Search results for: Elizabeth Baker
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 239

Search results for: Elizabeth Baker

119 Clinical and Structural Differences in Knee Osteoarthritis with/without Synovial Hypertrophy

Authors: Gi-Young Park, Dong Rak Kwon, Sung Cheol Cho

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Objective: The synovium is known to be involved in many pathological characteristic processes. Also, synovitis is common in advanced osteoarthritis. We aimed to evaluate the clinical, radiographic, and ultrasound findings in patients with knee osteoarthritis and to compare the clinical and imaging findings between knee osteoarthritis with and without synovial hypertrophy confirmed by ultrasound. Methods: One hundred knees (54 left, 46 right) in 95 patients (64 women, 31 men; mean age, 65.9 years; range, 43-85 years) with knee osteoarthritis were recruited. The Visual Analogue Scale (VAS) was used to assess the intensity of knee pain. The severity of knee osteoarthritis was classified according to Kellgren and Lawrence's (K-L) grade on a radiograph. Ultrasound examination was performed by a physiatrist who had 24 years of experience in musculoskeletal ultrasound. Ultrasound findings, including the thickness of joint effusion in the suprapatellar pouch, synovial hypertrophy, infrapatellar tendinosis, meniscal tear or extrusion, and Baker cyst, were measured and detected. The thickness of knee joint effusion was measured at the maximal anterior-posterior diameter of fluid collection in the suprapatellar pouch. Synovial hypertrophy was identified as the soft tissue of variable echogenicity, which is poorly compressible and nondisplaceable by compression of an ultrasound transducer. The knees were divided into two groups according to the presence of synovial hypertrophy. The differences in clinical and imaging findings between the two groups were evaluated by independent t-test and chi-square test. Results: Synovial hypertrophy was detected in 48 knees of 100 knees on ultrasound. There were no significant differences in demographic parameters and VAS score except in sex between the two groups (P<0.05). Medial meniscal extrusion and tear were significantly more frequent in knees with synovial hypertrophy than those in knees without synovial hypertrophy. K-L grade and joint effusion thickness were greater in patients with synovial hypertrophy than those in patients without synovial hypertrophy (P<0.05). Conclusion: Synovial hypertrophy in knee osteoarthritis was associated with greater suprapatellar joint effusion and higher K-L grade and maybe a characteristic ultrasound feature of late knee osteoarthritis. These results suggest that synovial hypertrophy on ultrasound can be regarded as a predictor of rapid progression in patients with knee osteoarthritis.

Keywords: knee osteoarthritis, synovial hypertrophy, ultrasound, K-L grade

Procedia PDF Downloads 45
118 Analysis of Pathogen Populations Occurring in Oilseed Rape Using DNA Sequencing Techniques

Authors: Elizabeth Starzycka-Korbas, Michal Starzycki, Wojciech Rybinski, Mirosława Dabert

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For a few years, the populations of pathogenic fungi occurring in winter oilseed rape in Malyszyn were analyzed. Brassica napus L. in Poland and in the world is a source of energy for both the men (oil), and animals, as post-extraction middling, as well as a motor fuel (oil, biofuel) therefore studies of this type are very important. The species composition of pathogenic fungi can be an indicator of seed yield. The occurrence of oilseed rape pathogens during several years were analyzed using the sequencing method DNA ITS. The results were compared in the gene bank using the program NCBI / BLAST. In field conditions before harvest of oilseed rape presence of pathogens infesting B. napus has been assessed. For example, in 2015, 150 samples have been isolated and applied to PDA medium for the identification of belonging species. From all population has been selected mycelium of 83 isolates which were sequenced. Others (67 isolates) were pathogenic fungi of the genus Alternaria which are easily to recognize. The population of pathogenic species on oilseed rape have been identified after analyzing the DNA ITS and include: Leptosphaeria sp. 38 (L. maculans 25, L. biglobosa 13), Alternaria sp. 29, Fusarium sp. 3, Sclerotinia sclerotiorum 7, heterogeneous 6, total of 83 isolates. The genus Alternaria sp. fungi wear the largest share of B. napus pathogens in particular years. Another dangerous species for oilseed rape was Leptosphaeria sp. Populations of pathogens in each year were different. The number of pathogens occurring in the field and their composition is very important for breeders and farmers because of the possible selection of the most resistant genotypes for sowing in the next growing season.

Keywords: B. napus, DNA ITS Sequencing, pathogenic fungi, population

Procedia PDF Downloads 262
117 Conservation Status of a Lowland Tropical Forest in South-West, Nigeria

Authors: Lucky Dartsa Wakawa, Friday Nwabueze Ogana, Temitope Elizabeth Adeniyi

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Timely and reliable information on the status of a forest is essential for assessing the extent of regeneration and degradation. However, when such information is lacking effective forest management practices becomes impossible. Therefore, this study assessed the tree species composition, richness, diversity, structure of Oluwa forest reserve with the view of ascertaining it conservation status. A systematic line transect was used in the laying of eight (8) temporary sample plots (TSPs) of size 50m x 50m. Trees with Dbh ≥ 10cm in the selected plots were enumerated, identified and measured. The results indicate that 535 individual trees were enumerated cutting across 26 families and 58 species. The family Sterculiaceae recorded the highest number of species (10) and occurrence (112) representing 17.2% and 20.93% respectively. Celtis zenkeri is the species with the highest number of occurrence of tree per hectare and importance value index (IVI) of 59 and 53.81 respectively. The reserve has the Margalef's index of species richness, Shannon-Weiner diversity Index (H') and Pielou's Species Evenness Index (EH) of 9.07, 3.43 and 0.84 respectively. The forest has a mean Dbh (cm), mean height (m), total basal area/ha (m2) and total volume/ha (m3) of 24.7, 16.9, 36.63 and 602.09 respectively. The important tropical tree species identified includes Diospyros crassiflora Milicia excels, Mansonia altisima, Triplochiton scleroxylon. Despite the level of exploitation in the forest, the forest seems to be resilience. Given the right attention, it could regenerate and replenish to save some of the original species composition of the reserve.

