Search results for: traumatic peripancreatic collection

Authors: Davit Khachatryan, Shuo Xiang

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Numerous published studies on the use of prazosin in the treatment of PTSD-related sleep disturbances in adult population have resulted in updates to the recommendation for prazosin for nightmares that showed its strength of evidence elevated from C to B in the US Department of Veterans Affairs clinical practice guideline. In addition, the American Academy of Sleep Medicine clinical practice guideline gave prazosin a level-A recommendation for the treatment of PTSD-associated nightmares. The aim of this review is to summarize the available literature for prazosin use for nightmares and other sleep disturbances in children and adolescents with PTSD. Method: A comprehensive search for studies on prazosin use for sleep disturbances in child and adolescent population with PTSD has been performed. We looked at MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, Scopus, Web of Science, and Cochrane CENTRAL databases. Results: Compared to adult population with similar psychopathology, the available literature in child and adolescent population is scarce. Despite increased interest in prazosin in the management of PTSD, only six studies investigating this medication in children and adolescents have been published. Conclusion: A large randomized control trial on this topic is needed for more definite evidence on the efficacy and safety of prazosin in the treatment of nightmares in children and adolescents with PTSD.

Keywords: guidelines, prazosin, PTSD, sleep disturbance

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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Authors: Muhammad Faizan Rehman Qureshi, Ahmed Al-Kaisy

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Accurate estimation of traffic loads is critical for pavement and bridge design, among other transportation applications. Given the disproportional impact of heavier axle loads on pavement and bridge structures, truck and heavy vehicle traffic is expected to be a major determinant of traffic load estimation. Further, heavy vehicle traffic is also a major input in transportation planning and economic studies. The traditional method for estimating heavy vehicle traffic primarily relies on AADT estimation using Monthly Day of the Week (MDOW) adjustment factors as well as the percent heavy vehicles observed using statewide data collection programs. The MDOW factors are developed using daily and seasonal (or monthly) variation patterns for total traffic, consisting predominantly of passenger cars and other smaller vehicles. Therefore, while using these factors may yield reasonable estimates for total traffic (AADT), such estimates may involve a great deal of approximation when applied to heavy vehicle traffic. This research aims at assessing the approximation involved in estimating heavy vehicle traffic using MDOW adjustment factors for total traffic (conventional approach) along with three other methods of using MDOW adjustment factors for total trucks (class 5-13), combination-unit trucks (class 8-13), as well as adjustment factors for each vehicle class separately. Results clearly indicate that the conventional method was outperformed by the other three methods by a large margin. Further, using the most detailed and data intensive method (class-specific adjustment factors) does not necessarily yield a more accurate estimation of heavy vehicle traffic.

Keywords: traffic loads, heavy vehicles, truck traffic, adjustment factors, traffic data collection

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Authors: Eunice Tang

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The main focus of this study is investigating introvert and extrovert university students’ perception of the use of interactive digital tools (such as Padlet and Mentimeter) in a face-to-face English for Specific Purposes (ESP) class after all classes in the university had been switched to online mode for three semesters. The subjects of the study were business students from three ESP classes at The Hong Kong University of Science and Technology. The basic tool for data collection was an anonymous online survey, which included 3 required multiple-choice questions and 3 open questions (2 required; 1 optional) about the effects of interactive digital tools on their amount of contribution to the class discussions, their perception of the role of interactive digital tools to the sharing of ideas and whether the students considered themselves introvert or extrovert. The online survey will be emailed to all 54 students in the three ESP classes and subjected to a three-week data collection period. The survey results will then be analyzed qualitatively, particularly on the effect the use of interactive digital tools had on the amount of contribution to the class among introvert and extrovert students, their perception of a language class with and without digital tools and most importantly, the implication to educators about how interactive digital tools can be used (or not) to cater for the needs of the introvert and extrovert students. The pandemic has given educators various opportunities to use interactive digital tools in class, especially in an online environment. It is interesting for educators to explore the potential of such tools when classes are back face-to-face. This research thus offers the students’ perspective on using interactive digital tools in a face-to-face classroom. While a lot has been said about introverted students responding positively to digital learning online, the student's perception of their own personality collected in the survey and the digital impact tools have on their contribution to class may shed some light on the potential of interactive digital tools in a post-pandemic era.

