Search results for: incidental findings

Authors: Shahbaz Ahmed

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This study is conducted to demonstrate the knowledge of intentional learning and incidental learning. Hypothesis of this experiment is intentional learning is better than incidental learning, participants were demonstrated and were asked to learn the 10 nonsense syllables in a specific sequence from the colored cards in the end they were asked to recall the background color of each card instead of nonsense syllables. Independent variables of the experiment are the colored cards containing nonsense syllables which are to be memorized by the participants, dependent variables are the number of correct responses made by the participant. The findings of the experiment concluded that intentional learning is better than incidental learning, hence hypothesis is proved.

Keywords: intentional learning, incidental learning, non-sense syllable cards, score sheets

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Authors: Zeena Dcosta, Junaid Ahmed, Ceena Denny, Nandita Shenoy

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In the field of dentistry, there are many conditions which warrant the requirement of three-dimensional imaging that can aid in diagnosis and therapeutic management. Cone beam computed tomography (CBCT) is considered highly accurate in producing a three-dimensional image of an object and provides a complete insight of various findings in the captured volume. But, most of the clinicians focus primarily on the teeth and jaws and numerous unanticipated clinically significant incidental findings may be missed out. Rapid integration of CBCT into the practice of dentistry has led to the detection of various incidental findings. However, the prevalence of these incidental findings is still unknown. Thus, the study aimed to discern the reason for referral and to identify incidental findings on the referred CBCT scans. Patient’s demographic data such as age and gender was noted. CBCT scans of multiple fields of views (FOV) were considered. The referral for CBCT scans was broadly classified into two major categories: diagnostic scan and treatment planning scan. Any finding on the CBCT volumes, other than the area of concern was recorded as incidental finding which was noted under airway, developmental, pathological, endodontics, TMJ, bone, soft tissue calcifications and others. Few of the incidental findings noted under airway were deviated nasal septum, nasal turbinate hypertrophy, mucosal thickening and pneumatization of sinus. Developmental incidental findings included dilaceration, impaction, pulp stone and gubernacular canal. Resorption of teeth and periapical pathologies were noted under pathological incidental findings. Root fracture along with over and under obturation was noted under endodontics. Incidental findings under TMJ were flattening, erosion and bifid condyle. Enostosis and exostosis were noted under bone lesions. Tonsillolth, sialolith and calcified styloid ligament were noted under soft tissue calcifications. Incidental findings under others included foreign body, fused C1- C2 vertebrae, nutrient canals, and pneumatocyst. Maxillofacial radiologists should be aware of possible incidental findings and should be vigilant about comprehensively evaluating the entire captured volume, which can help in early diagnosis of any potential pathologies that may go undetected. Interpretation of CBCT is truly an art and with the experience, we can unravel the secrets hidden in the grey shades of the radiographic image.

Keywords: cone beam computed tomography, incidental findings, maxillofacial region, radiologist

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Authors: Matheesha Herath, Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore

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Background: Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. It is unknown whether the acute surgical unit (ASU) model affects the management and disclosure of these findings. Methods: An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings and communication of the findings to the patient and to their general practitioner (GP). Results: 1,214 patients underwent emergency appendicectomy; 465 in the traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the traditional and ASU group with regards to communication of the findings to the patient (p=0.44) and their GP (p=0.27), and there was no difference in the rates of appropriate management (p=0.21). Conclusions: The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during an appendectomy.

Keywords: acute care surgery, appendicitis, appendicectomy, incidental

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Authors: Alisha M. Ebrahim, Bijoy K. Menon, Eddy Lang, Shelagh B. Coutts, Katie Lin

