Successful Acquisition Research Articles

Gender Effect in Using Strategies for Learning English Language: A Context of Aliya Madrasa Education in Bangladesh

Language learning strategies can be referred to a number of effective techniques, conscious behaviors or steps for proper acquisition of a second language. Several studies reported that females use more language learning strategies than males do, while some other research opined that there were no significant differences in the usage of learning strategies across genders. In Bangladesh, Aliya Madrasa students learn English language as a compulsory subject from Ebtedayi level that is equivalent to primary level and continues until Dakhil level which is equivalent to secondary school certificate level. However, from the very recent report of BANBEIS and World Bank of 2015 it has been observed that the English language proficiency level of the students of Aliya madaras are far below the acceptable level. The English language proficiency of the female Aliya madrasa students are more disappointing. Therefore, the researcher endeavors to identify weather differences exist between male and female English language learners of Aliya Madrasa in using different strategies to learn a second language. This study was conducted through a questionnaire survey and telephone interviews in which the researcher has made efforts to find out the various learning strategies applied by male and female learners ( at madrasa ) for successful acquisition of a second language. 160 learners of four different Aliya Madrasas participated in the study. Data were collected using a questionnaire adapted and modified from SILL (Oxford 1990) i.e., Strategy Inventory of language learning. Besides identifying the different kinds of strategies, the researcher also provides suggestions and recommendations for improving English language learning at Dakhil level, which will facilitate updating the education system in question and help the stakeholders to bring qualitative changes in the students’ learning outcome.

Relationship marketing: a strategy for acquiring long-term strategic sponsorships in the disability sport sector

ABSTRACT Since the founding of the National Wheelchair Basketball Association (NWBA) in 1949, wheelchair basketball has expanded to over 200 teams in the U.S. and Canada. Despite the success and growth of wheelchair basketball in the U.S., NWBA programs still face funding challenges. Considering the potential to generate funding through corporate sponsorship, nine semi-structured interviews were conducted with professionals in charge of sponsorship management of NWBA programs to gain insight into the acquisition and relationship management of their sponsorship programs. Findings showed several unique ways NWBA programs attract sponsors, including focusing on sponsors with an existing interest in the disability community, and highlighting the unique assets of NWBA teams such as their compelling stories, the program’s impact, disability expertise, and corporate social engagement opportunities. Communication, evaluation, and cross-marketing opportunities were found to be key in retaining sponsors. Both successful sponsorship acquisition and retention are underlined by relationship marketing efforts to build commitment and trust by establishing an emotional connection and mutually beneficial relationship between the sponsor and the team, as well as having a dense network of relationships between the sport property and sponsor. The results aid current and future programs in successful sponsorship acquisition and retention.

A CASE STUDY OF ENGLISH LANGUAGE STUDENT TEACHERS’ CREATIVITY POTENTIAL

Student teachers taking the Teaching of English as Second Language (TESL) program need to be creative in implementing the ESL curriculum in Malaysia. Creative student teachers can motivate school students to learn English Language creatively. In the past, boring language lessons had become a barrier to successful language acquisition. In this regard, the authors examined the creative abilities of thirty-two 1st and 2nd year TESL student teachers taking a Bachelor of Education course in a public university in Sabah, East Malaysia in term of their abilities to generate ideas via providing creative title with a short story. Creative potentials of the subjects were measured by a computer system. Findings revealed that 65.6% of the sample was in the moderate and creative category. Among the reasons identified in this study for producing fewer ideas in such activity were lots of reading (53.1%), the difficulty in predicting the outcome of the story (46.9%) and the lack of experience about the characters in the picture (56.3%). However, those who were found to be very creative were those who scored distinctions in English Language at SPM level („0‟ Level). Data also showed that higher English Language competency can improve creativity. The majority of the TESL student teachers surveyed also enjoyed the ideas generation activity and were thrilled to find out that such activity is able to improve their creative thinking abilities in language teaching, in particularly ESL. The researcher recommends that creative components be made an important element in future T & L activities.

