Search results for: post facial syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5200

Search results for: post facial syndrome

4720 Preservation of Endocrine Function after Central Pancreatectomy without Anastomoses for a Mid Gland Pancreatic Insulinoma: A Case Report

Authors: Karthikeyan M., Paul M. J.

Abstract:

This abstract describes a case of central pancreatectomy (CP) for a 50-year-old woman with a neuroendocrine tumor in the mid-body of the pancreas. CP, a parenchyma-sparing surgical option, preserves the distal pancreas and spleen, reducing the risk of pancreatic endocrine and exocrine insufficiency compared to traditional resections. The patient, initially misdiagnosed with transient ischemic attack, presented with hypoglycemic symptoms and was found to have a pancreatic lesion. Post-operative results were positive, with a reduction in pancreatic drain volume and normalization of blood sugar levels. This case highlights CP's efficacy in treating centrally located pancreatic lesions while maintaining pancreatic function.

Keywords: central pancreatectomy without anastomosis, no endocrine deficiency on follow-op, less post-op hospital stay, less post-op complications

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4719 Waist Circumference-Related Performance of Tense Indices during Varying Pediatric Obesity States and Metabolic Syndrome

Authors: Mustafa Metin Donma

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Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. One hundred and ninety-four children, aged 06-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight+obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements, as well as blood pressure values were taken. Tense indices were computed. The formula for the first tense index was (SP+DP)/2. The second index was Advanced Donma Tense Index (ADTI). The formula for this index was [(SP+DP)/2] * Height. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and advanced Donma tense index (ADTI), which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: blood pressure, child, height, metabolic syndrome, waist circumference

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4718 Technical, Functional, and Behavioural Aspects and Their Attributes in Survey Questionnaire for Post Occupancy Evaluation of Residential Hostels

Authors: Meenal Kumar

Abstract:

The structure of a questionnaire becomes critical in gathering accurate feedback in a post-occupancy evaluation of a building. A survey instrument like this one consists of questions based on various aspects of a constructed facility. The questions and the qualities reflect the goals and determine the nature of the survey, which can be classified into several types. Therefore, a survey instrument uses appropriately described attributes. This ongoing research aims to provide an appropriate technique for framing the Questionnaire, taking into account the relevant aspects of the study and its defining features that analyze building performance from the user's perspective, which can further benefit the architects, planners, and designers in designing user-friendly spaces.

Keywords: post occupancy evaluations, satisfaction, attributes, survey, building performance evaluations

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4717 Effect of Self-Questioning Strategy on the Improvement of Reading Comprehension of ESL Learners

Authors: Muhammad Hamza

Abstract:

This research is based on the effect of self-questioning strategy on reading comprehension of second language learners at medium level. This research is conducted to find out the effects of self-questioning strategy and how self-questioning strategy helps English learners to improve their reading comprehension. In this research study the researcher has analyzed that how much self-questioning is effective in the field of learning second language and how much it helps second language learners to improve their reading comprehension. For this purpose, the researcher has studied different reading strategies, analyzed, collected data from certificate level class at NUML, Peshawar campus and then found out the effects of self-questioning strategy on reading comprehension of ESL learners. The researcher has randomly selected the participants from certificate class. The data was analyzed through pre-test and post-test and then in the final stage the results of both tests were compared. After the pre-test and post-test, the result of both pre-test and post-test indicated that if the learners start to use self-questioning strategy before reading a text, while reading a text and after reading a particular text there’ll be improvement in comprehension level of ESL learners. The present research has addressed the benefits of self-questioning strategy by taking two tests (pre and post-test).After the result of post-test it is revealed that the use of the self-questioning strategy has a significant effect on the readers’ comprehension thus, they can improve their reading comprehension by using self-questioning strategy.

Keywords: strategy, self-questioning, comprehension, intermediate level ESL learner

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4716 Preoperative Anxiety Evaluation: Comparing the Visual Facial Anxiety Scale/Yumul Faces Anxiety Scale, Numerical Verbal Rating Scale, Categorization Scale, and the State-Trait Anxiety Inventory

Authors: Roya Yumul, Chse, Ofelia Loani Elvir Lazo, David Chernobylsky, Omar Durra

Abstract:

Background: Preoperative anxiety has been shown to be caused by the fear associated with surgical and anesthetic complications; however, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting given the duration and concentration required to complete the 40-item extensive questionnaire. Our primary aim in the study is to investigate the correlation of the Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparison analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusions: Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul FACES Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul FACES Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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4715 The Posthuman Condition and a Translational Ethics of Entanglement

Authors: Shabnam Naderi

Abstract:

