Search results for: Oral Laçin
Commenced in January 2007
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Edition: International
Paper Count: 1084

Search results for: Oral Laçin

334 Spironolactone in Psoriatic Arthritis: Safety, Efficacy and Effect on Disease Activity

Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

Abstract:

Therapeutic approaches used previously relied on disease-modifying antirheumatic drugs (DMARDs) that had only partial clinical benefit and were associated with significant toxicity. Spironolactone, an oral aldosterone antagonist, suppresses inflammatory mediators. Clinical efficacy of spironolactone compared with placebo in patients with active psoriatic arthritis despite treatment with prior traditional DMARDs. In the 24-week, placebo-controlled study patients (n=31) were randomized to placebo and spironolactone (2 m/kg/day). Patients on background concurrent DMARDs continued stable doses (methotrexate, leflunomide, and/or sulfasalazine). Primary outcome measures were the assessment of disease activity measures i.e. 28-joint disease activity score (DAS28) and diseases activity in psoriatic arthritis (DAPSA) at week 24. The key secondary endpoint was change from baseline in Health Assessment Questionnaire–Disability Index (HAQ-DI) at week 24. Additional efficacy outcome measures at week 24 included improvements in the markers of inflammation (ESR and CRP) and pro-inflammatory cytokines TNF-α, IL-6 and IL-1. At week 24, spironolactone significantly reduced disease activity measure DAS-28 (p<0.001) and DAPSA (p=0.001) compared with placebo. Significant improvements in key secondary measures HAQ-DI (disability index) were evident with spironolactone (p=0.02) versus placebo. After week 24, there was significant reduction in pro-inflammatory cytokines level TNF-α, IL-6 (p<0.01) as compared with placebo group. However, there was no significant improvement in IL-1 in both treatment and placebo groups. There were minor side effects which did not mandate stopping of spironolactone. No change in any biochemical profile was noted after spironolactone treatment. Spironolactone was effective in the treatment of PsA, improving disease activity, physical function and suppressing the level of pro-inflammatory cytokines. Spironolactone demonstrated an acceptable safety profile and was well tolerated.

Keywords: spironolactone, inflammation, inflammatory cytokine, psoriatic arthritis

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333 Surveillance of Adverse Events Following Immunization during New Vaccines Introduction in Cameroon: A Cross-Sectional Study on the Role of Mobile Technology

Authors: Andreas Ateke Njoh, Shalom Tchokfe Ndoula, Amani Adidja, Germain Nguessan Menan, Annie Mengue, Eric Mboke, Hassan Ben Bachir, Sangwe Clovis Nchinjoh, Yauba Saidu, Laurent Cleenewerck De Kiev

Abstract:

Vaccines serve a great deal in protecting the population globally. Vaccine products are subject to rigorous quality control and approval before use to ensure safety. Even if all actors take the required precautions, some people could still have adverse events following immunization (AEFI) caused by the vaccine composition or an error in its administration. AEFI underreporting is pronounced in low-income settings like Cameroon. The Country introduced electronic platforms to strengthen surveillance. With the introduction of many novel vaccines, like COVID-19 and the novel Oral Polio Vaccine (nOPV) 2, there was a need to monitor AEFI in the Country. A cross-sectional study was conducted from July to December 2022. Data on AEFI per region of Cameroon were reviewed for the past five years. Data were analyzed with MS Excel, and the results were presented in proportions. AEFI reporting was uncommon in Cameroon. With the introduction of novel vaccines in 2021, the health authorities engaged in new tools and training to capture cases. AEFI detected almost doubled using the open data kit (ODK) compared to previous platforms, especially following the introduction of the nOPV2 and COVID-19 vaccines. The AEFI rate was 1.9 and 160 per administered 100 000 doses of nOPV2 and COVID-19 vaccines, respectively. This mobile tool captured individual information for people with AEFI from all regions. The platform helped to identify common AEFI following the use of these new vaccines. The ODK mobile technology was vital in improving AEFI reporting and providing data to monitor using new vaccines in Cameroon.

Keywords: adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK

Procedia PDF Downloads 58
332 On Voice in English: An Awareness Raising Attempt on Passive Voice

Authors: Meral Melek Unver

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This paper aims to explore ways to help English as a Foreign Language (EFL) learners notice and revise voice in English and raise their awareness of when and how to use active and passive voice to convey meaning in their written and spoken work. Because passive voice is commonly preferred in certain genres such as academic essays and news reports, despite the current trends promoting active voice, it is essential for learners to be fully aware of the meaning, use and form of passive voice to better communicate. The participants in the study are 22 EFL learners taking a one-year intensive English course at a university, who will receive English medium education (EMI) in their departmental studies in the following academic year. Data from students’ written and oral work was collected over a four-week period and the misuse or inaccurate use of passive voice was identified. The analysis of the data proved that they failed to make sensible decisions about when and how to use passive voice partly because the differences between their mother tongue and English and because they were not aware of the fact that active and passive voice would not alternate all the time. To overcome this, a Test-Teach-Test shape lesson, as opposed to a Present-Practice-Produce shape lesson, was designed and implemented to raise their awareness of the decisions they needed to make in choosing the voice and help them notice the meaning and use of passive voice through concept checking questions. The results first suggested that awareness raising activities on the meaning and use of voice in English would be beneficial in having accurate and meaningful outcomes from students. Also, helping students notice and renotice passive voice through carefully designed activities would help them internalize the use and form of it. As a result of the study, a number of activities are suggested to revise and notice passive voice as well as a short questionnaire to help EFL teachers to self-reflect on their teaching.

Keywords: voice in English, test-teach-test, passive voice, English language teaching

Procedia PDF Downloads 196
331 Right Cerebellar Stroke with a Right Vertebral Artery Occlusion Following an Embolization of the Right Glomus Tympanicum Tumor

Authors: Naim Izet Kajtazi

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Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

Procedia PDF Downloads 52
330 Beliefs and Rituals among the Urak Lawoi Sea Gypsies in the Bulon Archipelago, Satun Province

Authors: Srisuporn Piyaratanawong, Suchai Assawapantanakul

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This study aims to reflect changes in beliefs and rituals among the Urak Lawoi sea gypsies on the Bulon archipelago of Satun Province that are related to changes of society according to each dimension of time. The historical study was conducted using an oral history approach. The study found that the traditional way of life as itinerants who moved seasonally resulted in their dependence on nature and beliefs in supernatural power, and mysterious powers and superstitions in the belief of ghosts, ancestors, guardian spirits, large banyan trees, life and living, treatment of diseases, king of nagas, and other beliefs. They displayed their respect to supernatural powers through rituals by worshiping, making offerings to spirits and performing Rongeng dance for spirits in return for fulfilling their vows. After World War II (1945), the Urak Lawoi sea gypsies on Bulon archipelago changed their itinerant way of life to permanent settlements. However, their beliefs in supernatural powers and ritual performances remained in existence. Until 1987, when tourism began to spread to the archipelago, some of them gradually turned to make a living with tourism. Moreover, during the last 20 years (from around 1994), Islam has spread among the people. With this social context, the traditional beliefs in supernatural powers have changed to beliefs according to the religion and the way of life that has changed. Thus, when the traditional beliefs and rituals can no longer fulfil the new way of life, they slowly disappear, such as the floating the boat ceremony that has been replaced with new beliefs and rituals according to Islam. Nevertheless, some beliefs and rituals still exist, such as beliefs about treatment of diseases and Rongeng dance for spirits in return for vow fulfilling. In conclusion, the traditional beliefs and rituals of the Urak Lawoi sea gypsies on the Bulon archipelago cannot fulfil the new way of life, and have, thus, brought about changes in beliefs and rituals that are congruent with the current society.