ПОПЕРЕДЖЕННЯ ПОРУШЕНЬ ПИСЕМНОГО МОВЛЕННЯ В ДІТЕЙ ДОШКІЛЬНОГО ВІКУ ІЗ ЗАТРИМКОЮ ПСИХІЧНОГО РОЗВИТКУ

This study is devoted to the problem of prevention of written language disorders in preschool children with intellectual disability. Based on the synthesis of previous pedagogical studies, it is known that writing, as higher mental function, is considered to be highly complex system, which involves all components of the structural and functional organization of the brain; it is also known that underdevelopment of any of these components leads to difficulties in the formation of writing abilities. It is determined that underdevelopment or impairment of one of the structural components of writing activity, or the mental functions that complement it, leads to the impairment or underdevelopment of writing activity as a whole; it was identified that in children with an intellectual disability, there is a relationship between a low level of formation of cognitive functions and aspects of independent planning, control and evaluation of outcomes of actions. Based on to the results of a pedagogical experiment, we demonstrated that the insufficient formation of motor control and cognitive skills in preschool children with intellectual disability resulted in these children's inclusion in the dysgraphia's «risk group». We justified the importance of prevention of written language disorders in preschool children with intellectual disability through speech therapy with neuropsychological corrections, which is grounded on the intentional formation of motor (general motor and graphomotor) and cognitive skills, which should positively affect the development of mental functions in preschool children with intellectual disability, and enable them to be better prepared for schooling, including successful acquisition of writing skills. Key words: impairment of written speech, retardation of mental development, prevention of impairments, preschool children, speech therapy work, programming, regulation, control, motor functions, cognitive functions.

A Phenomenological Investigation of Person-Organizational Fit: Characteristics and Leadership Styles

Theoretical framework: Mergers and acquisitions have become an important strategy used by companies to achieve certain organizational goals. However, people-organization fit issues will occur during the post-merger or post-acquisition. Design/methodology/approach: The method used in the research was carried out using a qualitative-phenomenological approach. Choice of method contributes to M&A knowledge. Using a phenomenological approach, this study incorporates detailed nuances into our understanding of the role of leadership during M&A through an experienced perspective. Thus, a deeper descriptive exploration of the topic can be obtained. Findings: In this study, it is stated that the success of mergers and acquisitions is influenced by the role of the leader before, during and after the merger/acquisition is carried out. This study argues that the lack of attention to the leadership aspects of M&A creates a knowledge gap, where little is known about the role of leadership during M&A, as well as its role in ensuring a favorable organizational climate for creating employee person-organizations that are appropriate to the post-M&A process. Research, Practical & Social implications: Previous studies have stated the importance of leaders to help organizational members achieve person-organization fit. The relationship of person-organization fit after the acquisition process has also been investigated. Originality/value: This study concludes that in general an effective leadership style in the M&A process tends to be Transformational. One of the effective leadership styles told by the informants is the leader's ability to be able to provide motivation, which is in line with one of the "4I" concepts of Transformational leadership, namely Inspirational motivation.

Tissue optimization strategies for high-quality ex vivo diffusion imaging.

Ex vivo diffusion imaging can be used to study healthy and pathological tissue microstructure in the rodent brain with high resolution, providing a link between in vivo MRI and ex vivo microscopy techniques. Major challenges for the successful acquisition of ex vivo diffusion imaging data however are changes in the relaxivity and diffusivity of brain tissue following perfusion fixation. In this study we address this question by examining the combined effects of tissue preparation factors that influence signal-to-noise ratio (SNR) and consequently image quality, including fixative concentration, contrast agent concentration and tissue rehydration time. We present an optimization strategy combining these factors to manipulate the and of fixed tissue and maximize SNR efficiency. We apply this strategy in the rat brain, for a diffusion-weighted spin echo protocol with TE = 27 ms on a 9.4 T scanner with a 39 mm volume coil and 660 mT/m 114 mm gradient insert. We used a reduced fixative concentration of 2% paraformaldehyde (PFA), rehydration time more than 20 days, 15 mM Gd-DTPA in perfusate and TR 250 ms. This resulted in a doubling of SNR and an increase in SNR per unit time of 135% in cortical grey matter and 88% in white matter compared with 4% PFA and no contrast agent. This improved SNR efficiency enabled the acquisition of excellent-quality high-resolution (78 m isotropic voxel size) diffusion data with b = 4000 s/mm , 30 diffusion directions and a field of view of mm3 in less than 4 days. It was also possible to achieve comparable data quality for a standard resolution (150 m) diffusion dataset in h. In conclusion, the tissue optimization strategy presented here may be used to improve SNR, increase spatial resolution and/or allow faster acquisitions in preclinical ex vivo diffusion MRI experiments.