Traditional understandings of ethics considered translators, translations, technologies and other agents as separate and prioritized human agents. In fact, ethics was equated with morality. This disengaged understanding of ethics is superseded by an ethics of relation/entanglement in the posthuman philosophy. According to this ethics of entanglement, human and nonhuman agents are in constant ‘intra-action’. The human is not separate from nature, from technology and from other nonhuman entities, and an ethics of translation in this regard cannot be separated from technology and ecology and get defined merely within the realm of human-human encounter. As such, a posthuman ethics offers opportunities for change and responds to the changing nature of reality, it is negotiable and reveals itself as a moment-by-moment practice (i.e. as temporally emergent and beyond determinacy and permanence). Far from the linguistic or cultural, or individual concerns, posthuman translational ethics discusses how the former rigid norms and laws are challenged in a process ontology which puts emphasis on activity and activation and considers ethics as surfacing in activity, not as a predefined set of rules and values. In this sense, traditional ethical principles like faithfulness, accuracy and representation are superseded by principles of privacy, sustainability, multiplicity and decentralization. The present conceptual study, drawing on Ferrando’s philosophical posthumanism (as a post-humanism, as a post-dualism and as a post-anthropocentrism), Deleuze-Guattarian philosophy of immanence and Barad’s physics-philosophy strives to destabilize traditional understandings of translation ethics and bring an ethics that has loose ends and revolves around multiplicity and decentralization into the picture.

Keywords: ethics of entanglement, post-anthropocentrism, post-dualism, post-humanism, translation

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4714 Lumbar Tuberculous Spondylitis in a Child Treated by Posterior Osteosynthesis: Apropos of a Case

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Tuberculous spondylodiscitis is an infection of the spine by Mycobacterium tuberculosis. Tuberculous spondylodiscitis still remains a topical disease in developing countries and continues to pose a public health problem in endemic countries. Materials and methods: Clinical case: This is a 12-year-old child followed in pediatrics for weight loss and progressively worsening low back pain. The neurological examination found an irritative pyramidal syndrome in both lower limbs with a severe lumbar spinal syndrome. The radiological assessment: (Rx of the spine supplemented by CT and MRI) shows L1L2 spondylodiscitis. Treatment: The child is put on anti-tuberculosis treatment, and the spine is restrained with a corset. Control MRI shows a worsening of the dorsal kyphosis with a backward movement of the posterior wall and spinal cord compression. The child is operated on via the posterior approach (the operative procedure consists of an L1 laminectomy and D11 L3 osteosynthesis). Results: Spinal cord décompression and stabilization of the spine. Conclusion: Tuberculous spondylodiscitis in children remains a rare, aggressive, and progressive condition. The prognosis depends on the diagnosis's precocity and the therapeutic management quality.

Keywords: tuberculous spondylodiscitis, mycobacterium tuberculosis, laminectomy, MRI

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4713 Difficulties in the Emotional Processing of Intimate Partner Violence Perpetrators

Authors: Javier Comes Fayos, Isabel RodríGuez Moreno, Sara Bressanutti, Marisol Lila, Angel Romero MartíNez, Luis Moya Albiol

Abstract:

Given the great impact produced by gender-based violence, its comprehensive approach seems essential. Consequently, research has focused on risk factors for violent behaviour, linking various psychosocial variables, as well as cognitive and neuropsychological deficits with the aggressors. However, studies on affective processing are scarce, so the present study investigates possible emotional alterations in men convicted of gender violence. The participants were 51 aggressors, who attended the CONTEXTO program with sentences of less than two years, and 47 men with no history of violence. The sample did not differ in age, socioeconomic level, education, or alcohol and other substances consumption. Anger, alexithymia and facial recognition of other people´s emotions were assessed through the State-Trait Anger Expression Inventory (STAXI-2), the Toronto Alexithymia Scale (TAS-20) and Reading the mind in the eyes (REM), respectively. Men convicted of gender-based violence showed higher scores on the anger trait and temperament dimensions, as well as on the anger expression index. They also scored higher on alexithymia and in the identification and emotional expression subscales. In addition, they showed greater difficulties in the facial recognition of emotions by having a lower score in the REM. These results seem to show difficulties in different affective areas in men condemned for gender violence. The deficits are reflected in greater difficulty in identifying and expressing emotions, in processing anger and in recognizing the emotions of others. All these difficulties have been related to the use of violent behavior. Consequently, it is essential and necessary to include emotional regulation in intervention programs for men who have been convicted of gender-based violence.