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Introduction: Frontline emergency physicians require clear and evidence-based approaches to guide neuroimaging investigations for patients presenting with suspected acute stroke or transient ischemic attack (TIA). Various forms of computed tomography (CT) are currently available for initial investigation, including non-contrast CT (NCCT), CT angiography head and neck (CTA), and CT perfusion (CTP). However, there is uncertainty around optimal imaging choice for cost-effectiveness, particularly for minor or resolved neurological symptoms. In addition to the cost of CTA and CTP testing, there is also a concern for increased incidental findings, which may contribute to the burden of overdiagnosis. Methods: In this cross-sectional observational study, analysis was conducted on 586 anonymized triage and diagnostic imaging (DI) reports for neuroimaging orders completed on patients presenting to adult emergency departments (EDs) with a suspected stroke or TIA from January-December 2019. The primary outcome of interest is the diagnostic yield of NCCT+CTA compared to NCCT alone for patients presenting to urban academic EDs with Canadian Emergency Department Information System (CEDIS) complaints of “symptoms of stroke” (specifically acute stroke and TIA indications). DI reports were coded into 4 pre-specified categories (endorsed by a panel of stroke experts): no abnormalities, clinically significant findings (requiring immediate or follow-up clinical action), incidental findings (not meeting prespecified criteria for clinical significance), and both significant and incidental findings. Standard descriptive statistics were performed. A two-sided p-value <0.05 was considered significant. Results: 75% of patients received NCCT+CTA imaging, 21% received NCCT alone, and 4% received NCCT+CTA+CTP. The diagnostic yield of NCCT+CTA imaging for prespecified clinically significant findings was 24%, compared to only 9% in those who received NCCT alone. The proportion of incidental findings was 30% in the NCCT only group and 32% in the NCCT+CTA group. CTP did not significantly increase the yield of significant or incidental findings. Conclusion: In this cohort of patients presenting with suspected stroke or TIA, an NCCT+CTA neuroimaging strategy had a higher diagnostic yield for clinically significant findings than NCCT alone without significantly increasing the number of incidental findings identified.

Keywords: stroke, diagnostic yield, neuroimaging, emergency department, CT

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Authors: Sharon Garyn-Tal, Shoshana Shahrabani

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Military service in general, and in combat units in particular, can be physically and psychologically stressful. Therefore, type of service may have significant implications for soldiers during and after their military service including emotions, judgments and risk perceptions. Previous studies have focused on risk propensity and risky behavior among soldiers, however there is still lack of knowledge on the impact of type of army service on risk perceptions. The current study examines the effect of type of army service (combat versus non-combat service) and negative incidental emotions on risk perceptions. In 2014 a survey was conducted among 153 combat and non-combat Israeli soldiers. The survey was distributed in train stations and central bus stations in various places in Israel among soldiers waiting for the train/bus. Participants answered questions related to the levels of incidental negative emotions they felt, to their risk perceptions (chances to be hurt by terror attack, by violent crime and by car accident), and personal details including type of army service. The data in this research is unique because military service in Israel is compulsory, so that the Israeli population serving in the army is wide and diversified. The results indicate that currently serving combat participants were more pessimistic in their risk perceptions (for all type of risks) compared to the currently serving non-combat participants. Since combat participants probably experienced severe and distressing situations during their service, they became more pessimistic regarding their probabilities of being hurt in different situations in life. This result supports the availability heuristic theory and the findings of previous studies indicating that those who directly experience distressing events tend to overestimate danger. The findings also indicate that soldiers who feel higher levels of incidental fear and anger have pessimistic risk perceptions. In addition, respondents who experienced combat army service also have pessimistic risk perceptions if they feel higher levels of fear. In addition, the findings suggest that higher levels of the incidental emotions of fear and anger are related to more pessimistic risk perceptions. These results can be explained by the compulsory army service in Israel that constitutes a focused threat to soldiers' safety during their period of service. Thus, in this stressful environment, negative incidental emotions even during routine times correlate with higher risk perceptions. In conclusion, the current study results suggest that combat army service shapes risk perceptions and the way young people control their negative incidental emotions in everyday life. Recognizing the factors affecting risk perceptions among soldiers is important for better understanding the impact of army service on young people.

Keywords: army service, combat soldiers, incidental emotions, risk perceptions

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Authors: Hosam Alzahrani, Martin Mackey, Emmanuel Stamatakis, Marina B. Pinheiro, Manuela Wicks, Debra Shirley

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Objective: To investigate the effectiveness of incidental (non-structured) physical activity interventions compared with other commonly prescribed interventions for the management of people with low back pain (LBP). Methods: We performed a systematic review with meta-analyses of eligible randomized controlled trials obtained by searching Medline, Scopus, CINAHL, EMBASE, and CENTRAL. This review considered trials investigating the effect of incidental physical activity interventions compared to other interventions in people aged 18 years or over, diagnosed with non-specific LBP. Analyses were conducted separately for short-term (≤3 months), intermediate-term (> 3 and < 12 months), and long-term (≥ 12 months), for each outcome. The analyses were conducted using the weighted mean difference (WMD). The overall quality of evidence was assessed using the GRADE system. Meta-analyses were only performed for pain and disability outcomes as there was insufficient data on the other outcomes. Results: For pain, the pooled results did not show any significant effects between the incidental physical activity intervention and other interventions at any time point. For disability, incidental physical activity was not statistically more effective than other interventions at short-term; however, the pooled results favored incidental physical activity at intermediate-term (WMD= -6.05, 95% CI: -10.39 to -1.71, p=0.006) and long-term (WMD= -6.40 95% CI: -11.68 to -1.12, p=0.02) follow-ups among participants with chronic LBP. The overall quality of evidence was rated “moderate quality” based on the GRADE system. Conclusion: The incidental physical activity intervention provided intermediate and long disability relief for people with chronic LBP, although this improvement was small and not likely to be clinically important.