Does IT Matter to Acquisitions? The Impacts of IT Distance on Post-Acquisition Performance

Although researchers have examined the role of dyadic dynamics (i.e., interactions between the acquirer and the target firm) in the success of acquisitions, little attention has been devoted to the role of information technology (IT). In this study, we extend this literature by examining how pre-acquisition IT distance (i.e., the difference between the enterprise IT systems of the two firms that reflects the system incompatibility and resulting costs of system integration) affects the acquirer’s post-acquisition performance. To measure IT distance, we used a word-embedding technique to map each firm’s IT systems portfolio to a low-dimensional embedding space and calculate the distance between the firms in that space. Using data on U.S. firms’ acquisition activities over seven years, we found that IT distance is negatively associated with the acquirer’s post-acquisition performance. Also, the adverse effect of IT distance is stronger for acquisitions motivated by operational synergies, compared to those seeking non-operational synergies. This finding supports our fundamental premise that IT distance disrupts post-acquisition synergy creation, and more so when the combined firm has a greater need for tight integration to create acquisition synergies. This research contributes to the merger and acquisition (M&A) literature in management and IS by introducing a novel concept of IT distance and by theorizing and empirically examining its performance implications in acquisitions. The findings of this study can inform practitioners on how to devise IT strategies in corporate acquisitions to mitigate IT risks and achieve greater post-acquisition performance.

Dynamic Online Trajectory Planning for a UAV-Enabled Data Collection System

Due to the maneuverability and flexibility of unmanned aerial vehicles (UAVs), the UAV-enabled data collection systems for wireless sensor networks (WSN) have received widespread attention. However, the state-of-the-art UAV trajectory designs mainly focus on static environments, which are not applicable in the practical scenarios considered in this work, e.g., mobile nodes, decommissioning of existing nodes, and new emergency nodes. This article proposes a two-level deep reinforcement learning (DRL) framework to solve this challenge. The first-level deep neural network (DNN) is applied to model the dynamic changing environment. In the second level, we employ a deep Q-learning network to plan a trajectory online according to the environment features from the first level DNN. Besides, online trajectory planning is performed by a low-power UAV edge computing platform. To enable online planning on the power-constraint UAV edge-computing platform, all networks adopt a lightweight low-complexity optimization design. According to simulation results, the proposed system achieves higher data acquisition success rates when compared to existing state-of-the-art methods. We also perform field tests on the proposed UAV edge computing platform, which also demonstrates high data acquisition performance.

Resuscitative transoesophageal echocardiography performed by emergency physicians in the emergency department: insights from a 1-year period.

Transoesophageal echocardiography (TOE) has increasingly been described as a possible complementary and point-of-care approach for patients with cardiac arrest (CA). It provides information about potentially reversible causes and prognosis and allows monitoring of resuscitation efforts without affecting ongoing chest compressions. The aim of this study was to assess the feasibility of TOE performed by emergency physicians (EPs) during CA in an emergency department (ED). This prospective study was performed at the Department of Emergency Medicine at the Medical University of Vienna from February 2020 to February 2021. All patients of ≥18 years old presenting with ongoing resuscitation efforts were screened. After exclusion of potential contraindications, a TOE examination was performed and documented by EPs according to a standardized four-view imaging protocol. The primary endpoint represents feasibility defined as successful probe insertion and acquisition of interpretable images. Of 99 patients with ongoing non-traumatic CA treated in the ED, a total of 62 patients were considered to be examined by TOE. The examination was feasible in 57 patients (92%) [females, 14 (25%), mean age 53 ± 13, and witnessed collapse 48 (84%)]. Within these, the examiners observed 51 major findings in 32 different patients (66%). In 21 patients (37%), these findings led to a direct change of therapy. In 18 patients (32%), the examiner found ventricular contractions without detectable pulse. No TOE-related complications were found. Our findings suggest that EPs may be able to acquire and interpret TOE images in the majority of patients during CA using a standardized four-view imaging protocol.

