Search results for: American english

Authors: Claudia Cabezas-Zabala, Jairo Lindarte-Artunduaga, Carlos Mario Zuluaga-Dominguez

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Amaranth is an emerging pseudocereal rich in such essential nutrients as protein and dietary fiber, which was employed as an ingredient in the formulation of crackers to evaluate the rheological performance and sensory acceptability of the obtained food. A completely randomized factorial design was used with two factors: (A) ratio of wheat and amaranth flour used in the preparation of the dough, in proportion 90:10 and 80:20 (% w/w) and (B) two levels of inulin addition of 8.4% and 16.7 %, having two control doughs made from amaranth and wheat flour, respectively. Initially, the functional properties of the formulations mentioned were measured, showing no significant differences in the water absorption capacity (WAC) and swelling power (SP), having mean values between 1.66 and 1.81 g/g for WAC and between 1.75 and 1.86 g/g for SP, respectively. The amaranth flour had the highest water holding capacity (WHR) of 8.41 ± 0.15 g/g and emulsifying activity (EA) of 74.63 ± 1.89 g/g. Moreover, the rheological behavior, measured through the use of farinograph, extensograph, Mixolab, and falling index, showed that the formulation containing 20% of amaranth flour and 7.16% of inulin had a rheological behavior similar to the control produced exclusively with wheat flour, being the former, the one selected for the preparation of crackers. For this formulation, the farinograph showed a mixing tolerance index of 11 UB, indicating a strong and cohesive dough; likewise, the Mixolab showed dough reaches stability at 6.47 min, indicating a good resistance to mixing. On the other hand, the extensograph exhibited a dough resistance of 637 UB, as well as extensibility of 13.4 mm, which corresponds to a strong dough capable of resisting the laminate. Finally, the falling index was 318 s, which indicates the crumb will retain enough air to enhance the crispness of a characteristic cracker. Finally, a sensory consumer test did not show significant differences in the evaluation of aroma between the control and the selected formulation, while this latter had a significantly lower rating in flavor. However, a purchase intention of 70 % was observed among the population surveyed. The results obtained in this work give perspectives for the industrial use of amaranth in baked goods. Additionally, amaranth has been a product typically linked to indigenous populations in the Andean South American countries; therefore, the search for diversification and alternatives of use for this pseudocereal has an impact on the social and economic conditions of such communities. The technological versatility and nutritional quality of amaranth is an advantage for consumers, favoring the consumption of healthy products with important contributions of dietary fiber and protein.

Keywords: amaranth, crackers, rheology, pseudocereals, kneaded products

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Authors: Martin Wiseman, Rachel Thompson, Panagiota Mitrou, Kate Allen

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Since 1997 World Cancer Research Fund (WCRF) International and the American Institute for Cancer Research (AICR) have been at the forefront of synthesising and interpreting the accumulated scientific literature on the link between diet, nutrition, physical activity and cancer, and deriving evidence-based Cancer Prevention Recommendations. The 2007 WCRF/AICR 2nd Expert Report was a landmark in the analysis of evidence linking diet, body weight and physical activity to cancer and led to the establishment of the Continuous Update Project (CUP). In 2018, as part of the CUP, WCRF/AICR will publish a new synthesis of the current evidence and update the Cancer Prevention Recommendations. This will ensure that everyone - from policymakers and health professionals to members of the public - has access to the most up-to-date information on how to reduce the risk of developing cancer. Overweight and obesity play a significant role in cancer risk, and rates of both are increasing in many parts of the world. This session will give an overview of new evidence relating obesity to cancer since the 2007 report. For example, since the 2007 Report, the number of cancers for which obesity is judged to be a contributory cause has increased from seven to eleven. The session will also shed light on the well-established mechanisms underpinning obesity and cancer links. Additionally, the session will provide an overview of diet and physical activity related factors that promote positive energy imbalance, leading to overweight and obesity. Finally, the session will highlight how policy can be used to address overweight and obesity at a population level, using WCRF International’s NOURISHING Framework. NOURISHING formalises a comprehensive package of policies to promote healthy diets and reduce obesity and non-communicable diseases; it is a tool for policymakers to identify where action is needed and assess if an approach is sufficiently comprehensive. The framework brings together ten policy areas across three domains: food environment, food system, and behaviour change communication. The framework is accompanied by a regularly updated database providing an extensive overview of implemented government policy actions from around the world. In conclusion, the session will provide an overview of obesity and cancer, highlighting the links seen in the epidemiology and exploring the mechanisms underpinning these, as well as the influences that help determine overweight and obesity. Finally, the session will illustrate policy approaches that can be taken to reduce overweight and obesity worldwide.

Keywords: overweight, obesity, nutrition, cancer, mechanisms, policy

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Authors: Wen Hsin Hsu, Pin Lin

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Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.

Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol

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Authors: L. Sun, C. Hardacre, A. Garforth, N. Zhang

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Higher Education (HE) degrees in the UK are attractive for international students. The recognized reputation of the HE and the world-leading researchers in some areas in the UK imply that the HE degree from the UK might be a passport to a successful career for abroad students. However, it is a challenge to inspire outstanding students applying for the universities in the UK. The incentives should be country-specific for undergraduates and postgraduates. The potential obstacles to stop students applying for the study in the UK mainly lie in these aspects: different HE systems between the UK and other countries, such as China; less information for the application procedures; worries for the study in English for those non-native speakers; and expensive international tuition fees. The hybrid incentives have been proposed by the efforts from the institutions, stuffs, and students themselves. For example, excellent students from top universities would join us based on the abroad exchange programs or ‘2+2 programme’ with discount tuition. They are potential PhD candidates in the further study in the UK. Diversity promotions are implemented to share information and answer queries for potential students and their guardians. Face to face presentations, workshops, and seminars deliver chances for students to admire teaching and learning in the UK, and give students direct answers for their confusions. WeChat official account and Twitter as the online information platform are set up to post messages of recruitment, the guidance for the application procedures, and international collaboration in teaching and research as well. Students who are studying in the UK and the alumni would share their experiences in the study and lives in the UK and their careers after obtaining the HE degree would play as a positive stimulus to our potential students. Short term modules in the UK with exchangeable credits in summer holidays would give abroad students firsthand experiences of the study in the reputable schools with excellent academics, different cultures and the network with international students. Successful cases at the University of Manchester illustrated the effectiveness of these presented methodologies.