Keywords: physical activity, incidental, low back pain, systematic review, meta-analysis

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Authors: Mohammad Hassanzadeh

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As far as incidental vocabulary learning is concerned, the basic contention of the Involvement Load Hypothesis (ILH) is that retention of unfamiliar words is, generally, conditional upon the degree of involvement in processing them. This study examined input modality and incidental vocabulary uptake in a task-induced setting whereby three variously loaded task types (marginal glosses, fill-in-task, and sentence-writing) were alternately assigned to one group of students at Allameh Tabataba’i University (n=2l) during six classroom sessions. While one round of exposure was comprised of the audiovisual medium (TV talk shows), the second round consisted of textual materials with approximately similar subject matter (reading texts). In both conditions, however, the tasks were equivalent to one another. Taken together, the study pursued the dual objectives of establishing a litmus test for the ILH and its proposed values of ‘need’, ‘search’ and ‘evaluation’ in the first place. Secondly, it sought to bring to light the superiority issue of exposure to audiovisual input versus the written input as far as the incorporation of tasks is concerned. At the end of each treatment session, a vocabulary active recall test was administered to measure their incidental gains. Running a one-way analysis of variance revealed that the audiovisual intervention yielded higher gains than the written version even when differing tasks were included. Meanwhile, task 'three' (sentence-writing) turned out the most efficient in tapping learners' active recall of the target vocabulary items. In addition to shedding light on the superiority of audiovisual input over the written input when circumstances are relatively held constant, this study for the most part, did support the underlying tenets of ILH.

Keywords: Keywords— Evaluation, incidental vocabulary learning, input mode, Involvement Load Hypothesis, need, search.

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Authors: Evgeniya V. Gavrilova, Sofya S. Belova

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The present study was aimed at clarifying the relationship between general intellectual abilities and efficiency in free recall and rhymed words generation task after incidental exposure to linguistic stimuli. The theoretical frameworks stress that general intellectual abilities are based on intentional mental strategies. In this context, it seems to be crucial to examine the efficiency of incidentally presented information processing in cognitive task and its relation to general intellectual abilities. The sample consisted of 32 Russian students. Participants were exposed to pairs of words. Each pair consisted of two common nouns or two city names. Participants had to decide whether a city name was presented in each pair. Thus words’ semantics was processed intentionally. The city names were considered to be focal stimuli, whereas common nouns were considered to be peripheral stimuli. Along with that each pair of words could be rhymed or not be rhymed, but this phonemic aspect of stimuli’s characteristic (rhymed and non-rhymed words) was processed incidentally. Then participants were asked to produce as many rhymes as they could to new words. The stimuli presented earlier could be used as well. After that, participants had to retrieve all words presented earlier. In the end, verbal and non-verbal abilities were measured with number of special psychometric tests. As for free recall task intentionally processed focal stimuli had an advantage in recall compared to peripheral stimuli. In addition all the rhymed stimuli were recalled more effectively than non-rhymed ones. The inverse effect was found in words generation task where participants tended to use mainly peripheral stimuli compared to focal ones. Furthermore peripheral rhymed stimuli were most popular target category of stimuli that was used in this task. Thus the information that was processed incidentally had a supplemental influence on efficiency of stimuli processing as well in free recall as in word generation task. Different patterns of correlations between intellectual abilities and efficiency in different stimuli processing in both tasks were revealed. Non-verbal reasoning ability correlated positively with free recall of peripheral rhymed stimuli, but it was not related to performance on rhymed words’ generation task. Verbal reasoning ability correlated positively with free recall of focal stimuli. As for rhymed words generation task, verbal intelligence correlated negatively with generation of focal stimuli and correlated positively with generation of all peripheral stimuli. The present findings lead to two key conclusions. First, incidentally processed stimuli had an advantage in free recall and word generation task. Thus incidental information processing appeared to be crucial for subsequent cognitive performance. Secondly, it was demonstrated that incidentally processed stimuli were recalled more frequently by participants with high nonverbal reasoning ability and were more effectively used by participants with high verbal reasoning ability in subsequent cognitive tasks. That implies that general intellectual abilities could benefit from operating by different levels of information processing while cognitive problem solving. This research was supported by the “Grant of President of RF for young PhD scientists” (contract № is 14.Z56.17.2980- MK) and the Grant № 15-36-01348a2 of Russian Foundation for Humanities.