Keywords: belief, ritual, Urak Lawoi, sea gypsy, Bulon Archipelago

Procedia PDF Downloads 258
329 Anti-Ulcer Activity of Hydro Alcoholic Extract of Ficus bengalensis Linn Bark in Experimental Rats

Authors: Jagdish Baheti, Sampat Navale

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The present study was performed to evaluate the anti-ulcerogenic activity of hydro-alcoholic extract of Ficus bengalensis Linn. against ethanol-induced gastric mucosal injury in rats and pylorus ligation gastric secretion in rats. Five groups of adult wistar rats were orally pre-treated respectively with carboxy methyl cellulose (CMC) solution (ulcer control group), Omeprazole 20 mg/kg (reference group), and 100, 200 and 300 mg/kg F. bengalensis Linn. bark extract in CMC solution (experimental groups), one hour before oral administration of absolute ethanol to generate gastric mucosal injury. Rats were sacrificed and the ulcer index, gastric volume, gastric pH, free acidity, total acidity of the gastric content was determined. Grossly, the ulcer control group exhibited severe mucosal injury, whereas pre-treatment with F. bengalensis Linn. bark extract exhibited significant protection of gastric mucosal injury in both model. Histological studies revealed that ulcer control group exhibited severe damage of gastric mucosa, along with edema and leucocytes infiltration of submucosal layer compared to rats pre-treated with F. bengalensis Linn. bark extract which showed gastric mucosal protection, reduction or absence of edema and leucocytes infiltration of submucosal layer. Acute toxicity study did not manifest any toxicological signs in rats. The present finding suggests that F. bengalensis Linn. bark extract promotes ulcer protection as ascertained grossly and histologically compared to the ulcer control group.

Keywords: Ficus bengalensis Linn., gastric ulcer, hydroalcoholic, pylorus ligation

Procedia PDF Downloads 266
328 Haematological Changes and Anticoccidial Activities of Kaempferol in Eimeria Tenella Infected Broiler Chickens

Authors: Ya'u Muhammad, Umar Umar A. Mallammadori, Dahiru Mansur

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Effect of kaempferol on haematological parameters in two weeks old broiler chickens with experimental Eimeria tenella infection was evaluated in this study. Sixty-day old broilers were randomly allotted into six groups (I-VI) of ten broilers each and brooded for two weeks with commercial broiler feed (vital feed®) and provided water ad libitum. At two weeks of age broilers in group 1 were neither infected nor treated. Broilers in groups II-VI were infected with Eimeria tenella sporulated oocyst (104/ml) via oral inoculation. After infection was established, broilers in groups II-IV were treated orally with 1 mg/kg, 1.5 mg/kg, and 2 mg/kg of kaempferol, respectively. Broilers in group V were treated for five days with amprolium, 1.25 g/L in drinking water. Broilers in group VI were administered normal saline, 5 ml/kg per os for five days. Five days post infection; all broilers were sacrificed by severing their jugular veins. Blood sample from each bird was collected in EDTA container for haematology. Caecal contents were harvested and used to determine the lesion score and caecal Oocyst count respectively. Data obtained was analyzed using pad prism version 5.0. Mean Packed Cell Volume (PCV), haemoglobin (Hb) concentration, and Red Blood Cell (RBC) count significantly (P < 0.05) increased in groups II, III, and IV in a dose dependent manner. Similarly, PCV, Hb concentration, and RBC count significantly (P < 0.05) increased in groups II, III, and IV when compared to VI. No significant (P > 0.05) difference in the mean values of PCV, Hb and RBC count were recorded between groups treated with kaempferol and group V. Caecal Oocyst counts and lesion scores reduced significantly (P < 0.05) in groups II, III, and IV in a dose dependent manner. It was therefore observed in this study that kaempferol improved haematological parameters and reduced Oocyst count as well as the lesion scores in broilers infected with Eimeria tenella.

Keywords: broilers, Eimeria tenella, kaempferol, lesion scores, oocyst count,

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327 Hematuria Following Magnesium Sulfate Administration in a Pregnant Patient with Renal Tubular Acidosis

Authors: Jan Gayl Barcelon, N. Gorgonio

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Renal tubular acidosis, a medical condition that involves the accumulation of acid in the body due to failure of the kidneys to maintain normal urine and blood pH, is rarely encountered in pregnancy. The effect of renal tubular acidosis in pregnancy is not fully established. It may worsen during pregnancy and cause maternal and fetal morbidity. A 30-year-old primigravida was diagnosed with renal tubular acidosis at age 7, but due to uncontrolled disease progression, she developed rickets at age 10. She was first seen in our institution at eight weeks gestation and maintained on bicarbonate and potassium supplementation. At 26 weeks gestation, she was diagnosed with polyhydramnios, causing on and off irregular uterine contractions. At 30 weeks gestation, despite oral Nifedipine, premature labor was uncontrolled; hence she was admitted for tocolysis. With elevated creatinine (123 umol/L) and a normal blood urea nitrogen level (6.70 mmol/L), she was referred to Nephrology Service, which cleared the patient prior to MgSO₄ drip. Dosing of 4g MgSO₄ over 20 minutes followed by a maintenance of 2g/hour x 24 hours for neuroprotection and tocolysis was ordered. Two hours after MgSO₄ drip initiation, hematuria developed with adequate urine output. The infusion was immediately stopped. The serum magnesium level was high normal at 6.7 mEq/L. After 4 hours of renal clearance, the repeat serum magnesium level was normal (2.7 mEq/L) and with clear urine output. The patient was then given Nifedipine 30mg/tab, 3x a day which controlled the uterine contractions. At 37 weeks gestation, the patient delivered via primary low transverse Cesarean Section to a live female with a birthweight of 2470gm, appropriate for gestational age. The use of MgSO₄ for the control of premature labor in patients with chronic renal disease secondary to renal tubular can cause hematuria.