Keywords: abroad students, degree study, high education, hybrid incentives

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Authors: Kever Bruno Paradelo Gomes, Rosana Carvalho Cristo Martins

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Payment for Environmental Services (PSA) has been a strategy used since the late 1990s by Latin American countries to finance environmental conservation. Payment for Environmental Services has been absorbing a growing amount of time in the discussions around environmentally sustainable development strategies in the world. In Brazil, this theme has permeated the discussions since the publication of the new Forest Code. The objective of this work was to verify the perception of the resident farmers in the region of Ponte Alta, Gama, Federal District, Brazil, on environmental legislation and Payments for Environmental Services. The work was carried out in 99 rural properties of the family farmers of the Rural Nucleus Ponte Alta, Administrative Region of Gama, in the city of Brasília, Federal District, Brazil. The present research is characterized methodologically as a quantitative, exploratory, and descriptive nature. The data treatment was performed through descriptive statistical analysis and hypothesis testing. The perceptions about environmental legislation in the rural area of Ponte Alta, Gama, DF respondents were positive. Although most of the family farmers interviewed have some knowledge about environmental legislation, it is perceived that in practice, the environmental adequacy of property is ineffective given the current situation of sustainable rural development; there is an abyss between what is envisaged by legislation and reality in the field. Thus, as in the reports of other researchers, it is verified that the majority of respondents are not aware of PSA (62.62%). Among those interviewed who were aware of the subject, two learned through the course, three through the university, two through TV and five through other people. The planting of native forest species on the rural property was the most informed practice by farmers if they received some Environmental Service Payment (PSA). Reflections on the environment allow us to infer that the effectiveness and fulfillment of the incentives and rewards in the scope of public policies to encourage the maintenance of environmental services, already existing in all spheres of government, are of great relevance to the process of environmental sustainability of rural properties. The relevance of the present research is an important tool to promote the discussion and formulation of public policies focused on sustainable rural development, especially on payments for environmental services; it is a space of great interest for the strengthening of the social group dedicated to production. Public policies that are efficient and accessible to the small rural producers become decisive elements for the promotion of changes in behavior in the field, be it economic, social, or environmental.

Keywords: forest code, public policy, rural development, sustainable agriculture

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Authors: Esraa Elaraby, Dania Abu Zahra, Ghidaa Maswadah, Osama Amira, Mohamed Alshoura, Nihar Dash

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Background: Human being uses salon for a variety of purposes, from trimming of hair and shaving to a range of beauty treatments such as manicure and pedicure. Salon activities involve use of several instruments including scissors, scalpels and razors, materials such as soaps, solutions, creams and gels on human skin and body. Besides, salon customers also use chair, bed and many other common shared utensils and appliances. These salons related activities create a suitable environment for the transmission of several diseases and pathogens including hepatitis B and C, scabies, tuberculosis, staphylococcus and MRSA etc. The transmission of these pathogens can be prevented by maintenance of adequate hygiene and standard preventive measures. Aim: To assess the customer’s level of knowledge about salon-acquired infections and practices taken to prevent their transmission. Methods: A cross-sectional study was conducted among 500 participants across the Emirates. Moreover, self-administered questionnaires (in English and Arabic) were distributed through convenience sampling methods between February and April 2017. Results: The study included 500 participants of which 250 were females. The mean age of the study population was 33 years (SD=4.77). The participants were from several nationalities including 325 Arabs (Non-GCC) (66.2%), 108 Non-Arabs (22%), and 59 Arabs (GCC) (11.8%). The majority of the participants 421 (84.4%) had required knowledge about salon-associated infections with a mean knowledge score of 6/10 (60%). However, when it comes down to preventive practices, only 73 of the 500 participants (14.6%) did carry their own equipment. Thus, there was insufficient correlation between the level of knowledge and preventive practices (p=0.139) of salon-associated infections. Conclusion: People’s knowledge about the salon-associated infections among UAE residents was good, but only a small number practically took the required preventative measures towards this issue. Therefore, a public awareness program is recommended to enhance the deficiencies in knowledge and practices to prevent salon-acquired infections among the users. Up to our knowledge, this is the first study of this kind in the UAE targeting the salon customers about this important issue.

Keywords: awareness, knowledge, practices, salon-associated infections

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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Authors: Salamah Ansari

