In many parts of the world, patients may find it difficult to visit doctors who share the same language and culture due to the intermingling of people and international recruitment of doctors among many other reasons. In these multilingual multicultural settings (MMSs), doctor-patient interactions face new communication challenges. This study aims to identify the structure of clinical consultation and its phases in an MMS where both doctors and patients are non-native speakers (NNSs) of English.
The aim of this study was to optimize the antioxidant activity of Piper nigrum L. essential oil extracted using the supercritical carbon dioxide (SC-CO₂) technique. Response surface methodology was applied using a three-factor central composite design to evaluate the effects of three independent extraction variables: pressure of 15-30 MPa, temperature of 40-50 °C and dynamic extraction time of 40-80 min. The DPPH radical scavenging method was used to evaluate the antioxidant activity of the extracts. The results showed that the best antioxidant activity was achieved at 30 MPa, 40 °C and 40 min. The extracts were analyzed by GC-FID and GC-MS. The main components extracted using SC-CO₂ extraction in optimum conditions were β-caryophyllene (25.38 ± 0.62%), limonene (15.64 ± 0.15%), sabinene (13.63 ± 0.21%), 3-carene (9.34 ± 0.04%), β-pinene (7.27 ± 0.05%), and α-pinene (4.25 ± 0.06%). The essential oil obtained through this technique was compared with the essential oil obtained using hydro-distillation. For the essential oil obtained by hydro-distillation, the most abundant compounds were β-caryophyllene (18.64 ± 0.84%), limonene (14.95 ± 0.13%), sabinene (13.19 ± 0.17%), 3-carene (8.56 ± 0.11%), β-pinene (9.71 ± 0.12%), and α-pinene (7.96 ± 0.14%). Radical scavenging activity of the extracts obtained by SC-CO₂ and hydro-distillation showed an EC₅₀ of 103.28 and 316.27 µg mL(-1) respectively.