Keywords: psychology for language learning, interactive digital tools, personality-based investigation, ESP

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Authors: Yolla Miranda, Marini Altyra, Karina Kalmapuspita Imas

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Oily sludge wastes always fill in upstream and downstream petroleum industry process. Sludge still contains oil that can use for energy storage. Recycling sludge is a method to handling it for reduce the toxicity and very probable to get the remaining oil around 20% from its volume. Froth flotation, a common method based on chemical unit for separate fine solid particles from an aqueous suspension. The basic composition of froth flotation is the capture of oil droplets or small solids by air bubbles in an aqueous slurry, followed by their levitation and collection in a froth layer. This method has been known as no intensive energy requirement and easy to apply. But the low efficiency and unable treat the high viscosity become the biggest problem in froth flotation unit. This study give the design to manage the high viscosity of sludge first and then entering the froth flotation including cavitation tube on it to change the bubbles into nano particles. The recovery in flotation starts with the collision and adhesion of hydrophobic particles to the air bubbles followed by transportation of the hydrophobic particle-bubble aggregate from the collection zone to the froth zone, drainage and enrichment of the froth, and finally by its overflow removal from the cell top. The effective particle separation by froth flotation relies on the efficient capture of hydrophobic particles by air bubbles in three steps. The important step is collision. Decreasing the bubble particles will increasing the collision effect. It cause the process more efficient. The pre-treatment, froth flotation, and cavitation tube integrated each other. The design shows the integrated unit and its process.

Keywords: sludge oil recovery, froth flotation, cavitation tube, nanobubbles, high viscosity

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Authors: Irem Ozten, Neri̇man Caglayan Keles

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Aim: Breastfeeding is a special process for a mother and her baby, and it is the first feeding option for a baby. However, not every society approves of breastfeeding in public to the same degree. The purpose of this study is to determine the attitudes and behaviors of women living in Türkiye toward breastfeeding in public. Materials and methods: This descriptive study was carried out in December 2023 with 515 women (N=515) who had babies aged 0-5 years and breastfed their babies. Based on the review of the literature, an online (Google Forms) data collection form consisting of 40 questions was created. While 13 of these questions were about sociodemographic and obstetric characteristics, 27 were about breastfeeding in public. It took each participant 5-7 minutes to respond to the data collection form by marking their choices on the form. The responses of the participants were analyzed using the R Core Team statistics program. Results: The mean age of the participants (N=515) was 30.6±4.07 (range: 20-44). According to their statements, 76.1% of the participants had undergraduate university degrees, and 77.1% of them had given vaginal birth in their last delivery. While 68.3% of the participants stated that they had heard about the concept of breastfeeding in public, 47.4% said they comfortably breastfed their babies in public, but 33.6% said they breastfed their babies for a shorter period than usual. It was determined that 40% of the participants were embarrassed about being seen by someone while breastfeeding their babies in public, 38.6% were afraid of men while breastfeeding, and 89.7% looked for a suitable place to breastfeed their babies. Among the participants, 93.6% stated that they covered their breasts with a cloth while breastfeeding, 49.5% thought a mother should breastfeed her baby in a place where she can be alone with her baby, and 29.1% thought a mother should breastfeed her baby in private. Conclusion: According to the results of the study, although most women had heard of the concept of breastfeeding in public, and some were comfortable breastfeeding in public, some breastfed their baby in public for a shorter period than usual, they covered their breasts with a cloth while breastfeeding their babies, they were embarrassed about being seen by someone while breastfeeding, and they were afraid of men while breastfeeding. Therefore, awareness should be raised about breastfeeding in public, and environments where mothers can conveniently breastfeed their babies should be created.

Keywords: breastfeeding in public, breastfeeding, breastfeeding attitudes, breastfeeding bahaviors

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Authors: Husni Mohd Radzi, Lilie Zahara Ramly, Sapora Sipon, Salhah Abdullah

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Malaysia have been experiencing series of huge floods all around the country for the past decades despide planned development done by local authorities. The floods incurred due to factors like natural climate change or man-made disaster. Floods have caused a lot of damages, destructions and losses in term of infrastructure, financial implications and physical health. However, other damaging aspect was not being given much attention are the psychological need of the flood victim. The traumatic impact from the natural disaster like floods may cause serious psychological and spiritual deterioration. Many flood relief shelters in the past did not provide counseling services for flood victims to consult, and as a result, it contributes to added stress among the flood victims, as the issue were not being addressed. Some studies indicates that flood victims did not look for counseling service being offered. A total of 257 flood victim was involved in this study. Main area of the study was Kg Bukit Changgang, Kg. Rancangan Tanah Belia, Kg. Labohan Dagang and Kg.Olak Lempit in Kuala Langat, Selangor. The flood victims have responded to the survey given and the data was analyze using SPSS for descriptive information and other measures. At least 13 victims were reported to have experienced moderate to severe level of stress and anxiety over the flood disaster incidents and a total of 88 respondents admitted to have at least thought and consider getting counseling service.