Keywords: hematuria, magnesium sulfate, premature labor, renal tubular acidosis

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326 The Nimbārka School of Vedānta and the Indian Classical Dance: The Philosophical Relevance through Rasa Theory

Authors: Shubham Arora

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This paper illustrates a relationship between the Dvaitādvaita (dualistic non-dualistic) doctrine of Nimbārka school of Vedānta and philosophy of Indian classical dance, through the Rasa theory. There would be a separate focus on the philosophies of both the disciplines and then analyzing Rasa theory as a connexion between them. The paper presents ideas regarding the similarity between the Brahman and the dancer, manifestation of enacting character and the Jīva (soul), the existence of the phenomenal world and the imaginary world classification of rasa on the basis of three modes of nature, and the feelings and expressions depicting the Dvaita and Advaita. The reason behind choosing such a topic is an intention to explore the relativity of the Vedantic philosophy of this school in real manner. It is really important to study the practical implications and relevance of the doctrine with other disciplines for perceiving it cogently. In our daily lives, we use various forms of facial expressions and bodily gestures in order to communicate, along with the oral and written means of communication. What if, when gestures and expressions mingle with the music beats, in order to present an idea? Indian Classical dance is highly rich in expressing the emotions using extraordinary expressions, unconventional bodily gestures and mesmerizing music beats. Ancient scriptures like Nāṭyaśāstra of Bharata Muni and Abhinava Bhārati by Abhinavaguptā recount aesthetics in a well-defined and structured way of acting and dancing and also reveal the grammar of rasa theory. Indian Classical dance is not only for entertainment but it is deeply in contact with divinity. During the period of Bhakti movement in India, this art form was used as a means to narrate the vignettes from epics like Rāmāyana and Mahābhārata and Purānas. Even in present era, this art has a deep rooted philosophy within.

Keywords: Advaita, Brahman, Dvaita, Jiva, Nimbarka, Rasa, Vedanta

Procedia PDF Downloads 280
325 Effect of Mobile Phone Text Message Reminders on Adherence to Routine Prenatal Iron/Folic Acid Supplement among Pregnant Women: A Pilot Study

Authors: Nneka U. Igboeli, Maxwell O. Adibe

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Iron and folate supplementation in pregnancy are important interventions that prevent maternal anaemia and fetal anomaly. Thus, daily oral doses of iron and folic acid are recommended throughout pregnancy as part of antenatal care. However, low adherence has been a major drawback leading to low effectiveness of these programs. The effect of mobile text message reminders to pregnant women to take their routine medications on adherence was evaluated in this study. The first 100 women who consented to the study were recruited and randomized to either receive a text message reminder on adherence to routine medications or not. Adherence was assessed using the 8-item Modified Morisky Adherence Scale (8-MMAS). The folders of successfully recruited women were tagged with the a study number assigned to each of them. The womens’ phone numbers were collected and these were used to send text messages reminders on adhering to routine drugs only to women in the intervention group. The text messages were sent three times per week for a period of four weeks with an adherence reassessment at the one month follow-up antenatal visit for recruited women. At one month follow-up, the lost to follow-up were 6 (16%) women for the intervention group and 17 (34%) for the control group. The across group mean difference in adherence score was 0.07 (-0.96 – 1.10) at baseline and 0.3 (-0.31 – 0.92) after intervention, both insignificant at p > 0.05. The within group change were increases of 0.58 (0.00 – 1.16) (p = 0.05) from baseline for the intervention group and a 0.35 (-0.51 – 1.20) (p = 0.395) for the control group. Non-significant increase in adherence scores were recorded for both groups. However, the increase in adherence scores of women in the intervention group was greater and may be potentially transformed into more positive results if the study period is increased with possibly reduced study drop-outs shows great promise for more positive results.

Keywords: adherence, mobile phone, pregnant women, reminders

Procedia PDF Downloads 152
324 The Significant of Effective Leadership on Management Growth and Survival: A Case Study of Bunato Limited Company, Ring Road Ibadan

Authors: A. S. Adegoke, O. N. Popoola

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The central purpose of management in any organization is that of coordinating the efforts of people towards the achievement of its goal. Effective and productive management is the function of leadership. Leadership plays a critical role in helping groups, organizations and societies to achieve their goals. Factors considered to make leadership to be effective are intelligence, social maturity, inner motivation and achievement drives and lastly, human relations attitudes. The factors affecting leadership style and effectiveness were examined. Also, the study examined which of the various leadership style best befits an organization and discussed the ways in which the style was determined. In order to meet the objectives of this study, different types of methods of data gathering were carried out. The methods include data from primary and secondary sources. The primary sources include personal interview, personal observation, and questionnaire while data from secondary sources were derived from various books, journal write up and other documentary records. Data were collected from respondents through questionnaire, and the field research carried out through oral interview to test each of the related hypotheses. From the data analysed it was determined that 45% strongly agreed that leadership traits are inborn not acquired and 28.3% agreed that leadership traits are inborn, while 11.7% and 10% strongly disagreed and disagreed respectively and 5% were undecided. 48.4% strongly agreed, and 43.3% agreed that environmental factors determined the appropriate style of leadership to be employed while 3.3% strongly disagreed, 1.7% disagreed and 3.3% were undecided. From the study, no single style of leadership is appropriate in any situation instead of concentrating on single leadership style; leader can vary approaches depending on forces in the leaders, characteristic of the subordinates, situational forces of the organization, lastly the expectations and behaviour of superior.

Keywords: hypothesis, leadership, management, organization

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323 DOG1 Expression Is in Common Human Tumors: A Tissue Microarray Study on More than 15,000 Tissue Samples

Authors: Kristina Jansen, Maximilian Lennartz, Patrick Lebok, Guido Sauter, Ronald Simon, David Dum, Stefan Steurer

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DOG1 (Discovered on GIST1) is a voltage-gated calcium-activated chloride and bicarbonate channel that is highly expressed in interstitial cells of Cajal and in gastrointestinal stromal tumors (GIST) derived from Cajal cells. To systematically determine in what tumor entities and normal tissue types DOG1 may be further expressed, a tissue microarray (TMA) containing 15,965 samples from 121 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry. DOG1 immunostaining was found in 67 tumor types, including GIST (95.7%), esophageal squamous cell carcinoma (31.9%), pancreatic ductal adenocarcinoma (33.6%), adenocarcinoma of the Papilla Vateri (20%), squamous cell carcinoma of the vulva (15.8%) and the oral cavity (15.3%), mucinous ovarian cancer (15.3%), esophageal adenocarcinoma (12.5%), endometrioid endometrial cancer (12.1%), neuroendocrine carcinoma of the colon (11.1%) and diffuse gastric adenocarcinoma (11%). Low level-DOG1 immunostaining was seen in 17 additional tumor entities. DOG1 expression was unrelated to histopathological parameters of tumor aggressiveness and/or patient prognosis in cancers of the breast (n=1,002), urinary bladder (975), ovary (469), endometrium (173), stomach (233), and thyroid gland (512). High DOG1 expression was linked to estrogen receptor expression in breast cancer (p<0.0001) and the absence of HPV infection in squamous cell carcinomas (p=0.0008). In conclusion, our data identify several tumor entities that can show DOG1 expression levels at similar levels as in GIST. Although DOG1 is tightly linked to a diagnosis of GIST in spindle cell tumors, the differential diagnosis is much broader in DOG1 positive epithelioid neoplasms.

