Search results for: self presentation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1291

Search results for: self presentation

481 Thematic English Textbook on Tasks Designed for a Public Educational Brazilian Context: Issues and Contributions

Authors: Fernanda Goulart, Rita de Cássia Barbirato

Abstract:

Task-based language teaching has received attention among researchers as it has been pointed out with the potential to provide more significant opportunities for using the target language and therefore generate successful language acquisition. Nevertheless, in the Brazilian context, few studies have analyzed the potential of tasks in English language acquisition. There is also a need for textbooks to meet the needs of Brazilian students. This work is part of doctoral research in its initial phase. It aims to demonstrate and discuss thematic textbook samples on tasks designed to be applied among high school and undergraduate students in a public technological educational context in São Paulo State, Brazil. It is a qualitative study. The data collection process for course design and textbook development initially included a survey administered to 159 students. Questions related to students’ English background knowledge, main learning interests, and needs. Most students reported difficulties communicating in English and showed a strong interest in a communicative English course. The theme “Cultural diversity” was chosen among other options provided. The textbook was then designed and comprised nine task cycles divided into four sequences. Cycles were composed of pre-tasks, tasks, and post-tasks. The main findings of this first phase of the research revealed that designing a task-based textbook is not easy and requires the necessary steps and lots of effort to meet students’ language needs. Several revisions were needed before the conclusion of the final version of the textbook. The material will be further applied in a three-month English course. In this presentation, we hope to contribute to discussions in research on task-based teaching. Also, we intend to support teachers with their knowledge of tasks and thematic material development in this field.

Keywords: task-based language teaching, language acquisition, English language teaching, task cycles

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480 Late Neolithic Cemeteries Funerary and Their Indications of Societies Changes and Religion Emergences of Sudan: Qalaat Shanan Site Case Study

Authors: Ahmed Hamid Nassr

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The significant of the old stone ages in the Sudan, seems from the longest times and the large differentiation in antiquities, so many Neolithic cemeteries have been discovered in the Sudan, which the studies revealed costumes’ funerary from the Form of grave and the contents has been contrasted in some elements and constant in the others. Many interpretations of the late Neolithic cemeteries tradition written from the earlier studies, most of them focus of the development and change in the burial from society’s development and ideas of afterlife beginnings. Another emphasis undertaken is the relationship between societies cultural aspects and the environmental conditions of the period; it has been considered that it hyper-affected the development of farming in one way or another. The site of Qalaat Shanan noted in earlier 1990 and excavated by the Author from 2011-2013, the site located north of Khartoum about 170 km in Shendi town. Site setting lies amongst a group of Neolithic sites in the Shendi area, it reflected a succession of various Neolithic activities from the early to the late horizons. Excavation revealed many late Neolithic graves, the adult and child graves show large funerary content, different in quality and quantity, which indicates of societies development and related to religion and ideas about the afterlife. This presentation discusses the variations of the Late Neolithic cemeteries in Galaat Shanan site from the grave form, content and differentiation of the sex and age and compared with other late Neolithic discoveries in Sudan and the Nile valley. The study shows many changes in the graves related to the societies changes in late Neolithic in Sudan, climate and economic subsistence's are well reasons, but also the idea change is the main reason for the changes. That is clear from the variations of grave shape and content in age and sex and might be society’s status and levels.

Keywords: Sudan, Shendi town, Qalaat Shanan, late neolithic, cemeteries, funerary, tradition

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479 Realizing the Rights of Prisoners with Disabilities in Nigeria: A Case Study of Four Lagos State Prisons