Keywords: focal and peripheral stimuli, general intellectual abilities, incidental information processing

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Authors: Zach Banzon, Marina Caculitan, Gianne Laisac, Stephanie Lopez, Marguerite Villegas

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The role of incidental positive emotions and gender on people’s trust decisions have been established by existing research. The aim of this experiment is to address the gap in the literature by examining whether these factors will have a similar effect on trust behavior even after the experience of betrayal. A total of 144 undergraduate students participated in a trust game involving the anonymous interaction of a participant and a transgressor. Of these participants, only 125 (63 males and 62 females) were included in the data analyses. A story was used to prime incidental positive emotions or emotions originally unrelated to the trustee. Recovered trust was measured by relating the proportion of the money passed before and after betrayal. Data was analyzed using two-way analysis of variance having two levels for gender (male, female) and two for priming (with, without), with trust propensity scores entered as a covariate. It was predicted that trust recovery will be more apparent in females than in males but the data obtained was not significantly different between the genders. Induced positive emotions, however, had a statistically significant effect on trust behavior even after betrayal. No significant interaction effect was found between induced positive emotion and gender. The experiment provides evidence that the manipulation of situational variables, to a certain extent, can facilitate the reparation of trust.

Keywords: gender effect, positive emotions, trust game, trust recovery

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Authors: Mohamed Amin Mekheimer

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This study aimed to investigate the effects of paper-based monolingual, pop-up and type-in electronic dictionaries on improving reading comprehension and incidental vocabulary acquisition and retention in an EFL context. It tapped into how computer-mediated dictionaries may have facilitated/impeded reading comprehension and vocabulary acquisition. Findings showed differential effects produced by the three treatments compared with the control group. Specifically, it revealed that the pop-up dictionary condition had the shortest average vocabulary searching time, vocabulary and text reading time, yet with less than the type-in dictionary group but more than the book dictionary group in terms of frequent dictionary 'look-ups' (p<.0001). In addition, ANOVA analyses also showed that text reading time differed significantly across all four treatments, and so did reading comprehension. Vocabulary acquisition was reported as enhanced in the three treatments rather than in the control group, but still with insignificant differences across the three treatments, yet with more differential effects in favour of the pop-up condition. Data also assert that participants preferred the pop-up e-dictionary more than the type-in and paper-based groups. Explanations of the findings vis-à-vis the cognitive load theory were presented. Pedagogical implications and suggestions for further research were forwarded at the end.

Keywords: computer-mediated dictionaries, type-in dictionaries, pop-up dictionaries, reading comprehension, vocabulary acquisition

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Authors: Miju Choi

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Shopping tourism is an emerging concept in tourism research, thus contradicting the notion that shopping is not a novel idea. Tourists have long been performing shopping activities, such as purchasing authentic handicrafts and souvenirs, to benefit from a pleasant tourism experience. Some scholars regarded shopping as one of the oldest tourist activities and stressed that a trip is incomplete without shopping. Others then asserted that shopping is inseparable from other activities in tourist destinations and may in fact be considered a main purpose for travel. In other words, shopping is regarded as an incidental tourist activity, thereby indicating its potential as a primary travel motivation. The current study investigates the personal values of shopping tourists and their satisfaction levels. Via convenience sampling, 230 samples were collected. The software packages SPSS Statistics 20.0 and AMOS 20.0 were used for statistical analysis. Findings showed that both hedonic and utilitarian values positively influence tourist satisfaction and positive word of mouth. Therefore, this research deepens understanding regarding tourist behavior in the context of shopping tourism research.

Keywords: shopping tourism, hedonic value, utilitarian value, tourist satisfaction

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Authors: Angelis P. Barlampas

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PURPOSE: Presentation of an interesting finding in an asymptomatic patient. MATERIAL: A patient came at hospital because of dysuric complaints and after a urologist’s prescription of a US exam of the urogenital system. The simple ultrasound examination of the lower abdomen revealed a moderate hypertrophy of the prostate and a solitary large bladder stone. The kidneys were normal. Then, the patient underwent a CT scan, which depicted the bladder stone and, as an incidental finding, a cystic lesion in contact with the upper anterior right surface of the bladder, with mural calcifications. METHOD: Abdominal ultrasound and abdominal computed tomography before and after intravenous contrast administration. RESULTS: The repeated US exam showed a cylindrical cystic lesion with a double wall and two mural hyperechoic foci, with partial posterior shadowing. Blood flow was not recognized on color doppler. The CT exam confirmed the cystic-like anechoic lesion, in the right iliac fossa, with the presence of two foci of mural calcifications. The differential diagnosis includes cases of enteric cyst, intestinal duplication cyst, chronic abscess, urachal cyst, Meckel's diverticulum, bladder diverticulum, old hematoma, thrombosed vascular aneurysm, diverticular abscess, etc. The patient refused surgical removal and is being monitored by ultrasound. CONCLUSIONS: The careful examination of the wider peri-abdominal area, especially during the routine ultrasound examination, can contribute to the identification of important asymptomatic findings. The radiologist must not be solely focused in a certain area of examination, even if the clinical doctor asks so, but should give attention to the neighboring areas, too.

Keywords: enteric cyst, US, CT, urogenital tract, miscellaneous findings

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Authors: Saima Noreen, Malcolm D. MacLeod

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Different types of forgiveness (emotional and decisional) have been shown to have differential effects on incidental forgetting of information related to a prior transgression. The present study explored the extent to which emotional and decisional forgiveness also influenced intentional forgetting; that is, the extent to which forgetting occurs following an explicit instruction to forget. Using the List-Method Directed Forgetting (LMDF) paradigm, 236 participants were presented with a hypothetical transgression and then assigned to an emotional forgiveness, a decisional forgiveness, or a no-forgiveness manipulation. Participants were then presented with two-word lists each comprising transgression-relevant and transgression-irrelevant words. Following the presentation of the first list, participants were told to either remember or forget the previously learned list of words. Participants in the emotional forgiveness condition were found to remember fewer relevant and more irrelevant transgression-related words, while the opposite was true for both decisional forgiveness and no-forgiveness conditions. Furthermore, when directed to forget words in List 1, participants in the decisional and no-forgiveness conditions were less able to forget relevant transgression-related words in comparison to participants in the emotional forgiveness condition. This study suggests that emotional forgiveness plays a pivotal role in the intentional forgetting of transgression-related information. The potential implications of these findings for coping with unpleasant incidents will be considered.

Keywords: decisional forgiveness, directed forgetting, emotional forgiveness, executive control, forgiveness

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Authors: Avent Grange, Frederic Bertrand, Jean-Baptiste Droin, Amandine Marrel, Jean-Henry Ferrasse, Olivier Boutin

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CEA and its industrial partners are designing a gas Power Conversion System (PCS) based on a Brayton cycle for the ASTRID Sodium-cooled Fast Reactor. Investigations of control and regulation requirements to operate this PCS during operating, incidental and accidental transients are necessary to adapt core heat removal. To this aim, we developed a methodology to optimize the thermal-hydraulic behavior of the reactor during normal operations, incidents and accidents. This methodology consists of a multi-objective optimization for a specific sequence, whose aim is to increase component lifetime by reducing simultaneously several thermal stresses and to bring the reactor into a stable state. Furthermore, the multi-objective optimization complies with safety and operating constraints. Operating, incidental and accidental sequences use specific regulations to control the thermal-hydraulic reactor behavior, each of them is defined by a setpoint, a controller and an actuator. In the multi-objective problem, the parameters used to solve the optimization are the setpoints and the settings of the controllers associated with the regulations included in the sequence. In this way, the methodology allows designers to define an optimized and specific control strategy of the plant for the studied sequence and hence to adapt PCS piloting at its best. The multi-objective optimization is performed by evolutionary algorithms coupled to surrogate models built on variables computed by the thermal-hydraulic system code, CATHARE2. The methodology is applied to a loss of off-site power sequence. Three variables are controlled: the sodium outlet temperature of the sodium-gas heat exchanger, turbomachine rotational speed and water flow through the heat sink. These regulations are chosen in order to minimize thermal stresses on the gas-gas heat exchanger, on the sodium-gas heat exchanger and on the vessel. The main results of this work are optimal setpoints for the three regulations. Moreover, Proportional-Integral-Derivative (PID) control setting is considered and efficient actuators used in controls are chosen through sensitivity analysis results. Finally, the optimized regulation system and the reactor control procedure, provided by the optimization process, are verified through a direct CATHARE2 calculation.

