Search results for: general surgery

Authors: Mohamed Ali Al Shaari, Khalid M. El Fitori

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In the field of Quran Studies known as Ghareeb A Quran (the study of the meanings of strange words and structures in Holy Quran), it is difficult to distinguish some pragmatic meanings from conceptual meanings. One who wants to study this subject may need to look for a common usage between any two words or more; to understand general meaning, and sometimes may need to look for common differences between them, even if there are synonyms (word sisters). Some of the distinguished scholars of Arabic linguistics believe that there are no synonym words, they believe in varieties of meaning and multi-context usage. Based on this viewpoint, our method was designed to look for synonyms of a word, then the differences that distinct the word and their synonyms. There are many available books that use such a method e.g. synonyms books, dictionaries, glossaries, and some books on the interpretations of strange vocabulary of the Holy Quran, but it is difficult to look up words in these written works. For that reason, we proposed a logical entity, which we called Differences Matrix (DM). DM groups the synonyms words to extract the relations between them and to know the general meaning, which defines the skeleton of all word synonyms; this meaning is expressed by a word of its sisters. In Differences Matrix, we used the sisters(words) as titles for rows and columns, and in the obtained cells we tried to define the row title (word) by using column title (her sister), so the relations between sisters appear, the expected result is well defined groups of sisters for each word. We represented the obtained results formally, and used the defined groups as a base for building the ontology of the Holy Quran synonyms.

Keywords: Quran, synonyms, differences matrix, ontology

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Authors: Ya-Chu May Tsai, Ibrahim Yacoub, Eoin Casey

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The Australian and New Zealand College of Anaesthetists (ANZCA) advises that smoking should not be permitted within 12 hours of surgery. There is little information in the medical literature regarding patients awareness of perioperative smoking cessation recommendations nor their appreciation of how smoking might negatively impact their perioperative course. The aim of the study is to assess the prevalence of current smokers presenting to Werribee Mercy Hospital (WMH) and to evaluate if pre-operative provision of both written and verbal pre-operative advice was, 1: Effective in improving patient awareness of the benefits of pre-operative smoking cessation, 2: Associated with an increase in the number of elective surgical patients who stop smoking at least 12 hours pre-operatively. Methods: The initial survey included all patients who presented to WMH for elective surgical procedures from 19 – 30 September 2016 using a standardized questionnaire focused on patients’ smoking history and their awareness of smoking cessation preoperatively. The intervention consisted of a standard pre-operative phone call to all patients advising them of the increased perioperative risks associated with smoking, and advised patients to cease 12 hours prior. In addition, written information on smoking cessation strategies were sent out in mail at least 1 week prior to planned procedure date to all patients. Questionnaire-based study after the intervention was conducted on day of elective procedure from 10 – 21 October 2016 inclusive. Primary outcomes measured were patient’s awareness of smoking cessation and proportion of smokers who quit >12 hours, considered a clinically meaning duration to reduce anaesthetics complications. Comparison of pre and post intervention results were made using SPSS 21.0. Results: In the pre-intervention group (n=156), 36 (22.4%) patients were current smokers, 46 were ex-smokers (29.5%) and 74 were non-smokers (48.1%). Of the smokers, 12 (33%) reported having been informed of smoking cessation prior to operation and 8 (22%) were aware of increased intra- and perioperative adverse events associated with smoking. In the post-intervention group n= 177, 38 (21.5%) patients were current smokers, 39 were ex-smokers (22.0%) and 100 were non-smokers (56.5%). Of the smokers, 32 (88.9%) reported having been informed of smoking cessation prior to operation and 35 (97.2%) reported being aware of increased intra- and perioperative adverse events associated with smoking. The median time since last smoke in the pre-intervention group was 5.5 hours (Q1-Q3 = 2-14) compared with 13 hours (Q1-Q3 = 5-24) in post intervention group. Amongst the smokers, smoking cessation at least 12 hours prior to surgery significantly increased from 27.8% pre-intervention to 52.6% post intervention (P=0.03). Conclusion: A standard preoperative phone call and written instruction on smoking cessation guidelines at time of waitlist placement increase preoperative smoking cessation rates by almost 2-fold.

Keywords: anaesthesia, audit, perioperative medicine, smoking cessation

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Authors: Mukadder Baran, Mustafa Sözbilir

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The purpose of this paper is to investigate the applicabillity of the Context- and Problem-Based Learning (CPBL) in general chemistry course to the subject of “Thermodynamics” but also the influence of CPBL on students’ achievement, retention of knowledge, their interest, attitudes, motivation and problem-solving skills. The study group included 13 freshman students who were selected with the sampling method appropriate to the purpose among those taking the course of General Chemistry within the Program of Medical Laboratory Techniques at Hakkari University. The application was carried out in the Spring Term of the academic year of 2012-2013. As the data collection tool, Lesson Observation form were used. In the light of the observations held, it was revealed that CPBL increased the students’ intragroup and intergroup communication skills as well as their self-confidence and developed their skills in time management, presentation, reporting, and technology use; and that they were able to relate chemistry to daily life. Depending on these findings, it could be suggested that the area of use of CPBL be widened; that seminars related to constructive methods be organized for teachers. In this way, it is believed that students will not be passive in the group any longer. In addition, it was concluded that in order to avoid the negative effects of the socio-cultural structure on the education system, research should be conducted in places where there is socio-cultural obstacles, and appropriate solutions should be suggested and put into practice.