Authors: Jacob Bogart, Adaobi Egboka

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Nigeria signed and ratified the Convention on the Rights of Persons with Disabilities in 2010, which was heralded as a much-needed step towards protecting the rights of persons with disabilities (PWDs). However, even with such progress, incarcerated PWDs have been left behind. The current legal framework in Nigeria does not consider the particular challenges PWDs face in prison nor make provisions to address them, despite the need for such reforms. Indeed, given the closed and restricted nature of prisons, and the violence that results from overcrowding, lack of supervision, and poor facilities, prisoners with disabilities often face significant challenges while incarcerated. While every prisoner is affected by these issues, PWDs are disproportionately harmed by them due to the nature of their disability. A study of four prisons in Lagos State, Nigeria was carried out by interviewing prisoners with disabilities, prison officials, advocates, and academics. The study found that for prisoners with physical disabilities, inaccessible prison facilities and a lack of mobility, hearing, or seeing assistance can often cause them to be dependent on the mercy of the other inmates for assistance in performing such basic functions as using the restroom, going to church, or washing themselves. Prison officials do not assist these PWDs or provide them with aids, such as crutches or a cane. Relatedly, prisoners with psychosocial disabilities (mental health conditions) often are not removed to health care facilities, despite a law to that effect, and are left to languish in prisons without the mental health care treatment they need. This presentation argues that reforms addressing the rights of PWDs must consider and make provisions for prisoners with disabilities, such as ensuring that prison facilities are accessible, providing PWDs with mobility, seeing or hearing aids as needed, and conducting mental health screenings for persons awaiting trial immediately upon entering the prison. These reforms, among others, are necessary first steps toward realizing the rights of prisoners with disabilities in Nigeria.

Keywords: disability rights, human rights, Lagos, Nigeria, prisoners with disabilities

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478 Colloquialism in Audiovisual Translation: English Subtitling of the Lebanese Film Capernaum as a Case Study

Authors: Fatima Saab

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This paper attempts to study colloquialism in audio-visual translation, with particular emphasis given to investigating the difficulties and challenges encountered by subtitlers in translating Lebanese colloquial into English. To achieve the main objectives of this study, ample and thorough cultural and translational analysis of examples drawn from the subtitled movie Capernaum are presented in order to identify the strategies used to overcome cultural barriers and differences and to show the process of decision-making by the translator. Also, special attention is given to explain the technicalities in translating subtitles and how they affect the translation process. The research is a descriptive analytical study whereby the writer sets out empirical observations, consisting of descriptive and analytical examination of the difficulties and problems associated with translating Arabic colloquialisms, specifically Lebanese, into English in the subtitled film, Capernaum. The research methodology utilizes a qualitative approach to group the selected data into the subtitling strategies presented by Gottlieb under the domesticating or foreignizing strategies according to Venuti's Model. It is shown that producing the same meanings to a foreign audience is not an easy task. The background of cultural elements and the stories that make up the history and mindset of the Lebanese and Arabic peoples leads to the use of the transfer and paraphrase methodologies most of the time (81% of the sample used for analysis). The research shows that translating and subtitling colloquialism needs special skills by the translators to overcome the challenges imposed by the limited presentation space as well as cultural differences. Translation of colloquial Arabic/Lebanese can be achieved to a certain extent and delivering the meaning and effect of the source language culture is accomplished in as much as the translator investigates and relates to the target culture.

Keywords: Lebanese colloquial, audio-visual translation, subtitling, Capernaum

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477 An Analysis of a Canadian Personalized Learning Curriculum

Authors: Ruthanne Tobin

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The shift to a personalized learning (PL) curriculum in Canada represents an innovative approach to teaching and learning that is also evident in various initiatives across the 32-nation OECD. The premise behind PL is that empowering individual learners to have more input into how they access and construct knowledge, and express their understanding of it, will result in more meaningful school experiences and academic success. In this paper presentation, the author reports on a document analysis of the new curriculum in the province of British Columbia. Three theoretical frameworks are used to analyze the new curriculum. Framework 1 focuses on five dominant aspects (FDA) of PL at the classroom level. Framework 2 focuses on conceptualizing and enacting personalized learning (CEPL) within three spheres of influence. Framework 3 focuses on the integration of three types of knowledge (content, technological, and pedagogical). Analysis is ongoing, but preliminary findings suggest that the new curriculum addresses framework 1 quite well, which identifies five areas of personalized learning: 1) assessment for learning; 2) effective teaching and learning; 3) curriculum entitlement (choice); 4) school organization; and 5) “beyond the classroom walls” (learning in the community). Framework 2 appears to be less well developed in the new curriculum. This framework speaks to the dynamics of PL within three spheres of interaction: 1) nested agency, comprised of overarching constraints [and enablers] from policy makers, school administrators and community; 2) relational agency, which refers to a capacity for professionals to develop a network of expertise to serve shared goals; and 3) students’ personalized learning experience, which integrates differentiation with self-regulation strategies. Framework 3 appears to be well executed in the new PL curriculum, as it employs the theoretical model of technological, pedagogical content knowledge (TPACK) in which there are three interdependent bodies of knowledge. Notable within this framework is the emphasis on the pairing of technologies with excellent pedagogies to significantly assist students and teachers. This work will be of high relevance to educators interested in innovative school reform.