Keywords: alexithymia, anger, emotional processing, emotional recognition, empathy, intimate partner violence

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4712 Post-Traumatic Stress Disorder Exhibited by Secondary School Students Exposed to Conflict in Kano Metropolis: Efficacy of a Brief Intervention

Authors: Valentine Ayo Mebu

Abstract:

The study examined the efficacy of a brief intervention programme in the treatment of post-traumatic stress disorder (PTSD) symptoms exhibited by secondary school students exposed to conflict in Kano metropolis. The study tested three hypotheses that there is no significant difference between post-test re-experiencing, hyper-arousal, and avoidance mean scores of students exposed to the intervention and those who were not exposed to the intervention. The design of the study was an experimental design, specifically the pre-test and post-test control group design. The purposive sampling technique was used to select 60 research participants (male=30, female=30, Mean Age=15.50) for the study. These participants met the Diagnostic Statistical Manual of Mental Disorders (DSM-5) criteria of PTSD symptoms and were randomly assigned to experimental and control groups, respectively. Instrument for data collection was the University of California Post-Traumatic Stress Disorder Reaction Index (UCLA PTSD Index). Findings from the study indicated that there was a significant effect of the intervention on post re-experiencing symptoms scores [ F (1, 57) = 85.97, p=.00, partial eta squared η²=.60], hyper-arousal symptoms scores[ F (1, 57) = 27.81, p=.00, partial eta squared η² =.33], and avoidance symptoms scores [ F (1, 57) = 59.56, p=.00, partial eta squared η² =.51]. The efficacy of this brief psycho-educational intervention as an effective treatment in reducing PTSD symptoms among secondary school students exposed to conflict is supported by the results of this study and this will also add to the existing literature on the effectiveness of psycho-educational intervention in treating PTSD symptoms among students exposed to conflict.

Keywords: avoidance symptoms, hyper-arousal symptoms, re-experiencing symptoms, post-traumatic stress disorder, psycho-education

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4711 Research on High Dielectric HfO₂ Stack Structure Applied to Field Effect Transistors

Authors: Kuan Yu Lin, Shih Chih Chen

Abstract:

This study focuses on the Al/HfO₂/Si/Al structure to explore the electrical properties of the structure. This experiment uses a radio frequency magnetron sputtering system to deposit high dielectric materials on p-type silicon substrates of 1~10 Ω-cm (100). Consider the hafnium dioxide film as a dielectric layer. Post-deposition annealing at 750°C in nitrogen atmosphere. Electron beam evaporation of metallic aluminum is then used to complete the top/bottom electrodes. The metal is post-annealed at 450°C for 20 minutes in a nitrogen environment to complete the MOS component. Its dielectric constant, equivalent oxide layer thickness, oxide layer defects, and leakage current mechanism are discussed. At PDA 750°C-5s, the maximum k value was found to be 21.2, and the EOT was 3.68nm.

Keywords: high-k gate dielectrics, HfO₂, post deposition annealing, RF magnetic

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4710 Risk of Fractures at Different Anatomic Sites in Patients with Irritable Bowel Syndrome: A Nationwide Population-Based Cohort Study

Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

Abstract:

A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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4709 Classification System for Soft Tissue Injuries of Face: Bringing Objectiveness to Injury Severity

Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

Abstract:

Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

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4708 The Effects of Watching Text-Relevant Video Segments with/without Subtitles on Vocabulary Development of Arabic as a Foreign Language Learners

Authors: Amirreza Karami, Hawraa Nafea Hameed Alzouwain, Freddie A. Bowles

Abstract:

This study investigates the effects of watching text-relevant video segments with/without subtitles on vocabulary development of Arabic as a Foreign Language (AFL) learners. The participants of the study were assigned to two groups: one control group and one experimental group. The control group received no video-based instruction while the experimental group watched a text-relevant video segment in three stages: pre, while, and post-instruction. The preliminary results of the pre-test and post-test show that watching text-relevant video segments through following a pre-while-post procedure can help the vocabulary development of AFL learners more than non-video-based instruction.

Keywords: text-relevant video segments, vocabulary development, Arabic as a Foreign Language, AFL, pre-while-post instruction

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4707 The Return of Daily Life — Improvement Experiments on Urban Village in the Post-Urban Village Era

Authors: Gan Lu, Xu Lei

Abstract:

This is an era when urban village is disappearing in China. A series of social phenomenon presented in post-urban village era is forcing rethinking of the future of urban village. Existing monotonous urban renewal mode based on gentrification is questioned, and the social values of urban village has been gaining increasing attention while the daily life and spatial power of underclass is being focused on. Based on the consensus on the positive meaning of urban village phenomenon, social sectors have taken amount of improvement experiments to explore the possibility of modern transition of urban village on the premise of existence. These experiments revealed that urban tremendous changes impact a lot on social daily life, and pointed out that it is necessary to bring up the responsibility of architects and the definition of urban for discussion again.

