Diplomacy as Pedagogy, Pedagogy as Diplomacy: Diplomatic Simulations, Constructivism, and the 2030 Sustainable Development Agenda

Diplomatic simulations, or simulations of international or regional organizations (i.e. Model United Nations), present great opportunities that extend beyond the pedagogical value suggested by limited literature. Operationalizing constructivism as both a pedagogical and international relations theory illuminates the implications of diplomatic simulations on participants, diplomacy, and multidisciplinary research. To accomplish this, this exploratory study first performs a thorough literature review to synthesize relevant works. An exploratory content analysis is then employed on documents in a Model United Nations simulation to investigate its utility in accomplishing the United Nations’ 2030 Sustainable Development Agenda, particularly Sustainable Development Goal (SDG) 4: Quality Education. Findings suggest that while diplomatic simulations develop skills and knowledge of international relations, they also impact actual diplomacy by disrupting ethnocentrism, exporting political agents, and norm diffusion. Diplomatic simulations can also be used as nontraditional data sources and research methods, providing a unique solution to resource-constrained research endeavors

CHARACTERISTICS AND CHEMICAL KINETICS OF HYDROGEN SULFIDE COMBUSTION IN THERMAL CLAUS REACTOR

Hydrogen sulfide is a hazardous gas from both environmental safety and human health perspectives. Hydrogen sulfide presence in any combustion application results in the formation of acidic gases that affects ozone layer and causes acidic precipitation. Exposure to H2S levels at 100 ppm or higher can endanger human life. Hydrogen sulfide is commonly found to exist in crude natural gas and oil wells. With the decrease in fossil fuels reserves around the world, we will have to rely on extracting energy from wells that contain higher amounts of H2S. In addition, environmental regulations strictly regulate the H2S discharge into the atmosphere. Subsequently, efficient hydrogen sulfide treatment becomes of increasing importance with time. Hydrogen sulfide treatment is typically a chemical reaction process (Claus process) in which hydrogen sulfide is combusted to end-products of sulfur and water. Hydrogen sulfide combustion in thermal Claus reactor has been investigated in this research. A reduced reaction mechanism for H2S oxidation has been developed using a novel error-propagation-based approach for reduction of detailed reaction mechanisms. The reduced mechanism has been used for detailed investigation of chemical kinetics mechanistic pathways in Claus process. Experimental examination of H2S combustion in different flames, methane/air and hydrogen/air, is provided. Chemical kinetics pathways and reaction conditions responsible for sulfurous compounds formation (SO2, CS2, and COS) are addressed. Hydrogen sulfide flame emissions have been investigated for intermediate species identification using chemiluminescence flame spectroscopy. Effect of acid gas composition (H2S, CO2 and N2) on hydrogen sulfide combustion and Claus process efficiency is also provided. Finally, examination of the quality of captured sulfur with respect to reactor conditions is presented

Integrating and Extending Competing Intention Models to Understand the Entrepreneurial Intention of Senior University Students

The growing interest in the development of Entrepreneurial Intention (EI) has increased the importance of theories that explain and anticipate the tendency among individuals to start a new business. However, most of these theories focus on the relationship between entrepreneurs perceptions and their intention and ignore the cognitive and psychological characteristics that might configure their perceptions. Therefore, the purpose of this study is to integrate the Theory of Planned Behavior (TPB) with the Entrepreneurial Event Model (EEM) and to extend the combined model to include the personality characteristics of an entrepreneur that might shape the perceptions and intentions. This study uses a sample of 688 senior university students (Emirati nationals, 91.2% and expatriates, 8.8%) and employs positivist research with a quantitative approach, adopting a survey strategy through questionnaires, and structural equation modeling (SEM). The results demonstrate the relevance and robustness of the suggested combined and extended model in the prediction of intention on the part of senior university students to become entrepreneurs (explained varience=73.3%) based on survey data (2017; n = 688). The main contribution of this paper lies not only in the integration of the TPB and the EEM but also in extending the two theories on which it is based through adding entrepreneurial personality characteristics and an explanation of the mechanism through which entrepreneurial perceptions and EI develop

Minimally Invasive Approach in Surgical Management of Renal Neoplasms National Cancer Institute Experience