Keywords: curriculum reform, K-12 school change, innovations in education, personalized learning

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476 Information Visualization Methods Applied to Nanostructured Biosensors

Authors: Osvaldo N. Oliveira Jr.

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The control of molecular architecture inherent in some experimental methods to produce nanostructured films has had great impact on devices of various types, including sensors and biosensors. The self-assembly monolayers (SAMs) and the electrostatic layer-by-layer (LbL) techniques, for example, are now routinely used to produce tailored architectures for biosensing where biomolecules are immobilized with long-lasting preserved activity. Enzymes, antigens, antibodies, peptides and many other molecules serve as the molecular recognition elements for detecting an equally wide variety of analytes. The principles of detection are also varied, including electrochemical methods, fluorescence spectroscopy and impedance spectroscopy. In this presentation an overview will be provided of biosensors made with nanostructured films to detect antibodies associated with tropical diseases and HIV, in addition to detection of analytes of medical interest such as cholesterol and triglycerides. Because large amounts of data are generated in the biosensing experiments, use has been made of computational and statistical methods to optimize performance. Multidimensional projection techniques such as Sammon´s mapping have been shown more efficient than traditional multivariate statistical analysis in identifying small concentrations of anti-HIV antibodies and for distinguishing between blood serum samples of animals infected with two tropical diseases, namely Chagas´ disease and Leishmaniasis. Optimization of biosensing may include a combination of another information visualization method, the Parallel Coordinate technique, with artificial intelligence methods in order to identify the most suitable frequencies for reaching higher sensitivity using impedance spectroscopy. Also discussed will be the possible convergence of technologies, through which machine learning and other computational methods may be used to treat data from biosensors within an expert system for clinical diagnosis.

Keywords: clinical diagnosis, information visualization, nanostructured films, layer-by-layer technique

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475 Epidemiology of Cutaneous Malignant Melanoma in Pakistan: Incidence, Clinical Subtypes, Tumor Stage and Localization

Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

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474 Innovative Screening Tool Based on Physical Properties of Blood

Authors: Basant Singh Sikarwar, Mukesh Roy, Ayush Goyal, Priya Ranjan

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This work combines two bodies of knowledge which includes biomedical basis of blood stain formation and fluid communities’ wisdom that such formation of blood stain depends heavily on physical properties. Moreover biomedical research tells that different patterns in stains of blood are robust indicator of blood donor’s health or lack thereof. Based on these valuable insights an innovative screening tool is proposed which can act as an aide in the diagnosis of diseases such Anemia, Hyperlipidaemia, Tuberculosis, Blood cancer, Leukemia, Malaria etc., with enhanced confidence in the proposed analysis. To realize this powerful technique, simple, robust and low-cost micro-fluidic devices, a micro-capillary viscometer and a pendant drop tensiometer are designed and proposed to be fabricated to measure the viscosity, surface tension and wettability of various blood samples. Once prognosis and diagnosis data has been generated, automated linear and nonlinear classifiers have been applied into the automated reasoning and presentation of results. A support vector machine (SVM) classifies data on a linear fashion. Discriminant analysis and nonlinear embedding’s are coupled with nonlinear manifold detection in data and detected decisions are made accordingly. In this way, physical properties can be used, using linear and non-linear classification techniques, for screening of various diseases in humans and cattle. Experiments are carried out to validate the physical properties measurement devices. This framework can be further developed towards a real life portable disease screening cum diagnostics tool. Small-scale production of screening cum diagnostic devices is proposed to carry out independent test.

Keywords: blood, physical properties, diagnostic, nonlinear, classifier, device, surface tension, viscosity, wettability

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473 Environmental Assessment of Roll-to-Roll Printed Smart Label