Keywords: post-urban village era, gentrification, social value, daily life, improvement experiment.

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4706 Comparison between Post- and Oxy-Combustion Systems in a Petroleum Refinery Unit Using Modeling and Optimization

Authors: Farooq A. Al-Sheikh, Ali Elkamel, William A. Anderson

Abstract:

A fluidized catalytic cracking unit (FCCU) is one of the effective units in many refineries. Modeling and optimization of FCCU were done by many researchers in past decades, but in this research, comparison between post- and oxy-combustion was studied in the regenerator-FCCU. Therefore, a simplified mathematical model was derived by doing mass/heat balances around both reactor and regenerator. A state space analysis was employed to show effects of the flow rates variables such as air, feed, spent catalyst, regenerated catalyst and flue gas on the output variables. The main aim of studying dynamic responses is to figure out the most influencing variables that affect both reactor/regenerator temperatures; also, finding the upper/lower limits of the influencing variables to ensure that temperatures of the reactors and regenerator work within normal operating conditions. Therefore, those values will be used as side constraints in the optimization technique to find appropriate operating regimes. The objective functions were modeled to be maximizing the energy in the reactor while minimizing the energy consumption in the regenerator. In conclusion, an oxy-combustion process can be used instead of a post-combustion one.

Keywords: FCCU modeling, optimization, oxy-combustion, post-combustion

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4705 Thermography Evaluation on Facial Temperature Recovery after Elastic Gum

Authors: A. Dionísio, L. Roseiro, J. Fonseca, P. Nicolau

Abstract:

Thermography is a non-radiating and contact-free technology which can be used to monitor skin temperature. The efficiency and safety of thermography technology make it a useful tool for detecting and locating thermal changes in skin surface, characterized by increases or decreases in temperature. This work intends to be a contribution for the use of thermography as a methodology for evaluation of skin temperature in the context of orofacial biomechanics. The study aims to identify the oscillations of skin temperature in the left and right hemiface regions of the masseter muscle, during and after thermal stimulus, and estimate the time required to restore the initial temperature after the application of the stimulus. Using a FLIR T430sc camera, a data acquisition protocol was followed with a group of eight volunteers, aged between 22 and 27 years. The tests were performed in a controlled environment with the volunteers in a comfortably static position. The thermal stimulus involves the use of an ice volume with controlled size and contact surface. The skin surface temperature was recorded in two distinct situations, namely without further stimulus and with the additions of a stimulus obtained by a chewing gum. The data obtained were treated using FLIR Research IR Max software. The time required to recover the initial temperature ranged from 20 to 52 minutes when no stimulus was added and varied between 8 and 26 minutes with the chewing gum stimulus. These results show that recovery is faster with the addition of the stimulus and may guide clinicians regarding the pre and post-operative times with ice therapy, in the presence or absence of mechanical stimulus that increases muscle functions (e.g. phonetics or mastication).

Keywords: thermography, orofacial biomechanics, skin temperature, ice therapy

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4704 Teaching in the Post Truth Era: A Narrative Analysis of Modern Anti-Scientific Discourses in the Classroom

Authors: Jason T. Hilton

Abstract:

The ‘post-truth era’ is marked by a shift toward a period in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief. Applying narrative analysis techniques to current public discourses in education that run counter to scientific findings, it becomes possible to identify weakness in modern pedagogy and suggest ways to counter false narratives in the classroom. Results of this study indicate that a failure to engage with popular narratives lessens teachers’ ability to be convincing in the classroom, even when presenting information supported by scientific evidence. This study seeks to empower teachers by illustrating the influence of story within the post-truth era and the ways in which narrative and rhetorical elements take hold in social media contexts. Equipped with this knowledge, teachers can create a shift in pedagogy, away from transmission of knowledge toward the crafting of powerful narratives, built upon evidence, and connected to the lives of modern learners.

Keywords: 21st century learner, critical pedagogy, culture, narrative, post-truth era, social media

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4703 Clinical Case Successful Surgical Treatment of Postinfarction Ventricular Septum Defect

Authors: Melikulov A. A., Toshpulotov Sh. G., Akhmedova M. F., Beshimov A. S., Rakhimov M. K. Zokirov N. K.