Keywords: perception, acceptance towards counseling, counseling service for flood victim, disaster

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Authors: Joel Zapata

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Chicana/o Activism in the Southern Plains Through Time and Space, a digital history project available at PlainsMovement.com, helps reveal an understudied portion of the Chicana/o Civil Rights Movement: the way it unfolded on the Southern Plains. The project centers around an approachable interactive map and timeline along with a curated collection of materials. Therefore, the project provides a digital museum experience that has not emerged within the region’s museums. That is, this digital history project takes scholarly research to the wider public, making it is also a publicly facing history project. In this way, the project adds to both scholarly and socially significant conversations, showing that the region was home to a burgeoning wing of the Chicana/o Movement and that instances of police brutality largely spurred this wing of the social justice movement. Moreover, the curated collection of materials demonstrates that police brutality united the plains’ Mexican population across political ideology, a largely overlooked aspect within the study of Mexican American civil rights movements. Such a finding can be of use today since contemporary Latina/o social justice organizations generally ignore policing issues even amid a rise in national awareness regarding police abuse. In making history accessible to Mexican origin and Latina/o communities, these same communities may in-turn use the knowledge gained from historical research towards the betterment of their social positions—the foundational goal of Chicana/o history and the related field of Chicana/o Studies. Ultimately, this digital history project is intended to draw visitors to further explore the Chicana/o Civil Rights Movement within and beyond the plains.

Keywords: Chicana/o Movement, digital history, police brutality, newspapers, protests, student activism

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Authors: Rosemary Hiscock, Clive Sabel, David Manley, Sam Wren-Lewis

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As part of the Happy City Index Project, Happy City have developed a survey instrument to measure experienced wellbeing: how people are feeling and functioning in their everyday lives. The survey instrument, called the Happiness Pulse, was developed in partnership with the New Economics Foundation (NEF) with the dual aim of collecting citywide wellbeing data and engaging individuals and communities in the measurement and promotion of their own wellbeing. The survey domains and items were selected through a review of the academic literature and a stakeholder engagement process, including local policymakers, community organisations and individuals. The Happiness Pulse was included in the Bristol pilot of the Happy City Index (n=722). The experienced wellbeing items were subjected to factor analysis. A reduced number of items to be included in a revised scale for future data collection were again entered into a factor analysis. These revised factors were tested for reliability and validity. Among items to be included in a revised scale for future data collection three factors emerged: Be, Do and Connect. The Be factor had good reliability, convergent and criterion validity. The Do factor had good discriminant validity. The Connect factor had adequate reliability and good discriminant and criterion validity. Some age, gender and socioeconomic differentiation was found. The properties of a new scale to measure experienced wellbeing, intended for use by municipal authorities, are described. Happiness Pulse data can be combined with local data on wellbeing conditions to determine what matters for peoples wellbeing across a city and why.

Keywords: city wellbeing , community wellbeing, engaging individuals and communities, measuring wellbeing and happiness

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Authors: Hosamuddin Hamza

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The major concept of 4D printing is self-folding under thermal and humidity changes. This concept relies on understanding how the microstructures of 3D-printed models can undergo spontaneous shape transformation under thermal and moisture changes. The transformation mechanism could be achieved by mixing, in a controllable pattern, a number of materials within the printed model, each with known strain/shrinkage properties. 4D printing has a strong potential to be applied in dentistry as the technology could produce dynamic and adaptable materials to be used as functional objects in the oral environment under the continuously changing thermal and humidity conditions. The motion criteria could override the undesired dimensional changes, thermal instability, polymerization shrinkage and microleakage. 4D printing could produce restorative materials being self-adjusted spontaneously without further intervention from the dentist or patient; that is, the materials could be capable of fixing its failed portions, compensating for some lost tooth structure, while avoiding microleakage or overhangs at the margins. In prosthetic dentistry, 4D printing could provide an option to manage the influence of bone and soft tissue imbalance during mastication (and at rest) with high predictability of the type/direction of forces. It can also produce materials with better fitting and retention characteristics than conventional or 3D-printed materials. Nevertheless, it is important to highlight that 4D-printed objects, having dynamic properties, could provide some cushion as they undergo self-folding compensating for any thermal changes or mechanical forces such as traumatic forces.

Keywords: functional material, self-folding material, 3D printing, 4D printing

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Authors: John Hardy

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The expansion of special operations forces (SOF) in the twenty-first century is often discussed in terms of the size and disposition of SOF units. Research regarding the number SOF personnel, the equipment SOF units procure, and the variety of roles and mission that SOF fulfill in contemporary conflicts paints a fascinating picture of changing expectations for the use of force. A strong indicator of the changing nature of SOF in contemporary conflicts is the fusion of strike and intelligence functions in the SOF in many countries. What were once more distinct roles on the kind of battlefield generally associated with the concept of conventional warfare have become intermingled in the era of persistent conflict which SOF face. This study presents a historical analysis of the co-evolution of the intelligence and direct action functions carried out by SOF in counterterrorism, counterinsurgency, and training and mentoring missions between 2004 and 2016. The study focuses primarily on innovation in the US military and the diffusion of key concepts to US allies first, and then more broadly afterward. The findings show that there were three key phases of evolution throughout the period of study, each coinciding with a process of innovation and doctrinal adaptation. The first phase was characterized by the fusion of intelligence at the tactical and operational levels. The second phase was characterized by the industrial counterterrorism campaigns used by US SOF against irregular enemies in Iraq and Afghanistan. The third phase was characterized by increasing forward collection of actionable intelligence by SOF force elements in the course of direct action raids. The evolution of strike and intelligence functions in SOF operations between 2004 and 2016 was significantly influenced by reciprocity. Intelligence fusion led to more effective targeting, which then increased intelligence collection. Strike and intelligence functions were then enhanced by greater emphasis on intelligence exploitation during operations, which further increased the effectiveness of both strike and intelligence operations.

Keywords: counterinsurgency, counterterrorism, intelligence, irregular warfare, military operations, special operations forces

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Authors: Maciej Bialorudzki, Zbigniew Izdebski, Alicja Kozakiewicz, Joanna Mazur

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The quality of sleep is extremely important for physical and mental health, especially among professional groups exposed to the suffering of the people they serve. The aim of the study is to assess sleep quality and various aspects of physical and mental health. A nationwide cross-sectional survey conducted in the first quarter of 2022 included 2227 healthcare professionals from 114 Polish hospitals and specialized outpatient clinics. The following distribution for each professional group was obtained (22% doctors; 52.6% nurses; 7.3% paramedics; 10.1% other medical professionals; 7.9% other non-medical professionals). The mean age of the respondents was 46.24 (SD=11.53). The Jenkins Sleep Scale with four items (JSS-4) was used to assess sleep quality, yielding a mean value of 5.35 (SD=5.20) in the study group and 13.7% of subjects with poor sleep quality using the cutoff point of the mean JSS-4 sum score as >11. More often, women than men reported poorer sleep quality (14,8% vs. 9,1% p=0,002). Respondents with poor sleep quality were more likely to report occupational burnout as measured by the BAT-12 (43.1% vs. 12.9% p<0.001) and high levels of stress as measured by the PSS-4 (72.5% vs. 27.5% p<0.001). In addition, those who declare experiencing a traumatic event compared to those who have not experienced it has an almost two times higher risk of poorer sleep quality (OR:1.958; 95% CI:1.509-2.542; p<0.001). In contrast, those with occupational burnout had more than five times the risk of those without occupational burnout (OR:5.092; 95% CI: 3.763-6.889; p<0.001). Sleep quality remains an important predictor of stress levels, job burnout, and quality of life assessment.

Keywords: quality of sleep, medical staff, mental health, physical health, occupational burnout, stress

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Faiza Belbachir, Thibault Schienhinski

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The massive development of online social networks allows users to post and share their opinions on various topics. With this huge volume of opinion, it is interesting to extract and interpret these information for different domains, e.g., product and service benchmarking, politic, system of recommendation. This is why opinion detection is one of the most important research tasks. It consists on differentiating between opinion data and factual data. The difficulty of this task is to determine an approach which returns opinionated document. Generally, there are two approaches used for opinion detection i.e. Lexical based approaches and Machine Learning based approaches. In Lexical based approaches, a dictionary of sentimental words is used, words are associated with weights. The opinion score of document is derived by the occurrence of words from this dictionary. In Machine learning approaches, usually a classifier is trained using a set of annotated document containing sentiment, and features such as n-grams of words, part-of-speech tags, and logical forms. Majority of these works are based on documents text to determine opinion score but dont take into account if these texts are really correct. Thus, it is interesting to exploit other information to improve opinion detection. In our work, we will develop a new way to consider the opinion score. We introduce the notion of trust score. We determine opinionated documents but also if these opinions are really trustable information in relation with topics. For that we use lexical SentiWordNet to calculate opinion and trust scores, we compute different features about users like (numbers of their comments, numbers of their useful comments, Average useful review). After that, we combine opinion score and trust score to obtain a final score. We applied our method to detect trust opinions in TRIPADVISOR collection. Our experimental results report that the combination between opinion score and trust score improves opinion detection.

Keywords: Tripadvisor, opinion detection, SentiWordNet, trust score

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Authors: Estephanie S. López Contreras, Vicente Aranda Palacios, Daniela Flores Silva, Felipe Oliveros Olivares, Romina Riquelme Escobedo, Iñaki Westerhout Usabiaga

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This research explored whether the context of online instruction has influenced the development of first-year English-teaching students' communication skills, being these speaking and listening. The theoretical basis finds its niche in the need to bridge the gap in knowledge about the Chilean online educational context and the development of English communicative skills. An interpretative paradigm and a phenomenological design were implemented in this study. Twenty- two first-year students and two teachers from an English teaching training program participated in the study. The students' ages ranged from 18 to 26 years of age, and the teachers' years of experience ranged from 5 to 13 years in the program. For data collection purposes, semi- structured interviews were applied to both students and teachers. Interview questions were based on the initial conceptualization of the central phenomenon. Observations, field notes, and focus groups with the students are also part of the data collection process. Data analysis considered two-cycle methods. The first included descriptive coding for field notes, initial coding for interviews, and creating a codebook. The second cycle included axial coding for both field notes and interviews. After data analysis, the findings show that students perceived online classes as instances in which active communication cannot always occur. In addition, changes made to the curricula as a consequence of the COVID-19 pandemic have affected students' speaking and listening skills.

Keywords: attitudes, communicative skills, EFL teaching training program, online instruction, and perceptions

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Authors: M. Feliciano, F. Maia, A. Gonçalves

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Olive oil production sector plays an important role in Portuguese economy. It had a major growth over the last decade, increasing its weight in the overall national exports. International market penetration for Mediterranean traditional products is increasingly more demanding, especially in the Northern European markets, where consumers are looking for more sustainable products. Trying to support this growing demand this study addresses olive oil production under the environmental and eco-efficiency perspectives. The analysis considers two consecutive product life cycle stages: olive trees farming; and olive oil extraction in mills. Addressing olive farming, data collection covered two different organizations: a middle-size farm (~12ha) (F1) and a large-size farm (~100ha) (F2). Results from both farms show that olive collection activities are responsible for the largest amounts of Green House Gases (GHG) emissions. In this activities, estimate for the Carbon Footprint per olive was higher in F2 (188g CO2e/kgolive) than in F1 (148g CO2e/kgolive). Considering olive oil extraction, two different mills were considered: one using a two-phase system (2P) and other with a three-phase system (3P). Results from the study of two mills show that there is a much higher use of water in 3P. Energy intensity (EI) is similar in both mills. When evaluating the GHG generated, two conditions are evaluated: a biomass neutral condition resulting on a carbon footprint higher in 3P (184g CO2e/Lolive oil) than in 2P (92g CO2e/Lolive oil); and a non-neutral biomass condition in which 2P increase its carbon footprint to 273g CO2e/Lolive oil. When addressing the carbon footprint of possible combinations among studied subsystems, results suggest that olive harvesting is the major source for GHG.

Keywords: carbon footprint, environmental indicators, farming subsystem, industrial subsystem, olive oil

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Authors: Adalberto Gregorio Back

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Historically, the Pinheiros River, which crosses the urban area of the largest South American metropolis, the city of São Paulo, has been the subject of several interventions involving different interests and multiple demands, including the implementation of road axes and industrial occupation in the city, following its floodplains. the dilution of sewers; generation of electricity, with the reversal of its waters to the Billings Dam; and urban drainage. These processes, together with the exclusionary and peripheral urban sprawl with high population density in the peripheries, result in difficulties for the collection and treatment of household sewage, which flow into the tributaries and the Pinheiros River itself. In the last 20 years, two separate projects have been undertaken to clean up its waters. The first one between 2001-2011 was the flotation system, aimed at cleaning the river in its own gutter with equipment installed near the Bilings Dam; and, more recently, from 2019 to 2022, the proposal to connect about 74 thousand dwellings to the sewage collection and treatment system, as well as to install treatment plants in the tributaries of Pinheiros where the connection to the system is impracticable, given the irregular occupations. The purpose of this paper is to make a comparative analysis on the dynamics of conflicts, interests and opportunities of coalitions between the actors involved in the two referred projects of pollution of the Pinheiros River. For this, we use the analysis of documents produced by the state government; as well as documents related to the legal disputes that occurred in the first attempt of decontamination involving the sanitation company; the Billings Dam management company interested in power generation; the city hall and regular and irregular dwellings not linked to the sanitation system.