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In absence of a comprehensive international legal regime for sovereign debt restructuring, majority of the complications arising from sovereign debt restructuring are frequently left to the uncertain market forces. The resort to market forces for sovereign debt restructuring has led to a phenomenal increase in litigations targeting assets of defaulting sovereign nations, internationally across jurisdictions with the first major wave of lawsuits against sovereigns in the 1980s with the Latin American crisis. Recent experiences substantiate that majority of obstacles faced during sovereign debt restructuring process are caused by inefficient creditor coordination and collective action problems. Collective action problems manifest as grab race, rush to exits, holdouts, the free rider problem and the rush to the courthouse. On defaulting, for a nation to successfully restructure its debt, all the creditors involved must accept some reduction in the value of their claims. As a single holdout creditor has the potential to undermine the restructuring process, hold-out creditors are snowballing with the increasing probability of earning high returns through litigations. This necessitates a mechanism to avoid holdout litigations and reinforce collective action on the part of the creditor. This can be done either through a statutory reform or through market-based contractual approach. In absence of an international sovereign bankruptcy regime, the impetus is mostly on inclusion of collective action clauses in debt contracts. The preference to contractual mechanisms vis- a vis a statutory approach can be explained with numerous reasons, but that's only part of the puzzle in trying to understand the economics of the underlying system. The contractual approach proposals advocate the inclusion of certain clauses in the debt contract for an orderly debt restructuring. These include clauses such as majority voting clauses, sharing clauses, non- acceleration clauses, initiation clauses, aggregation clauses, temporary stay on litigation clauses, priority financing clauses, and complete revelation of relevant information. However, voluntary market based contractual approach to debt workouts has its own complexities. It is a herculean task to enshrine clauses in debt contracts that are detailed enough to create an orderly debt restructuring mechanism while remaining attractive enough for creditors. Introduction of collective action clauses into debt contracts can reduce the barriers in efficient debt restructuring and also have the potential to improve the terms on which sovereigns are able to borrow. However, it should be borne in mind that such clauses are not a panacea to the huge institutional inadequacy that persists and may lead to worse restructuring outcomes.

Keywords: sovereign debt restructuring, collective action clauses, hold out creditors, litigations

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Authors: Gunnar Oskarsson, Irena Georgsdottir

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Tourism has been growing incredibly fast during the past years, including the cruise industry, which is gaining increasing popularity among various groups of travelers. It is a challenging task for companies serving cruise ship passengers with local products and services at the point of destination to reach them in due time with information about their offerings, as well learning how to adapt their offerings and messages to the type of customers arriving on each particular occasion. Although some research has been conducted in this sphere, there is still limited knowledge about many specifics within this sector of the tourist industry. The objective of this research is to examine one of these, with the main goal of studying the segmentation of cruise passengers and to learn about marketing practices directed towards them. A qualitative research method, based on in-depth interviews, was used, as this provides an opportunity to gain insight into the participants’ perspectives. Interviews were conducted with 10 respondents from different companies in the tourist industry in Iceland, who interact with cruise passengers on a regular basis in their work environment. The main objective was to gain an understanding of what distinguishes different customer groups, or segments, in this industry, and of the marketing approaches directed towards them. The main findings reveal that participants note the strongest difference between cruise passengers of different nationalities, passengers coming on different ships (size and type), and passengers arriving at different times of the year. A drastic difference was noticed between nationalities in four main segments, American, British, Other European, and Asian customers, although some of these segments could be divided into even further sub-segments. Other important differencing factors were size and type of ships, quality or number of stars on the ship, and travelling time of the year. Companies serving cruise ship passengers, as well as the customers themselves, could benefit if the offerings of services were designed specifically for particular segments within the industry. Concerning marketing towards cruise passengers, the results indicate that it is carried out almost exclusively through the Internet using; a reliable website and, search engine optimization. Marketing is also by word-of-mouth. This research can assist practitioners by offering a deeper understanding of the approaches that may be effective in marketing local products and services to cruise ship passengers, based on their segmentation and by identifying effective ways to reach them. The research, furthermore, provides a valuable contribution to marketing knowledge for the benefit of an increasingly important market segment in a fast growing tourist industry.

Keywords: capabilities, global integration, internationalisation, SMEs

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Authors: Mukhtar Raban

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Nelson Mandela University subscribes to a humanizing pedagogy (HP), as housed under broader critical pedagogy, that underpins and informs learning and teaching activities at the institution. The investigation sought to explore the implications of humanizing and critical pedagogical considerations for a technology-enhanced language learning (TELL) environment in a university course. The paper inquires into the design of a learning resource in an online learning environment of an English communication module, that applied HP principles. With an objective of creating agentive spaces for foregrounding identity, student voice, critical self-reflection, and recognition of others’ humanity; a flexible and open 'My Presence' feature was added to the TELL environment that allowed students and lecturers to share elements of their backgrounds in a ‘mutually vulnerable’ manner as a way of establishing digital identity and a more ‘human’ presence in the online language learning encounter, serving as a catalyst for the recognition of the ‘other’. Following a qualitative research design, the study adopted an auto-ethnographic approach, complementing the critical inquiry nature embedded into the activity’s practices. The study’s findings provide critical reflections and deductions on the possibilities of leveraging digital human expression within a humanizing pedagogical framework to advance the realization of HP-adoption in language learning and teaching encounters. It was found that the consideration of humanizing pedagogical principles in the design of online learning was more effective when the critical outcomes were explicated to students and lecturers prior to the completion of the activities. The integration of humanizing pedagogy also led to a contextual advancement of ‘affective’ language learning. Upon critical reflection and analysis, student identity and agency can flourish in a technology-enhanced learning environment when humanizing, and critical pedagogy influences the learning design.

Keywords: critical reflection, humanizing pedagogy, student identity, technology-enhanced language learning

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Authors: S. Dodd

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This presentation examines the gender gap in leadership positions at colleges and universities within the United States. Despite the fact that women now outnumber men in earning doctorate degrees, women continue to hold far fewer positions of educational leadership, and still, earn less money than men do at every level. Considering the lack of female representation in positions of leadership, there are clearly outside variables preventing women from attaining these positions, despite their educational attainment. Following this study, the American Council on Education (ACE) set a goal to achieve an equal percentage of females holding college presidency positions by the year 2030. This goal is particularly ambitious, especially when considering the gender disparity at all ranks in higher education. Men still hold nearly 70% of all full professorships at degree-granting institutions. Even when women are equally represented in numbers, men typically hold a higher rank and are more likely to be tenured. Across all four-year colleges and universities in the United States, men earn more money than women at every rank and in every discipline. There are over twice as many men than women represented on governing boards, who help formed and uphold campus policies. The fact that the low percentage of female presidents has remained static for many years deepens the challenge for the ACE. Although emphasizing the need to create greater opportunities for women in educational administration is admirable, it is difficult to simplify the social forces that create and uphold the status quo of male leadership. When aiming to ensure 'women' hold 50% of all college presidency positions, it is important to consider how the intersections of race, social class, and other factors also correlate with lower job status. This presentation explores how gendered notions of leadership begin in a child’s early years and are carried into future careers, and how these conceptualizations impact the creation and upholding of educational policies at every academic level. Current research that emphasizes the importance establishing a bottom-up approach to a gender equity infrastructure for children early in their educational careers will be discussed. A top-down approach starting with female college presidents is incomplete and insufficient if the mindsets of the youth who will one day be entering those institutions of higher education are not also taken into consideration. Although ACE has established this lofty goal for female college presidencies by the year 2030, a road map for this will ensue, has not yet been provided. The talent pool of women who are educated and experienced for such positions is vast, but acknowledging the social barriers existing for women in these positions will be crucial to making the changes necessary for these leadership opportunities to be long lasting and successful.