Abstract:

Postinfarction ventricular septal defect (PVSD) is a rare but life-threatening complication of acute myocardial infarction. Currently, an alternative direction of minimally invasive treatment of postinfarction ventricular septal defect (PVSD) is being developed - transcatheter closure of the defect using an occluder, but surgical closure of the defect remains the <> correction of post-infarction VSD. Our article presents a case of successful surgical treatment of a patient with a large post-infarction rupture of the interventricular septum (IVS) and post-infarction LV aneurysm under cardiopulmonary bypass and parallel perfusion.

Keywords: echocardiography, myocardial infarction, ventricular septal defect, parallel perfusion

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4702 Ulnar Nerve Changes Associated with Carpal Tunnel Syndrome Not Affecting Median versus Ulnar Comparative Studies

Authors: Emmanuel Kamal Aziz Saba, Sarah Sayed El-Tawab

Abstract:

The present study was conducted to assess the involvement of ulnar sensory and/or motor nerve fibers in patients with carpal tunnel syndrome (CTS) and whether this affects the accuracy of the median versus ulnar comparative tests. The present study included 145 CTS hands and 71 asymptomatic control hands. Clinical examination was done. The following tests were done: Sensory conduction studies: median, ulnar and dorsal ulnar cutaneous nerves; and median versus ulnar digit (D) four sensory comparative study; and motor conduction studies: median nerve, ulnar nerve and median versus ulnar motor comparative study. It was found that 17 CTS hands (11.7%) had ulnar sensory abnormalities in 17 different patients. The median versus ulnar sensory and motor comparative studies were abnormal among all these 17 CTS hands. There were significant negative correlations between median motor latency and both ulnar sensory amplitudes recording D5 and D4. In conclusion, there is ulnar sensory nerve abnormality among CTS patients. This abnormality affects the amplitude of ulnar sensory nerve action potential. This does not affect the median versus ulnar sensory and motor comparative tests accuracy for use in CTS.

Keywords: median nerve, motor comparative study, sensory comparative study, ulnar nerve

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4701 Research on Renovation of Existing Interior Space Based on Post Occupancy Evaluation: A Case Study of the Atrium Space of Zhejiang University Library in Hangzhou

Authors: Qin Dai

Abstract:

The renovation of existing interior space is big issue for architects in today’s China. However the traditional way of space renovation in China mostly focuses on the object itself, and the method also focuses on subjective level without the support of specific data. This research focuses the application of renovation of existing interior space based on post occupancy evaluation by a case study of a typical interior space. The research hopes to give a more scientific method of interior space renovation for architects and help promoting and guiding renovation practice. This research studies the post occupancy evaluation of the atrium space of Zhejiang University Library including subjective satisfaction and physical environmental satisfaction. The result provides necessary data support to conclude the design principles and strategies of renovation. Then the research uses simulation software to verify the availability of the strategy given based on the study. In conclusion, the research summarizes the application process of design methods of renovation of existing interior space based on the post-occupancy evaluation, and testifies to the practical significance of the renovation of existing interior space.

Keywords: existing interior space, physical environmental satisfaction, post occupancy evaluation, renovation of space, subjective satisfaction of space

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4700 The Scope and Effectiveness of Interactive Voice Response Technologies in Post-Operative Care

Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

Abstract:

More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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4699 Marketing and Customer Relationship in Post Consolidation Banking Sector of Nigeria

Authors: Nnedum Obiajuru Anthony Ugochukwu, Ezechukwu Emmanuel Ntomchukwu

Abstract:

The research investigated the importance of marketing and customer relationship management in post-consolidated banks in achieving success and survival in the face of intense competition and global economic meltdown. The problem lies in the fact that during the pre-consolidation era in the banking industry in Nigeria, banks were comfortable transacting their businesses from their armchairs. Little attention was paid to marketing by banks as a veritable means of achieving and consolidating their profit position. This situation, no doubt sustained because banks were more or less currency exchange centers where customers buy and sell foreign exchange which was highly demanded, but in very short supply. Today, deregulation and consolidation of banks in Nigeria have tremendously increased the tempo of activities in the banking industry, and competition has become very severe among banks. The weak link in the success of post-consolidated banks in Nigeria is the utter neglect, and light or unserious consideration of customer relationship marketing by banks. Armchair banking which banks have been practicing has no regard for marketing as a means to survival. However, in order to survive, post-consolidated banks must take relationship marketing and customer relationship management seriously especially in the face of the current global economic crisis. This paper aims at exploring the role of marketing in building and managing customer relationships as a means to survival in post-consolidation banking in Nigeria.

