Search results for: vital sign

Authors: Maria Tagarelli De Monte

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In 2021, the passage of the law recognizing Italian Sign Language (LIS) as the language of the Italian deaf minority was the input for including this visual-gestural language in the curricula of interpreters and translators choosing the academic setting for their training. Yet, a gap remains concerning LIS education of teachers and communication assistants as referring figures for people who are deaf or hard of hearing in mainstream education. As well documented in the related scientific literature, deaf children often experience severe difficulties with the languages spoken in the country where they grow up, manifesting in all levels of literacy competence. In the research introduced here, the experience of deaf students (and their teachers) attending schools is explored in areas that are characterized by strong native bilingualism, such as Friuli-Venezia Giulia (FVG), facing Italian Northeast borders. This region is peculiar as the native population may be bilingual Italian and Friulian (50% of the local population), German, and/or Slovenian. The research involved all schools of all levels in Friuli to understand the relationship between the language skills expressed by teachers and those shown by deaf learners with a background in sign language. In addition to collecting specific information on the degree of preparation of teachers in deaf-related matters and LIS, the research has allowed to highlight the role, often poorly considered, covered by the communication assistants who work alongside deaf students. On several occasions, teachers and assistants were unanimous in affirming the importance of mutual collaboration and adequate consideration of the educational-rehabilitative history of the deaf child and her family. The research was based on a mixed method of structured questionnaires and semi-structured interviews with the referring teachers. As a result, a varied and complex framework emerged, showing an asymmetry in preparing personnel dedicated to the deaf learner. Considering how Italian education has long invested in creating an inclusive and accessible school system (i.e. with the "Ten Theses for Democratic Language Education"), a constructive analysis will complete the discussion in an attempt to understand how linguistic (and modal) differences can become levers of inclusion.

Keywords: FVG, LIS, linguistic needs, deafness, teacher education, bilingual bimodal children, communication assistants, inclusion model

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Authors: Amrin Moger, Sagar Bhalerao, Martin Mathew

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Advertisements play a vital role in dissemination of information regarding products and services. Advertisements as Mass Media tool is not only a source of entertainment, but also a source of information, education and entertainment. It provides information about the outside world and exposes us to other ways of life and culture. Public service advertisements (PSA) are generally aimed at public well-being. Aim of PSA is not to make profit, but rather to change public opinion and raise awareness in the Society about a social issue.’ Start with the boys’ is one such PSA aims to create awareness about issue of ‘gender bias’ that is taught prevalent in the society. Persons with disabilities (PWDs) are also consumers of PSA in the society. The population of persons with disability in the society also faces gender bias and discrimination. It is a double discrimination. The advertisement selected for the study gives out a strong message on gender bias and therefore must be accessible to everyone including PWDs in the society. Accessibility of PSA in the digital format can be done with the help of Universal Design (UD) in digital media application. Features of UD inclusive in nature, and it focus on eliminating established barriers through initial designs. It considers the needs of diverse people, whether they are persons with or without disability. In this research two aspects of UD in digital media: captioning and Indian sign language (ISL) is used. Hence a short survey study was under taken to know the effects of a multimedia on gender bias, in accessible format on persons with and without disability. The result demonstrated a significant difference in the opinion, on the usage accessible and non-accessible format for persons with and without disability and their understanding of message in the PSA selected for the study.

Keywords: public service advertisements, gender, disability, accessibility

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

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Authors: Fadwa Chtioui

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Vital Pulp Therapy (VPT) is nowadays challenging the deep-rooted dogma of root canal treatment, being the only therapeutic option for permanent teeth diagnosed with irreversible pulpitis or carious pulp exposure. Histologic and clinical research has shown that compromised dental pulp can be treated without the full removal or excavation of all healthy pulp, and the outcome of the partial or full pulpotomy followed by a Tricalcium-Silicate-based dressing seems to show promising results in maintaining pulp vitality and preserving affected teeth in the long term. By reviewing recent advances in the techniques of VPT and their clinical effectiveness and safety in permanent teeth with irreversible Pulpitis, this work provides a new understanding of pulp pathophysiology and defense mechanisms and will reform dental practitioners' decision-making in treating irreversible pulpits from root canal therapy to vital pulp therapy by taking advantage of the biological effects of Tricalcium Silicate materials. Biography of presenting author: Fadwa Chitoui graduated from the school of Dental Medicine of Monastir, Tunisia, in 2015. After getting her DDS degree with honors, she earned her Postgraduate master's Degree in Endodontics and Restorative Dentistry from her Faculty. Since 2021, she has Started her own private and specialized practice based in the capital Tunis. She enjoys the sphere of associative life, worked with national and international associations, and got engaged in scientific dental research, whereby she tailored her passion for her field of specialty towards broadening her knowledge and ambitions, holding conferences and workshops nationally and internationally and publishing scientific articles in several journals.