Keywords: forest conservation, forest structure, Lowland tropical forest, South-west Nigeria

Procedia PDF Downloads 313
116 Sensory Gap Analysis on Port Wine Promotion and Perceptions

Authors: José Manue Carvalho Vieira, Mariana Magalhães, Elizabeth Serra

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The Port Wine industry is essential to Portugal because it carries a tangible cultural heritage and for social and economic reasons. Positioned as a luxury product, brands need to pay more attention to the new generation's habits, preferences, languages, and sensory perceptions. Healthy lifestyles, anti-alcohol campaigns, and digitalisation of their buying decision process need to be better understood to understand the wine market in the future. The purpose of this study is to clarify the sensory perception gap between Port Wine descriptors promotion and the new generation's perceptions to help wineries to align their strategies. Based on the interpretivist approach - multiple methods and techniques (mixed-methods), different world views and different assumptions, and different data collection methods and analysis, this research integrated qualitative semi-structured interviews, Port Wine promotion contents, and social media perceptions mined by Sentiment Analysis Enginius algorithm. Findings confirm that Port Wine CEOs' strategies, brands' promotional content, and social perceptions are not sufficiently aligned. The central insight for Port Wine brands' managers is that there is a long and continuous work of understanding and associating their descriptors with the most relevant perceptual values and criteria of their targets to reposition (when necessary) and sustainably revitalise their brands. Finally, this study hypothesised a sensory gap that leads to a decrease in consumption, trying to find recommendations on how to transform it into an advantage for a better attraction towards the young age group (18-25).

Keywords: port wine, consumer habits, sensory gap analysis, wine marketing

Procedia PDF Downloads 203
115 Impact of COVID-19 on Hospital Waste

Authors: Caroline Correia, Stefani Perna, John Gaughan, Elizabeth Cerceo

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Introduction: The COVID-19 pandemic has brought unprecedented changes to how hospitals function on a daily basis. Increased personal protective equipment (PPE) usage and measures to pre-package, separate, and decontaminate have the potential to increase the waste load. However, limiting non-essential surgeries drastically reduces operating room (OR) waste, and restricting visitation policies to contain outbreaks may help conserve resources. The impact of these policy changes with increased disposable PPE usage on hospital production of waste is unknown. Methods: Waste produced in pounds (lbs) was measured for January through June during both 2019 and 2020 through Stericycle in Cooper University Hospital in Camden, NJ. This timeframe was selected since the pandemic began in January 2020 in the US. The total waste produced during this time was 328,623 lbs in 2019 and 306,454 lbs in 2020. Using Poisson counts (α=.05), less waste was produced in 2020 (p < 0.001). The amount of sharps and regulated medical waste (grossly bloody items) were both significantly decreased as well (p < 0.0001, p=0.0002), and these account for 10-15% of the total waste produced. Discussion: Despite the increased usage of disposable PPE, overall hospital waste was decreased during the pandemic as compared to prior. As surgeries are estimated to be responsible for up to one-half of waste produced by hospitals, it is possible that constraint on elective procedures contributed to the decreased waste in all three categories; estimates of a 35% decrease in surgical volume would be expected to impact waste production. The effects of the pandemic on waste production should continue to be monitored to understand the environmental impact as health systems resume backlogged surgeries at a higher volume.

Keywords: COVID-19, hospital, surgery, waste

Procedia PDF Downloads 80
114 One Nature under God, and Divisible: Augustine’s “Duality of Man” Applied to the Creation Stories of Genesis

Authors: Elizabeth Latham

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The notion that women were created as innately inferior to men has yet to be expelled completely from the theological system of humankind. This question and the biblical exegesis it requires are of paramount importance to feminist philosophy—after all, the study can bear little fruit if we cannot even agree on equality within the theological roots of humanity. Augustine’s “Duality of Man” gives new context to the two creation stories in Genesis, texts especially relevant given the billions of people worldwide that ascribe to them as philosophical realities. Each creation story describes the origin of human beings and is matched with one of Augustine’s two orders of mankind. The first story describes the absolute origin of the human soul and is paired with Augustine’s notion of the “spiritual order” of a human being: divine and eternal, fulfilling the biblical idea that human beings were created in the image and likeness of God. The second creation story, in contrast, depicts those aspects of humanity that distinguish and separate us from God: doubt, fear, and sin. It also introduces gender as a concept for the first time in the Bible. This story is better matched with Augustine’s idea of the “natural order” of humanity, that by which he believes women, in fact, are inferior. In the synthesis of the two sources, one can see that the natural order and any inferiority that it implies are incidental and not intended in our creation. Gender inequality is introduced with and belongs in the category of human imperfection and to cite the Bible as encouraging it constitutes a gross misunderstanding of scripture. This is easy to see when we divide human nature into “spiritual” and “natural” and look carefully at where scripture falls.

Keywords: augustine, bible, duality of man, feminism, genesis

Procedia PDF Downloads 113
113 Synthesis of Zeolites from Bauxite and Kaolin: Effect of Synthesis Parameters on Competing Phases

Authors: Bright Kwakye-Awuah, Elizabeth Von-Kiti, Isaac Nkrumah, Baah Sefa-Ntiri, Craig D. Williams

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Bauxite and kaolin from Ghana Bauxite Company mine site were used to synthesize zeolites. Bauxite served as the alumina source and kaolin the silica source. Synthesis variations include variation of aging time at constant crystallization time and variation of crystallization times at constant aging time. Characterization techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive x-ray analysis (EDX) and Fourier transform infrared spectroscopy (FTIR) were employed in the characterization of the raw samples as well as the synthesized samples. The results obtained showed that the transformations that occurred and the phase of the resulting products were coordinated by the aging time, crystallization time, alkaline concentration and Si/Al ratio of the system. Zeolites A, X, Y, analcime, Sodalite, and ZK-14 were some of the phases achieved. Zeolite LTA was achieved with short crystallization times of 3, 5, 18 and 24 hours and a maximum aging of 24 hours. Zeolite LSX was synthesized with 24 hr aging followed with 24 hr hydrothermal treatment whilst zeolite Y crystallized after 48 hr of aging and 24 hr crystallization. Prolonged crystallization time produced a mixed phased product. Prolonged aging times, on the other hand, did not yield any zeolite as the sample was amorphous. Increasing the alkaline content of the reaction mixture above 5M introduced sodalite phase in the final product. The properties of the final products were comparable to zeolites synthesized from pure chemical reagents.