Authors: M. Torres, A. Moulay, M. Zhuldybina, M. Rozel, N. D. Trinh, C. Bois

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Printed electronics are a fast-growing market as their applications cover a large range of industrial needs, their production cost is low, and the additive printing techniques consume less materials than subtractive manufacturing methods used in traditional electronics. With the growing demand for printed electronics, there are concerns about their harmful and irreversible contribution to the environment. Indeed, it is estimated that 80% of the environmental load of a product is determined by the choices made at the conception stage. Therefore, examination through a life cycle approach at the developing stage of a novel product is the best way to identify potential environmental issues and make proactive decisions. Life cycle analysis (LCA) is a comprehensive scientific method to assess the environmental impacts of a product in its different stages of life: extraction of raw materials, manufacture and distribution, use, and end-of-life. Impacts and major hotspots are identified and evaluated through a broad range of environmental impact categories of the ReCiPe (H) middle point method. At the conception stage, the LCA is a tool that provides an environmental point of view on the choice of materials and processes and weights-in on the balance between performance materials and eco-friendly materials. Using the life cycle approach, the current work aims to provide a cradle-to-grave life cycle assessment of a roll-to-roll hybrid printed smart label designed for the food cold chain. Furthermore, this presentation will present the environmental impact of metallic conductive inks, a comparison with promising conductive polymers, evaluation of energy vs. performance of industrial printing processes, a full assessment of the impact from the smart label applied on a cellulosic-based substrate during the recycling process and the possible recovery of precious metals and rare earth elements.

Keywords: Eco-design, label, life cycle assessment, printed electronics

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472 The Effect of Visual Access to Greenspace and Urban Space on a False Memory Learning Task

Authors: Bryony Pound

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This study investigated how views of green or urban space affect learning performance. It provides evidence of the value of visual access to greenspace in work and learning environments, and builds on the extensive research into the cognitive and learning-related benefits of access to green and natural spaces, particularly in learning environments. It demonstrates that benefits of visual access to natural spaces whilst learning can produce statistically significant faster responses than those facing urban views after only 5 minutes. The primary hypothesis of this research was that a greenspace view would improve short-term learning. Participants were randomly assigned to either a view of parkland or of urban buildings from the same room. They completed a psychological test of two stages. The first stage consisted of a presentation of words from eight different categories (four manmade and four natural). Following this a 2.5 minute break was given; participants were not prompted to look out of the window, but all were observed doing so. The second stage of the test involved a word recognition/false memory test of three types. Type 1 was presented words from each category; Type 2 was non-presented words from those same categories; and Type 3 was non-presented words from different categories. Participants were asked to respond with whether they thought they had seen the words before or not. Accuracy of responses and reaction times were recorded. The key finding was that reaction times for Type 2 words (highest difficulty) were significantly different between urban and green view conditions. Those with an urban view had slower reaction times for these words, so a view of greenspace resulted in better information retrieval for word and false memory recognition. Importantly, this difference was found after only 5 minutes of exposure to either view, during winter, and with a sample size of only 26. Greenspace views improve performance in a learning task. This provides a case for better visual access to greenspace in work and learning environments.

Keywords: benefits, greenspace, learning, restoration

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471 From Homogeneous to Phase Separated UV-Cured Interpenetrating Polymer Networks: Influence of the System Composition on Properties and Microstructure

Authors: Caroline Rocco, Feyza Karasu, Céline Croutxé-Barghorn, Xavier Allonas, Maxime Lecompère, Gérard Riess, Yujing Zhang, Catarina Esteves, Leendert van der Ven, Rolf van Benthem Gijsbertus de With

Abstract:

Acrylates are widely used in UV-curing technology. Their high reactivity can, however, limit their conversion due to early vitrification. In addition, the free radical photopolymerization is known to be sensitive to oxygen inhibition leading to tacky surfaces. Although epoxides can lead to full polymerization, they are sensitive to humidity and exhibit low polymerization rate. To overcome the intrinsic limitations of both classes of monomers, Interpenetrating Polymer Networks (IPNs) can be synthesized. They consist of at least two cross linked polymers which are permanently entangled. They can be achieved under thermal and/or light induced polymerization in one or two steps approach. IPNs can display homogeneous to heterogeneous morphologies with various degrees of phase separation strongly linked to the monomer miscibility and also synthesis parameters. In this presentation, we synthesize UV-cured methacrylate - epoxide based IPNs with different chemical compositions in order to get a better understanding of their formation and phase separation. Miscibility before and during the photopolymerization, reaction kinetics, as well as mechanical properties and morphology have been investigated. The key parameters controlling the morphology and the phase separation, namely monomer miscibility and synthesis parameters have been identified. By monitoring the stiffness changes on the film surface, atomic force acoustic microscopy (AFAM) gave, in conjunction with polymerization kinetic profiles and thermomechanical properties, explanations and corroborated the miscibility predictions. When varying the methacrylate / epoxide ratio, it was possible to move from a miscible and highly-interpenetrated IPN to a totally immiscible and phase-separated one.

Keywords: investigation of properties and morphology, kinetics, phase separation, UV-cured IPNs

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470 Revisiting Classic Triad of Japanese Spotted Fever: A Case Series of Forty-Three Patients

Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

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Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.

Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica

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469 Optimal Design of a PV/Diesel Hybrid System for Decentralized Areas through Economic Criteria

Authors: David B. Tsuanyo, Didier Aussel, Yao Azoumah, Pierre Neveu

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An innovative concept called “Flexy-Energy”is developing at 2iE. This concept aims to produce electricity at lower cost by smartly mix different available energies sources in accordance to the load profile of the region. With a higher solar irradiation and due to the fact that Diesel generator are massively used in sub-Saharan rural areas, PV/Diesel hybrid systems could be a good application of this concept and a good solution to electrify this region, provided they are reliable, cost effective and economically attractive to investors. Presentation of the developed approach is the aims of this paper. The PV/Diesel hybrid system designed consists to produce electricity and/or heat from a coupling between Diesel gensets and PV panels without batteries storage, while ensuring the substitution of gasoil by bio-fuels available in the area where the system will be installed. The optimal design of this system is based on his technical performances; the Life Cycle Cost (LCC) and Levelized Cost of Energy are developed and use as economic criteria. The Net Present Value (NPV), the internal rate of return (IRR) and the discounted payback (DPB) are also evaluated according to dual electricity pricing (in sunny and unsunny hours). The PV/Diesel hybrid system obtained is compared to the standalone Diesel gensets. The approach carried out in this paper has been applied to Siby village in Mali (Latitude 12 ° 23'N 8 ° 20'W) with 295 kWh as daily demand. This approach provides optimal physical characteristics (size of the components, number of component) and dynamical characteristics in real time (number of Diesel generator on, their load rate, fuel specific consumptions, and PV penetration rate) of the system. The system obtained is slightly cost effective; but could be improved with optimized tariffing strategies.

Keywords: investments criteria, optimization, PV hybrid, sizing, rural electrification

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468 Hospital Acquired Bloodstream Infections Among Patients With Hematological and Solid Malignancies: Epidemiology, Causative Pathogens and Mortality

Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

Abstract:

The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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467 Challenges of Management of Subaortic Membrane in a Young Adult Patient: A Case Review and Literature Review

Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran

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This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.

Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure

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466 Teachers' Assessment Practices in Lower Secondary Schools in Tanzania: The Potential and Opportunities for Formative Assessment Practice Implementation

Authors: Joyce Joas Kahembe

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The implementation of education assessment reforms in developing countries has been claimed to be problematic and difficult. The socio-economic teaching and learning environment has pointed to constraints in the education reform process. Nevertheless, there are existing assessment practices that if enhanced, can have potential to foster formative assessment practices in those contexts. The present study used the sociocultural perspective to explore teachers’ assessment practices and factors influencing them in Tanzania. Specifically, the sociocultural perspective helped to trace social, economic and political histories imparted to teachers’ assessment practices. The ethnographic oriented methods like interviews, observations and document reviews was used in this exploration. Teachers used assessment practices, such as questioning and answering, tests, assignments and examinations, for evaluating, monitoring and diagnosing students’ understanding, achievement and performance and standards and quality of instruction practices. The obtained assessment information functioned as feedback for improving students’ understanding, performance, and the standard and quality of teaching instruction and materials. For example, teachers acknowledged, praised, approved, disapproved, denied, graded, or marked students’ responses to give students feedback and aid learning. Moreover, teachers clarified and corrected or repeated students’ responses with worded/added words to improve students’ mastery of the subject content. Teachers’ assessment practices were influenced by the high demands of passing marks in the high stakes examinations and the contexts of the social economic teaching environment. There is a need to ally education assessment reforms with existing socio-economic teaching environments and society and institutional demands of assessment to make assessment reforms meaningful and sustainable. This presentation ought to contribute on ongoing strategies for contextualizing assessment practices for formative uses.