Keywords: depollution of the Pinheiros River, interests groups, São Paulo, water energy nexus

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Authors: Myoungsoon You, Heejung Son

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During a pandemic, hospital workers should protect not only their vulnerable patients but also themselves from the consequences of rapidly spreading infection. However, the evidence on the psychological impact of an outbreak on hospital workers is limited. In this study, we aim to assess hospital workers’ psychological well-being and function at the workplace after an outbreak, by focusing on ‘psychological resilience’. Specifically, the effects of risk appraisal, emotional experience, and coping ability on resilience indicated by the likelihood of post-traumatic syndrome disorder and willingness to work were investigated. Such role and position of each factor were analyzed using a path model, and the result was compared between the healthcare worker and non-healthcare worker groups. In the investigation, 280 hospital workers who experienced the 2015 Middle East Respiratory Syndrome outbreak in South Korea have participated. The result presented, in both groups, the role of the appraisal of risk and coping ability appeared consistent with a previous research, that was, the former interrupted resilience while the latter facilitated it. In addition, the role of emotional experience was highlighted as, in both groups, emotional disruption not only directly associated with low resilience but mediated the effect of perceived risk on resilience. The differences between the groups were also identified, which were, the role of emotional experience and coping ability was more prominent in the non-HCW group in explaining resilience. From the results, implications on how to support hospital personnel during an outbreak in a way to facilitate their resilience after the outbreak were drawn.

Keywords: hospital workers, emotions, infectious disease outbreak, psychological resilience

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Authors: Soori Nnko, Zaina Mchome, John Dusabe, Angela Obasi

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In sub-Saharan Africa, adolescent girls living in urban and periurban settings are among the groups at increased risk of getting sexually transmitted infections. One of the challenges to improve uptake of sexual and reproductive health (SRH) services among adolescents is linked to little appreciation about their vulnerability and the knowledge on availability of the SRH services. Objective: This study assesses adolescents’ perceptions on risks for SRH problems and the availability of services to prevent against SRH problems. Methodology: The study was conducted in March 2011 in Mwanza region, Tanzania. Data collection techniques included 18 Participatory Group Discussions and 17 In-depth Interviews with adolescents and young mothers aged 15-20 years. Results: Adolescents indicated that risk places included their homes, bushes, commercial centers, roadsides as well as school settings. Risk for having unprotected sex varied depending on where you are, and the time of the day. For example, collection of firewood in the bushes or water from the wells exposed girls to men who forced or lured them to have sex. The girls reported to encounter motorcyclists who offered the ride in exchange for sex. Girls also knew myriads places to seek SRH services, including public and private clinics, drug shops and traditional healers. Despite being aware of risky environment, and places to seek the services, access to SRH services were limited due to the stigma and negative attitude of community regarding adolescents’ utilization of SRH services. Conclusion: Adolescents are exposed to various risky environments, yet due to social stigma they have difficult to access the available SRH services.

Keywords: adolescent girls, sexual and reproductive health, AIDS, risk, opportunities, interventions, sub Saharan africa

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Authors: Babina Aryal

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Background: The diagnosis of pancreatitis is generally based on clinical and laboratory findings; however, Computed Tomography (CT) is an imaging technique of choice specially Contrast Enhanced Computed Tomography (CECT) shows morphological characteristic findings that allow for establishing the diagnosis of pancreatitis and determining the extent of disease severity which is done along with the administration of appropriate contrast medium. The purpose of this study was to compare Computed Tomography Dose Index (CTDI), Dose Length Product (DLP) and Effective Dose (ED) among male and female patients from Contrast Enhanced Computed Tomography (CECT) Pancreatitis Protocol. Methods: This retrospective study involved data collection based on clinical/laboratory/ultrasonography diagnosis of Pancreatitis and has undergone CECT Abdomen pancreatitis protocol. data collection involved detailed information about a patient's Age and Gender, Clinical history, Individual Computed Tomography Dose Index and Dose Length Product and effective dose. Results: We have retrospectively collected dose data from 150 among which 127 were males and 23 were females. The values obtained from the display of the CT screen were measured, calculated and compared to determine whether the CTDI, DLP and ED values were similar or not. CTDI for females was more as compared to males. The differences in CTDI values for females and males were 32.2087 and 37.1609 respectively. DLP values and Effective dose for both the genders did not show significant differences. Conclusion: This study concluded that there were no more significant changes in the DLP and ED values among both the genders however we noticed that female patients had more CTDI than males.