Keywords: bauxite, kaolin, aging, crystallization, zeolites

Procedia PDF Downloads 193
112 Living with a Partner with Depression: The Role of Dispositional Empathy in Psychological Resilience

Authors: Elizabeth O'Brien, Raegan Murphy

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Research suggests that high levels of empathy in individuals with partners with mental health difficulties can lead to improved outcomes for their partner while compromising their own mental health. Specifically, it is proposed that the affective dimension of empathy diminishes resilience to the distress of a partner, whereas cognitive empathy (CE) enhances it. The relationship between different empathy dimensions and psychological resilience measures has not been investigated in partners of people with depression. Psychological inflexibility (PI) is a construct that can be understood as distress intolerance and is suggested to be an important feature of psychological resilience. The current study, therefore, aimed to investigate the differential role of dispositional empathy dimensions in PI for people living with a partner with depression. A cross-sectional design was employed in which 148 participants living with a partner with depression and 45 participants for a comparison sample were recruited using online platforms. Participants completed online surveys with measures relating to demographics, empathy, and PI. Scores were compared between the study and comparison samples. The study sample scored significantly lower for CE and affective empathy (AE) and significantly higher for PI than the comparison sample. Exploratory and regression analyses were run to examine associations between variables within the study sample. Analyses revealed that CE predicted the resilience outcome whilst AE did not. These results suggest that interventions for partners of people with depression that bolster the CE dimension alone may improve mental health outcomes for both members of the couple relationship.

Keywords: affective empathy, cognitive empathy, depression, partners, psychological inflexibility

Procedia PDF Downloads 103
111 Iron Response Element-mRNA Binding to Iron Response Protein: Metal Ion Sensing

Authors: Mateen A. Khan, Elizabeth J. Theil, Dixie J. Goss

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Cellular iron homeostasis is accomplished by the coordinated regulated expression of iron uptake, storage, and export. Iron regulate the translation of ferritin and mitochondrial aconitase iron responsive element (IRE)-mRNA by interaction with an iron regulatory protein (IRPs). Iron increases protein biosynthesis encoded in iron responsive element. The noncoding structure IRE-mRNA, approximately 30-nt, folds into a stem loop to control synthesis of proteins in iron trafficking, cell cycling, and nervous system function. Fluorescence anisotropy measurements showed the presence of one binding site on IRP1 for ferritin and mitochondrial aconitase IRE-mRNA. Scatchard analysis revealed the binding affinity (Kₐ) and average binding sites (n) for ferritin and mitochondrial aconitase IRE-mRNA were 68.7 x 10⁶ M⁻¹ and 9.2 x 10⁶ M⁻¹, respectively. In order to understand the relative importance of equilibrium and stability, we further report the contribution of electrostatic interactions in the overall binding of two IRE-mRNA with IRP1. The fluorescence quenching of IRP1 protein was measured at different ionic strengths. The binding affinity of IRE-mRNA to IRP1 decreases with increasing ionic strength, but the number of binding sites was independent of ionic strength. Such results indicate a differential contribution of electrostatics to the interaction of IRE-mRNA with IRP1, possibly related to helix bending or stem interactions and an overall conformational change. Selective destabilization of ferritin and mitochondrial aconitase RNA/protein complexes as reported here explain in part the quantitative differences in signal response to iron in vivo and indicate possible new regulatory interactions.

Keywords: IRE-mRNA, IRP1, binding, ionic strength

Procedia PDF Downloads 104
110 Teacher's Gender and Primary School Pupils Achievement in Social Studies and Its Educational Implications on Pupils

Authors: Elizabeth Oyenike Abegunrin

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This study is borne out of the dire need to improve the academic achievement of pupils in social studies. The paper attempted to reconcile the lacuna in teacher’s gender and primary school pupils’ achievement. With specific reference to Social Studies classroom, the aim of this study was to detail how pupils’ achievement is a function of the teacher’s gender as well as to establish the link (if any) between teacher’s gender and pupils’ educational achievement. The significance of this was to create gender-template standard for teachers, school owners, administrators and policy makers to follow in the course of engendering pupils’ achievement in Social Studies. By adopting a quasi-experimental research design, a sample of two hundred pupils was selected across five primary schools in Education District I, Lagos State and assigned to experimental and control groups. A 40-item Gender and Social Studies Achievement Test (GSSAT) was used to obtain data from the pupils. Having analyzed the data collected using Pearson Product Moment Correlation (PPMC), a reliability of 0.78 was obtained. Result revealed that teacher’s gender (male/female) had no significant effect on pupils’ achievement in Social Studies and that there was significant interaction effect of teacher’s commitment devoid of gender on the general education output of pupils in Social Studies. Taken together, the results revealed that there is a high degree correlation between teacher’s commitment and pupils academic achievement in social studies, and not gender-based. The study recommended that social studies teachers should re-assess their classroom instructional strategies and use more innovative instructional methods and techniques that will give the pupils equal opportunities to excel in social studies, rather than their gender differences.

Keywords: gender, academic achievement, social studies, primary school

Procedia PDF Downloads 184
109 Amperometric Biosensor for Glucose Determination Based on a Recombinant Mn Peroxidase from Corn Cross-linked to a Gold Electrode

Authors: Anahita Izadyar, My Ni Van, Kayleigh Amber Rodriguez, Ilwoo Seok, Elizabeth E. Hood

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Using a recombinant enzyme derived from corn and a simple modification, we fabricated a facile, fast, and cost-beneficial biosensor to measure glucose. The Nafion/ Plant Produced Mn Peroxidase (PPMP)– glucose oxidase (GOx)- Bovine serum albumin (BSA) /Au electrode showed an excellent amperometric response to detect glucose. This biosensor is capable of responding to a wide range of glucose—20.0 µM−15.0 mM and has a lower detection limit (LOD) of 2.90µM. The reproducibility response using six electrodes is also very substantial and indicates the high capability of this biosensor to detect a wide range of 3.10±0.19µM to 13.2±1.8 mM glucose concentration. Selectivity of this electrode was investigated in an optimized experimental solution contains 10% diet green tea with citrus containing ascorbic acid (AA), and citric acid (CA) in a wide concentration of glucose at 0.02 to 14.0mM with an LOD of 3.10µM. Reproducibility was also investigated using 4 electrodes in this sample and shows notable results in the wide concentration range of 3.35±0.45µM to of 13.0 ± 0.81 mM. We also used other voltammetry methods to evaluate this biosensor. We applied linear sweep voltammetry (LSV) and this technique shows a wide range of 0.10−15.0 mM to detect glucose with a lower detection limit of 19.5µM. The performance and strength of this enzyme biosensor were the simplicity, wide linear ranges, sensitivities, selectivity, and low limits of detection. We expect that the modified biosensor has the potential for monitoring various biofluids.