Keywords: chemistry, education, science, context-based learning

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Authors: Adebimpe Olubunmi Adebanjo

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This study observed students’ attitudes towards reading as a determinant of performance in O’ Level English in Oyo state secondary schools. Random sampling technique was used to select two schools from each of the five geo-political zones of the state while stratified sampling technique was used to select twenty students from each of the ten schools. A researcher designed questionnaire was used to gather information on students’ attitudes while a prepared test based on O’ Level syllabus was stapled to each of the questionnaire to ascertain their level of achievement in O’ Level English. The Percentage, Mean, Standard Deviation, Chi-square and Pearson Contingency Coefficient were used to answer and test the research questions and hypotheses raised. The findings showed that the general attitude of students towards reading was ambivalent; the general level of achievement was also low. The findings also revealed that there was a significant difference in the attitudes of students to reading on the basis of gender and home background. Students from educated homes also had better attitudes towards reading than their counterparts from illiterate homes. The findings also showed that there was a significant relationship between students’ attitudes to reading and their performance in O’ Level English. Students with positive attitude to reading had better grades in O’ Level English than students with ambivalent and negative attitudes. Based on the findings, it was recommended that students should change their attitudes to reading; the school and the home were also advised to always encourage students to read.

Keywords: positive, ambivalent, negative attitudes, o' level English

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Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

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Authors: Derwin K. C. Chan, Alfred S. Y. Lee

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The integrated model of self-determination theory and the theory of planned behaviour has been successfully applied to explain individuals’ adherence to health behaviours, including behavioural adherence toward rehabilitation. This study was a randomised controlled trial that examined the effectiveness of an mHealth intervention (i.e., mobile application) developed based on this integrated model in promoting treatment adherence of patients of anterior cruciate ligament rupture during their post-surgery home-based rehabilitation period. Subjects were 67 outpatients (aged between 18 and 60) who undertook anterior cruciate ligament (ACL) reconstruction surgery for less than 2 months for this study. Participants were randomly assigned either into the treatment group (who received the smartphone application; N = 32) and control group (who receive standard treatment only; N = 35), and completed psychological measures relating to the theories (e.g., motivations, social cognitive factors, and behavioural adherence) and clinical outcome measures (e.g., subjective knee function (IKDC), laxity (KT-1000), muscle strength (Biodex)) relating to ACL recovery at baseline, 2-month, and 4-month. Generalise estimating equation showed the interaction between group and time was significant on intention was only significant for intention (Wald x² = 5.23, p = .02), that of perceived behavioural control (Wald x² = 3.19, p = .07), behavioural adherence (Wald x² = 3.08, p = .08, and subjective knee evaluation (Wald x² = 2.97, p = .09) were marginally significant. Post-hoc between-subject analysis showed that control group had significant drop of perceived behavioural control (p < .01), subjective norm (p < .01) and intention (p < .01), behavioural adherence (p < .01) from baseline to 4-month, but such pattern was not observed in the treatment group. The treatment group had a significant decrease of behavioural adherence (p < .05) in the 2-month, but such a decrease was not observed in 4-month (p > .05). Although the subjective knee evaluation in both group significantly improved at 2-month and 4-month from the baseline (p < .05), and the improvements in the control group (mean improvement at 4-month = 40.18) were slightly stronger than the treatment group (mean improvement at 4-month = 34.52). In conclusion, the findings showed that the theory driven mobile application ameliorated the decline of treatment intention of home-based rehabilitation. Patients in the treatment group also reported better muscle strength than control group at 4-month follow-up. Overall, the mobile application has shown promises on tackling the problem of orthopaedics outpatients’ non-adherence to medical treatment.