Keywords: marketing, customer relationships, banking sector, Nigeria

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4698 The Potential Involvement of Platelet Indices in Insulin Resistance in Morbid Obese Children

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices

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4697 The Reduction of Post-Blast Fumes to Improve Productivity and Safety: A Review Paper

Authors: Nhleko Monique Chiloane

Abstract:

The gold mining industry has predominantly used ammonium nitrate fuel oil (ANFO) explosives for decades, although these are known to be “gassier” and their detonation results in toxic fumes, for example, carbon monoxide (CO), nitrogen oxides (NOx) and ammonia. Re-entry into underground workings too soon after blasting can lead to fatal exposure to toxic fumes. It is, therefore, required that the polluted air be removed from the affected areas within a reasonable period before employees' re-entry into the working area. Post-blast re-entry times have therefore been described as a productivity bottleneck. The known causes of post-blast fumes are water ingress, incorrect fuel to oxygen ratio, confinement, explosive additives etc. To prevent or minimize post-blast fumes, some researchers have used neutralization, re-burning technique and non-explosive products or different oxidizing agents. The use of commercial explosives without nitrate oxidizing agents can also minimize the production of blasting fumes and thereby reduce the time needed for the clearance of these fumes to allow workers to re-enter the underground workings safely. The reduction in non-production time directly contributes to an increase in the available time per shift for productive work, thus leading to continuous mining. However, owing to its low cost and ease of use, ANFO is still widely used in South African underground blasting operations.

Keywords: post-blast fumes, continuous mining, ammonium nitrate explosive, non-explosive blasting, re-entry period

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4696 Contribution of Women to Post-Colonial Education and Leadership

Authors: Naziema Begum Jappie

Abstract:

This paper explores the relationship between educational transformation and gender equity in higher education. It draws on various policies and experiences and investigates the paradox of increased female leadership in higher education and the persistence of gender discrimination in the sphere of work. The paper will also address specific aspects of culture and education in post-colonial South Africa. Traditional features of past education systems were not isolated, they became an essential component of the education system, post-democracy. This is currently contested through the call for decolonizing the education system. The debates and discussions seek to rectify the post-colonial education structure within which women suffered triple oppression. Using feminist critical policy analysis and post-colonial theory, the paper examines how transformation over the past two decades has impacted on gender equity and how educational reform is itself gendered. It considers the nature of gender restructuring and key developments in gender equity policy. The social inequality in education is highlighted throughout this discussion. Through an analysis of research and interviews, this paper argues that gender can no longer be privileged when identifying and responding to educational and workplace inequality. In conclusion, the paper discusses the important assumptions that support how social and educational change deliver equity and how social justice may inform equity policy and practice in a culturally diverse educational framework.

Keywords: culture, educational leadership, gender inequality in the workplace, policy implementation

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4695 Case Report: Clinical Improvement of Forbrain Neurologic Signs in 3- Month- Old Persian Mastiff Dog with Calvarial Hyperostosis Syndrome after Corticosteroid, Antiepileptic and Antibiotic Therapy

Authors: Hamidreza Jahani, Zahra Salehzadeh, Ehsan Amini, Mohsen Tohidifar

Abstract:

Calvarial Hyperostosis Syndrome (CHS) is a benign bone disease of the skull. It is a non-neoplastic and proliferative bone disease, and the main feature of the disease is progressive and asymmetrical bone involvement. CHS is mostly reported in young male and female bullmastiff dogs and less frequently in other breeds. The etiology of CHS is unknown. This is the first case report of CHS in Iran. A 3-month-old male Persian Mastiff was presented with chief complaints of multiple episodes of seizure, pacing, bizarre behavior, delayed growth, head pressing, and difficulty in opening the mouth. Central blindness and open fontanelles were observed in clinical examination. No abnormality was found in the complete blood count and routine blood biochemical tests. CT scan findings include cortical thickening of frontal and parietal bones and enlargement of the left retropharyngeal lymph node. For treatment, oral clindamycin for two weeks, prednisolone and phenobarbital for one month, respectively, were administrated, and the case showed improvement after a week and recovered after one month.

Keywords: calvarial hyperostosis, Persian Mastiff, frontal bone, seizure

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4694 Spectrum of Bacteria Causing Oral and Maxillofacial Infections and Their Antibiotic Susceptibility among Patients Attending Muhimbili National Hospital

Authors: Sima E. Rugarabamu, Mecky I. Matee, Elison N. M. Simon

Abstract:

Background: In Tanzania bacteriological studies of etiological agents of oro-facial infections are very limited, and very few have investigated anaerobes. The aim of this study was to determine the spectrum of bacterial agents involved in oral and maxillofacial infections in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania. Method: This was a hospital based descriptive cross-sectional study that was conducted in the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital in Dar es Salaam, Tanzania from 1st January 2014 to 31st August 2014. Seventy (70) patients with various forms of oral and maxillofacial infections who were recruited for the study. The study participants were interviewed using a prepared questionnaire after getting their consent. Pus aspirate was cultured on Blood agar, Chocolate Agar, MacConkey agar and incubated aerobically at 37°C. Imported blood agar was used for anaerobic culture whereby they were incubated at 37°Cin anaerobic jars in an atmosphere of generated using commercial gas-generating kits in accordance with manufacturer’s instructions. Plates were incubated at 37°C for 24 hours (For aerobic culture and 48 hours for anaerobic cultures). Gram negative rods were identified using API 20E while all other isolates were identified by conventional biochemical tests. Antibiotic sensitivity testing for isolated aerobic and anaerobic bacteria was detected by the disk diffusion, agar dilution and E-test using routine and commercially available antibiotics used to treat oral facial infections. Results: This study comprised of 41 (58.5%) males and 29 (41.5%) females with a mean age of 32 years SD +/-15.1 and a range of 19 to 70 years. A total of 161 bacteria strains were isolated from specimens obtained from 70 patients which were an average of 2.3 isolates per patient. Of these 103 were aerobic organism and 58 were strict anaerobes. A complex mix of strict anaerobes and facultative anaerobes accounted for 87% of all infections.The most frequent aerobes isolated was streptococcus spp 70 (70%) followed by Staphylococcus spp 18 (18%). Other organisms such as Klebsiella spp 4 (4%), Proteus spp 5 (5%) and Pseudomonas spp 2 (2%) were also seen. The anaerobic group was dominated by Prevotella spp 25 (43%) followed by Peptostreptococcus spp 18 (31%); other isolates were Pseudomonas spp 2 (1%), black pigmented Pophyromonas spp 4 (5%), Fusobacterium spp 3 (3%) and Bacteroides spp 5 (8%). Majority of these organisms were sensitive to Amoxicillin (98%), Gentamycin (89%), and Ciprofloxacin (100%). A 40% resistance to metronidazole was observed in Bacteroides spp otherwise this drug and others displayed good activity against anaerobes. Conclusions: Oral and maxillofacial facial infections at Muhimbili National Hospital are mostly caused by streptococcus spp and Prevotella spp. Strict anaerobes accounted for 36% of all isolates. The profile of isolates should assist in selecting empiric therapy for infections of the oral and maxillofacial region. Inclusion of antimicrobial agents against anaerobic bacteria is highly recommended.

Keywords: bacteria, oral and maxillofacial infections, antibiotic susceptibility, Tanzania

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4693 Identification of Some Factors Influencing Serum Uric Acid Concentration in Individuals With Metabolic Syndrome

Authors: Munkhtuul G., Bolortsetseg Z., Lutzul M., Sugar N., Nyamdorj D., Nomundari B., Zesemdorj O., Erdenebayar N., Lkhagvasuren T. S., Munkhbayarlakh S., Bayasgalan T. Uurtuya S. H.

Abstract:

Background: Elevated serum uric acid (SUA) levels are observed in metabolic and cardiovascular conditions as an early predictor of metabolic syndrome (MS). Hyperuricemia, characterised by high uric acid levels in serum, increases the risk of developing MS by 1.6 times. Being overweight and obese significantly contributes to developing MS and cardiovascular disorders. In Mongolia, the prevalence of overweight and obesity is reaching 48.8% among individuals aged 15 to 49 years, indicating a potential surge in the incidence of MS, cardiovascular disorders, diabetes mellitus, and gout.Objective: This study aimed to determine the SUA levels in men diagnosed with MS and investigate the factors influencing these levels.Methods: A total of 119 men aged 30-60, who underwent preventive examinations and resided in Ulaanbaatar city, were included in the study. The criteria established by the International Diabetes Federation (IDF), American Heart Association (AHA), and the National Heart, Lung, and Blood Institute (NHLBI) were employed to define metabolic syndrome. Hyperuricemia was defined as SUA levels ≥7 mg/dL. Dietary intake was evaluated through the 24-hour recall method.Results: The study revealed that the prevalence of MS among the participants was 42.9% (n=51), with hyperuricemia observed in 16.8% (n=20) of the individuals. Among men diagnosed with MS, 21.3% (n=10) exhibited hyperuricemia. The mean SUA levels were as follows: 4.7±0.8 mg/dL in the healthy group, 5.9±1.1 mg/dL in men without MS but presenting central obesity, and 6.2±1.3 mg/dL in men with MS. After adjusting for age and body mass index (BMI), a positive correlation was observed between SUA levels and triglycerides (β=0.93) as well as lipid accumulation product (LAP) (β=0.92) in men with MS. In the central obesity group, SUA levels exhibited a positive correlation with triglycerides (β=0.91), visceral adiposity index (VAI) (β=0.73), LAP (β=0.92), and cardiometabolic index (CMI) (β=0.69). The risk of hyperuricemia increased by 3.29 times with elevated triglycerides and 3.53 times with an increased LAP.Conclusion: The findings indicate that abdominal fat accumulation, as indicated by elevated triglyceride levels and LAP, is associated with increased SUA levels in men with MS. However, no significant relationship was observed between SUA levels and dietary intake.