BACKGROUND: Minimally invasive nephrectomy is considered a technically challenging procedure requiring a long learning curve to reach acceptable warm ischemia time and perioperative complications. These minimally invasive techniques result in a shorter hospital stay and less post-operative pain. AIM: This study aims to demonstrate the National Cancer Institute experience regarding the benefits of laparoscopic and robot-assisted nephrectomy over open technique. METHODS: This is a retrospective descriptive cohort study including 62 patients with renal masses treated with nephrectomy whether partial, total or radical, 26 cases were treated by minimally invasive techniques (8 robotic and 18 laparoscopic), while 36 cases were treated by open technique. Inclusion criteria were patients between 20 and 70 years with renal neoplasm without renal vein thrombosis, with tumor stage T1 or T2 N0 M0. Exclusion criteria were patients with medical comorbidities that preclude surgical management or minimally invasive techniques and patients refusing surgery in general. RESULTS: Minimally invasive nephrectomy resulted in shorter hospital stay (mean hospital stay was 2.2 days for the minimally invasive group and 3.6 days for the open group) and less post-operative pain than open technique (p < 0.001 and = 0.002, respectively), while open technique resulted in shorter operation time (p = 0.039, mean operation time 147.8 min compared to 184.8 in the minimally invasive group). CONCLUSION: Minimally invasive nephrectomy (laparoscopic and robotic) resulted in less post-operative pain and shorter hospital stay compared to open technique despite consuming longer operation time which may be decreased by improving the learning curve of operating surgeons

The evaluation of doxorubicin-induced cardiotoxicity: Comparison of Doppler and tissue Doppler-derived myocardial performance index

Background: Doxorubicin is a chemotherapeutic agent used in a wide spectrum of cancers. However, cardiotoxic effects have limited its clinical use. The early detection of doxorubicin-induced cardiotoxicity is crucial. The purpose of our study was to assess values of Doppler and tissue Doppler imaging (TDI)-derived myocardial performance index (MPI) in adult cancer patients receiving doxorubicin treatment. Methods: A total of 45 patients underwent echocardiographic examinations before any doxorubicin had been administered and then after doxorubicin. Doppler and TDI-derived MPI of left ventricular (LV) were determined in the evaluation of cardiotoxicity. Additionally, TDI-derived MPI of right ventricular (RV) was determined. Results: All patients underwent control echocardiographic examination after mean 5 ± 1.7 months. The LV MPI obtained by both Doppler and TDI were increased after doxorubicin treatment (0.56 ± 0.11, 0.61 ± 0.10, p = 0,005 vs 0.51 ± 0.09, 0.59 ± 0.09, p = 0.001, respectively). There was no correlation between Doppler-derived MPI and cumulative doxorubicin dose (coefficient of correlation 0.11, p = 0.6). TDI-derived MPI was correlated with cumulative doxorubicin dose (coefficient of correlation 0.35, p = 0.015), but this correlation is weak (r = 0.38). The study population was divided into two groups according to doxorubicin dose (below and above 300 mg level). There was a moderate correlation between TDI-derived MPI and less than 300 mg of doxorubicin dose (coefficient of correlation 0.51, p = 0.028). However, Doppler-derived MPI was not correlated with less than 300 mg of doxorubicin dose (coefficient of correlation 0.38, p = 0.123). Also, there was no significant change in the TDI-derived RV-MPI (0.49 ± 0.14, 0.50 ± 0.12, p = 0.56). Conclusions: TDI-derived MPI is a useful parameter and an early indicator compared with Doppler-derived MPI in the detection of cardiotoxicity during the early stages. Also, doxorubicin administration does not affect RV function

Allelic Discrimination of Vitamin D Receptor Polymorphisms and Risk of Type 2 Diabetes Mellitus: A Case-Controlled Study

(1) Background: Type 2 diabetes mellitus (T2DM) is one of the rapidly growing healthcare problems, and several vitamin D receptor (VDR) polymorphisms seem to modulate the risk of T2DM. Our research was designed to investigate the allelic discrimination of VDR polymorphisms and T2DM occurrence risk. (2) Methods: This case-control research included 156 patients with T2DM and 145 healthy control subjects. Most of the study population were males 56.6% vs. 62.8% in the case and control groups, respectively. Genotyping for VDR single nucleotide polymorphisms (SNPs), rs228570 (Fok1), rs7975232 (Apa1), and rs1544410 (Bsm1) was compared between both groups. (3) Results: There was a negative link between vitamin D levels and insulin sensitivity. A significant difference was noted in the allelic discrimination of VDR polymorphism rs228570 and rs1544410 between the study groups (p \u3c 0.001). No difference was observed in the allelic discrimination of VDR polymorphism rs7975232 between the groups (p = 0.063). Moreover, T2DM patients had significantly higher levels of fasting blood sugar (FBS), glycated hemoglobin HbA1c, 2-h post-prandial blood sugar (PP), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), total cholesterol, and triglycerides (p \u3c 0.001), while High-Density Lipoprotein (HDL) Cholesterol (HDL-C) was significantly decreased (p = 0.006). (4) Conclusions: VDR polymorphisms had a positive association with T2DM risk among the Egyptian population. Further large-scale research using deep sequencing of samples is strongly urged to investigate different vitamin D gene variants and interactions, as well as the influence of vitamin D on T2DM

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely