Search results for: rare presentation

Authors: John Monro, Suman Mishra

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Choosing foods for health benefits requires information that accurately represents the relative effectiveness of foods with respect to specific health end points, or with respect to responses leading to health outcomes. At present consumers must rely on nutrient composition data, and on health claims to guide them to healthy food choices. Nutrient information may be of limited usefulness because it does not reflect the effect of food structure and food component interactions – that is, whole food effects. Health claims demand stringent criteria that exclude most foods, even though most foods have properties through which they may contribute to positive health outcomes in a diet. In this presentation, we show how the functional efficacy of foods may be expressed in the same format as nutrients, with weight units, as virtual food components that allow a nutrition information panel to show not only what a food is, but also what it does. In the presentation, two body responses linked to well-being are considered – glycaemic response and colonic bulk – in order to illustrate the concept. We show how the nutrient information on available carbohydrates and dietary fibre values obtained by food analysis methods fail to provide information of the glycaemic potency or the colonic bulking potential of foods, because of failings in the methods and approach taken to food analysis. It is concluded that a category of food values that represent the functional efficacy of foods is required to accurately guide food choices for health.

Keywords: dietary fibre, glycaemic response, food values, food effects, health

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Authors: T. Rakhi, Thrivikram Shenoy

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Esophageal atresia is a disorder of maldevelopment of esophagus with or without a connection to the trachea. Radiological reviews are needed in consultation with the pediatric surgeon and neonatologist and we report a rare case of esophageal atresia associated with atrial septal defect-patent ductus arteriosus complex. A 2-day old female baby born at term, weighing 3.010kg, admitted to the Neonatal Intensive Care Unit with respiratory distress and excessive oral secretions. On examination, continuous murmur and cyanosis were seen. Esophageal atresia was suspected, after a failed attempt to pass a nasogastric tube. Chest radiograph showed coiling of the nasogastric tube and absent gas shadow in the abdomen. Echocardiography confirmed Patent Ductus Arteriosus with Atrial Septal Defect not in failure and was diagnosed with esophageal atresia with suspected fistula posted for surgical repair. After preliminary management with oxygenation, suctioning in prone position and antibiotics, investigations revealed Hb 17gms serum biochemistry, coagulation profile and C-Reactive Protein Test normal. The baby was premedicated with 5mcg of fentanyl and 100 mcg of midazolam and a rapid awake laryngoscopy was done to rule out difficult airway followed by induction with o2 air, sevo and atracurium 2 mg. Placement of a 3.5 tube was uneventful at first attempt and after confirming bilateral air entry positioned in the lateral position for Right thoracotomy. A pulse oximeter, Echocardiogram, Non-invasive Blood Pressure, temperature and a precordial stethoscope in left axilla were essential monitors. During thoracotomy, both the ends of the esophagus and the fistula could not be located after thorough search suggesting an on table finding of type A esophageal atresia. The baby was repositioned for gastrostomy, and cervical esophagostomy ventilated overnight and extubated uneventful. Absent gas shadow was overlooked and the purpose of this presentation is to create an awareness between the neonatologist, pediatric surgeons and anesthesiologist regarding variation of typing of Tracheoesophageal fistula pre and intraoperatively. A need for imaging modalities warranted for a definitive diagnosis in the presence of a gasless stomach.

Keywords: anesthetic, atrial septal defects, esophageal atresia, patent ductus arteriosus, perioperative, chest x-ray

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Authors: Noel Smith

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To achieve professional registration, UK social workers need to complete a programme of education and training which meets standards set down by central government. When it comes to practice, social work in local authorities must fulfil requirements of national legislation but there is considerable local variation in the organisation and delivery of services. This presentation discusses the on-going reform of social work education by central government in the context of research of social work services in a local authority. In doing so it highlights that the ‘direction of travel’ of the national reform of social work education seems at odds with the trajectory of development of local social work services. In terms of education reform, the presentation cites key government initiatives including the knowledge and skills requirements which have been published separately for, respectively, child and family social work and adult social work. Also relevant is the Government’s new ‘teaching partnership’ pilot which focuses exclusively on social work in local government, in isolation from social work in NGOs. In terms of research, the presentation discusses two studies undertaken by Professor Smith in Suffolk County Council, a local authority in the east of England. The first is an equality impact analysis of the introduction of a new model for the delivery of adult and community services in Suffolk. This is based on qualitative research with local government representatives and NGOs involved in social work with older people and people with disabilities. The second study is an on-going, mixed method evaluation of the introduction of a new model of social care for children and young people in Suffolk. This new model is based on the international ‘Signs of Safety’ approach, which is applied in this model to a wide range of services from early intervention to child protection. While both studies are localised, the service models they examine are good illustrations of the way services are developing nationally. Analysis of these studies suggest that, if services continue to develop as they currently are, then social workers will require particular skills which are not be adequately addressed in the Government’s plans for social work education. Two issues arise. First, education reform concentrates on social work within local government while increasingly local authorities are outsourcing service provision to NGOs, expecting greater community involvement in providing care, and integrating social care with health care services. Second, education reform focuses on the different skills required for working with older and disabled adults and working with children and families, to the point where potentially the profession would be fragmented into two different classes of social worker. In contrast, the development of adult and children’s services in local authorities re-asserts the importance of common social work skills relating to personalisation, prevention and community development. The presentation highlights the importance for social work education in the UK to be forward looking, in terms of the changing design of service delivery, and outward looking, in terms of lessons to be drawn from international social work.

Keywords: adult social work, children and families social work, European social work, social work education

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Authors: Yung Yau

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'Little people' are those who have extremely short stature as they suffer from rare bone diseases. They are commonly known as 'dwarves' or 'people with dwarfism'. Dwarfism is generally regarded as a type of rare disease for its extremely small odds (~1 in 15,000). On account of its rarity, dwarfism, unlike other types of disability, has attracted relatively little attention from the general public and in various academic fields (e.g. architecture, psychology and sociology) except medical science. In view of the extant research gaps, this study aims to investigate the physical barriers facing the little people in the built environment in Hong Kong. Between November 2017 and July 2018, ten little people or their family members participated in in-depth interviews. Responses of the interviewees were transcribed (i.e., speech being converted to text word for word). Interview data were then analyzed using the interpretative phenomenological analysis methodology developed by J. Smith and others in 2009. The findings of the project reveal that although Hong Kong's built environment has been designed barrier-free pursuant to the prevailing building standards, those standards do not cater to the special anthropometric characteristics of little people. As a result, little people face a lot of challenges when using built facilities. For example, most water closets, urinals, and wash hand basins are not fit for little people's use. As indicated by the project findings, we are still far away from providing a discrimination-free and barrier-free living environment for the little people in Hong Kong. To make Hong Kong society more inclusive to the little people, there is a need for further tailored building design. A set of building design principles for better inclusion of the little people in our society are highlighted. These principles include 'the building design should accommodate individuals with different heights' and 'the building design should allow individuals to use comfortably and efficiently with a minimum of fatigue'. At the end of the paper, the author also calls for an agenda for further studies. For instance, we need an anthropometric study on little people for developing practical building design guidelines.

Keywords: dwarfism, little people, inclusive buildings, people with disabilities, social sustainability

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Authors: Maria Francesca Lavadia-Gumabao, Mary Antoinette Salvamante-Torallo

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Introduction: The fibrous intrauterine adhesions forming inside the uterus and/or cervix in Asherman syndrome can obstruct the internal cervical orifice and may present as a case of outflow tract obstruction. Asherman syndrome is often overlooked since it has no specific presentation and is undetectable by routine physical examinations or diagnostic procedures such as an ultrasound. This paper highlights the delay and elusive diagnosis of Asherman syndrome which negatively impacted the patient’s fertility and quality of life. Case presentation: A 33-year-old woman (gravida 3, para 3) who presented with secondary amenorrhea for thirteen years associated with cyclic pelvic pain and secondary infertility sought a consultation at our institution for evaluation and specialty management. The patient had no other well-established risk factors for Asherman syndrome aside from pregnancy. For more than a decade, she delayed seeking medical care. At presentation, history taking, physical examination, and ultrasound were not helpful in identifying the cause of outflow tract obstruction. Diagnostic hysteroscopy was then performed, during which extensive scarring and fibrosis completely obscured the internal cervical orifice were observed, consistent with the diagnosis of Asherman syndrome (Grade 5B). The patient then underwent ultrasound guided hysteroscopy outflow tract dilatation and responded well to the treatment as she had her menstrual period a month after the procedure and no longer had cyclic pelvic pain with a repeat ultrasound finding of an unremarkable uterus. The hispathology result of the tissues retrieved revealed myometrial fragments with associated old hemorrhage benign endometrial stromal tissues, which failed to show endometrial glands. Conclusion: The delay and elusive diagnosis of Asherman syndrome can be brought about by poor health seeking behavior of patients and difficulty in detecting this condition by routine physical examinations or diagnostic procedures such as an ultrasound. It is, therefore, necessary to include Asherman syndrome in the differential diagnosis of secondary amenorrhea and secondary infertility. With expertise in hysteroscopy, early diagnosis, proper classification in the advent of hysteroscopy, and optimal management can improve patient outcomes.

Keywords: Asherman syndrome, outflow tract obstruction, secondary amenorrhea, infertility, hysteroscopy

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Authors: Irfan Khan, Chiemeka David Ekene Arize, Hilly Swami, Suprabha Jha

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Background: The rise of myocardial infarction (MI) among young adults, especially those with psychiatric conditions on antipsychotic medications, highlights the need to explore non-traditional cardiovascular risk factors. Case Presentation: We discuss a 24-year-old male with acute MI, diagnosed with an acute anxiety disorder, treated with risperidone and quetiapine, and with a history of occasional smoking. Despite no significant medical history, his presentation underscores the complex interactions between psychiatric conditions, antipsychotic medication, and lifestyle choices in the etiology of MI. Discussion: This case sheds light on the intricate relationship between minimal smoking habits, the use of atypical antipsychotics, and psychiatric illness as contributory factors to cardiovascular risk in young patients. It suggests a synergistic effect, amplifying the risk of MI, which is not adequately captured by traditional risk models. Conclusion: The case emphasizes the importance of an integrated care appro ach for young MI patients with psychiatric conditions and highlights the urgent need for further research to understand the compounded cardiovascular risk posed by psychiatric medications and lifestyle factors. It advocates for comprehensive risk assessments that consider these non-traditional factors to improve outcomes for this vulnerable patient population.

Keywords: myocardial infarction, young adults, psychiatric illness, antipsychotic medications, smoking

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Authors: Natália Maria Rego

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ALeibnizn-algebraGis aK-vector space endowed whit a n-linearbracket operation [-,…-] : GG … G→ Gsatisfying the fundamental identity, which can be expressed saying that the right multiplication map Ry2, …, ᵧₙ: Gn→ G, Rᵧ₂, …, ᵧₙn(ˣ¹, …, ₓₙ) = [[ˣ¹, …, ₓₙ], ᵧ₂, …, ᵧₙ], is a derivation. This structure, together with its skew-symmetric version, named as Lie n-algebra or Filippov algebra, arose in the setting of Nambumechanics, an n-ary generalization of the Hamiltonian mechanics. Thefirst goal of this work is to provide a characterization of various classes of central extensions of Leibniz n-algebras in terms of homological properties. Namely, Commutator extension, Quasi-commutator extension, Stem extension, and Stem cover. These kind of central extensions are characterized by means of the character of the map *(E): nHL1(G) → M provided by the five-term exact sequence in homology with trivial coefficients of Leibniz n-algebras associated to an extension E : 0 → M → K → G → 0. For a free presentation 0 →R→ F →G→ 0of a Leibniz n-algebra G,the term M(G) = (R[F,…n.., F])/[R, F,..n-1..,F] is called the Schur multiplier of G, which is a Baer invariant, i.e., it does not depend on the chosen free presentation, and it is isomorphic to the first Leibniz n-algebras homology with trivial coefficients of G. A central extension of Leibniz n-algebras is a short exact sequenceE : 0 →M→K→G→ 0such that [M, K,.. ⁿ⁻¹.., K]=0. It is said to be a stem extension if M⊆[G, .. n.., G]. Additionally, if the induced map M(K) → M(G) is the zero map, then the stem extension Eis said to be a stem cover. The second aim of this work is to analyze the interplay between stem covers of Leibniz n-algebras and the Schur multiplier. Concretely, in the case of finite-dimensional Leibniz n-algebras, we show the existence of coverings, and we prove that all stem covers with finite-dimensional Schur multiplier are isoclinic. Additionally, we characterize stem covers of perfect Leibniz n-algebras.

Keywords: leibniz n-algebras, central extensions, Schur multiplier, stem cover

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Authors: Bahieddine. Bouabdellah, Benameur. Amiri, Abdelkader.nouri

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Europium-doped gallium nitride (EuGaN) is a promising material for optoelectronic and thermoelectric devices. This study investigates its optical properties using density functional theory (DFT) with the FP-LAPW method and MBJ+U correction. The simulation substitutes a gallium atom with europium in a hexagonal GaN lattice (6% doping). Distinct absorption peaks are observed in the optical analysis. These results highlight EuGaN's potential for various applications and pave the way for further research on rare earth-doped materials.

Keywords: eugan, fp-lapw, dft, wien2k, mbj hubbard

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Authors: L. Mtibaa, N. Baccouchi, S. Hannechi, R. Abid, R. Battikh, B. Jemli

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Cryptococcosis is an opportunistic fungal infection which is commonly associated with an immune-compomised state, especially HIV infection. Rare cases of cryptococcosis have been reported in patients with multiple myeloma (MM), and they are all at a late stage of the disease. However, the inaugural character of cryptococcosis revealing the MM at an early stage has never been reported to our best knowledge. We presented here a case of neuromeningeal cryptococcosis in a patient without any apparent underlying conditions, who has revealed IgA-λ MM. Early detection and treatment of cryptococcosis are essential to reduce morbidity and for a better outcome.

Keywords: Cryptococcosis, Cryptococcus, hematologic, malignancy

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Authors: Sarah Hamdan Al-Jahdali, Khaled Alsaad, Abdullah Al-Sayyari

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Objectives: To study the prevalence, clinicopathological features, risk factors and outcome of biopsy proven polyoma (BK) virus infection among Saudi kidney transplant recipients and compare them to negative BK virus group. Methods: We retrospectively reviewed the charts of all the patients with biopsy-proven polyoma (BK) virus infection in King Abdulaziz Medical City in Riyadh between 2005 and 2011. The details of clinical presentation, the indication for kidney biopsy, the laboratory findings at presentation, the natural history of the disease, thepathological findings, the prognosis as well as the response to therapy were all recorded. Results: Kidney biopsy was performed in 37 cases of unexplained graft dysfunction. BK virus was found in 10 (27%). Out of those 10, 3 (30%) ended with graft failure. BK virus occurred in all patients who received ATG induction therapy 100% versus 59.3% in the non BK virus patients (p=0.06). Furthermore, the risk of BK virus was much less in those who received acyclovir as an anti-viral prophylaxis as compared to those who did not receive it (p=0.01). Also, patients with BK virus weighed much less (mean 46.7±20.6 Kgs) than those without BK virus at time of transplantation (mean 64.3±12.1). Graft survival was better among deceased donor kidneys compared to living ones (P=0.016) and with older age (P=0.005). Conclusion: Our findings suggest the involvement of ATG induction therapy, the lack of antiviral prophylaxis therapy and lower weight at transplant as significant risk factors for the development of BK virus infection.

Keywords: BKVAN, BKV, kidney transpant, Saudi Arabia

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Authors: Monika Zalewska

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Hans Kelsen was a versatile legal thinker whose achievements in the fields of legal theory, international law, and the theory of democracy are remarkable. All of the fields tackled by Kelsen are regarded as part of his “pure theory of law.” While the link between international law and Kelsen’s pure theory of law is apparent, the same cannot be said about the link between the theory of democracy and his pure theory of law. On the contrary, the general thinking concerning Kelsen’s thought is that it can be used to legitimize authoritarian regimes. The aim of this presentation is to address this concern by identifying the common ground between Kelsen’s pure theory of law and his theory of democracy and to show that they are compatible in a way that his pure theory of law and authoritarianism cannot be. The conceptual analysis of the purity of Kelsen’s theory and his goal of creating ideology-free legal science hints at how Kelsen’s pure theory of law and the theory of democracy are brought together. The presentation will first demonstrate that these two conceptions have common underlying values and meta-ethical convictions. Both are founded on relativism and a rational worldview, and the aim of both is peaceful co-existence. Second, it will be demonstrated that the separation of law and morality provides the maximum space for deliberation within democratic processes. The conclusion of this analysis is that striking similarities exist between Kelsen’s legal theory and his theory of democracy. These similarities are grounded in the Enlightenment tradition and its values, including rationality, a scientific worldview, tolerance, and equality. This observation supports the claim that, for Kelsen, legal positivism and the theory of democracy are not two separate theories but rather stem from the same set of values and from Kelsen’s relativistic worldview. Furthermore, three main issues determine Kelsen’s orientation toward a positivistic and democratic outlook. The first, which is associated with personality type, is the distinction between absolutism and relativism. The second, which is associated with the values that Kelsen favors in the social order, is peace. The third is legality, which creates the necessary condition for democracy to thrive and reveals that democracy is capable of fulfilling Kelsen’s ideal of law at its fullest. The first two categories exist in the background of Kelsen’s pure theory of law, while the latter is an inherent part of Kelsen’s concept of law. The analysis of the text concerning natural law doctrine and democracy indicates that behind the technical language of Kelsen’s pure theory of law is a strong concern with the trends that appeared after World War I. Despite his rigorous scientific mind, Kelsen was deeply humanistic. He tried to create a powerful intellectual weapon to provide strong arguments for peaceful coexistence and a rational outlook in Europe. The analysis provided by this presentation facilitates a broad theoretical, philosophical, and political understanding of Kelsen’s perspectives and, consequently, urges a strong endorsement of Kelsen’s approach to constitutional democracy.

Keywords: hans kelsen, democracy, legal positivism, pure theory of law

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Authors: Morenike Abimbola Adeleye, Anthony Temidayo Bolarinwa

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The genesis of talc bodies around Wonu, Ibadan-Apomu area, southwestern Nigeria, has been speculative due to inadequate compositional data on the talc and the mafic-ultramafic protoliths. Petrography, morphology, using scanning electron microscope, mineral chemistry, X-ray diffraction, and major, trace and rare-earth element compositions of the talc and the mafic-ultramafic in the area were undertaken with a view to determine the genesis of the talc bodies. Fine-grained amphibolite and lherzolite are the major mafic-ultramafic rocks in the study area. The amphibolite is fine-grained, composed of amphiboles, pyroxenes plagioclase, K-feldspar, ilmenite, magnetite, and garnet. The lherzolite and talc are composed of olivines, pyroxenes, amphiboles, and plagioclase. Alteration minerals include serpentine, amesite, talc, Cr-bearing clinochlore, and ferritchromite. Cr-spinel, pyrite, and magnetite are the accessory minerals present. Alteration of olivines, pyroxenes, and amphiboles to talc and chlinochlore; and spinel to ferritchchromite by hydrothermal (H₂O-CO₂-Cl-HF) fluids, provided by the granitic intrusions in the area, showed retrograde metasomatism of amphibolites to greenschist facies at 500-550ºC. This led to the formation of talc, amesite, anthophyllite, actinolite, and tremolite. The Al₂O₃-Fe₂O₃+TiO₂-MgO discrimination diagram suggests tholeiitic protolith for the amphibolite and komatitic protolith for the lherzolite. The lherzolite has flat rare-earth element patterns typical of komatiites and dunites. The Al₂O₃/TiO₂ ratios, Ce/Nb vs. Th/Nb, Cr-TiO₂, TiO₂ vs. Al₂O₃, and Nd vs. Nb discrimination diagrams indicated that the talcs are from two-parent sources: altered metacarbonates and tholeiitic basalts (amphibolites) to komatitic basalts (lherzolites).

Keywords: amphibolites, lherzolites, talc, komatiite

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Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

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Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

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Authors: Okan Cakir, Okan Tatli

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Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.

Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness

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Authors: John Bankier

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Development of academic English occurs not only in communities of practice but also within wider social networks, referred to by Zappa-Hollman and Duff as individual networks of practice. Such networks may exist whether students are developing academic English in English-dominant contexts or in contexts in which English is not a majority language. As yet, little research has examined how newcomers to universities interact with a variety of social ties in such networks to receive academic and emotional support as they develop the academic English necessary to succeed in local and global academia. The one-year ethnographic study described in this presentation followed five Japanese university students enrolled on an academic English program in their home country. We graphically represent participants’ individual networks of practice related to academic English and display the role of interaction in these networks to socialization. Specific examples of academic practices will be linked to specific instances of social interaction. Interaction supportive of the development of academic practices often occurred during unplanned interactions outside the classroom and among small groups of close friends who were connected to each other in more than one way, such as those taking multiple classes together. These interactions occurred in study spaces, in hallways between class periods, at lunchtimes, and online. However, constraints such as differing accommodation arrangements, class scheduling and the hierarchical levelling of English classes by test scores discouraged some participants both from forming strong ties related to English and from interacting with existing ties. The presentation will briefly describe ways in which teachers in all contexts can maximise interaction outside the classroom.

Keywords: academic, english, practice, network

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Authors: Zhu-Qing Jia, Tao Lin, Tong Zhou

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The recognition method of Optical Character Recognition has been expensively utilized, while it is rare to be employed specifically in recognition of electronic components. This paper suggests a high-effective algorithm on appearance identification of integrated circuit components based on the existing methods of character recognition, and analyze the pros and cons.

Keywords: optical character recognition, fuzzy page identification, mutual correlation matrix, confidence self-adaptation

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Authors: Cinzia Valente

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Over the last few years, national legislators have been forced to deal with social changes that have had important repercussions in family law and children’s law. This growing focus on minors has provoked important reforms, specifically on issues relating to the welfare and protection of children. My presentation focuses on the issue of migrant children in particular I refer to unaccompanied children, or ‘children on the move’, or separate children or any other term defining migrant minors who cross national borders seeking protection or better opportunities. They arrive often illegally, on the European territory without a responsible adult who take care of them. There is a common assumption that migrants are running away from conflicts, poverty and human rights abuse and they arrive in a foreign country hoping a better life; children without persons who takes care of them encounter some difficulties in their integration in the host country. The migration flows recorded in recent decades towards EU countries, and Italy in particular, have imposed an intense pressure to modernize institutions, services and specific legal frameworks, with the aim of responding adequately to the needs of foreign individuals, as well as ensuring a good level of living standards and facilitating integration, especially for migrant children. The object of my paper is the analysis of the Italian rules, practices and services existing in favor of unaccompanied children (foster care, reunification, acquisition of citizenship and other) in comparison with other European legal systems on the same thematic with a comparative method. Highlighting European standards to find common principles for the best solution to children's problems is the conclusive aim of my presentation.

Keywords: Children , Family Law, Migration , Uniform Law

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Authors: Abraham J. Rizkalla, Joanne F. Irons, Christopher Q. Cao

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Purpose: Lobectomy was considered the standard of care for early-stage non-small lung cancer (NSCLC) after the Lung Cancer Study Group trial demonstrated increased locoregional recurrence for sublobar resections. However, there has been heightened interest in segmentectomies for selected patients with peripheral lesions ≤2cm, as investigated by the JCOG0802 and CALGB140503 trials. Minimally invasive robotic surgery facilitates segmentectomies with improved maneuverability and visualization of intersegmental planes using indocyanine green. We hereby present a patient who underwent robotic lingulectomy for an undiagnosed ground-glass opacity. Methodology: This video demonstrates a robotic portal lingulectomy using three 8mm ports and a 12mm port. Stereoscopic direct vision facilitated the identification of the lingula artery and vein, and intra-operative bronchoscopy was performed to confirm the lingula bronchus. The intersegmental plane was identified by indocyanine green and a near-infrared camera. Thorough lymph node sampling was performed in accordance with international standards. Results: The 18mm lesion was successfully excised with clear margins to achieve R0 resection with no evidence of malignancy in the 8 lymph nodes sampled. Histopathological examination revealed lepidic predominant adenocarcinoma, pathological stage IA. Conclusion: This video presentation exemplifies the standard approach for robotic portal lingulectomy in appropriately selected patients.

Keywords: lung cancer, robotic segmentectomy, indocyanine green, lingulectomy

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Authors: Eva de Mingo-Fernández, Lourdes Rubio Rico, Carmen Ortega-Segura, Montserrat Querol-García, Raúl González-Jauregui

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Today, one of the great challenges that the university faces is to get closer to society and transfer knowledge. The competency-based training approach favours a continuous interaction between practice and theory, which is why it is essential to establish real experiences with reflection and debate and to contrast them with personal and professional knowledge. Service-learning (SL) consists of an integration of academic learning with service in the community, which enables teachers to transfer knowledge with social value and students to be trained on the basis of experience of real needs and problems with the aim of solving them. SLE combines research, teaching, and social value knowledge transfer with the real social needs and problems of a community. Goal: The objective of this study was to design, implement, and evaluate a service-learning program in the subject of adult nursing for second-year nursing students. Methodology: After establishing collaboration with eight associations of people with different pathologies, the students were divided into eight groups, and each group was assigned an association. The groups were made up of 10-12 students. The associations willing to participate were for the following conditions: diabetes, multiple sclerosis, cancer, inflammatory bowel disease, fibromyalgia, heart, lung, and kidney diseases. The methodological design consisting of 5 activities was then applied. Three activities address personal and individual reflections, where the student initially describes what they think it is like to live with a certain disease. They then express their reflections resulting from an interview conducted by peers, in person or online, with a person living with this particular condition, and after sharing the results of their reflections with the rest of the group, they make an oral presentation in which they present their findings to the other students. This is followed by a service task in which the students collaborate in different activities of the association, and finally, a third individual reflection is carried out in which the students express their experience of collaboration. The evaluation of this activity is carried out by means of a rubric for both the reflections and the presentation. It should be noted that the oral presentation is evaluated both by the rest of the classmates and by the teachers. Results: The evaluation of the activity, given by the students, is 7.80/10, commenting that the experience is positive and brings them closer to the reality of the people and the area.

Keywords: academic learning integration, knowledge transfer, service-learning, teaching methodology

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Authors: Eiman A. Al-Enezi, Gin Jose, Sikha Saha, Paul Millner

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Rare earth nanotechnology has gained a considerable amount of interest in the field of biosensing due to the unique luminescence properties of lanthanides. Chelating rare earth ions plays a significant role in biological labelling applications including medical diagnostics, due to their different excitation and emission wavelengths, variety of their spectral properties, sharp emission peaks and long fluorescence lifetimes. We aimed to develop a platform for biosensors based on Europium (Eu³⁺) chelates against biomarkers of cardiac injury (heart-type fatty acid binding protein; H-FABP3) and stroke (glial fibrillary acidic protein; GFAP). Additional novelty in this project is the use of synthetic binding proteins (Affimers), which could offer an excellent alternative targeting strategy to the existing antibodies. Anti-GFAP and anti-HFABP3 Affimer binders were modified to increase the number of carboxy functionalities. Europium nitrate then incubated with the modified Affimer. The luminescence characteristics of the Eu³⁺ complex with modified Affimers and antibodies against anti-GFAP and anti-HFABP3 were measured against different concentrations of the respective analytes on excitation wavelength of 395nm. Bovine serum albumin (BSA) was used as a control against the IgG/Affimer Eu³⁺ complexes. The emission spectrum of Eu³⁺ complex resulted in 5 emission peaks ranging between 550-750 nm with the highest intensity peaks were at 592 and 698 nm. The fluorescence intensity of Eu³⁺ chelates with the modified Affimer or antibodies increased significantly by 4-7 folder compared to the emission spectrum of Eu³⁺ complex. The fluorescence intensity of the Affimer complex was quenched proportionally with increased analyte concentration, but this did not occur with antibody complex. In contrast, the fluorescence intensity for Eu³⁺ complex increased slightly against increased concentration of BSA. These data demonstrate that modified Affimers Eu³⁺ complexes can function as nanobiosensors with potential diagnostic and analytical applications.

Keywords: lanthanides, europium, chelates, biosensors

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Authors: Anthony Townsend, Robyn Fasser

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While complete objectivity is a desirable scientific position from which to conduct a care and contact evaluation (CCE), it is precisely the recognition that we are inherently incapable of operating objectively that is the foundation of ethical practice and skilled assessment. Drawing upon recent research from Daniel Kahneman (2021) on the differences between noise and bias, as well as different inherent biases collectively termed “The Elephant in the Brain” by Kevin Simler and Robin Hanson (2019) from Oxford University, this presentation addresses both the various ways in which our judgments, perceptions and even procedures can be distorted and contaminated while conducting a CCE, but also considers the value of second order cybernetics and the psychodynamic concept of ‘ambivalence’ as a conceptual basis to inform our assessment methodologies to limit such errors or at least better identify them. Both a conceptual framework for ambivalence, our higher-order capacity to allow for the convergence and consideration of multiple emotional experiences and cognitive perceptions to inform our reasoning, and a practical methodology for assessment relying on data triangulation, Bayesian inference and hypothesis testing is presented as a means of promoting ethical practice for health care professionals conducting CCEs. An emphasis on widening awareness and perspective, limiting ‘splitting’, is demonstrated both in how this form of emotional processing plays out in alienating dynamics in families as well as the assessment thereof. In addressing this concept, this presentation aims to illuminate the value of ambivalence as foundational to ethical practice for assessors.

Keywords: ambivalence, forensic, psychology, noise, bias, ethics

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Authors: Natalie M. Khazaal

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The effects of the civil war on Lebanese women have been challenging to conceptualize. For some, war is a liberating and empowering force for women, while for others it is one that subjugates women and disempowers them in new ways. Scholars have explored the impact on the Lebanese civil war (1975-1990) on women in the fields of labor history, political activism and literary production. In all these arenas, women’s role and visibility were contested and negotiated in diverse ways. But probably the most visible arena where this contestation took place was television. Dramatized entertainment series were crucial sites where fictional women battled out the gender question, and which reflected and participated in the negotiations of gender politics. Even more stunningly, actual television stations became part of this battle through the plots and portrayals of women that they created. The state-backed Tele-Liban (TL) peddled patriarchal articulations of gender that directly competed with the edgy vision of liberated, independent women on the pirate Lebanese Broadcasting Corporation (LBC). This presentation explores how LBC used gender to distinguish its brand against the retrograde TL programing. Television series are an important medium for creating, testing and reenacting gender politics. They are even more consequential in another way. They are the sites where a dramatic shift in the relationship between Arab television and Arab publics—from benign neglect of public concerns towards engagement with audiences—took place for the first time. As this shift is at the heart of why Arab media was seen as a participant in the Arab uprisings, it is important to explore the roots of the shift in the dramas and comedy series of the mid-1980s Lebanese television. This presentation argues that television battles over gender were consequential and need serious consideration as sites of unexpected meaning.

Keywords: gender, Lebanon, television, war, women

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Authors: Chuang Bing-Kai, Shih Hsiang-Ju

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Previous studies showed that emergent adults used dating applications the most since it would satisfy their needs for intimacy. It's also found that those emergent adults were mostly non-heterosexual. What’s more, in this digital era, more and more bisexuals and homosexuals choose to establish connections with others through Internet to seek a sense of belonging. However, studies rarely focused on gay men in their emergent adulthood to explore their experiences of dating applications. The purpose of this study was to explore the experience of gay men using dating applications in their emerging adulthood and to understand their self-presentations and the process of it among different relationships while interacting with others upon using dating applications. The semi-structured interview was conducted with those gay men who aged from 18 to 29, felt attracted to people with same gender physically and mentally, considered themselves homosexual from their subjective understanding and had been using dating applications for more than half a year. Research invitations were distributed with the assistance of social media platforms and LGBTQ+ friends in the community. This study adopted a qualitative research approach and applied hermeneutic phenomenology as the method to analyze the transcripts transcribed from the recorded audio, and to explore their using experiences and self-presentations while interacting with others while using dating apps. It’s expected to find out that there are four stages in the self-presentation process including establishing personal identity, self-exploration and experimentation, exploring shared interest and values, developing and maintaining connections. Plus, gay men’s motives to use dating apps play an important role in this process and thus influence how they position the apps in their life. Through this study, professional workers can better understand gay men’s considerations and strategies in their self-presentation process as well as the impact of using motives.

Keywords: dating applications, emerging adulthood, gay men, hermeneutic phenomenology

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Authors: Eugenija Strazdiene, Violeta Bytautaite, Daivute Krisciuniene

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The object of the investigation is the suit for chemical protection, which totally covers human body together with breathing apparatus, breathing mask and helmet (JSC Ansell Protective Solutions Lithuania). The end users of such clothing are the members of rescue team – firefighters. During the presentation, the results of 3D scanning with stationary Human Solutions scanner and portable Artec Eva scanner will be compared on the basis of the efficiency of scanning procedure and scanning accuracy. Also, the possibilities to exporting scanned bodies into specialized CAD systems for suit design development and material consumption calculation will be analyzed. The necessity to understand and to implement corresponding clothing material properties during 3D visualization of garment on CAD systems will be presented. During the presentation, the outcomes of the project ‘Smart and Safe Work Wear Clothing SWW’ will be discussed. The project is carried out under the Interreg Baltic Sea Region Program as 2014-2020 European territorial cooperation objective. Thematic priority is Capacity for Innovation. The main goal of the project is to improve competitiveness and to increase business possibilities for work wear enterprises in the Baltic Sea Region. The project focuses on mass customization of products for various end users. It engages textile and clothing manufacturing technology researchers, work wear producers, end users, as well as national textile and clothing branch organizations in Finland, Lithuania, Latvia, Estonia and Poland.

Keywords: CAD systems, mass customization, 3D scanning, safe work wear

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Authors: Aravind Kumar

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The high terrains of Garhwal (Uttarakhand) Himalaya are the niches of a number of rare and endemic plant species of great therapeutic importance. However, the wild flora of the area is still under a constant threat due to rapid upsurge in human interferences, especially through multifarious tourism growth and peri-urban encroachments. After getting the status of a ‘Special State’ of the country since its inception in the year 2000, this newly borne State led to very rapid infrastructural growth and development. Consequently, its townships started expanding in an unmanaged way grabbing nearby agricultural lands and forest areas into peri-urban landscapes. Simultaneously, a boom in tourism and pilgrimage in the state and the infrastructural facilities raised by the government for tourists/pilgrims are destroying its biodiversity. Field survey revealed 242 plant species of therapeutic significance naturally growing in the area and being utilized by local inhabitants as traditional medicines. On conservation scale, 6 species (2.2%) were identified as critically endangered, 19 species (7.1%) as the endangered ones, 8 species (3.0%) under rare category, 17 species (6.4%) as threatened and 14 species (5.2%) as vulnerable. The Government of India has brought mega-biodiversity hot spots of the state under Biosphere Reserve, National Parks, etc. restricting all kinds of human interferences; however, the two most sacred shrines of Hindus and Sikhs viz. Shri Badrinath and Shri Hemkunt Sahib, and two great touristic attractions viz. Valley of Flowers and Auli-Joshimath Skiing Track oblige the government to maintain equilibrium between entries of visitors vis-à-vis biodiversity conservation in high terrains of Uttarakhand Himalaya.

Keywords: biodiversity conservation, ethno-botany, Garhwal (Uttarakhand) Himalaya, peri-urban encroachment, pilgrimage and tourism

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Authors: Peter Ferguson

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In 2018, Japan’s Ministry of Education revised the public elementary school curriculum. As part of widespread reforms, the recent Course of Study established English as an academic subject in Grades 5 and 6 plus lowered the starting age of 'foreign language activities' to Grade 3. These changes were implemented in April 2020. This presentation will examine the process and effects that policy implementation had on schools and teachers. A critical analysis of the 2018 Course of Study policy documents revealed several discourses were expressed concerning not only English education and foreign language acquisition, but that larger political and socioeconomic ideological beliefs on globalization, language, nation, culture, and identity were also articulated. Using excerpts from document analysis, the presenter will demonstrate how competing discourses were expressed in policy texts. Data from interviews with national policymakers also exposed several challenges policymakers faced as they tried to balance competing discourses and articulate important pedagogical concepts while having their voices heard. Findings show that some stakeholders were marginalized during the processes of policy creation, transmission, and implementation. This presentation is part of a larger multiple case study that utilized ethnography of language policy and critical analysis of discourse to examine how English education language policy was implemented into the national elementary school curriculum in Japan, and how stakeholders at the various educational levels contended with the creation, interpretation, and appropriation of the language policy.

Keywords: ethnography of language policy, elementary school EFL, language ideologies, discourse analysis

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Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan

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Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.

Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder

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Authors: J. Bouguebrine, L. Bouabsa

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The ground of study is localized in central Hoggar and contains the most important layers and Stanno-Wolframifére indices of the metallogenic province have tin and wolfram of Hoggar. These layers are always associate with post-orogenetic Panafrican magmatism (GMR) which was set up in the form of circumscribed granitic solid masses of relatively reduced size or in dykes of microgranites. The area studied are in Tounine, Aléméda, Hanana-hananére, Tim Amzi, El Karoussa. The geochemical data processing watch peralumineux character rich person out of Li-F and rare metals (MR). Pegmatites of the type stocksheider, formations of greisens and mineralization Sn-W accompany these granites. Mineralisation Sn-W, expressed particularly well in the seams of quartz and greinsen is spacialement and génitiquement dependent on the maguatism specific to white feldspar-topaz (GMR) (grained and microgrenu). the mineral paragenesis is primarily made up of wolframite and cassetérite. The minerals of gangue are represented by quartz, topaz, the micas containing lithia and the fluorite. A microthermometric study of fluid inclusions related to the granites end on white feldspar-topaz of Hanana, topaz of Hananére, the microgranite of Aléméda, and the seams of quartz D In Tounine (Tiftazouine) and of Tim Amzi; allows to characterize the fluids associated with these layers. It comes out from this study the abundance of aqueous inclusions and three types of fluids were given: -Hot and salted fluids rich in volatile elements particularly CO2; -follow-ups by aquo-carbonic fluids less hot and moderately salted with temperatures of homogenisations (HT) average respectively of 300°C and 180°C; -finally of the aqueous fluids very little salted (≤1%pds.éq.NaCl) and definitely colder. An estimate depths éteé made starting from the diagram of (Haas, 1971) in the system H2O-NaCl, the results are the following: • Inclusion aqueous (L and Lw): correspond to depths of about 50 à500m. • Inclusions aquo-carbonic (Lcw and Lwc): correspond to depths of L order of 600 with 1200m • Carbonic inclusion (Vcw): correspond to depths about 1400à1800m

Keywords: fluid inclusions microthermométrie, cassiterite wolframite, granites with rare metals, Central Hoggar

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Authors: Sawsan Al-Saaidi, Ghayth K. Shaker Al-Shaibani

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This paper investigates certain linguistics properties of four selected speeches by Al-Qaeda’s former leader Osama bin Laden who legitimated the use of jihad by Muslims in various countries when he was alive. The researchers adopt van Dijk’s (2009; 1998) Socio-Cognitive approach and Ideological Square theory respectively. Socio-Cognitive approach revolves around various cognitive, socio-political, and discursive aspects that can be found in political discourse as in Osama bin Laden’s one. The political discourse can be defined in terms of textual properties and contextual models. Pertaining to the ideological square, it refers to positive self-presentation and negative other-presentation which help to enhance the textual and contextual analyses. Therefore, among the most significant properties in Osama bin Laden’s discourse are the use of presuppositions and implicatures which are based on background knowledge and contextual models as well. Thus, the paper concludes that Osama bin Laden used a number of manipulative strategies which augmented and embellished the use of ‘jihad’ in order to develop a more effective discourse for his audience. In addition, the findings have revealed that bin Laden used different implicit and embedded interpretations of different topics which have been accepted as taken-for-granted truths for him to legitimate Jihad against his enemies. There are many presuppositions in the speeches analysed that result in particular common-sense assumptions and a world-view about the selected speeches. More importantly, the assumptions in the analysed speeches help consolidate the ideological analysis in terms of in-group and out-group members.

Keywords: Al-Qaeda, cognition, critical discourse analysis, Osama Bin Laden, jihad, implicature, legitimisation, presupposition, political discourse

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Authors: Farhat Jabeen, Syed Asfaq Hussain Bukhari

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In the wake of the contemporary period the basic objective of the research paper points out that socio-cultural scenario of Pakistan reveals that gender-based violence is deep rooted in the society irrespective of language and ethnicity. This paper would reconnaissance the possibility reforms in Pakistan for diminishing of violence. Women are not given their due role, rights, and respect. Furthermore, they are treated as chattels. This presentation will cover the socio-customary practices in the context of discrimination, stigmatization, and violence against women. This paper envisages justice in a broader sense of recognition of rights for women, and masculine structure of society, socio-customary practices and discrimination against women are a very serious concern which needs to be understood as a multidimensional problem. The paper will specially focus on understanding the existing obstacles of women in Pakistan in the constitutional scenario. Women stumble across discrimination and human rights manipulations, voluptuous violation and manipulation including domestic viciousness and are disadvantaged by laws, strategies, and programming that do not take their concerns into considerations. This presentation examines the role of honour killings among Pakistani community. This affects their self-assurance and capability to elevation integrity campaign where gender inequalities and discrimination in social, legal domain are to be put right. This paper brings to light the range of practices, laws and legal justice regarding the status of women and also covers attitude towards compensations for murders/killings, domestic violence, rape, adultery, social behavior and recourse to justice.

Keywords: discrimination, cultural, women, violence

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