Keywords: self-determination theory, theory of planned behaviour, mobile health, orthopaedic patients

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Authors: Igna Brajević Gizdić, Gorka Vuletić

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Introduction: Addiction is a chronic brain relapsing disorder. Opioid Substitution Therapy (OST) using buprenorphine as a medical treatment option shows as a promising option for achieving and maintaining abstinence in opioid-addicted patients. This research aimed to determine and evaluate the quality of life (QoL) in opiate-addicted patients after five years of buprenorphine therapy. Method: The total sample included 44 buprenorphine-maintained opiate addicts in outpatient treatment. The participants were administered the QoL questionnaire (WHOQOL-BREF) at two-time points (T1 and T2) with an interval of at least five years. WHOQOL-BREF contains a total of 26 questions. The first two questions, related to overall QoL and general health status, and the remaining questions (3–26), which represented four domains—physical, psychological, social, and environmental health—were evaluated separately. Results: The results indicated no significant differences in overall self-assessed QoL nor in individual domains after five years (T2) of abstinence with OST buprenorphine- maintenance. Conclusion: These findings indicated no improvement in QoL of buprenorphine-maintenance opiate addicts in outpatient treatment. However, this might be due to the smaller sample size and participants' overall high scores in QoL at T1. This study suggests the importance of expectations when considering the QoL and general health of buprenorphine-maintenance opiate addicts in outpatient treatment.

Keywords: abstinence, addicts, buprenorphine, opioid substitution therapy, quality of life

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Authors: Emil Danehorn, Ulla Peterson, Marie Oscarsson, Goldina Smirthwaite, Katarina Swahnberg

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Swedish students who choose to study abroad are common, but there has been limited research on exchange students. There are indications that some Swedish exchange students have been exposed to violence, but it is not known if they, already before their semester abroad, are more exposed to violence than students who remain on campus. Our aim was to investigate potential differences in exposure to physical, sexual, and emotional violence between prospective exchange students and campus students and between male and female students in general, as well as to determine any associations between mental health and exposure to violence among students in the total sample. Method: Comparative cross-sectional design using an online survey containing the NorVold Abuse Questionnaire and the General Health Questionnaire 12. A total of 565 participants took part in the study. Results: Prospective exchange students were less exposed to emotional violence compared to campus students. About one-half of all the participating female students had been exposed to sexual violence and about one-third of all the male students had been exposed to physical violence. The results also indicated that exposure to more than one form of violence was associated with poor mental health for students as a group. Conclusion: Prospective exchange students as a group do not report more exposure to physical and sexual violence than campus students but do report less exposure to emotional violence. However, the overall frequency of exposure to violence among the students was high. This highlights the need for proactive efforts for everyone, not least for exchange students who will be staying in a new environment unknown to them.

Keywords: sexual violence, physical violence, emotional violence, exchange students, mental health

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Authors: Ian M. Grey, Bryan Roche, Anna Dillon, Justin Thomas, Sarah Cassidy, Dylan Colbert, Ian Stewart

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This paper presents findings from a study conducted in two schools in Abu Dhabi. The hypothesis is that teaching young children to derive various relations between stimuli leads to increases in full-scale IQ scores of typically developing children. In the experimental group, sixteen 6-7-year-old children were exposed over six weeks to an intensive training intervention designed specifically for their age group. This training intervention, presented on a tablet, aimed to improve their understanding of the relations Same, Opposite, Different, contextual control over the concept of Sameness and Difference, and purely arbitrary derived relational responding for Sameness and Difference. In the control group, sixteen 6-7-year-old children interacted with KIBO robotics over six weeks. KIBO purports to improve cognitive skills through engagement with STEAM activities. Increases in full-scale IQ were recorded for most children in the experimental group, while no increases in full-scale IQ were recorded for the control group. These findings support the hypothesis that relational skills underlie many aspects of general cognitive ability.

Keywords: early childhood, derived relational responding, intelligence, relational frame theory, relational skills

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Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: traditional healing system, healers, pluralist healthcare system, post-colonial era

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Authors: Andres Portocarrero Bonifaz, Caterina Sandra Camarena Rodriguez, Ricardo Palma Esparza, Nicolas Antonio Romero Carlos

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Reference levels for common X-rays procedures have been set in many protocols. In Peru, during quality control tests, the dose tolerance is set by these international recommendations. Nevertheless, further studies can be made to assess the national reality and relate dose levels with different parameters such as kV, mA/mAs, exposure time, type of processing (digital, digitalized or conventional), etc. In this paper three radiologic procedures were taken into account for study, general X-rays (fixed and mobile), intraoral X-rays (fixed, mobile and portable) and mammography. For this purpose, an Unfors Xi detector was used; the dose was measured at a focus - detector distance which varied depending on the procedure, and was corrected afterward to find the surface entry dose. The data used in this paper was gathered over a period of over 3 years (2015-2018). In addition, each X-ray machine was taken into consideration only once. The results hope to achieve a new standard which reflects the local practice, and address the issues of the ‘Bonn Call for Action’ in Peru. For this purpose, the 75% percentile of the dose of each radiologic procedure was calculated. In future quality control services, those machines with dose values higher than the selected threshold should be informed that they surpass the reference dose levels established in comparison other radiological centers in the country.