Keywords: equity, higher education, leadership, women

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Authors: Paul Lam, Kevin Wong, Chi Him Chan

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Constant practicing and accurate, immediate feedback are the keys to improving students’ speaking skills. However, traditional oral examination often fails to provide such opportunities to students. The traditional, face-to-face oral assessment is often time consuming – attending the oral needs of one student often leads to the negligence of others. Hence, teachers can only provide limited opportunities and feedback to students. Moreover, students’ incentive to practice is also reduced by their anxiety and shyness in speaking the new language. A mobile app was developed to use artificial intelligence (AI) to provide immediate feedback to students’ speaking performance as an attempt to solve the above-mentioned problems. Firstly, it was thought that online exercises would greatly increase the learning opportunities of students as they can now practice more without the needs of teachers’ presence. Secondly, the automatic feedback provided by the AI would enhance students’ motivation to practice as there is an instant evaluation of their performance. Lastly, students should feel less anxious and shy compared to directly practicing oral in front of teachers. Technically, the program made use of speech-to-text functions to generate feedback to students. To be specific, the software analyzes students’ oral input through certain speech-to-text AI engine and then cleans up the results further to the point that can be compared with the targeted text. The mobile app has invited English teachers for the pilot use and asked for their feedback. Preliminary trials indicated that the approach has limitations. Many of the users’ pronunciation were automatically corrected by the speech recognition function as wise guessing is already integrated into many of such systems. Nevertheless, teachers have confidence that the app can be further improved for accuracy. It has the potential to significantly improve oral drilling by giving students more chances to practice. Moreover, they believe that the success of this mobile app confirms the potential to extend the AI-assisted assessment to other language skills, such as writing, reading, and listening.

Keywords: artificial Intelligence, mobile learning, oral assessment, oral practice, speech-to-text function

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Authors: Tatsuhiko Aizawa, Hiroshi Morita

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The tool steels such as SKD11 and SKH51 have been utilized as punch and die substrates for cold stamping, forging, and fine blanking processes. The heat-treated SKD11 punches with the hardness of 700 HV wrought well in the stamping of SPCC, normal steel plates, and non-ferrous alloy such as a brass sheet. However, they suffered from severe damage in the fine blanking process of smaller holes than 1.5 mm in diameter. Under the high aspect ratio of punch length to diameter, an elastoplastic bucking of slender punches occurred on the production line. The heat-treated punches had a risk of chipping at their edges. To be free from those damages, the blanking punch must have sufficient rigidity and strength at the same time. In the present paper, the small-hole blanking punch with a dual toughness structure was proposed to provide a solution to this engineering issue in production. The low-temperature plasma nitriding process was utilized to form the nitrogen supersaturated thick layer into the original SKD11 punch. Through the plasma nitriding at 673 K for 14.4 ks, the nitrogen supersaturated layer, with the thickness of 50 μm and without nitride precipitates, was formed as a high nitrogen steel (HNS) layer surrounding the original SKD11 punch. In this two-zone structured SKD11 punch, the surface hardness increased from 700 HV for the heat-treated SKD11 to 1400 HV. This outer high nitrogen SKD11 (HN-SKD11) layer had a homogeneous nitrogen solute depth profile with a nitrogen solute content plateau of 4 mass% till the border between the outer HN-SKD11 layer and the original SKD11 matrix. When stamping the brass sheet with the thickness of 1 mm by using this dually toughened SKD11 punch, the punch life was extended from 500 K shots to 10000 K shots to attain a much more stable production line to yield the brass American snaps. Furthermore, with the aid of the masking technique, the punch side surface layer with the thickness of 50 μm was modified by this high nitrogen super-saturation process to have a stripe structure where the un-nitrided SKD11 and the HN-SKD11 layers were alternatively aligned from the punch head to the punch bottom. This flexible structuring promoted the mechanical integrity of total rigidity and toughness as a punch with an extremely small diameter.

Keywords: high nitrogen supersaturation, semi-dry cold stamping, solid solution hardening, tool steel dies, low temperature nitriding, dual toughness structure, extremely small diameter punch