Keywords: assessment, feedback, practices, formative assessment

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465 Effect of Stress Relief of the Footbath Using Bio-Marker in Japan

Authors: Harumi Katayama, Mina Suzuki, Taeko Muramatsu, Yui Shimogawa, Yoshimi Mizushima, Mitsuo Hiramatsu, Kimitsugu Nakamura, Takeshi Suzue

Abstract:

Purpose: There are very often footbaths in the hot-spring area as culture from old days in Japan. This culture moderately supported mental and physical health among people. In Japanese hospitals, nurses provide footbath for severe patients to mental comfortable. However, there are only a few evidences effect of footbath for mental comfortable. In this presentation, we show the effect of stress relief of the footbath using biomarker among 35 college students in volunteer. Methods: The experiment was designed in two groups of the footbath group and the simple relaxation group randomly. As mental load, Kraepelin test was given to the students beforehand. Ultra-weak chemiluminescence (UCL) in saliva and self-administered liner scale measurable emotional state were measured on four times concurrently; there is before and after the mental load, after the stress relief, and 30 minutes after the stress relief. The scale that measured emotional state was consisted of 7 factors; there is excitement, relaxation, vigorous, fatigue, tension, calm, and sleepiness with 22 items. ANOVA was calculated effect of the footbath for stress relief. Results: The level of UCL (photons/100sec) was significantly increased in response on both groups after mental load. After the two types of stress relief, UCL (photons/100sec) of footbath group was significantly decreased compared to simple relaxation group. Score of sleepiness and relaxation were significantly increased after the stress relief in the footbath group than the simple relaxation group. However, score of excitement, vigorous, tension, and calm were exhibit the same degree of decrease after the stress relief on both group. Conclusion: It was suggested that salivary UCL may be a sensitive biomarker for mild stress relief as nursing care. In the future, we will measure using UCL to evaluate as stress relief for inpatients, outpatients, or general public as the subjects.

Keywords: bio-marker, footbath, Japan, stress relief

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464 The Experimental House: A Case Study to Assess the Long-Term Performance of Waste Tires Used as Replacement for Natural Material in Backfill Applications for Basement Walls in Manitoba

Authors: M. Shokry Rashwan

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This study follows a number of experiments conducted at Red River College (RRC) to investigate the short term properties of tire derived aggregate (TDA) produced from shredding off-the-road (OTR) wasted tires in a proposed new application. The application targets replacing natural material used under concrete slabs and as backfills for residential homes’ basement slabs and walls, respectively, with TDA. The experimental work included determining: compressibility, gradation distribution, unit weight, hydraulic conductivity and lateral pressure. Based on the results of those short term properties; it was decided to move forward to study the long-term performance of this otherwise waste material through on-site demonstration. A full-scale basement replicating a typical Manitoba home was therefore built at RRC where both TDA and Natural Materials (NM) were used side-by-side. A large number of sensing and measuring systems are used to compare between the performances of each material when exposed to the typical ground and weather conditions. Parameters monitored and measured include heat losses, moisture migration, drainage ability, lateral pressure, relative movements of slabs and walls, an integrity of ground water and radon emissions. Up-to-date results have confirmed part of the conclusions reached from the earlier laboratory experiments. However, other results have shown that construction practices; such as placing and compaction, may need some adjustments to achieve more desirable outcomes. This presentation provides a review of both short-term tests as well as up-to-date analysis of the on-site demonstration.

Keywords: tire derived aggregate (TDA), basement construction, TDA material properties, lateral pressure of TDA, hydraulic conductivity of TDA

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463 Changing Patterns of Colorectal Cancer in Hail Region

Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

Abstract:

Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: colorectal cancer, Hail Region, changing pattern, distal shift

Procedia PDF Downloads 190
462 Visualization of Taiwan's Religious Social Networking Sites

Authors: Jia-Jane Shuai

Abstract:

Purpose of this research aims to improve understanding of the nature of online religion by examining the religious social websites. What motivates individual users to use the online religious social websites, and which factors affect those motivations. We survey various online religious social websites provided by different religions, especially the Taiwanese folk religion. Based on the theory of the Content Analysis and Social Network Analysis, religious social websites and religious web activities are examined. This research examined the folk religion websites’ presentation and contents that promote the religious use of the Internet in Taiwan. The difference among different religions and religious websites also be compared. First, this study used keywords to examine what types of messages gained the most clicks of “Like”, “Share” and comments on Facebook. Dividing the messages into four media types, namely, text, link, video, and photo, reveal which category receive more likes and comments than the others. Meanwhile, this study analyzed the five dialogic principles of religious websites accessed from mobile phones and also assessed their mobile readiness. Using the five principles of dialogic theory as a basis, do a general survey on the websites with elements of online religion. Second, the project analyzed the characteristics of Taiwanese participants for online religious activities. Grounded by social network analysis and text mining, this study comparatively explores the network structure, interaction pattern, and geographic distribution of users involved in communication networks of the folk religion in social websites and mobile sites. We studied the linkage preference of different religious groups. The difference among different religions and religious websites also be compared. We examined the reasons for the success of these websites, as well as reasons why young users accept new religious media. The outcome of the research will be useful for online religious service providers and non-profit organizations to manage social websites and internet marketing.