Keywords: general X-rays, intraoral X-rays, mammography, reference dose levels

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Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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Authors: J. Sagouis, A. Chamel, E. Carre, C. Casasreales, G. Rudnik, M. Cerdan

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Robotics provides answers to amputees. The most expensive solutions surgically connect the prosthesis to nerve endings. There are also several types of non-invasive technologies that recover nerve messages passing through the muscles. After analyzing these messages, myoelectric prostheses perform the desired movement. The main goal is to avoid all surgeries, which can be heavy and offer cheaper alternatives. For an amputee, we use valid muscles to recover the electrical signal involved in a muscle movement. EMG sensors placed on the muscle allows us to measure a potential difference, which our program transforms into control for a robotic arm with two degrees of freedom. We have shown the feasibility of non-invasive prostheses with two degrees of freedom. Signal analysis and an increase in degrees of freedom is still being improved.

Keywords: prosthesis, electromyography (EMG), robotic arm, nerve message

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Authors: Vladyslav Povoroznyuk, Oksana Ivanyk, Nataliia Dzerovych

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In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: osteoporosis, bone tissue mineral density, bone quality, fat mass, lean mass, postmenopausal osteoporosis

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Authors: Abdelrahman Abdelrahman, Lawrence Nip, Seun Ikotun, Iman Satar, Anur Miah

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Introduction: Incision and drainage of an abscess is a common procedure performed by the general surgeon. Pus swabs are often obtained routinely for MC&S.Our study aimed to investigate whether swabs taken at our local institution had any impact on the overall management plan for uncomplicated abscesses. Methods: We retrospectively assessed all patients presenting to University Hospital Lewisham with an abscess between October 2020 – April 2021. Exclusion criteria were recurrent abscesses, patients admitted with sepsis, known inflammatory bowel disease, immunocompromised, and those managed non-operatively. Results: We identified 131 patients who met the inclusion criteria. Two thirds were performed in theatre under general anaesthetic and the other one third under local. 63% of patients had a pus swab collected. Of these, 96% were not followed up by the requesting doctor, and there was no further patient contact. In the other 4%, the organisms cultured were flagged as atypical such as MRSA. In these cases, microbiology advice was that if the patient was clinically well and adequate drainage was achieved, then no furtherantibiotics were required. All patients were discharged before any microbiology results had come back with no subsequent change in the management plan. Average cost of pus swab = £10.10 – potentially cost saving of £1656.4 annually. Conclusion: Our study reveals that the majority of pus swabs taken from uncomplicated abscessesare not followed up by requesting doctor with no impact on the overall management plan. We, therefore, do not recommend the routine use of pus swabs for uncomplicated abscesses.

Keywords: pus swabs, uncomplated abscess, Pus MCS, follow up of uncomplicated abscess

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Authors: Po-Chun Lee, Li-Lin Liang, Ching-Yuan Huang

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Purpose: Research on electronic word-of-mouth (eWOM)& online review has been widely used in service industry management research in recent years. The SERVQUAL scale is the most commonly used method to measure service quality. Therefore, the purpose of this research is to combine electronic word of mouth & online review with the SERVQUAL scale. To explore the comparative study of positive and negative electronic word-of-mouth reviews of a certain armed force general hospital in Taiwan. Data sources: This research obtained online word-of-mouth comment data on google maps from a military hospital in Taiwan in the past ten years through Internet data mining technology. Research methods: This study uses the semantic content analysis method to classify word-of-mouth reviews according to the revised PZB SERVQUAL scale. Then carry out statistical analysis. Results of data synthesis: The results of this study disclosed that the negative reviews of this military hospital in Taiwan have been increasing year by year. Under the COVID-19 epidemic, positive word-of-mouth has a downward trend. Among the five determiners of SERVQUAL of PZB, positive word-of-mouth reviews performed best in “Assurance,” with a positive review rate of 58.89%, Followed by 43.33% of “Responsiveness.” In negative word-of-mouth reviews, “Assurance” performed the worst, with a positive rate of 70.99%, followed by responsive 29.01%. Conclusions: The important conclusions of this study disclosed that the total number of electronic word-of-mouth reviews of the military hospital has revealed positive growth in recent years, and the positive word-of-mouth growth has revealed negative growth after the epidemic of COVID-19, while the negative word-of-mouth has grown substantially. Regardless of the positive and negative comments, what patients care most about is “Assurance” of the professional attitude and skills of the medical staff, which needs to be strengthened most urgently. In addition, good “Reliability” will help build positive word-of-mouth. However, poor “Responsiveness” can easily lead to the spread of negative word-of-mouth. This study suggests that the hospital should focus on these few service-oriented quality management and audits.