Keywords: plant-produced manganese peroxidase, enzyme-based biosensors, glucose, modified gold electrode, glucose oxidase

Procedia PDF Downloads 114
108 Effect of Brown Algae, Ecklonia arborea and Silvetia compressa, in Lipidemic and Hepatic Metabolism in Wistar Rats

Authors: Laura Acevedo-Pacheco, Janet Alejandra Gutierrez-Uribe, Lucia Elizabeth Cruz-Suarez, Segio Othon Serna-Saldivar

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Seaweeds can generate changes in the metabolism of lipids; as a consequence, this may diminish cholesterol and other lipids in the blood. However, the consumption of marine algae may also alter the functions of other organs. Therefore, the objective of this research was to study the effect of two different sorts of algae (Ecklonia arborea and Silvetia compressa) in the metabolism of lipids, as well as, in the physiology of the liver. Wistar male rats were fed for two months with independent diets composed of 20% of fat and 2.5% of E. arborea and S. compressa each. Blood parameters (cholesterol, lipoproteins, triglycerides, hepatic enzymes) and triglycerides in the liver were quantified, and also hepatic histology analyses were performed. While S. compressa reduced 18% total cholesterol compared to the positive control, E. arborea increased it 5.8%. Animals fed with S. compressa presented a decrement, compared to the positive control, not only in low density lipoproteins levels (53%) but also in triglycerides (67%). The presence of steatosis in the histologies and the high levels of triglycerides showed an evident lipid accumulation in hepatic tissues of rats fed with both algae. These results indicate that even though S. compressa showed a promising resource to decrease total cholesterol and low-density lipoproteins in blood, a detrimental effect was observed in liver physiology. Further investigations should be made to find out if toxic compounds associated with these seaweeds may cause liver damage especially in terms of heavy metals.

Keywords: brown algae, Eisenia arborea, hepatic metabolism, lipidemic metabolism, Pelvetia compressa, steatosis

Procedia PDF Downloads 104
107 Characterization of 2,4,6-Trinitrotoluene (Tnt)-Metabolizing Bacillus Cereus Sp TUHP2 Isolated from TNT-Polluted Soils in the Vellore District, Tamilnadu, India

Authors: S. Hannah Elizabeth, A. Panneerselvam

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Objective: The main objective was to evaluate the degradative properties of Bacillus cereus sp TUHP2 isolated from TNT-Polluted soils in the Vellore District, Tamil Nadu, India. Methods: Among the 3 bacterial genera isolated from different soil samples, one potent TNT degrading strain Bacillus cereus sp TUHP2 was identified. The morphological, physiological and the biochemical properties of the strain Bacillus cereus sp TUHP2 was confirmed by conventional methods and genotypic characterization was carried out using 16S r-DNA partial gene amplification and sequencing. The broken down by products of DNT in the extract was determined by Gas Chromatogram- Mass spectrometry (GC-MS). Supernatant samples from the broth studied at 24 h interval were analyzed by HPLC analysis and the effect on various nutritional and environmental factors were analysed and optimized for the isolate. Results: Out of three isolates one strain TUHP2 were found to have potent efficiency to degrade TNT and revealed the genus Bacillus. 16S rDNA gene sequence analysis showed highest homology (98%) with Bacillus cereus and was assigned as Bacillus cereus sp TUHP2. Based on the energy of the predicted models, the secondary structure predicted by MFE showed the more stable structure with a minimum energy. Products of TNT Transformation showed colour change in the medium during cultivation. TNT derivates such as 2HADNT and 4HADNT were detected by HPLC chromatogram and 2ADNT, 4ADNT by GC/MS analysis. Conclusion: Hence this study presents the clear evidence for the biodegradation process of TNT by strain Bacillus cereus sp TUHP2.

Keywords: bioremediation, biodegradation, biotransformation, sequencing

Procedia PDF Downloads 436
106 Constructing a Grounded Theory of Parents' Musical Engagement with Their Premature Baby Contributing to Their Emerging Parental Identity in a Neonatal Unit

Authors: Elizabeth McLean, Katrina Skewes-McFerran, Grace Thompson

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Scholarship highlights the need to further examine and better understand and foster the process of becoming a parent to a premature baby in the neonatal context to support the critical development of the parent-infant relationship. Music therapy research documents significant benefits of music therapy on neonatal physiological and neurodevelopmental function, reduced maternal anxiety and validating parents’ relationship with their premature baby, yet limited studies examine the role of music in supporting parental identity. This was a multi-site study, exploring parents’ musical engagement with their hospitalised baby and parental identity in a NU. In-depth interviews with nine parents of a premature baby across varying time points in their NU journey took place. Data collection and analysis was influenced by Constructive Grounded Theory methodology. Findings in the form of a substantive grounded theory illuminated the contribution of parents’ musical engagement on their sense of parental identity in the NU. Specifically, the significance of their baby’s level and type of response during musical interactions in influencing parents’ capacity to engage in musical dialogue with their baby emerged. Specific conditions that acted as both barriers and fosters in parents’ musical engagement across a high- risk pregnancy and NU admission also emerged. Recommendations for future research into the role of music and music therapy in supporting parental coping and transition to parenthood during a high-risk pregnancy and birth and beyond the NU will be discussed.

Keywords: grounded theory, musical engagement, music therapy, parental identity

Procedia PDF Downloads 150
105 Assessment of E-learning Facilities and Information Need by Open and Distance Learning Students in Jalingo, Nigeria

Authors: R. M. Bashir, Sabo Elizabeth

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Electronic learning is an increasingly popular learning approach in higher educational institutions due to vast growth of internet technology. An investigation on the assessment of e-learning facilities and information need by open and distance learning students in Jalingo, Nigeria was conducted. Structured questionnaires were administered to 70 students of the university. Information sourced from the respondents covered demographic, economic and institutional variables. Data collected for demographic variables were computed as frequency count and percentages. Information on assessment of e-learning facilities and information need among open and distance learning students was computed on a three or four point Likert Rating Scale. Findings indicated that there are more men compared to women, a large proportion of the respondents are married and there are more matured students. A high proportion of the students obtained qualifications higher than the secondary school certificate. The proportion of computer literate students was higher compared with those students that owned a computer. Inadequate e-books and reference materials, internet gadgets and inadequate books (hard copies) and reference material are factors that limit utilization of e-learning facilities. Inadequate computer facilities caused delay in examination schedule at the study center. Open and distance learning students required to a high extent information on university timetable and schedule of activities, books (hard and e-books) and reference materials and contact with course coordinators via internet for better learning and academic performance.