Keywords: content analysis, online religion, social network analysis, social websites

Procedia PDF Downloads 155
461 Administrative and Legal Instruments of Disciplining Maintenance Debtors in Poland - A Critical Analysis of Their Effectiveness

Authors: Tomasz Kosicki

Abstract:

The subject of the presentation will be the administrative and legal instruments of disciplining maintenance debtors adopted by the Polish legislator, the substantive legal bases of which were adopted in the Act of 7 September 2007 on assistance to persons entitled to maintenance (Journal of Laws of 2022, item 1205). These provisions are complemented by procedural regulations resulting from the Act of 14 June 1960 - Code of Administrative Procedure (Journal of Laws of 2021, item 735, as amended). The first part of the paper will focus on the administrative proceedings regarding the recognition of the debtor as evading maintenance obligations. The initiation of this procedure ex officio is preceded by a number of actions by public administration bodies, including Conducting a maintenance interview with the debtor, during which his health and professional situation and the reasons for non-payment of maintenance are determined, Professional activation in a situation where the lack of payment of maintenance results from the lack of employment. The reasons for initiating the above-mentioned administrative proceedings ex officio will be indicated, taking into account the current views of the judicial decisions. The second part of the paper will focus on the instrument of retaining the driving license of the debtor, who was previously found to be evading maintenance. The author points out that the detention of the driving license is one of the types of administrative sanctions of a very severe nature. Doubts of a constitutional nature will also be highlighted, as well as those concerning the effectiveness of this legal instrument and the protection of the debtor's rights. The thesis will be presented that the administrative procedure for the retention of a driving license does not fulfill its role and especially does not affect the collection of maintenance obligations from debtors. All the considerations will be based on the current and most representative views of the literature on the subject and the jurisprudence of Polish administrative courts.

Keywords: maintenance debtor, administrative proceedings, detention of driving license, administrative sanction, polish administrative law, public administration

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460 Exploring the Subculture of New Graduate Nurses’ Everyday Experience in Mental Health Nursing: An Ethnography

Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

Procedia PDF Downloads 169
459 Traumatic Chiasmal Syndrome Following Traumatic Brain Injury

Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

Abstract:

Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

Procedia PDF Downloads 66
458 Administrative and Legal Instruments of Disciplining Maintenance (alimony) Debtors in Poland - A Critical Analysis of their Effectiveness

Authors: Tomasz Kosicki

Abstract:

The subject of the presentation will be the administrative and legal instruments of disciplining maintenance debtors adopted by the Polish legislator, the substantive legal bases of which were adopted in the Act of 7 September 2007 on assistance to persons entitled to maintenance (Journal of Laws of 2022, item 1205). These provisions are complemented by procedural regulations resulting from the Act of 14 June 1960 - Code of Administrative Procedure (Journal of Laws of 2021, item 735, as amended). The first part of the paper will focus on the administrative proceedings regarding the recognition of the debtor as evading maintenance obligations. The initiation of this procedure ex officio is preceded by a number of actions by public administration bodies, including Conducting a maintenance interview with the debtor, during which his health and professional situation and the reasons for non-payment of maintenance are determined, Professional activation in a situation where the lack of payment of maintenance results from the lack of employment. The reasons for initiating the above-mentioned administrative proceedings ex officio will be indicated, taking into account the current views of the judicial decisions. The second part of the paper will focus on the instrument of retaining the driving license of the debtor, who was previously found to be evading maintenance. The author points out that the detention of the driving license is one of the types of administrative sanctions of a very severe nature. Doubts of a constitutional nature will also be highlighted, as well as those concerning the effectiveness of this legal instrument and the protection of the debtor's rights. The thesis will be presented that the administrative procedure for the retention of a driving license does not fulfill its role and especially does not affect the collection of maintenance obligations from debtors. All the considerations will be based on the current and most representative views of the literature on the subject and the jurisprudence of Polish administrative courts.