Keywords: biomarker, DOG1, immunohistochemistry, tissue microarray

Procedia PDF Downloads 183
322 Zimbabwe's Foreign Policy in Southern Africa, 1980-2013

Authors: Dylan Yanano Mangani, Theodore Nkadimeng Mahosi

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Soon after independence on 18th April 1980, Zimbabwe’s foreign policy was shaped by the realities on the ground, which saw the country managing a sound relationship with both the Capitalist West and the Communist Eastern blocs. The post-independence foreign policy was therefore premised on security concerns illuminated by the Cold War era. This was one the reasons President Robert Mugabe adopted a policy of reconciliation and this earned his government recognition on the international platform. However, in Southern Africa apartheid South Africa was still the vanguard of capitalism and oppression such that she posed a serious threat to the newly born Zimbabwean nation which necessitated that Zimbabwe position herself both in the region and the continent to counter potential internal stability from within. Irrespective of how the international community viewed the country’s foreign policy Zimbabwe has continued to influence regional, continental and world geo-politics, especially on behalf of the developing nations. This raises a question why as a result of its foreign policy the country is now regarded a pariah state, especially some Western countries which used to applaud its political economic policies immediately after independence. Therefore, this study argues that the political economy of Zimbabwe had a far-reaching bearing on its foreign policy. For this reason, the problem necessitates the investigation of Zimbabwe’s foreign policy perspectives in Southern Africa since the turn of the 1990s. Two main theories which are Realism, Afro-centrism inform the study as an attempt to understand Zimbabwe’s foreign policy paradigm shift and perhaps provide answers to the objectives raised. The research therefore employs a qualitative approach where the conceptual nature of the study into the foreign policy of Zimbabwe is largely desktop research. However, the nature of the study will also require that oral interviews are conducted to substantiate some of the arguments advanced.

Keywords: cold war set up, foreign policy, look east policy, pan-africanism, post 2000 period, Southern Africa, Zimbabwe

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321 Speech Anxiety in Higher Education Students-Retention of an Ancestral Trait: A Study into the Students' Perspective of Communication Anxiety with Suggestions on How to Minimise Student Distress

Authors: Paul D. Facey, Claire Morgan

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Speech anxiety is thought to be deep-seated within the human evolutionary lineage.As a result, almost all people display high levels of anxiety when asked to communicate in front of an audience.However, proficiency in oral communication is considered as an essential skill for a graduate career and significant emphasis is placed on developing these skills in many degree programs.Because of this, many degree schemes incorporate some form of assessed dialogic presentation. Yet, a student’s anxiety over public speaking, especially if severe, can be so great that at worst it can cause the student to withdraw from their study. This study investigated how students perceive their own levels of anxiety when faced with public speaking using the Personal Report of Public Speaking Anxiety (PRPSA) questionnaire developed by McCroskey. Additionally, students were asked to provide examples of adjustments that could be implemented that they felt would alleviate some/all of their anxiety. The results of the study indicated that the majority of the students experienced a moderate level of anxiety. However, further analysis showed that of those who were in the moderate anxiety’ group, 43% fell into the higher range suggesting that overall more students experience higher levels of anxiety when faced with public speaking than maybe first envisaged. Thus, it is essential that steps are taken to address student anxiety in order that students engage with presentations, are motivated and encouraged and do not avoid such assignments. The feedback from our students indicated a need to implement systematic desensitization programs where students learn to overcome their anxiety through a series of sessions that gradually increase their anxiety levels. Furthermore, these sessions should be run in parallel with skills sessions in order for students to be better prepared and allow self-reflection and self-analysis.This study highlights the paucity of these sessions on many degree schemes and suggests that they should form an integral part of a students’ early academic learning.

Keywords: student anxiety, communication anxiety, public speaking, higher education, desensitisation

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320 The Presence of Ochratoxin a in Breast-Milk, Urine and Serum of Lactating Women

Authors: Magdalena Twaruzek, Karolina Ropejko

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Mycotoxins are secondary metabolites of molds. Ochratoxin A (OTA) is the most common in the Polish climate. It is produced by fungi of the genera Aspergillus and Penicillium. It is produced as a result of improper food storage. It is present in many products that are consumed both by humans and animals: cereals, wheat gluten, coffee, dried fruit, wine, grape juice, spices, beer, and products based on them. OTA is nephrotoxic, hepatotoxic, potentially carcinogenic, and teratogenic. OTA mainly enters an organism by oral intake. The aim of the study was to detect the presence of OTA in milk, urine, and serum of lactating women. A survey was also conducted regarding the daily diet of women. The research group consisted of 32 lactating women (11 were the donors from the Milk Bank in Toruń, the other 21 were recruited for this study). Results of the analysis showed the occurrence of OTA only in 3 milk samples (9.38%). The minimum level was 0.01 ng/ml, while the maximum 0.018 ng/ml and the mean 0.0013 ng/ml. Twenty-six urine samples (81.25%) were OTA positive, with minimum level 0.013 ng/ml, maximum level 0.117 ng/ml and mean 0.0192 ng/ml. Also, all 32 serum samples (100%) were contaminated by OTA, with a minimum level of 0.099 ng/ml, a maximum level of 2.38 ng/ml, and a mean of 0.4649 ng/ml. In the case of 3 women, OTA was present in all tested body fluids. Based on the results, the following conclusions can be drawn: the breast-milk of women in the study group is slightly contaminated with ochratoxin A. Ten samples of urine contained ochratoxin A above its average content in tested samples. Moreover, serum of 8 women contains ochratoxin A at a level above the average content of this mycotoxin in tested samples. The average ochratoxin A level in serum in the presented studies was 0.4649 ng/ml, which is much lower than the average serum ochratoxin A level established in several countries in the world, i.e., 0.7 ng/ml. Acknowledgment: This study was supported by the Polish Minister of Science and Higher Education under the program 'Regional Initiative of Excellence' in 2019 - 2022 (Grant No. 008/RID/2018/19).