Keywords: quality of medical service, electronic word-of-mouth, armed forces general hospital

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Authors: Shuang Luo, Er-Xiang Song

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Many problems in geotechnical engineering, such as foundation deformation, groundwater seepage, seismic wave propagation and geothermal transfer problems, may involve analysis in the ground which can be seen as extending to infinity. To that end, consideration has to be given regarding how to deal with the unbounded domain to be analyzed by using numerical methods, such as finite element method (FEM), finite difference method (FDM) or finite volume method (FVM). A simple artificial boundary approach derived from the analytical solutions for transient radial seepage problems, is introduced. It should be noted, however, that the analytical solutions used to derive the artificial boundary are particular solutions under certain boundary conditions, such as constant hydraulic head at the origin or constant pumping rate of the well. When dealing with unbounded domains with unsteady boundary conditions, a more sophisticated artificial boundary approach to deal with the infinity of the domain is presented. By applying Laplace transforms and introducing some specially defined auxiliary variables, the global artificial boundary conditions (ABCs) are simplified to local ones so that the computational efficiency is enhanced significantly. The introduced two local ABCs are implemented in a finite element computer program so that various seepage problems can be calculated. The two approaches are first verified by the computation of a one-dimensional radial flow problem, and then tentatively applied to more general two-dimensional cylindrical problems and plane problems. Numerical calculations show that the local ABCs can not only give good results for one-dimensional axisymmetric transient flow, but also applicable for more general problems, such as axisymmetric two-dimensional cylindrical problems, and even more general planar two-dimensional flow problems for well doublet and well groups. An important advantage of the latter local boundary is its applicability for seepage under rapidly changing unsteady boundary conditions, and even the computational results on the truncated boundary are usually quite satisfactory. In this aspect, it is superior over the former local boundary. Simulation of relatively long operational time demonstrates to certain extents the numerical stability of the local boundary. The solutions of the two local ABCs are compared with each other and with those obtained by using large element mesh, which proves the satisfactory performance and obvious superiority over the large mesh model.

Keywords: transient seepage, unbounded domain, artificial boundary condition, numerical simulation

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Authors: Jenny Ringblom, Marie Proczkowska, Laura Korhonen, Ingrid Wåhlin

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Background: Emergence delirium is a well-known behaviour of perceptual disturbances that may occur after general anaesthesia in children. Children with emergence delirium are often confused; they cry, are involuntarily physically active and are almost impossible to console. The prevalence varies considerably between about 13% and 53%. Research has mainly focused on how different medication accents affect the incidence of emergence delirium, but less is known about parents’ experiences of emergence delirium during the recovery process. Aim: The aim of this study was to describe parents’ experiences and reflections during their child's emergence delirium behaviour when recovering from anaesthesia. Method: The study has a qualitative design, and the data has been analyzed using thematic analysis. A total of 16 parents were interviewed at two county hospitals in Sweden. Results: When the parents reunited with their child at the recovering unit, they felt as if they were encountering an incomprehensible scenario. When watching their child demonstrating emergence delirium, they experienced fear and insecurity and had feelings of powerlessness and guilt. Information and previous experience turned out to offer relief and being seen by the healthcare staff when they, in their vulnerability, failed to reach or console their child gave hope and energy. Conclusion: Emergence delirium must be extensively considered in children undergoing general anaesthesia. Healthcare staff needs to be aware of the parental difficulties it may cause. There is also important to know what parents experience as relieving, such as receiving information and when staff members are being available, responsive and supportive during the wake-up period.

Keywords: emergence delirium, experiences, pediatrics, parents, postoperative care

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Authors: Martin Leroux, Sylvain Brisebois

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Eating a meal is among the Activities of Daily Living, but it takes a lot of time and effort for people with physical or functional limitations. Dedicated technologies are cumbersome and not portable, while general-purpose assistive robots such as wheelchair-based manipulators are too hard to control for elaborate continuous motion like eating. Eating with such devices has not previously been automated, since there existed no description of a feeding motion for uncontrolled environments. In this paper, we introduce a feeding mode for assistive manipulators, including a mathematical description of trajectories for motions that are difficult to perform manually such as gathering and scooping food at a defined/desired pace. We implement these trajectories in a sequence of movements for a semi-automated feeding mode which can be controlled with a very simple 3-button interface, allowing the user to have control over the feeding pace. Finally, we demonstrate the feeding mode with a JACO robotic arm and compare the eating speed, measured in bites per minute of three eating methods: a healthy person eating unaided, a person with upper limb limitations or disability using JACO with manual control, and a person with limitations using JACO with the feeding mode. We found that the feeding mode allows eating about 5 bites per minute, which should be sufficient to eat a meal under 30min.