Keywords: irreversible pulpitis, permanenet teeth, vital pulp therapy, pulpotomy

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Tracey Bone

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Deaf inmates, whose first or preferred language is a Signed Language, experience barriers to accessing the necessary two-way communication with correctional staff, and the educational and social programs that will enhance their eligibility for conditional release from the federal prison system in Canada. The development of visual content to enhance the knowledge and skill development of correctional staff is a contemporary strategy intended to significantly improve the correctional experience for deaf inmates. This presentation reports on the development of two distinct training videos created to enhance staff’s understanding of the needs of deaf inmates; one a two-part simulation of an interaction with a deaf inmate, the second an interview with a deaf academic. Part one of video one demonstrates the challenges and misunderstandings inherent in communicating across languages without a qualified sign language interpreter; the second part demonstrates the ease of communication when communication needs are met. Video two incorporates the experiences of a deaf academic to provide the cultural grounding necessary to educate staff in the unique experiences associated with being a visual language user. Lack of staff understanding or awareness of deaf culture and language must not be acceptable reasons for the inadequate treatment of deaf visual language users in federal prisons. This paper demonstrates a contemporary approach to meeting the human rights and needs of this unique and often ignored inmate subpopulation. The deaf community supports this visual approach to enhancing staff understanding of the unique needs of this population. A study of its effectiveness is currently underway.

Keywords: accommodations, American Sign Language (ASL), deaf inmates, sensory deprivation

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Authors: Saroj Panthi, Sher Singh Thagunna

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Reliable and sufficient information regarding status, distribution and habitat preference of red panda (Ailurus fulgens fulgens) is lacking in Nepal. The research activities on red panda in the mid-western Nepal are very limited, so the status of red panda in the region is quite unknown. The study conducted during May, 2013 in three Village Development Committees (VDCs) namely Godhemahadev, Malikathata and Tamti of Jumla district was an important step for providing vital information including distribution and habitat preference of this species. The study included the reconnaissance, key informants survey, interviews, and consultation for the most potential area identification, opportunistic survey comprising the direct observation and indirect sign count method for the presence and distribution, habitat assessment consisting vegetation sampling and ocular estimation. The study revealed the presence of red panda in three forests namely Bahirepatan, Imilchadamar and Tyakot of Godhemahadev, Tamti and Malikathata VDCs respectively. The species was found distributed between 2880 and 3244 m with an average dropping encounter rate of 1.04 per hour of searching effort and 12 pellets per dropping. Red panda mostly preferred the habitat in the elevation range of 2900 - 3000 m with southwest facing steep slopes (36˚ - 45˚), associated with water sources at the distance of ≤100 m. Trees such as Acer spp., Betula utilis and Quercus semecarpifolia, shrub species of Elaeagnus parvifolia, Drepanostachyum spp. and Jasminum humile, and the herbs like Polygonatum cirrhifolium, Fragaria nubicola and Galium asperifolium were found to be the most preferred species by red panda. The red panda preferred the habitat with dense crown coverage ( >20% - 100%) and 31% - 50% ground cover. Fallen logs (39%) were the most preferred substrate used for defecation.