Keywords: breast-milk, urine, serum, contamination, ochratoxin A

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319 Study on Effective Continuous Assessments Methods to Improve Undergraduates English Language Skills

Authors: K. M. R. Siriwardhana

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Sri Lanka is a developing country in South Asia which uses English as its second language. Today, most of the university students in Sri Lanka are eagerly exploring knowledge giving special consideration to English as their 2nd Language with the understanding that to climb up the career ladder, English is inevitable both in local and international contexts. However, still a considerable failing rate in English can also be seen among the Sri Lankan undergraduates Further, most of the Sri Lankan universities now practice English as their medium of instructions making English a credited Subject to brighten the future of the Sri Lankan students. Accordingly, in many universities an array of assessments are employed to evaluate undergraduates’ competence in English language. The main objective of this study was to ascertain the effective assessment methods to improve the 2nd language skills of the Sri Lankan university students which also create a more interest in them to learn English. Accordingly, hundred (100) undergraduates were selected as the research sample and the primary data was collected employing a semi structured questionnaire along with class room observations and semi structured interviews. Data was mainly analyzed descriptively employing graphical illustrations. According to the research findings, it was revealed that practical assessments such as oral tests, competitive drama and presentations are more effective in improving their language skills and preferred by the majority of students than written assignments and papers. Further, most of the students have scored better in practical assignments than in the written assignments. Hence, the study concludes that best and the benefited way of improving English language skills of Sri Lankan undergraduates is practical assessments as it gives them the opportunity to apply the language with much confidence and competence in actual situations. Further, the study recommends the language teachers to improve their own skills and creativity in practicing and employing such assessments as it will develop both second language teaching and learning skills. Ultimately, the university graduates will be able to secure their positions internationally as they are well capable in English, the lingua franca of the world.

Keywords: assessments, second language, Sri Lanka, undergraduates

Procedia PDF Downloads 281
318 Attitudes and Knowledge of Dental Patients Towards Infection Control Measures in Kuwait University Dental Center

Authors: Fatima Taqi, Abrar Alanzi

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Objectives: The objective of this study is to determine and assess the level of knowledge and attitudes of dental patients attending Kuwait University Dental Clinics (KUDC) regarding the infection control protocols practiced in the clinic. The results would highlight the importance of conducting awareness campaigns in the community to promote good oral healthcare in Kuwait. Materials and Methods: A cross-sectional descriptive survey was carried out among dental patients attending KUDC. A structured questionnaire, in both Arabic and English languages, was used for data collection about the socio-demographic characteristics, knowledge about the dental cross-infection, and attitudes and self-reported practices regarding infection transmission and control in dentistry. Results: A response rate of 80% (202/250) was reported. 47% of respondents had poor knowledge about dental infection transmission, and only 19.8% had satisfactory knowledge. Female participants obtained a higher satisfactory score (14.3%) compared to males (5.5%). Patients with a university degree or higher education had a better level of knowledge compared to patients with a lower educational level (p < 0.05). The majority of participants agreed that the dentist should wear gloves (95.5%), masks (89.6%), safety glasses (70.3%), and gowns (84.7%). Many patients believed that the protection measures are mainly to stop the infection transmission from patient to patient via the dentist. Half of the participants would ask if the instruments are sterilized and might accept treatment from non-vaccinated dentists. Conclusions: Many dental patients attending KUDC have obtained poor knowledge scores regarding infection transmission in the dental clinic. The educational level was significantly associated with their level of knowledge. An overall positive attitude was reported regarding the infection control protocols practiced in the dental clinic. Raising awareness among dental patients about dental infection transmission and protective measures is of utmost importance.

Keywords: dental infection, knowledge, dental patients, infection control

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317 Development of Personal Protection Equipment for Dental Surgeon

Authors: Thi. A. D. Tran, Matthieu Arnold, Dominique Adolphe, Laurence Schcher, Guillaume Reys

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During daily oral health cares, dental surgeons are in contact with numerous potentially infectious germs from patients' saliva and blood. In order to take into account these risks, a product development process has been unrolled to propose to the dental surgeon a personal protection equipment that is suitable with their expectations in terms of images, protection and comfort. After a consumer study, to evaluate how the users wear the garment and their expectations, specifications have been carried out and technical solutions have been developed in order to answer to the maximum of the desiderata. Thermal studies and comfort studies have been performed. The obtained results lead to define the technical solutions concerning the design of the new scrub. Three main functions have been investigated, the ergonomic aspect, the protection and the thermal comfort. In terms of ergonomic aspect, instrumented garments have been worn and pressure measurements have been done. The results highlight that a raglan shape for the sleeves has to be selected for a better dynamic comfort. Moreover, spray tests helped us to localize the potential contamination area and therefore protection devices have been placed on the garment. Concerning the thermal comfort, an I-R study was conducted in consulting room under the real working conditions; the heating zones have been detected. Based on these results, solutions have been proposed and implemented in a new gown. This new gown is currently composed of three different parts; a protective layer placed in the chest area to avoid contamination; a breathable layer placed in the back and in the armpits and a normal PET/Cotton fabric for the rest of the gown. Through the fitting tests conducted in hospital, it was obtained that the new design was highly appreciated. Some points can nevertheless be further improved. A final product will be produced based on necessary improvements.

Keywords: comfort, dentists, garment, thermal

Procedia PDF Downloads 285
316 Ethno-Botanical Research on Medicinal Plants Commonly Used for Children’s Health in South East Nigeria

Authors: Chioma J. Nwakamma, Blessing O. Oyedemi, Garuba Omosun

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This research surveys and documents information on medicinal plants and their botanical preparations used in the treatment of children’s ailments in South-Eastern Nigeria. Children under the age of 5 in developing countries suffer from diseases with high morbidity and mortality rate yearly due to inaccessible and unaffordable healthcare. Structured questionnaires were administered to herbal sellers, traditional medicine practitioners, nursing mothers, and adult dwellers to collect data on the names of plants used to treat the conditions, methods of preparation, duration of treatment, adverse effects, and the methods of administration of the plant materials. A total of 135 plants belonging to 55 families were identified for the management of children’s health in the area. Common pediatric ailments which were said to be treated with herbal remedies by the respondents included malaria, pneumonia, stomach ache, diarrhea, dysentery, measles, chickenpox/smallpox, convulsion, jaundice, pile, ringworm, scabies, eczema, stubborn cough, scurvy, catarrh, wounds, boils, insect bites, food poison, cholera, and umbilical cord complications. Percentages of respondents were; herbal sellers (48.2%), traditional medical practitioners (21.6%), nursing mothers (11.1%), and others (19.1%). The most occurring plant families were Euphorbiaceae, Fabaceae, and Apocynaceae, with 8 species of plants each followed by Annonaceae and Asteriaceae with 7 and 6 species, respectively. The recipes were made from the combination of different parts of two or more plant species, and others were made from single plant parts. Methods of extraction were mostly decoction and raw-squeezing out of the juice and infusion, while oral administration was the main route of administration.

Keywords: ethno-botanicals, children’s health, medicinal plants, South-Eastern Nigeria

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315 Tocotrienol Rich Fraction in Nicotine-Induced Embryos: Cytoskeletal Changes of Actin and Tubulin

Authors: Nurul Hamirah Kamsani, Mohd Hamim Rajikin, Nor Ashikin Mohamed Noor Khan, Sharaniza Abdul Rahim

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Cytoskeletal structures, in particular actin and tubulin, provide a fundamental framework in all cells, including embryos. Under influence of nicotine, the cytoskeletal organization may be subjected to oxidative stress (OS) insult and cause alteration. Tocotrienol-rich fraction (TRF) is proven to enhance fertility better than the other sub-group of Vitamin E, tocopherols (TCPs). The objective of this study was to evaluate the effects of TRF on 1) actin and tubulin of 2- and 8-cell murine embryos and 2) the regulation of reactive oxygen species (ROS)-scavenging enzymes; induced by nicotine. Twenty four female Balb/C were subjected to either subcutaneous (sc) injection of 0.9% NaCl; sc injection of 3.0 mg/kg bw/day nicotine; sc injection of 3.0 mg/kg bw/day nicotine + oral gavage (OG) of 60 mg/kg bw/day TRF; or OG of 60 mg/kg bw/day TRF for 7 consecutive days. After superovulation and mating, animals were euthanized. 2-cell developing embryos were retrieved. 50% of the retrieved embryos were visualized under confocal laser staining microscopy (CLSM) for alterations of actin and tubulin. The remaining amount of embryos was cultured in vitro until 8-cell stage followed by CLSM visualization. Blood plasma was subjected to OS assays. Plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were determined and analysed accordingly. At both 2- and 8-cell developing stages, actin intensities were significantly reduced in the nicotine group (p<0.001). After the intervention, actin intensity was significantly increased compared to that of the nicotine group (p<0.001). The same trend was seen in tubulin at both cell stages. TRF has minimized the deleterious effects of nicotine in actin and tubulin of both 2- and 8-cell developmental stages during pre-implantation embryonic development in mice in vitro. Levels of endogenous anti-oxidative enzymes were sustained close to control accompanied by decreased levels of OS biomarker.

Keywords: actin, nicotine, pre-implantation embryos, tocotrienol rich fraction, tubulin

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314 Sudanese Dietitian’s Role in the Provision of Parenteral Nutrition: The Past, Present, and Future

Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

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313 Delivery of Ginseng Extract Containing Phytosome Loaded Microsphere System: A Preclinical Approach for Treatment of Neuropathic Pain in Rodent Model

Authors: Nitin Kumar

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Purpose: The current research work focuses mainly on evolving a delivery system for ginseng extract (GE), which in turn will ameliorate the neuroprotective potential by means of enhancing the ginsenoside (Rb1) bio-availability (BA). For more noteworthy enhancement in oral bioavailability (OBA) along with pharmacological properties, the drug carriers’ performance can be strengthened by utilizing phytosomes-loaded microspheres (PM) delivery system. Methods: For preparing the disparate phytosome complexes (F1, F2, and F3), an aqueous extract of ginseng roots (GR) along with phospholipids were reacted in disparate ratio. Considering the outcomes, F3 formulation (spray-dried) was chosen for preparing the phytosomes powder (PP), PM, and extract microspheres (EM). PM was made by means of loading of F3 into Gum Arabic (GA) in addition to maltodextrin polymer mixture, whereas EM was prepared by means of the addition of extract directly into the same polymer mixture. For investigating the neuroprotective effect (NPE) in addition to their pharmacokinetic (PK) properties, PP, PM, and EM formulations were assessed. Results: F3 formulation gave enhanced entrapment efficiency (EE) (i.e., 50.61%) along with good homogeneity of spherical shaped particle size (PS) (42.58 ± 1.4 nm) with least polydispersity index (PDI) (i.e., 0.193 ± 0.01). The sustained release (up to 24 h) of ginsenoside Rb1 (GRb1) is revealed by the dissolution study of PM. A significantly (p < 0.05) greater anti-oxidant (AO) potential of PM can well be perceived as of the diminution in the lipid peroxidase level in addition to the rise in the glutathione superoxide dismutase (SOD) in addition to catalase levels. It also showed a greater neuroprotective potential exhibiting significant (p < 0.05) augmentation in the nociceptive threshold together with the diminution in damage to nerves. A noteworthy enhancement in the relative BA (157.94%) of GRb1 through the PM formulation can well be seen in the PK studies. Conclusion: It is exhibited that the PM system is an optimistic and feasible strategy to enhance the delivery of GE for the effectual treatment of neuropathic pain.

Keywords: ginseng, neuropathic, phytosome, pain

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312 Cucurbita pepo L. Attenuates Diabetic Neuropathy by Targeting Oxidative Stress in STZ-Nicotinamide Induced Diabetic Rats

Authors: Navpreet Kaur, Randhir Singh

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Diabetic neuropathy is one of the most common microvascular complications of diabetes mellitus which affects more than 50% of diabetic patients. The present study targeted oxidative stress mediated nerve damage in diabetic rats using a hydro-alcohol extract of Cucurbita pepo L. (Family: Cucurbitaceae) and its potential in treatment of diabetic neuropathy. Diabetes neuropathy was induced in Wistar rats by injection of streptozotocin (65 mg/kg, i.p.) 15 min after Nicotinamide (230 mg/kg, i.p.) administration. Hydro-alcohol extract of C. pepo seeds was assessed by oral administration at 100, 200 and 400 mg/kg in STZ-nicotinamide induced diabetic rats. Thermal hyperalgesia (Eddy's hot plate and tail immersion), mechanical hyperalgesia (Randall-Selitto) and tactile allodynia (Von Frey hair tests) were evaluated in all groups of streptozotocin diabetic rats to assess the extent of neuropathy. Tissue (sciatic nerve) antioxidant enzymes (SOD, CAT, GSH and LPO) levels were measured along with the formation of AGEs in serum to assess the effect of hydro-alcohol extract of C. pepo in ameliorating oxidative stress. Diabetic rats exhibited significantly decreased tail-flick latency in the tail-immersion test and decreased paw withdrawal threshold in both Randall-Selitto and von-Frey hair test. A decrease in the nociceptive threshold was accompanied by significantly increased oxidative stress in sciatic nerve of diabetic rats. Treatment with the C. pepo hydro-alcohol extract significantly attenuated all the behavioral and biochemical alterations in a dose-dependent manner. C. pepo attenuated the diabetic condition and also reversed neuropathic pain through modulation of oxidative stress and thus it may find application as a possible therapeutic agent against diabetic neuropathy.