Keywords: gas power conversion system, loss of off-site power, multi-objective optimization, regulation, sodium fast reactor, surrogate model

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Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

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Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

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Authors: Salam Kodsi

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In this research, we sought to focus on constructive play and examine its components in the context of two different educational approaches: Waldorf and normative schools. When they are free to choose, construction is one of the forms of play most favored by children. Its short-term and long-term cognitive contributions are apparent in various areas of development. The lack of empirical studies about play in Waldorf schools, which addresses the possibility of this incidental learning inspired the need to enrich the body of existing knowledge. 90 children (4-6 yrs.old) four preschools ( two normative, two Waldorf) participated in a small homogeneous city. Naturalistic observations documented the time frame, physical space, and construction materials related to the freeform building; processes of construction among focal representative children and its products. The study’s main finding with respect to the construction output points to a connection between educational approach and level of construction sophistication. Higher levels of sophistication were found at the Waldorf preschools than at the mainstream preschools. This finding emerged due to the differences in the level of sophistication among the older children in the two types of preschools, while practically no differences emerged among the younger children. Discussion of the research findings considered the differences between the play environments in terms of time, physical space, and construction materials. The construction processes were characterized according to the design model stages. The construction output was characterized according to the sophistication scale dimensions and the connections between approach, age and gender, and sophistication level.

Keywords: constructive play, preschool, design process model, complexity

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Authors: Gabriel Hunduma

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Asymptomatic intra-thoracic neurogenic tumours are rare. Tumours arising from the intercostal nerves of the chest wall are exceedingly rare. This paper reports an incidental discovery of a neurogenic intercostal tumour while being investigated for Coronavirus Disease 2019 (COVID-19). A 54-year-old female underwent a thoracotomy and resection for an intercostal tumour. Pre-operative images showed an intrathoracic mass, and the biopsy revealed a schwannoma. The most common presenting symptom recorded in literature is chest pain; however, our case remained asymptomatic despite the size of the mass and thoracic area it occupied. After an extensive search of the literature, COVID-19 was found to have an influence on the development of certain cells in breast cancer. Hence there is a possibility that COVID-19 played a role in progressing the development of the schwannoma cells.

Keywords: thoracic surgery, intercostal schwannoma, chest wall oncology, COVID-19

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Authors: Tan Dexian Arthur, James Wei Ming Kwek, Ian Loh, Lee Tee Sin

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Statement of the Problem: Mucoceles most commonly affect the frontal sinus, which results from chronic obstruction of the sinus ostium or cystic dilatation of mucous glands with ductal obstruction. They are known to cause bony erosion of the sinus walls, which can lead to large defects. These defects were typically managed by obliteration or cranialization of the frontal sinus. Although short term outcomes of conservative management of significant posterior table defects from fractures are promising, there have been no studies on the long-term outcomes of large dehiscences in the posterior wall of the frontal sinus. Methodology & Findings : Computed Tomography (CT) Paranasal Sinuses images were analyzed and found complete spontaneous osteogenesis of a large dehiscent frontal sinus posterior wall, secondary to a large mucocele, 9 years from functional endoscopic sinus surgery with the defect managed conservatively. Conclusion & Significance: The dura is well known for its osteogenic properties. Prior studies have showed that dura could induce osteogenesis in cutaneous tissue in the absence of other central nervous system structures. It was also demonstrated that osteogenesis and chondrogenesis were possible in zygomatic fractures by transplanting neonatal dura grafts to the bony defects in rats. Extrapolating from these studies, the authors postulate that the presence of dura beneath the bony deformity of the posterior frontal sinus wall had likely initiated the osteogenesis and restored the bony defect in the patient. In our literature review, we did not find any reports of spontaneous osteogenesis of large frontal sinus defects. While our experience is incidental, it reinforces the osteogenetic potential of an intact dura and further highlights that selected large defects of the posterior wall of the frontal sinus can be conservatively managed.

Keywords: paranasal sinus mucocele, mucocele, osteogenesis, dehiscence

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Authors: Rashmi Shahu

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This is a comparative study of the Organizational Role Stress among the private and government sector employees. There was no known similar kind of Organizational Role Stress study in the field area i.e. Nagpur city. Hence, in order to understand the ORS level pertaining to the government and private sector employees in various offices it was taken as the subject for this study. The Method used for this study was the incidental sampling method. The Organizational Role Scale containing 50 statements related to the ten different ORS areas was used for observations. All 60 participants were tested. The results of the study show that there was a significant difference in only one area of ORS i.e. Personal Inadequacy for the participants. The employees from the private sector showed higher Personal Inadequacy than the government employees. Rest of the ORS areas showed no significant difference meaning that the employees were well adjusted in the respective areas.

Keywords: organozational role stress, private sector, government sector, personal inadequacy

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Authors: K. Y. Shih, H. M. Lin, S. Y. Lee, T. L. Hong

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Recently a number of food safety scandals have been on the news. In view of the fact that in Taiwan the majority of undergraduate college students reside in the dorms and dine out, the problem of restaurant sanitation is of utmost importance in their lives. The purpose of this study is to analyze students' dining habit and their perception of food safety. Four universities in the city of Tainan were randomly selected, and from each selected university a class was then chosen to receive 50 questionnaires. The total of 200 questionnaires yielded 144 usable returns. Students were asked to respond to questions, and each question was graded on a scale from 1 to 5 according to the importance. There were 32 questions ranging over various aspects: cleanliness of surroundings, washroom, food sanitation, serving temperature, kitchen sanitation, and service personnel cleanliness. It is found that the food sanitation received the highest score, while the service personnel ranked the lowest. An incidental finding is that the students tend to dine out in groups and as such their choice of restaurants are mostly dictated by consensus.

Keywords: food safety, restaurant, risk perception, sanitation

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Authors: Ratul Das

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The present experimental study insights the decontamination of instantaneous velocity fluctuations captured by Acoustic Doppler Velocimeter (ADV) in gravel-bed streams to ascertain near-bed turbulence for low Reynolds number. The interference between incidental and reflected pulses produce spikes in the ADV data especially in the near-bed flow zone and therefore filtering the data are very essential. Nortek’s Vectrino four-receiver ADV probe was used to capture the instantaneous three-dimensional velocity fluctuations over a non-cohesive bed. A spike removal algorithm based on the acceleration threshold method was applied to note the bed roughness and its influence on velocity fluctuations and velocity power spectra in the carrier fluid. The velocity power spectra of despiked signals with a best combination of velocity threshold (VT) and acceleration threshold (AT) are proposed which ascertained velocity power spectra a satisfactory fit with the Kolmogorov “–5/3 scaling-law” in the inertial sub-range. Also, velocity distributions below the roughness crest level fairly follows a third-degree polynomial series.

Keywords: acoustic doppler velocimeter, gravel-bed, spike removal, reynolds shear stress, near-bed turbulence, velocity power spectra

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Authors: Marisa P. De Brito

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The internet is affecting the way the industry operates and communicates. It is also becoming a customary means for leisure, tourism, and hospitality consumers to seek and exchange information and views on hotels, destinations events and attractions, or to develop social ties with other users. On the one hand, the internet is a rich field to conduct leisure, tourism, and hospitality research; on the other hand, however, there are few researchers formally embracing online methods of research, such as netnography. Within social sciences, netnography falls under the interpretative/ethnographic research methods umbrella. It is an adaptation of anthropological techniques such as participant and non-participant observation, used to study online interactions happening on social media platforms, such as Facebook. It is, therefore, a research method applied to the study of online communities, being the term itself a contraction of the words network (as on internet), and ethnography. It was developed in the context of marketing research in the nineties, and in the last twenty years, it has spread to other contexts such as education, psychology, or urban studies. Since netnography is not universally known, it may discourage researchers and educators from using it. This work offers guidelines for researchers wanting to apply this method in the field of leisure, tourism, and hospitality or for educators wanting to teach about it. This is done by means of a double approach: a content analysis of the literature side-by-side with educational data, on the use of netnography. The content analysis is of the incidental research using netnography in leisure, tourism, and hospitality in the last twenty years. The educational data is the author and her colleagues’ experience in coaching students throughout the process of writing a paper using primary netnographic data - from identifying the phenomenon to be studied, selecting an online community, collecting and analyzing data to writing their findings. In the end, this work puts forward, on the one hand, a research agenda, and on the other hand, an educational roadmap for those wanting to apply netnography in the field or the classroom. The educator’s roadmap will summarise what can be expected from mini-netnographies conducted by students and how to set it up. The research agenda will highlight for which issues and research questions the method is most suitable; what are the most common bottlenecks and drawbacks of the method and of its application, but also where most knowledge opportunities lay.

Keywords: netnography, online research, research agenda, educator's roadmap

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Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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Authors: Jiyoung Lee, Andrew D. Gershoff, Jerry Jisang Han