Keywords: distribution, habitat preference, jumla, red panda

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Authors: Syue-Wen Lin

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Objective: This article explores the nursing experience of an 84-year-old male lung cancer patient who underwent a thoracoscopic right lower lobectomy and treatment. The patient has multiple medical histories, including hypertension and diabetes. The nursing process involved cancer treatment, postoperative pain management, as well as wound care and healing. Methods: The nursing period is from February 10 to February 17, 2024. During the nursing process, pain management strategies are implemented, including morphine drugs and non-drug methods, and music therapy, essential oil massage, and extended reception time are used to make patients feel physically and mentally comfortable so as to reduce postoperative pain and encourage active participation in rehabilitation. Strict sterile wound dressing procedures and advanced wound care techniques are used to promote wound healing and prevent infection. Due to septic shock, dialysis is used to relieve worsening symptoms. Taking into account the patient's cancer status, the nursing team provides comprehensive cancer care based on the patient's physical and psychological needs. Given the complexity of the patient's condition, including advanced cancer, palliative care is also incorporated throughout the care process to relieve discomfort and provide psychological support. Results: Through comprehensive health assessment, the nursing team fully understood the patient's condition and developed a personalized care plan based on the patient's condition. The interprofessional critical care team provides respiratory therapy and lung expansion exercises to reduce muscle loss while addressing the patient's psychological status, pain management, and vital sign stabilization needs, resulting in a comprehensive approach to care. Lung expansion exercises and the use of a high-frequency chest wall oscillation vest successfully improved sputum drainage and facilitated weaning from mechanical ventilation. In addition, helping patients stabilize their vital signs and the integration of cancer care, pain management, wound care and palliative care helps the patient be fully supported throughout the recovery process, ultimately improving his quality of life. Conclusion: Lung cancer and septic shock present significant challenges to patients, and the nursing team not only provides critical care but also addresses the unique needs of patients through comprehensive infection control, cancer care, pain management, wound care, and palliative care interventions. These measures effectively improve patients' quality of life, promote recovery, and provide compassionate palliative care for terminally ill patients. Nursing staff work closely with family members to develop a comprehensive care plan to ensure that patients receive high-quality medical care as well as psychological support and a comfortable recovery environment.

Keywords: septic shock, lung cancer, palliative care, nursing experience

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Authors: S. H. Jang

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Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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Authors: Harshit Mittal, Neeraj Garg

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Hand symbol recognition is a pivotal component in the domain of computer vision, with far-reaching applications spanning sign language interpretation, human-computer interaction, and accessibility. This research paper discusses the approach with the integration of the Canny Edge algorithm and convolutional neural network. The significance of this study lies in its potential to enhance communication and accessibility for individuals with hearing impairments or those engaged in gesture-based interactions with technology. In the experiment mentioned, the data is manually collected by the authors from the webcam using Python codes, to increase the dataset augmentation, is applied to original images, which makes the model more compatible and advanced. Further, the dataset of about 6000 coloured images distributed equally in 5 classes (i.e., 1, 2, 3, 4, 5) are pre-processed first to gray images and then by the Canny Edge algorithm with threshold 1 and 2 as 150 each. After successful data building, this data is trained on the Convolutional Neural Network model, giving accuracy: 0.97834, precision: 0.97841, recall: 0.9783, and F1 score: 0.97832. For user purposes, a block of codes is built in Python to enable a window for hand symbol recognition. This research, at its core, seeks to advance the field of computer vision by providing an advanced perspective on hand sign recognition. By leveraging the capabilities of the Canny Edge algorithm and convolutional neural network, this study contributes to the ongoing efforts to create more accurate, efficient, and accessible solutions for individuals with diverse communication needs.

Keywords: hand symbol recognition, computer vision, Canny edge algorithm, convolutional neural network

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Authors: Ihab Al-Mokrani

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The Arabic heritage has two types of spoken rhetoric: the first type which al-Jaahiz calls “the rhetoric of the sign,” which means body language, and the rhetoric of silence which is of no less importance than the rhetoric of the sign, the speaker’s appearance and movements, etc. The second type is the spoken performance of utterances which bears written rhetoric arts like metaphor, simile, metonymy, etc. Rationale of the study: First: in spite of the factual existence of rhetorical phenomena in the Arabic heritage, there has been no contemporary study handling the spoken rhetoric in the Arabic heritage. Second: Arabic Civilization is originally a spoken one. Comparing the Arabic culture and civilization, from one side, to the Greek, roman or Pharaonic cultures and civilizations, from the other side, shows that the latter cultures and civilizations started and flourished written while the former started among illiterate people who had no interest in writing until recently. That sort of difference on the part of the Arabic culture and civilization created a rhetoric different from rhetoric in the other cultures and civilizations. Third: the spoken nature of the Arabic civilization influenced the Arabic rhetoric in the sense that specific rhetorical arts have been introduced matching that spoken nature. One of these arts is the art of concision which compensates for the absence of writing’s means of preserving the text. In addition, this interprets why many of the definitions of the Arabic rhetoric were defining rhetoric as the art of concision. Also, this interprets the fact that the literary genres known in the Arabic culture were limited by the available narrow space like poetry, anecdotes, and stories, while the literary genres in the Greek culture were of wide space as epics and drama. This is not of any contrast to the fact that some Arabic poetry would exceed 100 lines of poetry as Arabic poetry was based on the line organic unity, which means that every line could stand alone with a full meaning that is not dependent on the rest of the poem; and that last aspect has never happened in any culture other than the Arabic culture.

Keywords: Arabic rhetoric, spoken rhetoric, Arabic heritage, culture

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Authors: Ramadan Ahmed Abugeddida

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Libya is one of the third world countries, has a lot of natural resources, notably oil and gas, as well as attractive tourist sites, in addition to the vast area and diversity of the regions, oil is the main source of income in Libya, which was discovered in the sixties of the last century, which also contributed to the creation of some fundamental changes in the country's infrastructure, such as roads, hospitals, schools, airports, seaports, as well as factories. This paper focuses on airports as one of the most vital institutions in the country, linking the country to the outside world, where dealing with the current situation of airports, in terms of capabilities and infrastructure, as well as the level of services, in other words, to assess the current status of the airports and to identify strengths and weaknesses, as well as general description of the position and what can be done in the future for the advancement of this vital sector. This paper is a part of the doctoral thesis will be carried out by the researcher during the coming period entitled efficiency improvement through implementation of strategic quality management.

Keywords: airports, efficiency improvement, quality, strategy

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Authors: Mehrnoosh Mirzaei

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Children are among the most vulnerable at the occurrence of natural disasters such as earthquakes. Most of the management and measures which are considered for both before and during an earthquake are neither suitable nor efficient for this age group and cannot be applied. On the other hand, due to their age, it is hard to educate and train children to learn and understand the concept of earthquake risk mitigation as matters like earthquake prevention and safe places during an earthquake are not easily perceived. To our knowledge, children’s awareness of such concepts via their own world with the help of games is the best training method in this case. In this article, the researcher has tried to consider the child an active element before and during the earthquake. With training, provided by adults before the incidence of an earthquake, the child has the ability to learn disaster risk reduction (DRR). The focus of this research is on learning risk reduction behavior and regarding children as an individual element. The information of this article has been gathered from library resources, observations and the drawings of 10 children aged 5 whose subject was their conceptual definition of an earthquake who were asked to illustrate their conceptual definition of an earthquake; the results of 20 questionnaires filled in by preschoolers along with information gathered by interviewing them. The design of the suitable educational game, appropriate for the needs of this age group, has been made based on the theory of design with help of the user and the priority of children’s learning needs. The final result is a package of a game which is comprised of a learning table and matching cards showing sign marks for safe and unsafe places which introduce the safe behaviors and safe locations before and during the earthquake. These educational games can be used both in group contexts in kindergartens and on an individual basis at home, and they help in earthquake risk reduction.

Keywords: disaster education, earthquake sign marks, learning table, matching card, risk reduction behavior

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Authors: Katherine O'Grady-Bray

