be incorporated into different Arabic second language learning tools such as Moocs, websites, platforms, etc.

Keywords: arabic foreign language, learning, audio-visuel translation, subtitled videos

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2123 Comparison Constructions in the Language of the Qur'an

Authors: Safiah Ahmed Yahya Madkhali

Abstract:

The aim of the present paper is to provide a characterization of the expression of comparison in the language of the Qur’an, the language of the Divine Book of the Muslim nation. It focuses on quantitative as well as qualitative comparisons. While works on comparison constructions in Arabic focus on a type(s) of the comparison construction and exclude another and investigate its behaviour in Standard Arabic, the paper aims to be inclusive of the varied instances that are scalar comparison constructions and describe its aspects in the language of the Qur’an. To the best of my knowledge, comparative constructions in the language of the Qur’an has not been tackled before and hence the characterization provided in the paper would be the contribution of the present work. The paper highlights the several rhetorical features of the construction as present in the different verses in the Qur’an which set them distinct from the ordinary use of the construction in the different verities of the Arabic language.

Keywords: comparison constructions, inequality, comparative, superlative, equality

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2122 Artificial Intelligence-Generated Previews of Hyaluronic Acid-Based Treatments

Authors: Ciro Cursio, Giulia Cursio, Pio Luigi Cursio, Luigi Cursio

Abstract:

Communication between practitioner and patient is of the utmost importance in aesthetic medicine: as of today, images of previous treatments are the most common tool used by doctors to describe and anticipate future results for their patients. However, using photos of other people often reduces the engagement of the prospective patient and is further limited by the number and quality of pictures available to the practitioner. Pre-existing work solves this issue in two ways: 3D scanning of the area with manual editing of the 3D model by the doctor or automatic prediction of the treatment by warping the image with hand-written parameters. The first approach requires the manual intervention of the doctor, while the second approach always generates results that aren’t always realistic. Thus, in one case, there is significant manual work required by the doctor, and in the other case, the prediction looks artificial. We propose an AI-based algorithm that autonomously generates a realistic prediction of treatment results. For the purpose of this study, we focus on hyaluronic acid treatments in the facial area. Our approach takes into account the individual characteristics of each face, and furthermore, the prediction system allows the patient to decide which area of the face she wants to modify. We show that the predictions generated by our system are realistic: first, the quality of the generated images is on par with real images; second, the prediction matches the actual results obtained after the treatment is completed. In conclusion, the proposed approach provides a valid tool for doctors to show patients what they will look like before deciding on the treatment.

Keywords: prediction, hyaluronic acid, treatment, artificial intelligence

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2121 Relationship between Pain, Social Support and Socio-Economic Indicators in Individuals with Spinal Cord Injury

Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

Abstract:

Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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2120 Improving Vocabulary and Listening Comprehension via Watching French Films without Subtitles: Positive Results

Authors: Yelena Mazour-Matusevich, Jean-Robert Ancheta

Abstract:

This study is based on more than fifteen years of experience of teaching a foreign language, in my case French, to the English-speaking students. It represents a qualitative research on foreign language learners’ reaction and their gains in terms of vocabulary and listening comprehension through repeatedly viewing foreign feature films with the original sountrack but without English subtitles. The initial idea emerged upon realization that the first challenge faced by my students when they find themselves in a francophone environment has been their lack of listening comprehension. Their inability to understand colloquial speech affects not only their academic performance, but their psychological health as well. To remedy this problem, I have designed and applied for many years my own teaching method based on one particular French film, exceptionally suited, for the reasons described in detail in the paper, for the intermediate-advanced level foreign language learners. This project, conducted together with my undergraduate assistant and mentoree J-R Ancheta, aims at showing how the paralinguistic features, such as characters’ facial expressions, settings, music, historical background, images provided before the actual viewing, etc., offer crucial support and enhance students’ listening comprehension. The study, based on students’ interviews, also offers special pedagogical techniques, such as ‘anticipatory’ vocabulary lists and exercises, drills, quizzes and composition topics that have proven to boost students’ performance. For this study, only the listening proficiency and vocabulary gains of the interviewed participants were assessed.

Keywords: comprehension, film, listening, subtitles, vocabulary

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2119 Retrospective Analysis of Facial Skin Cancer Patients Treated in the Department of Oral and Maxillofacial Surgery Kiel

Authors: Abdullah Saeidi, Aydin Gülses, Christan Flörke

Abstract:

Skin cancer of the face region is the most common type of malignancy and surgical excision is the preferred approach. However, the clinical long term results reported in the literature are still controversial. Objectives: To describe; 1. Demographical characteristics 2. Affected site, distribution and TNM classification regarding tumor type 3. Surgical aspects • Surgical removal: excision principles, safety margins, the need for secondary resection, primary reconstruction/ defect closure, anesthesia protocol, duration of hospital stay (if any) • Secondary intervention for defect closure/reconstruction: Flap technique, anesthesia protocol, duration of hospital stay (if any), postoperative wound management etc. 4. Tumor recurrences 5. Clinical outcomes 6. Studying the possible therapy approach throw Biostatistical relation and correlation between multiple Histological, diagnostics and clinical Faktors. following surgical ablation of the skin cancer of the head and neck region. Methods: Selection and statistical analysis of medical records of patients who had admitted to the Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Campus Kiel during the period of 2015-2019 will be retrospectively evaluated. Data will be collected via ORBIS Information-Management-System (ORBIS AG, Saarbrücken, Germany).

Keywords: non melanoma skin cancer, face skin cancer, skin reconstruction, non melanoma skin cancer recurrence, non melanoma skin cancer metastases

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