Keywords: open and distance learning, information required, electronic books, internet gadgets, Likert scale test

Procedia PDF Downloads 258
104 Virtual Life: Fashion, Expression, and Identity in the Digital World

Authors: Elizabeth Bourgeois

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During social distancing, fashion and self-expression have been pushed further into virtual environments. In VR spaces, identities can be curated easily, untethered from the necessities of life and work. Personal styles reach a wider audience and follow new rules. Digital platforms leave some, but not all, 'real world' clothing constraints behind. Virtual aesthetics are set by the user and the software. Gen Z is a native user, applying face filters on Instagram and Snapchat and styling outfits and skins in apps like Gacha Life, Roblox, and Fortnite. These games cultivate space for community and personal style. Loosely tied to human forms, each app has physical aesthetics, with clear vernacular dress defining it. There are ecosystems of makers, consumers, and critics. Designer-modelers create original assets, brands, and luxury items. Fashion and beauty are ephemeral but always reflect the idealization of form and self. Online communities have already established new beauty ideals that impact live fashion trends. Fashion houses develop AR filters, gaming hairstyles challenge real-world colorists, and musicians perform virtual concerts in their avatar forms. In these times, social media and gaming communities promote the expression of public identity. The online dress is no longer tied to 'real' bodies or cloth. In virtual worlds, there are still tribes, status symbols, gender identities, and roles, but free of fabric, form, and static social structure, there is room for fantastic invention.

Keywords: virtual reality, fashion, Gen Z, social media, gaming

Procedia PDF Downloads 107
103 Perceptions About the Academic Performance of Autistic Students

Authors: Afaf Alhusayni, Elizabeth Sheppard, Asiyya Jaffrani, Peter Mitchell, Lauren Marsh

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Introduction: Previous research has found that people make systematic judgments about others based on small glimpses of their behavior. Furthermore, autistic people are consistently judged more negatively than non-autistic people in terms of favourability and approachability. Objectives: This project focuses on a hitherto unstudied type of judgment that is highly relevant within a university context, judgments about academic performance. This is particularly important as autistic university students are less likely to complete their degrees than neurotypical students. Methods: Twenty-five neurotypical perceivers (21 females - 4 males) viewed a series of 4s video clips featuring an individual ‘target’ displaying natural behavior. Nine of these targets were autistic and nine were neurotypical. Perceivers were asked to rate each target on four aspects related to university life (motivation, success, grades, and happiness). Results: Autistic targets were judged more negatively on all aspects compared to neurotypical targets. Conclusions: This study concludes that neurotypical perceivers negatively judge the academic performance of autistic students. This suggests that autistic university students face unfavorable scrutiny and judgment, which may negatively impact their academic success. Implications: These initial findings provide important evidence that autistic people are negatively stigmatized within education environments. Further work is needed to ascertain the extent to which these negative judgments may feed into attainment gaps for autistic students. This information is useful for the education department, government, and social care organizations, enabling change in the provision of support for autistic students.

Keywords: autistic person perception, academic performance, stigma and judgment, higher education

Procedia PDF Downloads 99
102 The Impact of COVID-19 on Reconstructive Breast Surgery and Future Prospective

Authors: Amenah Galo, Mohammed Farid, Kareem Alsharkawy, Robert Warner, Karthikeyan Srinivasan, Haitham Khalil, Ruth Waters

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Introduction: The cessation of elective surgery, particularly breast reconstruction, continue to be affected by the COVID-19 pandemic. The restructuring of medical services and staff redeployment severely affected the ability to return to normality for surgical specialties. The aim of this study is to determine the decline in breast reconstruction affected by the COVID-19 pandemic in a tertiary center. Methods: A retrospective review of breast reconstruction cases (autologous, non-autologous) or mastectomies Pre- COVID (March 2019-March 2020) and during COVID (March 2020- March 2021) at Queen Elizabeth Hospital, Birmingham, were collated. Data included patient demographics, BMI, previous and recent reconstruction, length of hospital stay, and mastectomies, including risk-reducing. Results: The number of patients who had breast reconstruction was significantly lower during COVID (n=62) compared to pre-COVID (n=199). The mean age (pre-COVID 51, COVID 59 years), BMI (Pre-COVID and COVID = 27), previous reconstruction (pre-COVID n=101, 51%, COVID n=33, 53%) and length hospital stay was less during COVID (3 days) compared to Pre-COVID (4 days). The proportion of risk-reducing mastectomies and reconstruction during COVID (32%, n=20) were higher than pre-COVID (21%, n=41). A higher proportion rate of autologous reconstruction (DIEP 56, TRAM 17) Pre-COVID compared to COVID (DIEP 22, TRAM 7). Implant reconstructions were higher during COVID (n=19, 31%) than pre-COVID (n=31, 16%). Conclusion: The lack of regular provision for breast reconstruction continues to decline during the pandemic. This will have a tremendous impact on waiting lists without a timeline for reconstruction to offer patients. An international survey highlights the disparities in offering breast reconstruction and strategies to rectify this issue.

Keywords: breast reconstruction, COVID-19 pandemic, mastectomy, autologous, implant

Procedia PDF Downloads 186
101 Disparities in Suicide and Mental Health among Student Athletes of Ethnic and Racial Minorities Compared to Their White Non-latinx Counterparts

Authors: Elizabeth Russo, Angelica Terepka

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The present paper reviews literature examining trends among suicide, suicidal ideation, and mental illness rates in ethnic and racial minority student-athletes. While the rates of suicide amongst student athlete populations is lower than rates of suicide seen in the general student populations, there is a discrepancy amongst rates of suicide in student athletes; specifically, those identifying with racial and ethnic minority backgrounds endorse higher rates of suicidal ideation. The samples from the existing literature consisted of White, Black, Hispanic/Latinx, Asian/ Pacific Islander, Multiracial, and Native American student-athletes. Studies suggest that ethnic and racial minority students are more susceptible to suicide, depression, and other mental health concerns compared to their white counterparts. Across the literature, White student athletes appeared to have more social and academic support from fellow classmates, university administration and professors, and staff within their athletic departments. Student athletes who did not identify as White endorsed higher rates of loneliness, felt ethnically and racially underrepresented within their athletic department, and endorsed lack of appropriate medical treatment for injuries by athletic department medical staff. Additionally, non-White student athletes receive less peer support and must balance additional stressors such as discrimination in contrast to their White/non-Latinx peers. Recommendations for athletic departments and mental health providers supporting student athletes who identify as racial and ethnic minorities are discussed.