Keywords: assistive robotics, automated feeding, elderly care, trajectory design, human-robot interaction

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Authors: Sean Vincent

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Within the academic community, there is a consensus that political parties in established liberal democracies are facing a myriad of organisational challenges as a result of falling membership, weakening links to grass-roots support and rising voter apathy. During the same period of party decline and growing public disengagement political parties have become increasingly professionalised. The professionalisation of political parties owes much to changes in technology, with television becoming the dominant medium for political communication. In recent years, however, it has become clear that a new medium of communication is becoming utilised by political parties and candidates – New Media. New Media, a term hard to define but related to internet based communication, offers a potential revolution in political communication. It can be utilised by anyone with access to the internet and its most widely used platforms of communication such as Facebook and Twitter, are free to use. The advent of Web 2.0 has dramatically changed what can be done with the Internet. Websites now allow candidates at the constituency level to fundraise, organise and set out personalised policies. Social media allows them to communicate with supporters and potential voters practically cost-free. As such candidate dependency on the national party for resources and image now lies open to debate. Arguing that greater candidate independence may be a natural next step in light of the contemporary challenges faced by parties, this paper examines how New Media is being used by candidates at the constituency level to increase their personal vote. The paper will present findings from research carried out during two elections – the Japanese Lower House election of 2014 and the UK general election of 2015. During these elections a sample of candidates, totalling 150 candidates, from the three biggest parties in each country were selected and their new media output, specifically candidate websites, Twitter and Facebook output subjected to content analysis. The analysis examines how candidates are using new media to both become more functionally, through fundraising and volunteer mobilisation and politically, through the promotion of personal/local policies, independent from the national party. In order to validate the results of content analysis this paper will also present evidence from interviews carried out with 17 candidates that stood in the 2014 Japanese Lower House election or 2015 UK general election. With a combination of statistical analysis and interviews, several conclusions can be made about the use of New Media at constituency level. The findings show not just a clear difference in the way candidates from each country are using New Media but also differences within countries based upon the particular circumstances of each constituency. While it has not yet replaced traditional methods of fundraising and activist mobilisation, New Media is also becoming increasingly important in campaign organisation and the general consensus amongst candidates is that its importance will continue to grow along as politics in both countries becomes more diffuse.

Keywords: political campaigns, elections, new media, political communication

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Authors: Pratibha Srivastava, Chithra V. J., Sudhakar S., Nitin K. D.

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A closed-loop system comprises of a controller, a response system, and an actuating system. The controller, which is the system under test for us, excites the actuators based on feedback from the sensors in a periodic manner. The sensors should provide the feedback to the System Under Test (SUT) within a deterministic time post excitation of the actuators. Any delay or miss in the generation of response or acquisition of excitation pulses may lead to control loop controller computation errors, which can be catastrophic in certain cases. Such systems categorised as hard real-time systems that need special strategies. The real-time operating systems available in the market may be the best solutions for such kind of simulations, but they pose limitations like the availability of the X Windows system, graphical interfaces, other user tools. In this paper, we present strategies that can be used on a general purpose operating system (Bare Linux Kernel) to achieve a deterministic deadline and hence have the added advantages of a GPOS with real-time features. Techniques shall be discussed how to make the time-critical application run with the highest priority in an uninterrupted manner, reduced network latency for distributed architecture, real-time data acquisition, data storage, and retrieval, user interactions, etc.

Keywords: real time data acquisition, real time kernel preemption, scheduling, network latency

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Authors: Achim Kampker, Kai Kreiskoether, Johannes Wagner, Sarah Fluchs

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The growing speed of innovation in related industries requires the automotive industry to adapt and increase release frequencies of new vehicle derivatives which implies a significant reduction of investments per vehicle and ramp-up times. Emerging markets in various parts of the world augment the currently dominating established main automotive markets. Local content requirements such as import tariffs on final products impede the accessibility of these micro markets, which is why in the future market exploitation will not be driven by pure sales activities anymore but rather by setting up local assembly units. The aim of this paper is to provide an overview of the concept of decentralized assembly and to discuss and critically assess some currently researched and crucial approaches in production technology. In order to determine the scope in which complementary mobile assembly can be profitable for manufacturers, a general cost model is set up and each cost driver is assessed with respect to varying levels of decentralization. One main result of the paper is that the presented approaches offer huge cost-saving potentials and are thus critical for future production strategies. Nevertheless, they still need to be further exploited in order for decentralized assembly to be profitable for companies. The optimal level of decentralization must, however, be specifically determined in each case and cannot be defined in general.