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For some deaf children, reading books can be a challenge. Frank Barnes School (FBS) provides guided reading time with Teachers of the Deaf, in which they read books with deaf children using a bilingual approach. The vocabulary and context of the story is explained to deaf children in BSL so they develop skills bridging English and BSL languages. However, the success of this practice is only achieved if the person is fluent in both languages. FBS piloted a scheme to convert an Oxford Reading Tree (ORT) book into an e-book that can be read using tablets. Deaf readers at FBS have access to both languages (BSL and English) during lessons and outside the classroom. The pupils receive guided reading sessions with a Teacher of the Deaf every morning, these one to one sessions give pupils the opportunity to learn how to bridge both languages e.g. how to translate English to BSL and vice versa. Generally, due to our pupils’ lack of access to incidental learning, gaining new information about the world around them is limited. This highlights the importance of quality time to scaffold their language development. In some cases, there is a shortfall of parental support at home due to poor communication skills or an unawareness of how to interact with deaf children. Some families have a limited knowledge of sign language or simply don’t have the required learning environment and strategies needed for language development with deaf children. As the majority of our pupils’ preferred language is BSL we use that to teach reading and writing English. If this is not mirrored at home, there is limited opportunity for joint reading sessions. Development of the e-Book required planning and technical development. The overall production took time as video footage needed to be shot and then edited individually for each page. There were various technical considerations such as having an appropriate background colour so not to draw attention away from the signer. Appointing a signer with the required high level of BSL was essential. The language and pace of the sign language was an important consideration as it was required to match the age and reading level of the book. When translating English text to BSL, careful consideration was given to the nonlinear nature of BSL and the differences in language structure and syntax. The e-book was produced using Apple’s ‘iBook Author’ software which allowed video footage of the signer to be embedded on pages opposite the text and illustration. This enabled BSL translation of the content of the text and inferences of the story. An interpreter was used to directly ‘voice over’ the signer rather than the actual text. The aim behind the structure and layout of the e-book is to allow parents to ‘read’ with their deaf child which helps to develop both languages. From observations, the use of e-books has given pupils confidence and motivation with their reading, developing skills bridging both BSL and English languages and more effective reading time with parents.

Keywords: bilingual book, e-book, BSL and English, bilingual e-book

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Authors: Francesco Piluso

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Nowadays, to restore the deconstructive power of semiotics implies a critical analysis of neoliberal ideology, and, even more critically, a confrontation with materialist perspective. The theoretical path of Jean Baudrillard is crucial to understand the ambivalence of this intersection. A semiotic critique of Baudrillard’s work, through tools of both structuralism and interpretative semiotics, has the aim to give materialism a new consistent semiotic approach and vice-versa. According to Baudrillard, the commodity form is characterized by the same abstract and systemic logic of the sign-form, in which the production of the signified (use-value) is a mere ideological mean for the reproduction of the signifiers-chain (exchange-value). Nevertheless, this parallelism is broken by the author himself: if the use-value is deconstructed in its relative logic, the signified and the referent, both as discrete and positive elements, are collapsed on the same plane at the shadows of the signified forms. These divergent considerations lead Baudrillard to the same crucial point: the dismissal of the material world, replaced by the hyperreality as reproduction of a semiotic (genetic) Code. The stress on the concept of form, as an epistemological and semiotic tool to analyse the construction of values in the consumer society, has led to the Code as its ontological drift. In other words, Baudrillard seems to enclose consumer society (and reality) in this immanent and self-fetishized world of signs–an ideological perspective that mystifies the gravity of the material relationships between Northern-Western World and Third World. The notion of Encyclopaedia by Umberto Eco is the key to overturn the relationship of immanence/transcendence between the Code and the economic political of the sign, by understanding the former as an ideological plane within the encyclopedia itself. Therefore, rather than building semiotic (hyper)realities, semiotics has to deal with materialism in terms of material relationships of power which are mystified and reproduced through such ideological ontologies of signs.

Keywords: Baudrillard, Code, Eco, Encyclopaedia, epistemology vs. ontology, semiotics vs. materialism

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Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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Authors: Bajraktarevic Adnan, Djukic Branka, Sporisevic Lutvo, Krdzalic Zecevic Belma, Uzicanin Sajra, Hadzimuratovic Admir, Hadzimuratovic Hadzipasic Emina, Abduzaimovic Alisa, Kustric Amer, Suljevic Ismet, Serafi Ismail, Tahmiscija Indira, Khatib Hakam, Semic Jusufagic Aida, Haas Helmut, Vladicic Aleksandra, Aplenc Richard, Kadic Deovic Aida

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Introduction: Joubert syndrome has an autosomal recessive pattern of inheritance. It is referred as the brain malfunctioning and caused due to the underdevelopment of the cerebellar vermis. Associated conditions involving the eye, the kidney, and ocular disease are well described. Aims: Research helps us better understand this diseases, Joubert syndrome and can lead to advances in diagnosis and treatment. Methods: Different several conditions have been described in which the molar tooth sign and characteristics of Joubert syndrome in ten different places in the world. Carrier testing and diagnosis are available if one of these gene mutations has been identified in an affected family member. Results: Authors have described eleven cases during twenty years of Joubert syndrome. It is a clinically and genetically heterogeneous group of disorders characterized by hypoplasia of the cerebellar vermis with the characteristic neuroradiologic molar tooth sign, and accompanying neurologic symptoms, including dysregulation of breathing pattern and developmental delay. We made confirmation of diagnosis in twin sisters with Joubert syndrome with renal anomalies. Ocular symptoms have existed in seven cases (63.64%) from total eleven. Eleven cases were different sex, five boys (45.45%) and six girls (54.44%). Conclusions: Joubert syndrome is inherited as an autosomal recessive genetic disorder with several features of the disease.