Keywords: racial and ethnic minority, suicide, student-athlete, suicidal ideation

Procedia PDF Downloads 51
100 Glycerol-Based Bio-Solvents for Organic Synthesis

Authors: Dorith Tavor, Adi Wolfson

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In the past two decades a variety of green solvents have been proposed, including water, ionic liquids, fluorous solvents, and supercritical fluids. However, their implementation in industrial processes is still limited due to their tedious and non-sustainable synthesis, lack of experimental data and familiarity, as well as operational restrictions and high cost. Several years ago we presented, for the first time, the use of glycerol-based solvents as alternative sustainable reaction mediums in both catalytic and non-catalytic organic synthesis. Glycerol is the main by-product from the conversion of oils and fats in oleochemical production. Moreover, in the past decade, its price has substantially decreased due to an increase in supply from the production and use of fatty acid derivatives in the food, cosmetics, and drugs industries and in biofuel synthesis, i.e., biodiesel. The renewable origin, beneficial physicochemical properties and reusability of glycerol-based solvents, enabled improved product yield and selectivity as well as easy product separation and catalyst recycling. Furthermore, their high boiling point and polarity make them perfect candidates for non-conventional heating and mixing techniques such as ultrasound- and microwave-assisted reactions. Finally, in some reactions, such as catalytic transfer-hydrogenation or transesterification, they can also be used simultaneously as both solvent and reactant. In our ongoing efforts to design a viable protocol that will facilitate the acceptance of glycerol and its derivatives as sustainable solvents, pure glycerol and glycerol triacetate (triacetin) as well as various glycerol-triacetin mixtures were tested as sustainable solvents in several representative organic reactions, such as nucleophilic substitution of benzyl chloride to benzyl acetate, Suzuki-Miyaura cross-coupling of iodobenzene and phenylboronic acid, baker’s yeast reduction of ketones, and transfer hydrogenation of olefins. It was found that reaction performance was affected by the glycerol to triacetin ratio, as the solubility of the substrates in the solvent determined product yield. Thereby, employing optimal glycerol to triacetin ratio resulted in maximum product yield. In addition, using glycerol-based solvents enabled easy and successful separation of the products and recycling of the catalysts.

Keywords: glycerol, green chemistry, sustainability, catalysis

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99 The Effect of Contrast on Approach Distances of Carcharhinus perezi

Authors: Elizabeth Farquhar, Erich Ritter

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Studying shark's interaction with humans and their behavioral responses will have enormous implications for other fields of marine biology and oceanography. The health of sharks has direct impacts on the stability of human society with a reported 3.5 billion people depending on the ocean for food and/or livelihood. Discovering how sharks behave and interact with people, will have enormous implications for future studies, along with the development of more effective ways to reduce negative shark/human interactions. This specific study investigates the effects of contrasting ponchos worn by divers on the approach distances of Carcharhinus perezi. Data was collected over a two week period at a test site off the shore of Eleuthera Island in the Bahamas, with a depth of approximately 55 feet during mid-August. Sixty-minute dive trials were conducted and videoed from above with 5-meter radius markers on the ocean floor surrounding the two divers, kneeling back-to-back. Five poncho colors were worn by the two divers (black, navy blue, dark green, yellow and orange), rotating the color permutations randomly to test the distance a shark will approach each color. Results indicate significantly closer approach patterns when divers were wearing orange ponchos, and the combination of orange with black and blue ponchos were found to be statistically significant. These results are relevant to understanding how sharks perceive contrast and dive equipment in the marine environment, which could have the potential to prevent negative shark/human interactions.

Keywords: shark behavior, animal behavior, marine biology, conservation

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98 Enhancing Audience Engagement: Informal Music Learning During Classical Concerts

Authors: Linda Dusman, Linda Baker

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The Bearman Study of Audience Engagement examined the potential for real-time music education during online symphony orchestra concerts. It follows on the promising results of a preliminary study of STEAM (Science, Technology, Engineering, Arts, and Mathematics) education during live concerts, funded by the National Science Foundation with the Baltimore Symphony Orchestra. For the Bearman Study, audience groups were recruited to attend two previously recorded concerts of the National Orchestral Institute (NOI) in 2020 or the Utah Symphony in 2021. They used a smartphone app called EnCue to present real-time program notes about the music being performed. Short notes along with visual information (photos and score fragments) were designed to provide historical, cultural, biographical, and theoretical information at specific moments in the music where that information would be most pertinent, generally spaced 2-3 minutes apart to avoid distraction. The music performed included Dvorak Symphony No. 8 and Mahler Symphony No. 5 at NOI, and Mendelssohn Scottish Symphony and Richard Strauss Metamorphosen with the Utah Symphony, all standard repertoire for symphony orchestras. During each phase of the study (2020 and 2021), participants were randomly assigned to use the app to view program notes during the first concert or to use the app during the second concert. A total of 139 participants (67 in 2020 and 72 in 2021) completed three online questionnaires, one before attending the first concert, one immediately after the concert, and the third immediately after the second concert. Questionnaires assessed demographic background, expertise in music, engagement during the concert, learning of content about the composers and the symphonies, and interest in the future use of the app. In both phases of the study, participants demonstrated that they learned content presented on the app, evidenced by the fact that their multiple-choice test scores were significantly higher when they used the app than when they did not. In addition, most participants indicated that using the app enriched their experience of the concert. Overall, they were very positive about their experience using the app for real-time learning and they expressed interest in using it in the future at both live and streaming concerts. Results confirmed that informal real-time learning during concerts is possible and can generate enhanced engagement and interest in classical music.

Keywords: audience engagement, informal education, music technology, real-time learning

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97 A Metric to Evaluate Conventional and Electrified Vehicles in Terms of Customer-Oriented Driving Dynamics

Authors: Stephan Schiffer, Andreas Kain, Philipp Wilde, Maximilian Helbing, Bernard Bäker

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Automobile manufacturers progressively focus on a downsizing strategy to meet the EU's CO2 requirements concerning type-approval consumption cycles. The reduction in naturally aspirated engine power is compensated by increased levels of turbocharging. By downsizing conventional engines, CO2 emissions are reduced. However, it also implicates major challenges regarding longitudinal dynamic characteristics. An example of this circumstance is the delayed turbocharger-induced torque reaction which leads to a partially poor response behavior of the vehicle during acceleration operations. That is why it is important to focus conventional drive train design on real customer driving again. The currently considered dynamic maneuvers like the acceleration time 0-100 km/h discussed by journals and car manufacturers describe longitudinal dynamics experienced by a driver inadequately. For that reason we present the realization and evaluation of a comprehensive proband study. Subjects are provided with different vehicle concepts (electrified vehicles, vehicles with naturally aspired engines and vehicles with different concepts of turbochargers etc.) in order to find out which dynamic criteria are decisive for a subjectively strong acceleration and response behavior of a vehicle. Subsequently, realistic acceleration criteria are derived. By weighing the criteria an evaluation metric is developed to objectify customer-oriented transient dynamics. Fully-electrified vehicles are the benchmark in terms of customer-oriented longitudinal dynamics. The electric machine provides the desired torque almost without delay. This advantage compared to combustion engines is especially noticeable at low engine speeds. In conclusion, we will show the degree to which extent customer-relevant longitudinal dynamics of conventional vehicles can be approximated to electrified vehicle concepts. Therefore, various technical measures (turbocharger concepts, 48V electrical chargers etc.) and drive train designs (e.g. varying the final drive) are presented and evaluated in order to strengthen the vehicle’s customer-relevant transient dynamics. As a rating size the newly developed evaluation metric will be used.

Keywords: 48V, customer-oriented driving dynamics, electric charger, electrified vehicles, vehicle concepts

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96 Influential Factors Impacting the Utilization of Pain Assessment Tools among Hospitalized Elderly Patients in Taiwan

Authors: Huei Jiun Chen, Hui Mei Huan

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Introduction: Pain is an unpleasant experience for hospitalized patients that impacts both their physical and mental well-being. It is important to select appropriate pain assessment tools to ensure effective pain management. Therefore, it is suggested to use Verbal Rating Scale (VRS) instead for better assessment. The Wong-Baker FACES Pain Rating Scale(WBS) is a widely used pain assessment tool in Taiwan to help individuals communicate the intensity of their pain. However, in clinical practice, even when using various assessment tools to evaluate pain, Numeric Rating Scale-11 (NRS-11) is still commonly utilized to quantify the intensity of pain. The correlation between NRS and other pain assessment tools has not been extensively explored in Taiwan. Additionally, the influence of gender and education level on pain assessment among elderly individuals has not been extensively studied in Taiwan. The aim of this study is to investigate the correlation between pain assessment scales (NRS-11, VRS, WBS) in assessing pain intensity among elderly inpatients. The secondary objective of this study is to examine how gender and education level influence pain assessment among individuals, as well as to explore their preferences regarding pain assessment tools. Method: In this study, a questionnaire survey and purposive sampling were employed to recruit participants from a medical center located in central Taiwan. Participants were requested to assess their pain intensity in the past 24 hours using NRS-11, VRS, and WBS. Additionally, the study investigated their preferences for pain assessment tools. Result: A total of 252 participants were included in this study, with a mean age of 71.1 years (SD=6.2). Of these participants, 135 were male (53.6%), and 44.4% had a primary level or below education. Participants were asked to use NRS-11, VRS, and WBS to assess their current, maximum, and minimum pain intensity experienced in the past 24 hours. The findings indicated a significant correlation (p< .01) among all three pain assessment tools. No significant differences were observed in gender across the three pain assessment scales. For severe pain, there were significant differences in self-rated pain scales among the elderly participants with different education levels (F=3.08, p< .01; X²=17.25, X²=17.21, p< .01), but there were no significant differences observed for mild pain. Regarding preferences for pain assessment tools, 158 participants (62.7%) favored VRS, followed by WBS; gender and education level had no influence on their preferences. Conclusion: Most elderly participants prefer using VRS (Verbal Rating Scale) to self-reported their pain. The reason for this preference may be attributed to the verbal nature of VRS, as it is simple and easy to understand. Furthermore, it could be associated with the level of education among the elderly participants. The pain assessment using VRS demonstrated a significant correlation with NRS-11 and WBS, and gender was not found to have any influence on these assessment. Further research is needed to explore the effect of different education levels on self-reported pain intensity among elderly people in Taiwan.

Keywords: pain assessment, elderly, gender, education

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95 Smart Oxygen Deprivation Mask: An Improved Design with Biometric Feedback

Authors: Kevin V. Bui, Richard A. Claytor, Elizabeth M. Priolo, Weihui Li

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Oxygen deprivation masks operate through the use of restricting valves as a means to reduce respiratory flow where flow is inversely proportional to the resistance applied. This produces the same effect as higher altitudes where lower pressure leads to reduced respiratory flow. Both increased resistance with restricting valves and reduce the pressure of higher altitudes make breathing difficultier and force breathing muscles (diaphragm and intercostal muscles) working harder. The process exercises these muscles, improves their strength and results in overall better breathing efficiency. Currently, these oxygen deprivation masks are purely mechanical devices without any electronic sensor to monitor the breathing condition, thus not be able to provide feedback on the breathing effort nor to evaluate the lung function. That is part of the reason that these masks are mainly used for high-level athletes to mimic training in higher altitude conditions, not suitable for patients or customers. The design aims to improve the current method of oxygen deprivation mask to include a larger scope of patients and customers while providing quantitative biometric data that the current design lacks. This will be accomplished by integrating sensors into the mask’s breathing valves along with data acquisition and Bluetooth modules for signal processing and transmission. Early stages of the sensor mask will measure breathing rate as a function of changing the air pressure in the mask, with later iterations providing feedback on flow rate. Data regarding breathing rate will be prudent in determining whether training or therapy is improving breathing function and quantify this improvement.

Keywords: oxygen deprivation mask, lung function, spirometer, Bluetooth

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94 Assessment of E-Learning Facilities in Open and Distance Learning and Information Need by Students

Authors: Sabo Elizabeth

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Electronic learning is increasingly popular learning approach in higher educational institutions due to vast growth of internet technology. This approach is important in human capital development. An investigation of open distance and e-learning facilities and information need by open and distance learning students was carried out in Jalingo, Nigeria. Structured questionnaires were administered to 70 registered ODL students of the NOUN. Information sourced from the respondents covered demographic, economic and institutional variables. Data collected for demographic variables were computed as frequency count and percentages. Assessment of the effectiveness of ODL facilities and information need among open and distance learning students was computed on a three or four point Likert Rating Scale. Findings indicated that there are more men compared to women. A large proportion of the respondents are married and there are more matured students in ODL compared to the youth. A high proportion of the ODL students obtained qualifications higher than the secondary school certificate. The proportion of computer literate ODL students was high, and large number of the students does not own a laptop computer. Inadequate e -books and reference materials, internet gadgets and inadequate books (hard copies) and reference material are factors that limit utilization of e-learning facilities in the study areas. Inadequate computer facilities and power back up caused inconveniences and delay in administering and use of e learning facilities. To a high extent, open and distance learning students needed information on university time table and schedule of activities, availability and access to books (hard and e-books) and reference materials. The respondents emphasized that contact with course coordinators via internet will provide a better learning and academic performance.