An evaluation of the present status of quality assurance program implementation in digital mammography facilities in a developing country

Quality assurance program (QAP) implementation in mammography is a key aspect to guarantee the acquisition of -quality images and, thus, an opportune diagnosis of breast cancer. A QAP involves planned and systematic actions, such as quality control (QC) tests that will produce consistently high-quality images, while considering low radiation exposure for stakeholders. Currently, there is poor evidence of the current QAP implementation status in developing countries, particularly in Latin America. In this work, 47 Mexican digital mammography facilities were evaluated in terms of their QAP implementation’s current status during the period October 2021 to April 2022. A survey of three key indicators of compliance/non-compliance with QAPs was carried out. Also, 17 QC test parameters were assessed in all mammography units according to an international framework. The Kruskal–Wallis test, McNemar test, and Spearman correlation were used to identify the significant correlation between the QC tests and QAP indicators. Statistical analysis showed a significant positive correlation between the QAP indicators and QC parameters that were evaluated, especially associated with an increase in image quality. Almost 90% of the facilities evaluated failed in some QAP indicators, and only 44.68% of the facilities had an updated and current QAP implemented. Successful QAP implementation directly impacted on the QC mammography test results, particularly in terms of image quality, thus conditioning a successful mammography acquisition chain. The results obtained in this work suggest that better regulations need to be implemented to guarantee QAP surveillance, which could mean an increase in opportune diagnosis and management of breast cancer, with improved radiological safety for patients and occupational exposure personnel.

TnSmu1 is a functional integrative and conjugative element in Streptococcus mutans that when expressed causes growth arrest of host bacteria.

Integrative and conjugative elements (ICEs) are major drivers of horizontal gene transfer in bacteria. They mediate their own transfer from host cells (donors) to recipients and allow bacteria to acquire new phenotypes, including pathogenic and metabolic capabilities and drug resistances. Streptococcus mutans, a major causative agent of dental caries, contains a putative ICE, TnSmu1, integrated at the 3' end of a leucyl tRNA gene. We found that TnSmu1 is a functional ICE, containing all the genes necessary for ICE function. It excised from the chromosome and excision was stimulated by DNA damage. We identified the DNA junctions generated by excision of TnSmu1, defined the ends of the element, and detected the extrachromosomal circle. We found that TnSmu1 can transfer from S. mutans donors to recipients when co-cultured on solid medium. The presence of TnSmu1 in recipients inhibited successful acquisition of another copy and this inhibition was mediated, at least in part, by the likely transcriptional repressor encoded by the element. Using microscopy to track individual cells, we found that activation of TnSmu1 caused an arrest of cell growth. Our results demonstrate that TnSmu1 is a functional ICE that affects the biology of its host cells.

Abstract 197: Location, Location, Location! Association Of Success In Transthoracic Echocardiography Image Acquisition With Location During Cardiopulmonary Resuscitation.

Introduction: Currently, no consensus exists regarding the ideal location for obtaining a transthoracic echocardiography (TTE) image during cardiopulmonary resuscitation (CPR). Of the three common locations, sub-xiphoid (SX), parasternal (PS) and apical (AP), the SX is most frequently used in cardiac arrest (CA) to avoid interfering with CPR. The recent adoption of mechanical chest compression devices may have led to increased use of alternate locations. We aim to assess the association between successful TTE image acquisition and the locations, also to compare the duration of CPR interruptions at each location. Hypothesis: We hypothesized that PS location will have a higher success rate compared to SX, but not a longer CPR interruption time. Methods: This is a retrospective study of all video-recorded non-traumatic, CA patients ≥18 years old in a quaternary care Emergency Department (ED) from 08/07/2019 to 05/18/2022 where an intra-arrest TTE was performed. Video recordings of cardiac arrest patients were reviewed by 2 physicians with years of experience and a well-established process. Successful image acquisition was defined as 1) visualization of the heart on the ultrasound machine or 2) clinicians verbalizing visualization in the video recording. Chi-square and Kruskal-Wallis tests were performed to compare the success rates and duration of CPR interruptions based on TTE locations. Our health system’s Institutional Review Board approved the conduct of this study. Results: A total of 59 patients yielded a combined 154 video recorded TTE attempts 90 (58.4%) SX, 56 (36.4%) PS, and 8 (5.2%) AP. Median age was 81 years, 50.8% female, 81.4% non-shockable initial rhythm, and 89.8% were receiving mechanical CPR. Because there were only 8 AP attempts, PS and SX were the only locations analyzed. PS was successful in 89.3% (68 of 90) compared to 75.6% (50 of 56) for the SX (p=0.04). The median duration of interruptions for PS was 17.5 seconds (IQR: 12.0, 22.0) compared to 15 seconds (IQR: 11.0, 24.0) for SX (p=0.5). Conclusion: During CPR, PS location for TTE image acquisition is associated with higher success when compared to SX. However, the median CPR interruption times are not significantly different.