Keywords: advanced glycation end products, antioxidant enzymes, cucurbita pepo, hyperglycemia

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311 “MaxSALIVA”: A Nano-Sized Dual-Drug Delivery System for Salivary Gland Radioprotection and Repair in Head and Neck Cancer

Authors: Ziyad S. Haidar

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Background: Saliva plays a major role in maintaining oral and dental health (consequently, general health and well-being). Where it normally bathes the oral cavity and acts as a clearing agent. This becomes more apparent when the amount and quality of salivare significantly reduced due to medications, salivary gland neoplasms, disorders such as Sjögren’s syndrome, and especially ionizing radiation therapy for tumors of the head and neck, the fifth most common malignancy worldwide, during which the salivary glands are included within the radiation field or zone. Clinically, patients affected by salivary gland dysfunction often opt to terminate their radiotherapy course prematurely because they become malnourished and experience a significant decrease in their quality of life. Accordingly, the development of an alternative treatment to restore or regenerate damaged salivary gland tissue is eagerly awaited. Likewise, the formulation of a radioprotection modality and early damage prevention strategy is also highly desirable. Objectives: To assess the pre-clinical radio-protective effect as well as the reparative/regenerative potential of layer-by-layer self-assembled lipid-polymer-based core-shell nanocapsules designed and fine-tuned in this experimental work for the sequential (ordered) release of dual cytokines, following a single local administration (direct injection) into a murine sub-mandibular salivary gland model of irradiation. Methods: The formulated core-shell nanocapsules were characterized by physical-chemical-mechanically pre-/post-loading with the drugs (in solution and powder formats), followed by optimizing the pharmaco-kinetic profile. Then, nanosuspensions were administered directly into the salivary glands, 24hrs pre-irradiation (PBS, un-loaded nanocapsules, and individual and combined vehicle-free cytokines were injected into the control glands for an in-depth comparative analysis). External irradiation at an elevated dose of 18Gy (revised from our previous 15Gy model) was exposed to the head-and-neck region of C57BL/6 mice. Salivary flow rate (un-stimulated) and salivary protein content/excretion were regularly assessed using an enzyme-linked immunosorbent assay (3-month period). Histological and histomorphometric evaluation and apoptosis/proliferation analysis followed by local versus systemic bio-distribution and immuno-histochemical assays were then performed on all harvested major organs (at the distinct experimental end-points). Results: Monodisperse, stable, and cytocompatible nanocapsules capable of maintaining the bioactivity of the encapsulant within the different compartments with the core and shell and with controlled/customizable pharmaco-kinetics, resulted, as is illustrated in the graphical abstract (Figure) below. The experimental animals demonstrated a significant increase in salivary flow rates when compared to the controls. Herein, salivary protein content was comparable to the pre-irradiation (baseline) level. Histomorphometry further confirmed the biocompatibility and localization of the nanocapsules, in vivo, into the site of injection. Acinar cells showed fewer vacuoles and nuclear aberration in the experimental group, while the amount of mucin was higher in controls. Overall, fewer apoptotic activities were detected by a Terminal deoxynucleotidyl Transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay and proliferative rates were similar to the controls, suggesting an interesting reparative and regenerative potential of irradiation-damaged/-dysfunctional salivary glands. The Figure below exemplifies some of these findings. Conclusions: Biocompatible, reproducible, and customizable self-assembling layer-by-layer core-shell delivery system is formulated and presented. Our findings suggest that localized sequential bioactive delivery of dual cytokines (in specific dose and order) can prevent irradiation-induced damage via reducing apoptosis and also has the potential to promote in situ proliferation of salivary gland cells; maxSALIVA is scalable (Good Manufacturing Practice or GMP production for human clinical trials) and patent-pending.

Keywords: saliva, head and neck cancer, nanotechnology, controlled drug delivery, xerostomia, mucositis, biopolymers, innovation

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310 [Keynote Talk]: Treatment Satisfaction and Safety of Sitagliptin versus Pioglitazone in Patients with Type 2 Diabetes Mellitus Inadequately Controlled on Metformin Monotherapy

Authors: Shahnaz Haque, Anand Shukla, Sunita Singh, Anil Kem

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Introduction: Diabetes Mellitus is a chronic metabolic disease affecting millions worldwide. Metformin is the most commonly prescribed first line oral hypoglycemic drug for type 2 diabetes mellitus, but due to progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. Objective: This study was designed to assess the treatment satisfaction between Sitagliptin versus Pioglitazone added to Metformin in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective, open label, randomized, parallel group study in SIMS, Hapur, U.P. Eligible patients fulfilling inclusion criteria were randomized into two groups having 25 patients in each group using tab Sitagliptin 100mg, tab Pioglitazone 30mg added to ongoing tab Metformin (500mg) therapy for 16 weeks. The follow-up visits were on weeks 4,12 and 16. Result: 16 weeks later, addition of Sitagliptin 100mg compared to that of Pioglitazone 30 mg to ongoing Metformin therapy provided similar glycosylated hemoglobin (HbA1c) lowering efficacy in patients with T2DM with inadequate glycemic control on metformin monotherapy. Change in HbA1c in group1 was -0.656±0.21%(p<0.0001) whereas in group2 was -0.748±0.35%(p<0.0001). Hence decrease in HbA1c from baseline was more in group2. Both treatments were well tolerated with negligible risk of hypoglycaemia. Weight loss was observed with Sitagliptin in contrast to weight gain seen in Pioglitazone. Conclusion: In this study, Sitagliptin 100 mg along with metformin therapy in comparison to pioglitazone 30 mg plus metformin therapy was both effective, well-tolerated and improved glycemic control in both the groups. Addition of pioglitazone had cause oedema and weight gain to the patients whereas sitagliptin caused weight loss in its patients.