Keywords: open and distance learning, information required, electronic books, internet gadgets, Likert scale test

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93 Effectiveness of Computer Video Games on the Levels of Anxiety of Children Scheduled for Tooth Extraction

Authors: Marji Umil, Miane Karyle Urolaza, Ian Winston Dale Uy, John Charle Magne Valdez, Karen Elizabeth Valdez, Ervin Charles Valencia, Cheryleen Tan-Chua

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Objective: Distraction techniques can be successful in reducing the anxiety of children during medical procedures. Dental procedures, in particular, are associated with dental anxiety which has been identified as a significant and common problem in children, however, only limited studies were conducted to address such problem. Thus, this study determined the effectiveness of computer video games on the levels of anxiety of children between 5-12 years old scheduled for tooth extraction. Methods: A pre-test post-test quasi-experimental study was conducted involving 30 randomly-assigned subjects, 15 in the experimental and 15 in the control. Subjects in the experimental group played computer video games for a maximum of 15 minutes, however, no intervention was done on the control. The modified Yale Pre-operative Anxiety Scale (m-YPAS) with a Cronbach’s alpha of 0.9 was used to assess anxiety at two different points: upon arrival in the clinic (pre-test anxiety) and 15 minutes after the first measurement (post-test anxiety). Paired t-test and ANCOVA were used to analyze the gathered data. Results: Results showed that there is a significant difference between the pre-test and post-test anxiety scores of the control group (p=0.0002) which indicates an increased anxiety. A significant difference was also noted between the pre-test and post-test anxiety scores of the experimental group (p=0.0002) which indicates decreased anxiety. Comparatively, the experimental group showed lower anxiety score (p=<0.0001) than the control. Conclusion: The use of computer video games is effective in reducing the pre-operative anxiety among children and can be an alternative non-pharmacological management in giving pre-operative care.

Keywords: play therapy, preoperative anxiety, tooth extraction, video games

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92 The Health Impact of Intensive Case Management on Women with an Opioid Use Disorder and Their Infants

Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

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91 RNA-seq Analysis of Liver from NASH-HCC Model Mouse Treated with Streptozotocin-High Fat Diet

Authors: Bui Phuong Linh, Yuki Sakakibara, Ryuto Tanaka, Elizabeth H. Pigney, Taishi Hashiguchi

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Non-alcoholic steatohepatitis (NASH) is a chronic liver disease, often associated with type II diabetes, which sometimes progresses to more serious conditions such as liver fibrosis and hepatocellular carcinoma (HCC). NASH has become an important health problem worldwide, buttherapeutic agents for NASH have not yet been approved, and animal models with high clinical correlation are required. TheSTAM™ mouse shows the same pathological progression as human NASH patients and has been widely used for both drug efficacy and basic research, such as lipid profiling and gut microbiota research. In this study, we analyzed the RNA-seq data of STAM™mice at each pathological stage (steatosis, steatohepatitis, liver fibrosis, and HCC) and examined the clinical correlation at the genetic level. NASH was induced in male mice by a single subcutaneous injection of 200 µg streptozotocin solution 2 days after birth and feeding with high fat dietafter 4 weeks of age. The mice were sacrificed and livers collected at 6, 8, 10, 12, 16, and 20 weeks of age. For liver samples, the left lateral lobe was snap frozen in liquid nitrogen and stored at -80˚C for RNA-seq analysis. Total RNA of the cells was isolated using RNeasy mini kit. The gene expression of the canonical pathways in NASH progression from steatosis to hepatocellular carcinoma were analyzed, such as immune system process, oxidation-reduction process, lipid metabolic process. Moreover, since it has been reported that genetic traits are involved in the development of NASH-HCC, we next analyzed the genetic mutations in the STAM™mice. The number of individuals showing mutations in Mtorinvolved in Insulin signaling increases as the disease progresses, especially in the liver cancer phase. These results indicated a clinical correlation of gene profiles in the STAM™mouse.

Keywords: steatosis, non-alcoholic steatohepatitis, fibrosis, hepatocellular carcinoma, RNA-seq

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90 Existential Suffering in the Daily Lives of Those Living with Palliative Care Needs Arising from Chronic Obstructive Pulmonary Disease

Authors: Louise Elizabeth Bolton

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Statement of the problem: There are an estimated 328 million cases of COPD worldwide. It is likely to become the third biggest cause of death by 2030. The impact of living with palliative care needs arising from COPD disrupts an individual’s existential situation. Understandings of individuals' existential situations within COPD are limited within the research literature and are rarely addressed within clinical practice, yet existential suffering has been linked to poor health-related quality of life for those living with other chronic conditions. The purpose of this integrative review is to provide a synthesis of existing evidence on existential suffering for those living with palliative care needs arising from COPD. Methods: This is an integrative review undertaken in accordance with PRISMA guidelines. Nine electronic databases were searched from April 2019 to January 2021. Thirty-five empirical research papers of both qualitative and quantitative methodologies, alongside systematic literature reviews, were included. Data analysis was undertaken using an integrative thematic analysis approach. Findings: Identified themes of existential suffering when living with palliative care needs arising from COPD are as follows: Liminality, Lamented Life, Loss of Personal Liberty, Life Meaning and Existential isolation. The absence of life meaning and purpose was of most importance to patients. Conclusion and Significance: This integrative review provides a synthesis of international evidence upon the presence of existential suffering. It is present and of significant impact within the daily lives of those living with palliative care needs arising from COPD. The absence of life meaning has the most significant impact, requiring further exploration of both its physical and psychological impact. Rediscovery of life meaning diminishes feelings of worthlessness and hopelessness in daily life and facilitates feelings of inner peace. For those with COPD living with such a relentless symptom burden, a positive existential situation is desirable.

Keywords: palliative care, COPD, existential suffering, end of life care

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