Key Successful Factors of M&A

In order to reduce costs and increase revenue, expand strength, develop rapidly in a very short period of time, and establish its market advantages and brand advantages, enterprises often have to use their own brands to continuously acquire more similar companies to make cross-media and Multi-level service gets a best play. Mr. Redstone, chairman and CEO of Viacom, has developed his family business, National Entertainment Corporation, into the second largest media group in the world in just 15 years. Its development history is the true portrayal of capital mergers and acquisitions in the media field. This article starts from the analysis of Viacom-CBS mergers and acquisitions, which is a intricate, complex and lengthy large-scale business mergers and acquisitions cases, and studies how to estimate the exact value of business acquisitions through understanding business culture and corporate strategy before business acquisitions. In the acquisition process, negotiation skills, preparation and negotiation strategy are making a great difference to the negotiation. After the successful acquisition, the efficient operation and cooperation of the enterprise play an important role in the long-term development of the enterprise. The research of this paper is of great significance for enterprise acquisition, increasing business interests and improving the efficiency of enterprise management.

An Acquisition Deal in the Gaming World

The gaming industry has seen acquisitions big and small. In recent years, Microsoft's acquisition of Activision Blizzard topped the list with a total value of 68.7 billion dollars. This paper focuses on the deal as a case study, with reference to the value of both companies and potential risks. It aims to explore the motivation of both parties based on their perceived pros and cons of this acquisition, so as to delineate the logic behind this gigantic acquisition. After conducting multiple studies on both companies, this paper finds the deal worthwhile indeed for both sides, despite the higher potential risks imposed on Microsoft. Activision Blizzard has seen its public image tarted in recent years by rampant sexual harassment rumors and the resultant massive outflow of employees. This decreases its leverage over Microsoft and weakens its position in negotiations. On the other hand, appreciating the profit-making potentials of several big game IPs owned by Blizzard, Microsoft is willing to make a general purchasing offer at a premium (Activision Blizzard market value of about $61.6 billion, but Microsoft acquired with $68.7 billion). This is despite relevant concerns raised about the potential risks of digesting the latter’ s bad reputation. Overall, the paper argues that such compromises are cost-efficient for Microsoft, since the deal helps it gain a firm foothold in the gaming industry. Based on the study findings, the essay also brings into discussion many other factors required to complete a successful acquisition.

Improving Vocabulary and Pronunciation of Secondary Level ESL Learners Through Language and Meaning-Focused Listening- An Experimental Study

Listening plays a larger role in language acquisition and is a critical aim for students in order to receive information generated in the target language. Its successful acquisition requires students to absorb cognitive processes and then use them in their spoken interactions in order to promote understanding in a variety of communication settings. It is the instructor's job to choose the most effective methods for ensuring students' effective learning of this language ability by selecting projects and resources that best meet their unique and linguistic learning requirements and interests. The main purpose of this research paper is to emphasize the critical role of Language-focused and Meaning-focused listening in the process of English as a second language (ESL) learning through an experimental study. Since, listening skill contributes a major part in the enhancement of ESL learners’ language proficiency, the feasible activities and strategies provided in this paper improve the vocabulary and pronunciation of secondary level ESL learners. The paper also discusses the processes of listening skill: top-down and bottom-up methods to emphasize the enhancement of ESL students’ vocabulary and pronunciation. The researcher has chosen grade 9 students of a government school as a sample for the experiment.

The environment, the tick, and the pathogen - It is an ensemble.