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Authors: Catherine Harrison

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Faced with arrest, imprisonment and the denazification process in 1945, Tübingen University’s Professor of Theology, Gerhard Kittel, refused to abandon the “Christian” antisemitism which he had first expounded in his Die Judenfrage [The Jewish Question] (1933 and 1934). At the heart of this paper is a critical engagement with Die Judenfrage, the first in English. Putting Die Judenfrage into dialogue with Kittel’s 1946, Meine Verteidigung [My Defence] (1945-6) exposes the remarkable consistency of Kittel’s idiosyncratic but closely argued Christian theology of antisemitism. Girdling his career as a foremost theologian, antisemite and enthusiastic supporter of Hitler and the NSDAP, the consistency between Die Judenfrage and Meine Verteidigung attests Kittel’s consistent and authentic, intellectual position. In both texts, he claims to be advancing Christian, as opposed to “vulgar” or racial, antisemitism. Yet, in the thirteen years which divide them, Kittel had mediated contact with Nazi illuminati Rudolph Hess, Alfred Rosenberg, Winnifred Wagner, Josef Goebbels and Baldur von Schirach, through his publications in various antisemitic journals. The paper argues: Die Judenfrage, as both a text and as a theme, is axiomatic to Kittel’s defence statement; and that Die Judenfrage constitutes the template of Kittel’s arcane, personal “Christian” antisemitism of which Meine Verteidigung is a faithful impression. Both are constructed on the same theologically chimeric and abstruse hypotheses regarding Volk, Spätjudentum [late Judaism] and Heilgeschichte [salvation history]. Problematising these and other definitional vagaries that make up Kittel’s “Christian” antisemitism highlight the remarkable theoretical consistency between Die Judenfrage and Meine Verteidigung. It is concluded that a deadly synergy of Nazi racial antisemitism and the New Testament antisemitism shaped Kittel’s judgement to the degree that, despite the slipstream of concentration camp footage which was shaking the foundations of post-war German academia, Meine Verteidigung is a simple restatement of the antisemitsm conveyed in Die Judenfrage.

Keywords: Gerhard Kittel, Third Reich theology, the Jewish Question, Nazi antisemitism

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Authors: Shaista Maseeh

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English Literature from the beginning itself has had psychological, social and environment concerns. Virgil, Shakespeare, John Milton, William Wordsworth to the most current Robert Hass have shown and proved their environmental and ecological interests as well as distress related to its loss. Pastoral literature is also one such genre that links literature with environment. Thanks to the contemporary literary theories that they successfully are relating Literature formally to the subjects other than written text. One of such literary theory is 'Ecocriticism.' It stands under the umbrella of the Economics term, Sustainable Development,' or it can also be understood as an ecological extension of it. Ecocriticism helps the reader to study the dynamic relation between literature and our degrading environment. It draws attention towards the ravaged condition of nature and animals, that how nature is exploited by human beings for their own benefit leaving nature at a repairable loss. For instance, deforestation is reducing the size of forest every year, injuring permanently flora, fauna and also the habitat of animals. This paper will study the ecological and environmental concerns in the latest novel by Pakistani British writer Kamila Shamsie, A God in every Stone (2014). The book is not only a literary masterpiece in elegant prose, but also a novel posing a lot of questions about 'nature and environment' in general and 'animals' in particular. It gives the glimpses of the interesting history of Temple of Zeus in Greece and Ancient Caria, and covers many episodes of history the Indian freedom struggle. In course of novel's narrative Kamila Shamsie poses disturbing question about environmental abuse, about how human beings are more 'beasts' than so call beasts, poor animals. She also glorifies the simplicity of past. The novel has enough instances to prove Shamsie's positive stand on saving the earth that is being more abused than used by human beings. This paper will provide an ecocritical approach to study A God in Every Stone (2014).

Keywords: animals, ecocriticism, environment, nature

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Authors: Sriranjani Srinivasan

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To appreciate Indian art and architecture by studying it in India alone will only lead to partial understanding of the whole story and the variety of the statement has been amply proved by subsequent decades of patient research. The results of the work of the Archaeological Survey of India forms only one half of the picture, the other half emerges with the studies of the archaeology and art of the Far East that progressed almost simultaneously under the Archaeological Survey of the Dutch East Indies, the École française d'Extrême-Orient (EFEO), or French School of Asian Studies, and allied institutions. The conclusions arrived at have only rendered the assertion that India produced her ultimate master pieces only through foreign influences and in foreign lands (the South-Eastern peninsular and archipelagic regions) almost axiomatic. Angkor in Cambodia and Borobudur in Java, undoubtedly the two greatest architectural marvels of Indian genius, for in content and spirit these (and other monuments of varying magnitudes), are purely Indian, would well illustrate the statement mentioned earlier. Stimulated research followed the discoveries and among the many studies and publications of such pioneers like Coedes, Parmentier, Coomaraswamy and many others in Dutch, French and English made growing contributions to the subject. This paper will discuss in detail the impact of India on the architecture of South East Asia by detailed comparison of architectural styles, elements, and construction materials of a few specific architectural master pieces, in both India and South East Asian countries. It will also analyze the reasoning behind the influence of India on South East Asian countries in spite of them being exposed to the equally culturally rich and civilized kingdoms of China. The intention of this paper is to understand that, conquest by war is not always the only reason for architectural influences and impacts.

Keywords: architectural influence, Buddhist architecture, Indian architecture, Southeast Asian architecture

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Authors: Archana Rao R., Deepak P., Chayashree P. D., Darshan H. S.

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Cognitive abilities in bilinguals have been widely studied over the last few decades. Bilingualism has been found to extensively facilitate the ability to store and manipulate information in Working Memory (WM). The mechanism of WM includes primary memory, attentional control, and secondary memory, each of which makes a contribution to WM. Many researches have been done in an attempt to measure WM capabilities through both verbal (phonological) and nonverbal tasks (visuospatial). Since there is a lot of speculations regarding the relationship between WM and bilingualism, further investigation is required to understand the nature of WM in bilinguals, i.e., with respect to sequential and simultaneous bilinguals. Hence the present study aimed to highlight the verbal working memory abilities in sequential and simultaneous bilinguals with respect to the processing and recall abilities of nouns and verbs. Two groups of bilinguals aged between 18-30 years were considered for the study. Group 1 consisted of 20 (10 males and 10 females) sequential bilinguals who had acquired L1 (Kannada) before the age of 3 and had exposure to L2 (English) for a period of 8-10 years. Group 2 consisted of 20 (10 males and 10 females) simultaneous bilinguals who have acquired both L1 and L2 before the age of 3. Working memory abilities were assessed using two tasks, and a set of stimuli which was presented in gradation of complexity and the stimuli was inclusive of frequent and infrequent nouns and verbs. The tasks involved the participants to judge the correctness of the sentence and simultaneously remember the last word of each sentence and the participants are instructed to recall the words at the end of each set. The results indicated no significant difference between sequential and simultaneous bilinguals in processing the nouns and verbs, and this could be attributed to the proficiency level of the participants in L1 and the alike cognitive abilities between the groups. And recall of nouns was better compared to verbs, maybe because of the complex argument structure involved in verbs. Similarly, authors found a frequency of occurrence of nouns and verbs also had an effect on WM abilities. The difference was also found across gradation due to the load imposed on the central executive function and phonological loop.