Keywords: automotive assembly, e-mobility, production technology, release capability, small series assembly

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Authors: Moez Yeddes

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The property of opacity is widely used in the formal verification of security in computer systems and protocols. Opacity is a general language-theoretic scheme of many security properties of systems. Opacity is parametrized with framework in which several security properties of a system can be expressed. A secret behaviour of a system is opaque if a passive attacker can never deduce its occurrence from the system observation. Instead of considering the case of static observability where the set of observable events is fixed off-line or dynamic observability where the set of observable events changes over time depending on the history of the trace, we introduce Orwellian partial observability where unobservable events are not revealed provided that downgrading events never occurs in the future of the trace. Orwellian partial observability is needed to model intransitive information flow. This Orwellian observability is knwon as ipurge function. We show in previous work how to verify opacity for regular secret is opaque for a regular language L w.r.t. an Orwellian projection is PSPACE-complete while it has been proved undecidable even for a regular language L w.r.t. a general Orwellian observation function. In this paper, we address two problems of opacification of a regular secret ϕ for a regular language L w.r.t. an Orwellian projection: Given L and a secret ϕ ∈ L, the first problem consist to compute some minimal regular super-language M of L, if it exists, such that ϕ is opaque for M and the second consists to compute the supremal sub-language M′ of L such that ϕ is opaque for M′. We derive both language-theoretic characterizations and algorithms to solve these two dual problems.

Keywords: security policies, opacity, formal verification, orwellian observation

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Authors: Yi-Hsuan Gloria Lo

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The educational objective of vocational high schools (VHSs) is to equip VHS students with practical skills and knowledge that can be applied in the job-related market. However, with the increasing number of technological universities over the past two decades, the majority of VHS students have chosen to receive higher education rather than enter the job market. VHS English education has been confronting a dilemma: Should an English for specific purposes (ESP) approach, which aligns with the educational goal of VHS education, be taken or should an English for general purposes (EGP) approach, which prepares VHS students for advanced studies in universities, be followed? While ESP theorists proposed that that ESP can be taught to secondary learners, little was known about VHS students’ perspective on this ESP-versus-EGP dilemma. Scant research has investigated different facets of students’ needs (necessities, wants, and lacks) for both ESP and EGP in terms of the four language skills and the factors that contribute to any differences. To address the gap in the literature, 100 VHS students responded to statements related to their necessities, wants, and lacks in learning ESP and EGP on a 6-point Likert scale. Six VHS students were interviewed to tap into the reasons for different facets of the needs for learning EGP and ESP. The statistical analysis indicates that at this stage of learning English, VHS subjects believed that EGP was more necessary than ESP; EGP was more desirable than ESP. However, they reported that they were more lacking in ESP than in EGP learning. Regarding EGP, the results show that the VHS subjects rated speaking as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference was found between perceived learning necessities and lacks and between perceived wants and lacks. No statistical difference was found between necessities and wants. In the aspect of ESP, the results indicate that the VHS subjects marked reading as their most necessary skill, speaking as the most desirable skill, and writing as the most lacking skill. A significant difference exists between their perceived necessities and lacks and between their wants and lacks. However, there is no statistically significant difference between their perceived lacks and wants. Despite the lack of a significant difference between learning necessities and wants, the qualitative interview data reveal that the reasons for their perceived necessities and wants were different. The findings of the study confirm previous research that demonstrates that ‘needs’ is a multiple and conflicting construct. What VHS students felt most lacking was not necessarily what they believed they should learn or would like to learn. Although no statistical difference was found, different reasons were attributed to their perceived necessities and wants. Both theoretical and practical implications have been drawn and discussed for ESP research in general and teaching ESP in VHSs in particular.

Keywords: vocational high schools (VHSs), English for General Purposes (EGP), English for Specific Purposes (ESP), needs analysis

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Authors: Siphat Lim

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This study used Autoregressive Distributed Lag (ARDL) approach to cointegration. In the long-run the general price level and exchange rate have a positively significant effect on domestic output. The estimated result further revealed that fiscal stimulus help stimulate domestic output in the long-run, but not in the short-run, while monetary expansion help to stimulate output in both short-run and long-run. The result is complied with the theory which is the macroeconomic policies, fiscal and monetary policy; help to stimulate domestic output in the long-run. The estimated result of the Vector Error Correction Model (VECM) has indicated more clearly that the consumer price index has a positive effect on output with highly statistically significant. Increasing in the general price level would increase the competitiveness among producers than increase in the output. However, the exchange rate also has a positive effect and highly significant on the gross domestic product. The exchange rate depreciation might increase export since the purchasing power of foreigners has increased. More importantly, fiscal stimulus would help stimulate the domestic output in the long-run since the coefficient of government expenditure is positive. In addition, monetary expansion would also help stimulate the output and the result is highly significant. Thus, fiscal stimulus and monetary expansionary would help stimulate the domestic output in the long-run in Cambodia.

Keywords: fiscal policy, monetary policy, ARDL, VECM

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Authors: Ofelia Loani Elvir Lazo, Roya Yumul, Sevan Komshian, Ruby Wang, Jun Tang

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Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices.