Keywords: computed tomography, contrast enhanced computed tomography, computed tomography dose index, dose length product, effective dose

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Authors: Mads Kirk Larsen

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Strict air pollution control is today high on the agenda world-wide. By reducing the particular emission, not only the mg/Nm3 will be reduced – also parts of mercury and other hazardous matters attached to the particles will be reduced. Furthermore, it is possible to catch the fine particles (PM2.5). For particulate control, the precipitators are still the preferred choice and much efforts have been done to improve the efficiencies. Many ESP’s have seen electrical upgrading by changing the traditional 1 phase power system into either 3 phase or SMPS (High Frequency) units. However, there exist a 4th type of power supply – the pulse type. This is unfortunately widely unknown, but may be of great benefit to power plants. The FLSmidth type is called COROMAX® and it is a high voltage pulse generator for precipitators using a semiconductor switch operating at medium potential. The generated high voltage pulses have rated amplitude of 80 kV and duration of 75 μs and are superimposed on a variable base voltage of 60 kV rated voltage. Hereby, achieving a peak voltage of 140 kV. COROMAX® has the ability to increase the voltage beyond the natural spark limit inside the precipitator. Voltage levels may often be twice as high after installation of COROMAX®. Hereby also the migration velocity increases and thereby the efficiency. As the collection efficiency is proportional to the voltage peak and mean values, this also increases the collection efficiency of the fine particles where test has shown 80% removal of particles less than 0.07 micron. Another great advantage is the indifference to back-corona. Simultaneously with emission reduction, the power consumption will also be reduced. Another great advantage of the COROMAX® system is that the emission can be improved without the need to change the internal parts or enlarge the ESP. Recently, more than 150 units have been installed in China, where emissions have been reduced to ultra-low levels.

Keywords: eleectrostatic precipitator, high resistivity dust, micropulse energization, particulate removal

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Authors: Ahmed Fawzy, Khaled Ayad, Gh. M. Koura, W. Reda

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The excessive frontal plane motion of the lower extremity during sports activities is thought to be a contributing factor to many traumatic and overuse injuries of the knee joint, little is known about the biomechanical factors that contribute to this loading pattern. Objectives: The purpose of this study was to investigate if there is a relationship between hip external rotators isometric strength and the value of frontal plane projection angle (FPPA) during single leg landing tasks in normal male subjects. Methods: One hundred (male) subjects free from lower extremity injuries for at least six months ago participated in this study. Their mean age was (23.25 ± 2.88) years, mean weight was (74.76 ± 13.54) (Kg), mean height was (174.23 ± 6.56) (Cm). The knee frontal plane projection angle was measured by digital video camera using single leg landing task. Hip external rotators isometric strength were assessed by portable hand held dynamometer. Muscle strength had been normalized to the body weight to obtain more accurate measurements. Results: The results demonstrated that there was no significant relationship between hip external rotators isometric strength and the value of FPPA during single leg landing tasks in normal male subjects. Conclusion: It can be concluded that there is no relationship between hip external rotators isometric strength and the value of FPPA during functional activities in normal male subjects.

Keywords: 2-dimensional motion analysis, hip strength, kinematics, knee injuries

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Authors: Y. J. Zhou, G. Lu

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In this paper, an analytical study is made for the dynamic behavior of human brain tissue under transient loading. In this analytical model the Mooney-Rivlin constitutive law is coupled with visco-elastic constitutive equations to take into account both the nonlinear and time-dependent mechanical behavior of brain tissue. Five ordinary differential equations representing the relationships of five main parameters (radial stress, circumferential stress, radial strain, circumferential strain, and particle velocity) are obtained by using the characteristic method to transform five partial differential equations (two continuity equations, one motion equation, and two constitutive equations). Analytical expressions of the attenuation properties for spherical wave in brain tissue are analytically derived. Numerical results are obtained based on the five ordinary differential equations. The mechanical responses (particle velocity and stress) of brain are compared at different radii including 5, 6, 10, 15 and 25 mm under four different input conditions. The results illustrate that loading curves types of the particle velocity significantly influences the stress in brain tissue. The understanding of the influence by the input loading cures can be used to reduce the potentially injury to brain under head impact by designing protective structures to control the loading curves types.

Keywords: analytical method, mechanical responses, spherical wave propagation, traumatic brain injury

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Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

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The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

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Authors: Anat Yaron Antar, Tomer Einat

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This study explores the effects of the imprisonment of women together with females with mental disorders on the well-being of the former both during imprisonment and after their release from prison. Based on in-depth interviews with 22 women ex-prisoners who had been imprisoned for a period of at least two years in the single Israeli female correctional facility, Neve Tirza Prison, and released one to three months before the initiation of the study to a community-based agency managed by the Israeli Prisoner Rehabilitation Authority, and based on a qualitative, constructive strategy. We found that: (i) mentally ill prisoners’ conduct creates severe feelings of stress and discomfort among many of the prisoners without a mental disorder prisoners; (ii) The intimate and often long-term encounters with prisoners with a mental illness lead to increased feelings of distress, helplessness, fear, and frustration among many of the women prisoners; (iii) the damaging encounters between women prisoners and mentally-ill prisoners harmed the reintegration of the formers into society after release, and (iv) The women ex-prisoners lacked the basic mental, cognitive, and social tools necessary for dealing with female inmates with a mental illness and had received no psychological or emotional support from the prison personnel. Consequently, they suffered – and still suffer – from traumatic and upsetting memories Our findings led us to conclude that women prisoners should be imprisoned separately from female prisoners with mental disorders or be offered a wide range of psychological and emotional coping tools as well as various rehabilitative treatment programs.