Ixodes scapularis is one of the predominant vectors of Borrelia burgdorferi, the agent of Lyme disease in the USA. The geographic distribution of I. scapularis, endemic to the northeastern and northcentral USA, is expanding as far south as Georgia and Texas, and northwards into Canada and poses an impending public health problem. The prevalence and spread of tick-borne diseases are influenced by the interplay of multiple factors including microbiological, ecological, and environmental. Molecular studies have focused on interactions between the tick-host and pathogen/s that determine the success of pathogen acquisition by the tick and transmission to the mammalian host. In this review we draw attention to additional critical environmental factors that impact tick biology and tick-pathogen interactions. With a focus on B. burgdorferi we highlight the interplay of abiotic factors such as temperature and humidity as well as biotic factors such as environmental microbiota that ticks are exposed to during their on- and off-host phases on tick, and infection prevalence. A molecular understanding of this ensemble of interactions will be essential to gain new insights into the biology of tick-pathogen interactions and to develop new approaches to control ticks and tick transmission of B. burgdorferi, the agent of Lyme disease.

A PDK-1 allosteric agonist improves spatial learning and memory in a βAPP/PS-1 transgenic mouse-high fat diet intervention model of Alzheimer's disease

Diabetes mellitus (DM), peripheral insulin resistance (IR) and obesity are clear risk factors for Alzheimer's disease. Several anti-diabetic drugs and insulin have been tested in rodents and humans with MCI or AD, yielding promising but inconclusive results. The PDK-1/Akt axis, essential to the action of insulin, has not however been pharmacologically interrogated to a similar degree. Our previous cell culture and in vitro studies point to such an approach. Double transgenic APPsw/PSENdE9 mice, a model for Alzheimer's disease, were used to test the oral administration of PS48, a PDK-1 agonist, on preventing the expected decline in learning and memory in the Morris Water Maze (MWM). Mice were raised on either standard (SD) or high fat (HFD) diets, dosed beginning 10 months age and tested at an advanced age of 14 months.PS48 had positive effects on learning the spatial location of a hidden platform in the TG animals, on either SD or HFD, compared to vehicle diet and WT animals. On several measures of spatial memory following successful acquisition (probe trials), the drug also proved significantly beneficial to animals on either diet. The PS48 treatment-effect size was more pronounced in the TG animals on HFD compared to on SD in several of the probe measures. HFD produced some of the intended metabolic effects of weight gain and hyperglycemia, as well as accelerating cognitive impairment in the TG animals. PS48 was found to have added value in modestly reducing body weights and improving OGTT responses in TG groups although results were not definitive. PS48 was well tolerated without obvious clinical signs or symptoms and did not itself affect longevity. These results recommend a larger preclinical study before human trial.

New Strategies for Potential Contrast Agents’ Synthons Highly Active to MRI Based on Gd3+, Eu3+, and Tb3+

The library of new smart contrast agents based on Gd3+, Eu3+, and Tb3+ used as biomarkers is in continuous development due to its applications in diagnostic imaging. The search for safer and more efficient contrast agents has focused on the design of compounds that exhibit high relaxivity. Herein, we present alternative synthetic strategies for the development of theoretically high-relaxivity synthons based on lanthanides using the Solomon–Bloembergen–Morgan equations through click chemistry and direct addition. Special attention has been devoted to the analysis of the different aspects interfering with the successful acquisition of these complexes and their troubleshooting during their synthesis. Our preliminary results showed that not only the mathematical background needs to be considered, but also the synthetic strategy and the use of procedures free of metallic ions favor the total synthesis of these challenging complexes.

S1076 Anesthesia Care Provider Sedation (ACPS) Is Superior to Conscious Sedation (CS) for Successful Diagnostic Tissue Acquisition in Endoscopic Ultrasound Fine Needle Aspiration and/or Biopsy (EUS FNA/B)