Keywords: central obesity, obesity, triglycerides, hyperuricemia

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4692 Design Criteria Recommendation to Achieve Accessibility In-House to Different Users

Authors: Claudia Valderrama-Ulloa, Cristian Schmitt, Juan Pablo Marchetti, Viviana Bucarey

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Access to adequate housing is a fundamental human right and a crucial factor for health. Housing should be inclusive, accessible, and able to meet the needs of all its inhabitants at every stage of their lives without hindering their health, autonomy, or independence. This article addresses the importance of designing housing for people with disabilities, which varies depending on individual abilities, preferences, and cultural considerations. Based on the components of the International Classification of Functioning, Disability and Health, wheelchair users, little people (achondroplasia), children with autism spectrum disorder and Down syndrome were characterized, and six domains of activities related to daily life inside homes were defined. The article describes the main barriers homes present for this group of people. It proposes a list of architectural and design aspects to reduce barriers to housing use. The aspects are divided into three main groups: space management, building services, and supporting facilities. The article emphasizes the importance of consulting professionals and users with experience designing for diverse needs to create inclusive, safe, and supportive housing for people with disabilities.

Keywords: achondroplasia, autism spectrum disorder, disability, down syndrome, wheelchair user

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4691 Learning from Long COVID: How Healthcare Needs to Change for Contested Illnesses

Authors: David Tennison

Abstract:

In the wake of the Covid-19 pandemic, a new chronic illness emerged onto the global stage: Long Covid. Long Covid presents with several symptoms commonly seen in other poorly-understood illnesses, such as fibromyalgia (FM) and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). However, while Long Covid has swiftly become a recognised illness, FM and ME/CFS are still seen as contested, which impacts patient care and healthcare experiences. This study aims to examine what the differences are between Long Covid and FM; and if the Long Covid case can provide guidance for how to address the healthcare challenge of contested illnesses. To address this question, this study performed comprehensive research into the history of FM; our current biomedical understanding of it; and available healthcare interventions (within the context of the UK NHS). Analysis was undertaken of the stigma and stereotypes around FM, and a comparison made between FM and the emerging Long Covid literature, along with the healthcare response to Long Covid. This study finds that healthcare for chronic contested illnesses in the UK is vastly insufficient - in terms of pharmaceutical and holistic interventions, and the provision of secondary care options. Interestingly, for Long Covid, many of the treatment suggestions are pulled directly from those used for contested illnesses. The key difference is in terms of funding and momentum – Long Covid has generated exponentially more interest and research in a short time than there has been in the last few decades of contested illness research. This stands to help people with FM and ME/CFS – for example, research has recently been funded into “brain fog”, a previously elusive and misunderstood symptom. FM is culturally regarded as a “women’s disease” and FM stigma stems from notions of “hysteria”. A key finding is that the idea of FM affecting women disproportionally is not reflected in modern population studies. Emerging data on Long Covid also suggests a slight leaning towards more female patients, however it is less feminised, potentially due to it emerging in the global historical moment of the pandemic. Another key difference is that FM is rated as an extremely low-prestige illness by healthcare professionals, while it was in large part due to the advocacy of affected healthcare professionals that Long Covid was so quickly recognised by science and medicine. In conclusion, Long Covid (and the risk of future pandemics and post-viral illnesses) highlight a crucial need for implementing new, and reinforcing existing, care networks for chronic illnesses. The difference in how contested illnesses like FM, and new ones like Long Covid are treated have a lot to do with the historical moment in which they emerge – but cultural stereotypes, from within and without medicine, need updating. Particularly as they contribute to disease stigma that causes genuine harm to patients. However, widespread understanding and acceptance of Long Covid could help fight contested illness stigma, and the attention, funding and research into Long Covid may actually help raise the profile of contested illnesses and uncover answers about their symptomatology.

Keywords: long COVID, fibromyalgia, myalgic encephalomyelitis, chronic fatigue syndrome, NHS, healthcare, contested illnesses, chronic illnesses, COVID-19 pandemic

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