Keywords: women, prisoners, mentally ill, health

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Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

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Authors: Javier A. Maldonado E., Duvert A. Puentes T., Diego F. Villegas B.

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The SLAP lesion (Superior Labral Anterior to Posterior) involves the labrum, causing pain and mobility problems in the glenohumeral joint. This injury is common in athletes practicing sports that requires throwing or those who receive traumatic impacts on the shoulder area. This paper determines the biomechanical behavior of soft tissues of the glenohumeral joint when type II SLAP lesion is present. This pathology is characterized for a tear in the superior labrum which is simulated in a 3D model of the shoulder joint. A 3D model of the glenohumeral joint was obtained using the free software Slice. Then, a Finite Element analysis was done using a general purpose software which simulates a compression test with external rotation. First, a validation was done assuming a healthy joint shoulder with a previous study. Once the initial model was validated, a lesion of the labrum built using a CAD software and the same test was done again. The results obtained were stress and strain distribution of the synovial capsule and the injured labrum. ANOVA was done for the healthy and injured glenohumeral joint finding significant differences between them. This study will help orthopedic surgeons to know the biomechanics involving this type of lesion and also the other surrounding structures affected by loading the injured joint.

Keywords: biomechanics, computational model, finite elements, glenohumeral joint, superior labral anterior to posterior lesion

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Authors: M. L. Yeung

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With the surge of divorce rate and male cancer onset/death rates, the phenomenon of divorced wives in the facing cancer death of their ex-husbands is not uncommon in Hong Kong. Yet, there is a dearth of study on the experiences of bereaved-divorced wives in the Hong Kong cultural context. This project fills the knowledge gap by conducting a qualitative study for having interviewed four bereaved ex-wives, who returned to ex-husbands’ end-of-life caregiving and eventually grieved for the ex-spousal’s death. From the perspectives of attachment theory and disenfranchised grief in the Hong Kong cultural context, a ‘double-loss’ experience is found in which interviewees suffer from the first loss of divorce and the second loss of ex-husbands’ death. Traumatic childhood experiences, attachment needs, role ambiguity, unresolved emotions and unrecognized grief are found significant in their lived experiences which alert the ‘double-loss’ is worthy of attention. Extending a family-centered end-of-life and bereavement care services to divorced couples is called for, in which validation on the attachment needs, ex-couple reconciliation, and acknowledgement on the disenfranchised grief are essential for social work practice on this group of clienteles specifically in Hong Kong cultural context.

Keywords: changing family, disenfranchised grief, divorce, ex-spousal death, marriage

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Authors: A. Martins, I. Martins, O. Pereira

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The purpose of this research is to focus on the importance of distributed leadership in universities and Higher Education Institutions (HEIs). The research question is whether there a significant finding in self-reported ratings of leadership styles of those respondents that are studying management. The study aims to further discover whether students are encouraged to become responsible and proactive citizens, to develop their skills set, specifically shared leadership and higher-level skills to inspire creation knowledge, sharing and distribution thereof. Contemporary organizations need active and responsible individuals who are capable to make decisions swiftly and responsibly. Leadership influences innovative results and education play a dynamic role in preparing graduates. Critical reflection of extant literature indicates a need for a culture of leadership and innovation to promote organizational sustainability in the globalised world. This study debates the need for HEIs to prepare the graduate for both organizations and society as a whole. This active collaboration should be the very essence of both universities and the industry in order for these to achieve responsible sustainability. Learning and innovation further depend on leadership efficacy. This study follows the pragmatic paradigm methodology. Primary data collection is currently being gathered via the web-based questionnaire link which was made available on the UKZN notice system. The questionnaire has 35 items with a Likert scale of five response options. The purposeful sample method was used, and the population entails the undergraduate and postgraduate students in the College of Law and Business, University of KwaZulu-Natal, South Africa. Limitations include the design of the study and the reliance on the quantitative data as the only method of primary data collection. This study is of added value for scholars and organizations in the innovation economy.

Keywords: knowledge creation, learning, performance, sustainability

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