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Most extant research on consumer privacy concerns and their willingness to share personal data has focused on contextual factors (e.g., types of information collected, type of compensation) that lead to consumers’ personal information disclosure. Unfortunately, the literature lacks a clear understanding of how consumers’ incidental psychological needs may influence consumers’ decisions to share their personal information with companies or brands. In this research, we investigate how social exclusion, which is an increasing societal problem, especially since the onset of the COVID-19 pandemic, leads to increased information disclosure intentions for consumers. Specifically, we propose and find that when consumers become socially excluded, their desire for social connection increases, and this desire leads to a greater willingness to disclose their personal information with firms. The motivation to form and maintain interpersonal relationships is one of the most fundamental human needs, and many researchers have found that deprivation of belongingness has negative consequences. Given the negative effects of social exclusion and the universal need to affiliate with others, people respond to exclusion with a motivation for social reconnection, resulting in various cognitive and behavioral consequences, such as paying greater attention to social cues and conforming to others. Here, we propose personal information disclosure as another form of behavior that can satisfy such social connection needs. As self-disclosure can serve as a strategic tool in creating and developing social relationships, those who have been socially excluded and thus have greater social connection desires may be more willing to engage in self-disclosure behavior to satisfy such needs. We conducted four experiments to test how feelings of social exclusion can influence the extent to which consumers share their personal information with brands. Various manipulations and measures were used to demonstrate the robustness of our effects. Through the four studies, we confirmed that (1) consumers who have been socially excluded show greater willingness to share their personal information with brands and that (2) such an effect is driven by the excluded individuals’ desire for social connection. Our findings shed light on how the desire for social connection arising from exclusion influences consumers’ decisions to disclose their personal information to brands. We contribute to the consumer disclosure literature by uncovering a psychological need that influences consumers’ disclosure behavior. We also extend the social exclusion literature by demonstrating that exclusion influences not only consumers’ choice of products but also their decision to disclose personal information to brands.

Keywords: consumer-brand relationship, consumer information disclosure, consumer privacy, social exclusion

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Authors: Michelangelo Liban, Debbie Liquete

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A case of a 93-year-old Filipina who experienced a sudden onset of left-sided hemichorea hemiballismus after falling from a standing height due to dizziness and then sought consult at the Emergency Room. She was not known to have diabetes mellitus nor experienced any symptoms of diabetes aside from its rare neurological manifestation of hemichorea-hemiballismus prior to this consult. On further workup, her baseline laboratory tests at the Emergency Room Department showed a CBG of 340mg/dL, an HbA1c of 15%, no ketones were detected in her urine but a hyperdensity with a Hounsfeld unit of 38 on CT, and hyperintensity on T1 weighted MRI on her right striatum with an incidental finding of a subdural hematoma measured as a 0.7cm hyperdensity on her right temporoparietal area with no midline shift. She was then treated with Clonazepam 2mg ¼ tab twice a day before bedtime and insulin 70/30 16 units in the morning and eight units in the evening, which provided good glycemic control maintained at 140-180 mg/dL, complete cessation of the left-sided hemichorea hemiballismus was also observed. The subdural hematoma was deemed non-surgical, and she refused admission into our institution; hence observation on an outpatient basis was done. This is a case of a rare neurological manifestation of diabetes mellitus but with good treatment response to anti-chorea medications combined with diabetes medications.

Keywords: hemichorea, hemiballismus, striatopathy, diabetes

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Authors: Vladimir V. Iakovlev, Erin T. Carey, John Steege

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The use of polypropylene mesh devices for Pelvic Organ Prolapse (POP) spread rapidly during the last decade, yet our knowledge of the mesh-tissue interaction is far from complete. We aimed to perform a thorough pathological examination of explanted POP meshes and describe findings that may explain mechanisms of complications resulting in product excision. We report a spectrum of important findings, including nerve ingrowth, mesh deformation, involvement of detrusor muscle with neural ganglia, and polypropylene degradation. Analysis of these findings may improve and guide future treatment strategies.

Keywords: transvaginal, mesh, nerves, polypropylene degradation

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Authors: Oludare Olupemi Ezekiel

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This research examines the rhythmic structure of Sakara music by tracing its roots and analyzing the various rhythmic patterns of this neo-traditional genre, as well as the contributions of the major exponents and contemporary practitioners, using these as a model for understanding and establishing African rhythms. Biography of the major exponents and contemporary practitioners, interviews and participant observational methods were used to elicit information. Samples of the genre which were chosen at random were transcribed, notated and analyzed for academic use and documentation. The research affirmed that rhythms such as the Hemiola, Cross-rhythm, Clave or Bell rhythm, Percussive, Speech and Melodic rhythm and other relevant rhythmic theories were prevalent and applicable to Sakara music, while making important contributions to musical scholarship through its analysis of the music. The analysis and discussions carried out in the research pointed towards a conclusion that the Yoruba musicians are guided by some preconceptions and sound musical considerations in making their rhythmic patterns, used as compositional techniques and not mere incidental occurrence. These rhythmic patterns, with its consequential socio-cultural connotations, enhance musical values and national identity in Nigeria. The study concludes by recommending that musicologists need to carry out more research into this and other neo-traditional genres in order to advance the globalisation of African music.

Keywords: compositional techniques, globalisation, identity, neo-traditional, rhythmic theory, Sakara music

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Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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Authors: Elizabeth Latham

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

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

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Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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