Introduction: EUS-FNA/B is frequently used for diagnosis of suspicious intestinal, subepithelial, and extraintestinal lesions. Our study aimed to evaluate the role of sedation in the diagnostic yield of EUS-FNA/B of suspicious lesions in the mediastinum, abdomen and pelvis. Given frequent use and experience of CS with diagnostic EUS at our institution, we hypothesized that the diagnostic yield of EUS-FNA/B would be equivalent for both sedation groups. Methods: A retrospective, single-center, cohort study was conducted including patients aged >18 years old who received EUS-FNA/B at our institution from 9/2018 – 5/2021 for further evaluation of suspicious lesions. Relevant baseline variables were collected for both groups. The primary endpoint was EUS diagnostic yield of neoplastic lesions. Successful cytologic diagnosis was defined by positive or suspicious results. Unsuccessful cytological results were defined by unsatisfactory, indeterminate, or false negative results. Secondary endpoint was adverse events (AEs). AEs were recorded for EUS only (EUS/ERCP patients were excluded from AE tally due to possible confounding). Baseline statistical comparison was done using the Chi-square test and Wilcoxon two sample tests. Univariate and multivariate logistic regression analysis was conducted to further evaluate primary and secondary outcomes. All statistical analyses were performed utilizing SAS Software (version 9.4; SAS Institute Inc. Cary, NC, USA). Results: 369 patients met initial inclusion criteria. 67 cases with confirmed or suspected benign lesions were eliminated from analysis. Successful FNA/B was present in 146/196 (74.5%) of patients in the ACPS group and 66/106 (62.3%) in the CS group, (p = 0.0274). Upon multivariate logistic regression controlling for lesion size, location, needle size, number of passes, and presence of ROSE, the difference in diagnostic yield between the CS and GA groups remained statistically significant (adjusted odds ratio [95% CI]: 0.558 [0.315 - 0.987], P = 0.0451) (Table). Adverse events (AEs) occurred more frequently in the ACPS group. This difference was sustained on multivariate analysis controlling for BMI, age, and ASA class. Conclusion: ACPS is associated with improved diagnostic yield when performing EUS-FNA/B for suspicious lesions in the mediastinum, abdomen, and pelvis. AEs occur more frequently in ACPS albeit most AEs are mild and associated with general anesthesia. Table 1. - Descriptive Analysis of demographics, Univariate/Multivariate logistic regression analysis, and Adverse Events Demographics Type of sedation P value Anesthesia Conscious Sedation N(number of patients) % N % Gender 0.07 Male 110 47.21 51 37.5 Female 123 52.79 85 62.5 ASA Class < 0.001 1 5 2.15 8 5.88 2 45 19.31 63 46.32 3 169 72.53 65 47.79 4 14 6.01 . . Location 0.001 Thoracic 1 0.43 1 0.74 Abdominal (non-pancreas) 26 11.16 22 16.18 Pelvic 3 1.29 2 1.47 pancreas ampulla/uncinate/head 130 55.79 42 30.88 neck/body/tail pancreas 50 21.46 46 33.82 SEL 22 9.44 22 16.18 Cytologic Result 0.007 Unsatisfactory specimen 14 6.01 22 16.18 Negative for malignancy 43 18.45 33 24.26 Atypical/Indeterminate 30 12.88 15 11.03 Suspicious for malignancy 10 4.29 3 2.21 Positive for malignancy 136 58.37 63 46.32 FNB < 0.001 N 140 60.09 115 84.56 Y 93 39.91 21 15.44 Univariate and Multivariate logistic regression analysis Univariate logistic regression (Crude effect) Unit OR 95% Confidence Limits p-Value Type of sedation (CS vs Anesthesia) 1 0.565 0.34 0.938 0.0274 Adjusted Effect Unit OR 95% Confidence Limits Column1 p-Value Type of sedation CS vs Anesthesia 1 0.558 0.315 0.987 0.0451 Location Others vs (pancreas ampulla/uncinate/head) 1 0.46 0.2 1.063 0.0691 Number of needle passed 1 1.473 1.191 1.822 0.0004 Categories of Adverse Events Type of Sedation CS Anesthesia Severity GA MAC Mild 3 14 2 Moderate 1 5 0 Severe 0 3 0 Fatal 0 0 0 Total 4 22 2 **Total of 28 adverse events.

Language outcomes after cochlear implant.

A young infant seen in our practice was diagnosed with profound congenital hearing loss. Their parents want to pursue cochlear implant surgery for their child, but they are concerned about language acquisition before and after the surgery. What should they know about the procedure, and how can they improve language outcomes? Congenital hearing loss is often identified on newborn screening hearing tests. Cochlear implants may lead to overall improved spoken language skills among children with profound hearing loss. Some factors associated with successful language acquisition in children after cochlear implant surgery include having the procedure at an earlier age and family engagement in early intervention programs. Learning sign language before cochlear implant surgery may improve subsequent language outcomes and support the child's cognitive and socioemotional success.