Keywords: bilinguals, nouns, verbs, working memory

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Authors: Eunice Gan Ghee Wu, Marcus Goh Tian Xi, Alicia Chua Si Wen, Helen Bound, Lee Liang Ying, Albert Lee

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The Map of Dialogical Inquiry provides a conceptual basis of learning processes. According to the Map, dialogical inquiry motivates complex thinking, dialogue, reflection, and learner agency. For instance, classrooms that incorporated dialogical inquiry enabled learners to construct more meaning in their learning, to engage in self-reflection, and to challenge their ideas with different perspectives. While the Map contributes to the psychology of learning, its qualitative approach makes it hard to track and compare learning processes over time for both teachers and learners. Qualitative approach typically relies on open-ended responses, which can be time-consuming and resource-intensive. With these concerns, the present research aimed to develop and validate a quantifiable measure for the Map. Specifically, the Map of Dialogical Inquiry reflects the eight different learning processes and perspectives employed during a learner’s experience. With a focus on interpersonal and emotional learning processes, the purpose of the present study is to construct and validate a scale to measure the “Relating” aspect of learning. According to the Map, the Relating aspect of learning contains four conceptual components: using intuition and empathy, seeking personal meaning, building relationships and meaning with others, and likes stories and metaphors. All components have been shown to benefit learning in past research. This research began with a literature review with the goal of identifying relevant scales in the literature. These scales were used as a basis for item development, guided by the four conceptual dimensions in the “Relating” aspect of learning, resulting in a pool of 47 preliminary items. Then, all items were administered to 200 American participants via an online survey along with other scales of learning. Dimensionality, reliability, and validity of the “Relating” scale was assessed. Data were submitted to a confirmatory factor analysis (CFA), revealing four distinct components and items. Items with lower factor loadings were removed in an iterative manner, resulting in 34 items in the final scale. CFA also revealed that the “Relating” scale was a four-factor model, following its four distinct components as described in the Map of Dialogical Inquiry. In sum, this research was able to develop a quantitative scale for the “Relating” aspect of the Map of Dialogical Inquiry. By representing learning as numbers, users, such as educators and learners, can better track, evaluate, and compare learning processes over time in an efficient manner. More broadly, this scale may also be used as a learning tool in lifelong learning.

Keywords: lifelong learning, scale development, dialogical inquiry, relating, social and emotional learning, socio-affective intuition, empathy, narrative identity, perspective taking, self-disclosure

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Authors: Jou-An Chung

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The purpose of this study is to investigate the verb bias of the Mandarin verbs in children’s reading materials and provide the criteria for categorization. Verb bias varies cross-linguistically. As Mandarin and English are typological different, this study hopes to shed light on Mandarin verb bias with the use of corpus and provide thorough and detailed criteria for analysis. Moreover, this study focuses on children’s reading materials since it is a significant issue in understanding children’s sentence processing. Therefore, investigating verb bias of Mandarin verbs in children’s reading materials is also an important issue and can provide further insights into children’s sentence processing. The small corpus is built up for this study. The corpus consists of the collection of school textbooks and Mandarin Daily News for children. The files are then segmented and POS tagged by JiebaR (Chinese segmentation with R). For the ease of analysis, the one-word character verbs and intransitive verbs are excluded beforehand. The total of 20 high frequency verbs are hand-coded and are further categorized into one of the three types, namely DO type, SC type and other category. If the frequency of taking Other Type exceeds the threshold of 25%, the verb is excluded from the study. The results show that 10 verbs are direct object bias verbs, and six verbs are sentential complement bias verbs. The paired T-test was done to assure the statistical significance (p = 0.0001062 for DO bias verb, p=0.001149 for SC bias verb). The result has shown that in children’s reading materials, the DO biased verbs are used more than the SC bias verbs since the simplest structure of sentences is easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child's reading materials but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context. Sentences are easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child corpus, but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context.

Keywords: corpus linguistics, verb bias, child language, psycholinguistics

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Authors: Hushyar Azari

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Aim and background: Deep brain stimulation (DBS) is regarded as an important therapeutic choice for Parkinson's disease (PD). The two most common targets for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). This review was conducted to compare the clinical effectiveness of these two targets. Methods: A systematic literature search in electronic databases: Embase, Cochrane Library and PubMed were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies which evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) compared both GPi and STN DBS; (2) had at least three months follow-up period; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified, of these, 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). According to Modified Jadad Scale, the majority of included studies had low evidence quality which was a limitation of this review. 5 studies reported no statistically significant between-group difference for improvements in UPDRS ш scores. At the same time, there were some results in terms of pain, action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice. Regarding the adverse effects, GPi was superior. Conclusion: It is clear that other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for deep brain stimulation in Parkinson’s disease and imposes fewer adverse effects on the patients. Meanwhile, STN seems more reasonable according to the results of this systematic review.

Keywords: brain stimulation, globus pallidus, Parkinson's disease, subthalamic nucleus

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Authors: Ashley Hobson, Ashley Efaw

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Professionalism is an essential skill for clinicians, particularly for Occupational Therapy Providers (OTPs). The World Federation of Occupational Therapy (WFOT) Guiding Principles for Ethical Occupational Therapy and American Occupational Therapy Association (AOTA) Code of Ethics establishes expectations for professionalism among OTPs, emphasizing its importance in the field. However, the teaching and assessment of professionalism vary across OTP programs. The flexibility provided by the country standards allows programs to determine their own approaches to meeting these standards, resulting in inconsistency. Educators in both academic and fieldwork settings face challenges in objectively assessing and providing feedback on student professionalism. Although they observe instances of unprofessional behavior, there is no standardized assessment measure to evaluate professionalism in OTP students. While most students are committed to learning and applying professionalism skills, they enter OTP programs with varying levels of proficiency in this area. Consequently, they lack a uniform understanding of professionalism and lack an objective means to self-assess their current skills and identify areas for growth. It is crucial to explicitly teach professionalism, have students to self-assess their professionalism skills, and have OTP educators assess student professionalism. This approach is necessary for fostering students' professionalism journeys. Traditionally, there has been no objective way for students to self-assess their professionalism or for educators to provide objective assessments and feedback. To establish a uniform approach to professionalism, the authors incorporated professionalism content into our curriculum. Utilizing an operational definition of professionalism, the authors integrated professionalism into didactic, fieldwork, and capstone courses. The complexity of the content and the professionalism skills expected of students increase each year to ensure students graduate with the skills to practice in accordance with the WFOT Guiding Principles for Ethical Occupational Therapy Practice and AOTA Code of Ethics. Two professionalism assessments were developed based on the expectations outlined in the both documents. The Professionalism Self-Assessment allows students to evaluate their professionalism, reflect on their performance, and set goals. The Professionalism Assessment for Educators is a modified version of the same tool designed for educators. The purpose of this workshop is to provide educators with a framework and tools for assessing student professionalism. The authors discuss how to integrate professionalism content into OTP curriculum and utilize professionalism assessments to provide constructive feedback and equitable learning opportunities for OTP students in academic, fieldwork, and capstone settings. By adopting these strategies, educators can enhance the development of professionalism among OTP students, ensuring they are well-prepared to meet the demands of the profession.

Keywords: professionalism, assessments, student learning, student preparedness, ethical practice

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Authors: Dike Ibegbulem

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This paper interrogates the chances of Nigeria achieving its target of making the list of the first 70 countries in World Bank’s Ease of Doing Business (EoDB) rankings by the year 2023. That is, in light of existing conflicts in policies relating to the door-to-door carriage of goods and multimodal transport operations (MTOs) in the country. Drawing on the famed Legal Origins theory plus data from World Bank; and using Singapore as a touchstone, the paper unveils how amongst the top-ranked Commonwealth jurisdictions, positive correlations have been recorded over the past years between certainty in their policies on MTOs on the one hand; and their Enforcing Contracts (EC) and Doing Business (DB) indices on the other. The paper postulates that to increase Nigeria’s chances of achieving her DB2023 objective, legislative and curial policies on MTOs and door-to-door carriage of goods have to be realigned in line with prevailing policies in highly-ranked Commonwealth jurisdictions of the Global North. Her appellate courts, in particular, will need some unshackling from English pedigrees which still delimit admiralty jurisdiction to port-to-port shipping, to the exclusion of door-to-door carriage of goods beyond navigable waters. The paper identifies continental and domestic instruments, plus judicial precedents, which provide bases for expanding admiralty jurisdiction to adjudication of claims derived from door-to-door or multimodal transport contracts and other allied maritime-plus contracts. It prescribes synergy between legislative and curial policies on MTOs and door-to-door carriage of goods as species of admiralty – an emerging trend in top-ranked Commonwealth jurisdictions of the Global North.

Keywords: admiralty jurisdiction, legal origins, world bank, ease of doing business, enforcing contracts, multimodal transport operation, door-to-door, carriage of goods by sea, combined transport shipping

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Authors: Gülcan Taşkıran, Ayla Bayık Temel

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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.

Keywords: Crimean war, Florence Nightingale, nursing, statistics

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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: 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: Jesus Salmeron, Carmen De Vega, Maria Soledad Vicente, Mireia Olabarria, Olaia Martinez

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Dysphagia or difficulty in swallowing affects mostly elder people: 56-78% of the institutionalized and 44% of the hospitalized. Liquid food thickening is a necessary measure in this situation because it reduces the risk of penetration-aspiration. Until now, and as proposed by the American Dietetic Association in 2002, possible consistencies have been categorized in three groups attending to their viscosity: nectar (50-350 mPa•s), honey (350-1750 mPa•s) and pudding (>1750 mPa•s). The adequate viscosity level should be identified for every patient, according to her/his impairment. Nevertheless, a systematic review on dysphagia diet performed recently indicated that there is no evidence to suggest that there is any transition of clinical relevance between the three levels proposed. It was also stated that other physical properties of the bolus (slipperiness, density or cohesiveness, among others) could influence swallowing in affected patients and could contribute to the amount of remaining residue. Texture parameters need to be evaluated as possible alternative to viscosity. The aim of this study was to evaluate the instrumental extrusion-compression test as a possible tool to characterize changes along time in water thickened with various products and in the three theoretical consistencies. Six commercial thickeners were used: NM® (NM), Multi-thick® (M), Nutilis Powder® (Nut), Resource® (R), Thick&Easy® (TE) and Vegenat® (V). All of them with a modified starch base. Only one of them, Nut, also had a 6,4% of gum (guar, tara and xanthan). They were prepared as indicated in the instructions of each product and dispensing the correspondent amount for nectar, honey and pudding consistencies in 300 mL of tap water at 18ºC-20ºC. The mixture was stirred for about 30 s. Once it was homogeneously spread, it was dispensed in 30 mL plastic glasses; always to the same height. Each of these glasses was used as a measuring point. Viscosity was measured using a rotational viscometer (ST-2001, Selecta, Barcelona). Extrusion-compression test was performed using a TA.XT2i texture analyzer (Stable Micro Systems, UK) with a 25 mm diameter cylindrical probe (SMSP/25). Penetration distance was set at 10 mm and a speed of 3 mm/s. Measurements were made at 1, 5, 10, 20, 30, 40, 50 and 60 minutes from the moment samples were mixed. From the force (g)–time (s) curves obtained in the instrumental assays, maximum force peak (F) was chosen a reference parameter. Viscosity (mPa•s) and F (g) showed to be highly correlated and had similar development along time, following time-dependent quadratic models. It was possible to predict viscosity using F as an independent variable, as they were linearly correlated. In conclusion, compression-extrusion test could be an alternative and a useful tool to assess physical characteristics of thickened liquids.

Keywords: compression-extrusion test, dysphagia, texture analyzer, thickener

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Authors: Weeradej Cheewapattananuwong, Keeree Srivichian, Godchamon Somchai, Wasin Phusanong, Nontawat Yoddamnern

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Natural rubber used for traffic devices in Thailand has been developed and researched for several years. When compared with Dry Rubber Content (DRC), the quality of Rib Smoked Sheet (RSS) is better. However, the cost of admixtures, especially CaCO₃ and sulphur, is higher than the cost of RSS itself. In this research, Flexible Guideposts and Rubber Fender Barriers (RFB) are taken into consideration. In case of flexible guideposts, the materials used are both RSS and DRC60%, but for RFB, only RSS is used due to the controlled performance tests. The objective of flexible guideposts and RFB is to decrease a number of accidents, fatal rates, and serious injuries. Functions of both devices are to save road users and vehicles as well as to absorb impact forces from vehicles so as to decrease of serious road accidents. This leads to the mitigation methods to remedy the injury of motorists, form severity to moderate one. The solution is to find the best practice of traffic devices using natural rubber under the engineering concepts. In addition, the performances of materials, such as tensile strength and durability, are calculated for the modulus of elasticity and properties. In the laboratory, the simulation of crashes, finite element of materials, LRFD, and concrete technology methods are taken into account. After calculation, the trials' compositions of materials are mixed and tested in the laboratory. The tensile test, compressive test, and weathering or durability test are followed and based on ASTM. Furthermore, the Cycle-Repetition Test of Flexible Guideposts will be taken into consideration. The final decision is to fabricate all materials and have a real test section in the field. In RFB test, there will be 13 crash tests, 7 Pickup Truck tests, and 6 Motorcycle Tests. The test of vehicular crashes happens for the first time in Thailand, applying the trial and error methods; for example, the road crash test under the standard of NCHRP-TL3 (100 kph) is changed to the MASH 2016. This is owing to the fact that MASH 2016 is better than NCHRP in terms of speed, types, and weight of vehicles and the angle of crash. In the processes of MASH, Test Level 6 (TL-6), which is composed of 2,270 kg Pickup Truck, 100 kph, and 25 degree of crash-angle is selected. The final test for real crash will be done, and the whole system will be evaluated again in Korea. The researchers hope that the number of road accidents will decrease, and Thailand will be no more in the top tenth ranking of road accidents in the world.

Keywords: LRFD, load and resistance factor design, ASTM, american society for testing and materials, NCHRP, national cooperation highway research program, MASH, manual for assessing safety hardware

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Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

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BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

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Authors: Jane E. Hill

Abstract:

Many variables led to the changes in the insanity defense since the Wild Beast Standard of 1723 until the Federal Insanity Defense Reform Act of 1984. The insanity defense is used in criminal trials and argued that the defendant is ‘not guilty by reason of insanity’ because the individual was unable to distinguish right from wrong during the time they were breaking the law. The issue that surrounds whether or not to use the insanity defense in the criminal court depends on the mental state of the defendant at the time the criminal act was committed. This leads us to the question of did the defendant know right from wrong when they broke the law? In 1723, The Wild Beast Test stated that to be exempted from punishment the individual is totally deprived of their understanding and memory and doth not know what they are doing. The Wild Beast Test became the standard in England for over seventy-five years. In 1800, James Hadfield attempted to assassinate King George III. He only made the attempt because he was having delusional beliefs. The jury and the judge gave a verdict of not guilty. However, to legal confine him; the Criminal Lunatics Act was enacted. Individuals that were deemed as ‘criminal lunatics’ and were given a verdict of not guilty would be taken into custody and not be freed into society. In 1843, the M'Naghten test required that the individual did not know the quality or the wrongfulness of the offense at the time they committed the criminal act(s). Daniel M'Naghten was acquitted on grounds of insanity. The M'Naghten Test is still a modern concept of the insanity defense used in many courts today. The Irresistible Impulse Test was enacted in the United States in 1887. The Irresistible Impulse Test suggested that offenders that could not control their behavior while they were committing a criminal act were not deterrable by the criminal sanctions in place; therefore no purpose would be served by convicting the offender. Due to the criticisms of the latter two contentions, the federal District of Columbia Court of Appeals ruled in 1954 to adopt the ‘product test’ by Sir Isaac Ray for insanity. The Durham Rule also known as the ‘product test’, stated an individual is not criminally responsible if the unlawful act was the product of mental disease or defect. Therefore, the two questions that need to be asked and answered are (1) did the individual have a mental disease or defect at the time they broke the law? and (2) was the criminal act the product of their disease or defect? The Durham courts failed to clearly define ‘mental disease’ or ‘product.’ Therefore, trial courts had difficulty defining the meaning of the terms and the controversy continued until 1972 when the Durham rule was overturned in most places. Therefore, the American Law Institute combined the M'Naghten test with the irresistible impulse test and The United States Congress adopted an insanity test for the federal courts in 1984.

Keywords: insanity defense, psychology law, The Federal Insanity Defense Reform Act of 1984, The Wild Beast Standard in 1723

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