Keywords: antinociception, bispectral index (BIS), general anesthesia, laryngeal mask airway, qCON/qNOX

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Authors: Dins Sumerags, Mara Pilmane, Vita Konopecka, Gunta Sumeraga

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Reinke’s oedema is a specific type of chronic laryngitis evolving only in smokers. Our study aimed to identify the presence and interaction of the immunohistochemical markers for inflammation [IL-1α] and [IL-10], proliferation [Ki-67] and immunoreactive innervation [PGP 9.5] in the laryngeal mucosa using biotin-streptavidin immunochemical staining method. The laryngeal tissue samples were taken from the vocal cord during the surgery of the Reinke’s oedema and compared to the control group from the tissue samples of the cadavers without any visual laryngeal disease. The study results confirm increased cellular proliferation and elevation of the inflammation markers in the laryngeal mucosa in the case of Reinke’s oedema by comparing with the control.

Keywords: reinke`s oedema, immunohistochemical markers, laryngeal mucosa, biotin-streptavidin

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Authors: Hadi Farahani, Mahsa Tahzibi, Laleh Golamrej Eliasi, Mohammad Torkashvand

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Iranian deafs are an under-researched population. The lack of research comes from the fact that if none, there are very few researchers capable of speaking sign language. The exclusion of this minority group from mainstream society often distorts the general understanding of prevalent issues of the deaf in Iran. The topic of this research was co-created through preliminary discussions with the Iranian deaf. Domestic violence then was picked up as an infrastructural issue impacting other dimensions of deaf lives such as work, education, and outside family relationships. For this purpose, we systematically searched the literature seeking a comprehensive questionnaire. We came across a 46-item standardized questionnaire measuring domestic violence in Iran. To adapt this questionnaire, we followed standard procedures reflected in another article. The inclusion criteria of the current research were married (had experienced living with a partner before) and +18-year-old deaf. Sampling was random and recruitment of the participants was through governmental or voluntary organizations for the deaf. 390 questionnaires then were analyzed through SPSS version 27. Analysis showed that the prevalence rate of domestic violence was 26% in general that emotional violence with 29% was the most prevalent type. Findings suggested that the more educated, and economically independent were the participants, the lower the probability of encountering domestic violence. Domestic violence within families where all members were deaf proved to be less usual than in families in which only the participant was deaf. Further interventional research is needed to assess how to empower the Iranian deaf regarding domestic violence.

Keywords: deaf, domestic violence, economic violence, emotional violence, physical violence, sexual violence

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Authors: Amanda Andrea Beatrix Brita, Dominic J. Buenaventura, Charmaine A. Seromines, Antonne Noel V. Chua, Ma. Luisa G. Badilles

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Online ranting, or the act of forcefully expressing your opinion towards other people over the Internet, has been an ongoing issue ever since the creation of the Internet. Due to the COVID-19 pandemic, the rise of active users has been observed to have increased during this time, thus increasing the number of people being engaged in online activities, which consequently affects the number of individuals who participate in online ranting. However, with all that is observed, what is usually not a topic being discussed about this event are the motivations that lead people to do online ranting. The study was undertaken to discover the level of aggression, Satisfaction, and online engagement in their environment. We utilized 2 researcher-made questionnaires that were validated by three experts, namely for the Satisfaction and engagement levels. We adapted Cyber-Aggression Typology Questionnaire (CATQ) for the level of aggression. Quota sampling was used in determining the respondents. A quota of 250 students was recommended. The results showed that the students in every institution have a deficient level of aggression, and the majority of the institution has a shallow level of Satisfaction when it comes to online ranting. Similar findings are presented in the level of engagement; 2 out of 3 of the institution students have shallow engagement in the general settings that expound students' engagement. Although the result shows deficient levels, there are still instances and possibilities that students may still engage in an online rant regarding various circumstances when triggered. Researchers assumed that there are restrictions on movements likely to show opinions online because of consequences.

Keywords: aggression, satisfaction, online rant engagement, online rant

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Authors: Haruna Abdu Usman, Bashir Usman Mohammed, Mohammed Umar Jamil

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Municipal solid waste management constitutes a serious problem bedeviling environmental protection agencies in many cities of developing countries. Most agencies do not collect the totality of the waste generated in their cities. This study presents the current solid waste management practices and problems in Bauchi metropolis, Bauchi state Nigeria. The general feature is characterized by inefficient, insufficient and irrational collection and improper disposal alternatives. The consequent environmental effects of these problems depict clogged city drains, uncollected heap of waste on road sides of residential areas, vacant plots and uncompleted buildings and highways. This contributes immensely to flooding in the city. The major challenges facing the state environmental protection agency includes; lack of collection and disposal points, technical and institutional arrangements, financial resources and general attitude of the serving public among others. The study suggested a comprehensive and integrated approach to the solid waste management which recognizes and incorporates the interventionist role of the state government, the private formal and informal waste management operators and the serving public.

Keywords: municipal solid waste, bauchi metropolitan area, environmental protection agency, solid waste management, waste disposal

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