Keywords: sitagliptin, pioglitazone, metformin, type 2 diabetes mellitus

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309 Combination of Diane-35 and Metformin to Treat Early Endometrial Carcinoma in PCOS Women with Insulin Resistance

Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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308 Basic Examination of Easily Distinguishable Tactile Symbols Attached to Containers and Packaging

Authors: T. Nishimura, K. Doi, H. Fujimoto, Y. Hoshikawa, T. Wada

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In Japan, it is expected that reasonable accommodation for persons with disabilities will progress further. In particular, there is an urgent need to enhance information support for visually impaired persons who have difficulty accessing information. Recently, tactile symbols have been attached to various surfaces, such as the content labels of containers and packaging of various everyday products. The advantage of tactile symbols is that they are useful for visually impaired persons who cannot read Braille. The method of displaying tactile symbols is prescribed by the International Organization for Standardization (ISO). However, the quantitative data on the shapes and dimensions of tactile symbols is insufficient. In this study, through an evaluation experiments, we examine the easy-to-distinguish shapes and dimensions of tactile symbols used for various applications, including the content labels on containers and packaging. Visually impaired persons participated in the experiments. They used tactile symbols on a daily basis. The details and processes of the experiments were orally explained to the participants prior to the experiments, and the informed consent of the participants was obtained. They were instructed to touch the test pieces of tactile symbols freely with both hands. These tactile symbols were selected because they were likely to be easily distinguishable symbols on the content labels of top surfaces of containers and packaging based on a hearing survey that involved employees of an organization of visually impaired and a social welfare corporation, as well as academic experts of support technology for visually impaired. The participants then answered questions related to ease of distinguishing of tactile symbols on a scale of 5 (where 1 corresponded to ‘difficult to distinguish’ and 5 corresponded to ‘easy to distinguish’). Hearing surveys were also performed in an oral free answer manner with the participants after the experiments. This study revealed the shapes and dimensions regarding easily distinguishable tactile symbols attached to containers and packaging. We expect that this knowledge contributes to improvement of the quality of life of visually impaired persons.

Keywords: visual impairment, accessible design, tactile symbol, containers and packaging

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307 A Study on the Cultural Landscape of the Living Environment of Hoklo-Hakka: Case Study of Dacun

Authors: Meng-Li Lin, Shang-Hsuan Chiu

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Taiwan is a country of diverse ethnic groups, the historical background of each ethnic group is different, and the conflict between them influence on each other, result in Taiwan's multi-culture. The Changhua County in Taiwan is the largest county of Hoklo-Hakka. Hakka people get along with Hoklo people for a long time. There are integration and conflict during that time and makes Hakka people gradually assimilated Hoklo-Hakka people. Today in Changhua Plain area, many Hoklo-Hakka people do not speak Hakka language. Therefore, it has been difficult to find information of Hakka from the Hakka language in the group of Hoklo-Hakka. But in the living space or culture to find relevant historical traces of life could be confirmed in Hakka Culture. In this paper, through the investigation of descent, life field, religion, language and other investigations of the Dacun, Changhua County residents to carry out the analysis of the process of assimilating Hoklo in living cultural landscape. First is through the local literature, the elderly and other oral history stories, to investigate the changes in Dacun field historical. Second, the comparison of collected traditional Hakka culture and the living cultural landscape of Hoklo-Haka are done to explore the differences between the living cultural landscape and the traditional Hakka culture. After analysis Hoklo-Hakka living cultural landscape, the significant differences, we proposed preservation strategy to provide recommendations to save the cultural life of Hoklo-Hakka landscape in future. Changhua Dacun traditional Hakka landscape is disappearing, in this study, we explore and investigate the data of Changhua Dacun Hoklo-Hakka living cultural landscape to analyze and to provide strategic advice to save. Here we have three study purposes. 1. Discuss the Hoklo-Hakka living cultural landscape of Changhua Dacun. 2. Investigate and record the Hoklo-Hakka living cultural landscape. 3. Propose a reserve strategy of the Hoklo-Hakka living cultural landscape in future.

Keywords: Hoklo-Hakka, Dacun, save policy, life Culture

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306 E-Portfolios as a Means of Perceiving Students’ Listening and Speaking Progress

Authors: Heba Salem

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This paper aims to share the researcher’s experience of using e-Portfolios as an assessment tool to follow up on students’ learning experiences and performance throughout the semester. It also aims at highlighting the importance of students’ self-reflection in the process of language learning. The paper begins by introducing the advanced media course, with its focus on listening and speaking skills, and introduces the students’ profiles. Then it explains the students’ role in the e-portfolio process as they are given the option to choose a listening text they studied throughout the semester and to choose a recorded oral production of their collection of artifacts throughout the semester. Students showcase and reflect on their progress in both listening comprehension and speaking. According to the research, re-listening to work given to them and to their production is a means of reflecting on both their progress and achievement. And choosing the work students want to showcase is a means to promote independent learning as well as self-expression. Students are encouraged to go back to the class learning outcomes in the process of choosing the work. In their reflections, students express how they met the specific learning outcome. While giving their presentations, students expressed how useful the experience of returning and going over what they covered to select one and going over their production as well. They also expressed how beneficial it was to listen to themselves and literally see their progress in both listening comprehension and speaking. Students also reported that they grasped more details from the texts than they did when first having it as an assignment, which coincided with one of the class learning outcomes. They also expressed the fact that they had more confidence speaking as well as they were able to use a variety of vocabulary and idiomatic expressions that students have accumulated. For illustration, this paper includes practical samples of students’ tasks and instructions as well as samples of their reflections. The results of students’ reflections coincide with what the research confirms about the effectiveness of the e-portfolios as a means of assessment. The employment of e-Portfolios has two-folded benefits; students are able to measure the achievement of the targeted learning outcomes, and teachers receive constructive feedback on their teaching methods.

Keywords: e-portfolios, assessment, self assessment, listening and speaking progress, foreign language, reflection, learning out comes, sharing experience

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305 Anterior Tooth Misalignment: Orthodontics or Restorative Treatment

Authors: Maryam Firouzmandi, Moosa Miri

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Smile is considered to be one of the most effective methods of influencing people. Increasing numbers of patients are requesting cosmetic dental procedures to achieve the perfect smile. Based on the patient’s age, oral and facial characteristics, and the dentist’s expertise, different concepts of treatment would be available. Orthodontics is the most conservative and the ideal treatment alternative for crowded anterior teeth; however, it may be rejected by patients due to occupational limitations of time, physical discomfort including pain and functional limitations, psychological discomfort, and appearance during treatment. In addition, orthodontic treatment will not resolve deficits of contour and color of the anterior teeth. In consequence, patients may demand restorative techniques to resolve their anterior mal-alignment instead, often called "instant orthodontics". Following its introduction, however, adhesive dentistry has suffered at times from overuse. Creating short-term attractive smiles at the expense of long-term dental health and optimal tooth biomechanics by using cosmetic techniques should not be considered an ethical approach. The objective of this narrative review was to investigate the literature for guidelines with regard to decision making and treatment planning for anterior tooth mal-alignment. In this regard, indications of orthodontic, restorative, combination of both treatments, and adjunctive periodontal surgery were discussed in clinical cases to achieve a proportional smile. Restorative modalities would include disking, cosmetic contouring, veneers, and crowns and were compared with limited or comprehensive orthodontic options. A rapid review was also presented on pros and cons of snap on smile to mask malalignments. Diagnostic tools such as mock up, wax up, and digital smile design were also considered to achieve more conservative and functional treatments with respect to biologic factors.

Keywords: crowding, misalignment, veneer, crown, orthodontics

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