Keywords: maintenance debtor, administrative proceedings, detention of driving license, administrative sanction, polish administrative law, public administration

Procedia PDF Downloads 68
457 Migrants in the West Immersed on Nihilism: Towards a Space for Mutual Recognition and Self-Realization

Authors: Marinete Araujo da Silva Fobister

Abstract:

This presentation aims to discuss how the feeling of ‘nostalgia’ both present on Westerns and migrants could shed light to a mutual recognition and an exchange of ways of life that could enhance mutual possibilities of self-realization. It seems that this feeling of nostalgia is related to another unfolding of the nihilism of the death of God diagnosed by Nietzsche. Westerns are feeling on the margins of the values of their own culture as they feel such values as external to them. At the same time, some groups are claiming the return of the old devalued values. In this scenario, the West is receiving many migrants from different parts of the world since the second half of the last century. Migrants might be suffering from nostalgia or homesickness for having left their home. It might be that sharing a sense of nostalgia, although with different meanings, can bring together Westerns and migrants. Migrants bring ways of life that might be unknown and inexperienced in the West, and these can shed light to new forms of interpretation and cultivation of ones’ drives, and forces and this could become a source of mutual strength cultivation. Therefore, this mutual feeling of nostalgia could lead to ways of exploring the idea of self- realization in Nietzsche detaching it from the idea of being mainly individual to a more trans-individual-cultural claim. Nietzsche argues that nihilism is a European event here translated as a Western event, which would take 200 years until it could be overcome. To overcome nihilism a new kind of human would be needed, a creative and strong kind. For Nietzsche, there is not a fixed or true self, hence one possibility for one to achieve self-realization would reside on cultivating their multiple creative forces. The argument here is that in this recent unfolding of nihilism, translated in the sense of nostalgia, the encounter between the mainstream western immersed on nihilism with migrants could create a sense of a shared temporary home, where these different ways of life could inspire each other to create new meanings. Indeed, contributing to the expansion of one’s world view, drives and forces. Therefore, fertilizing the soil for the cultivation of self-realization and consequently the creation of new values.

Keywords: migration, nihilism, nostalgia, self-realization

Procedia PDF Downloads 184
456 Tracking of Intramuscular Stem Cells by Magnetic Resonance Diffusion Weighted Imaging

Authors: Balakrishna Shetty

Abstract:

Introduction: Stem Cell Imaging is a challenging field since the advent of Stem Cell treatment in humans. Series of research on tagging and tracking the stem cells has not been very effective. The present study is an effort by the authors to track the stem cells injected into calf muscles by Magnetic Resonance Diffusion Weighted Imaging. Materials and methods: Stem Cell injection deep into the calf muscles of patients with peripheral vascular disease is one of the recent treatment modalities followed in our institution. 5 patients who underwent deep intramuscular injection of stem cells as treatment were included for this study. Pre and two hours Post injection MRI of bilateral calf regions was done using 1.5 T Philips Achieva, 16 channel system using 16 channel torso coils. Axial STIR, Axial Diffusion weighted images with b=0 and b=1000 values with back ground suppression (DWIBS sequence of Philips MR Imaging Systems) were obtained at 5 mm interval covering the entire calf. The invert images were obtained for better visualization. 120ml of autologous bone marrow derived stem cells were processed and enriched under c-GMP conditions and reduced to 40ml solution containing mixture of above stem cells. Approximately 40 to 50 injections, each containing 0.75ml of processed stem cells, was injected with marked grids over the calf region. Around 40 injections, each of 1ml normal saline, is injected into contralateral leg as control. Results: Significant Diffusion hyper intensity is noted at the site of injected stem cells. No hyper intensity noted before the injection and also in the control side where saline was injected conclusion: This is one of the earliest studies in literature showing diffusion hyper intensity in intramuscularly injected stem cells. The advantages and deficiencies in this study will be discussed during the presentation.

Keywords: stem cells, imaging, DWI, peripheral vascular disease

Procedia PDF Downloads 62
455 Tibial Hemimelia Type VIIa: A Case Report

Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

Abstract:

Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

Procedia PDF Downloads 147
454 Osteoarticular Manifestations and Abnormalities of Bone Metabolism in Celiac Disease

Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

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453 Hyper-Immunoglobulin E (Hyper-Ige) Syndrome In Skin Of Color: A Retrospective Single-Centre Observational Study

Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

Abstract:

Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

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452 Congenital Heart Defect(CHD) “The Silent Crises”; The Need for New Innovative Ways to Save the Ghanaian Child - A Retrospective Study

Authors: Priscilla Akua Agyapong

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Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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