Keywords: Joubert syndrome, cerebellooculorenal syndrome, autosomal recessive genetic disorder (ARGD), children

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Authors: Ranjan Chakravarty, Satpal Yadav, Biswajit Basumatary, Arvind S. Sajwan

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The purpose of this study is to compare the basketball players of different level on selected respiratory indices. Ninety male basketball players from different universities those who participated in intercollegiate and inter- varsity championship. Selected respiratory indices were resting pulse rate, resting blood pressure, vital capacity and resting respiratory rate. Mean and standard deviation of selected respiratory indices were calculated and three different levels i.e. beginners, intermediate and advanced were compared by using analysis of variance. In order to test the hypothesis, level of significance was set at 0.05. It was concluded that variability does not exist among the basketball players of different groups with respect to their selected respiratory indices i.e. resting pulse rate, resting blood pressure, vital capacity and resting respiratory rate.

Keywords: respiratory indices, sports performance, basketball players, intervarsity level

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Authors: Atefeh Abedini, Fatemeh Razavi, Mihan Pourabdollah Toutkaboni, Hossein Mehravaran, Arda Kiani

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In countries with the highest prevalence of tuberculosis, such as Iran, the differentiation of malignant tumors from non-malignant is very important. In this study, which was conducted for the first time among the Iranian population, the utility of the ultrasonographic morphological characteristics in patients undergoing EBUS was used to distinguish the non-malignant versus malignant lymph nodes. The morphological characteristics of lymph nodes, which consist of size, shape, vascular pattern, echogenicity, margin, coagulation necrosis sign, calcification, and central hilar structure, were obtained during Endobronchial Ultrasound-Guided Trans-Bronchial Needle Aspiration and were compared with the final pathology results. During this study period, a total of 253 lymph nodes were evaluated in 93 cases. Round shape, non-hilar vascular pattern, heterogeneous echogenicity, hyperechogenicity, distinct margin, and the presence of necrosis sign were significantly higher in malignant nodes. On the other hand, the presence of calcification and also central hilar structure were significantly higher in the benign nodes (p-value ˂ 0.05). Multivariate logistic regression showed that size>1 cm, heterogeneous echogenicity, hyperechogenicity, the presence of necrosis signs and, the absence of central hilar structure are independent predictive factors for malignancy. The accuracy of each of the aforementioned factors is 42.29 %, 71.54 %, 71.90 %, 73.51 %, and 65.61 %, respectively. Of 74 malignant lymph nodes, 100% had at least one of these independent factors. According to our results, the morphological characteristics of lymph nodes based on Endobronchial Ultrasound-Guided Trans-Bronchial Needle Aspiration can play a role in the prediction of malignancy.

Keywords: EBUS-TBNA, malignancy, nodal characteristics, pathology

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Authors: Mohammad Mahdi Namdari, Hosein Torki

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Security as an abstract concept, has involved human being from the beginning of creation to the present, and certainly to the future. Accordingly, battles, conflicts, challenges, legal proceedings, crimes and all issues related to human kind are associated with this concept. Today by interviewing people about their life, the security of societies and Social crimes are interviewed too. Along with the security as an infrastructure and vital concept, the economy and related issues e.g. welfare, per capita income, total government revenue, export, import and etc. is considered another infrastructure and vital concept. These two vital concepts (Security and Economic) have linked together complexly and significantly. The present study employs analytical-descriptive research method using documents and Statistics of official sources. Discovery and explanation of this mutual connection are comprising a profound and extensive research; so management, development and reform in system and relationships of the scope of this two concepts are complex and difficult. Tourism and its position in today's economy is one of the main pillars of the economy of the 21st century that maybe associate with the security and social crimes more than other pillars. Like all human activities, economy of societies and partially tourism dependent on security especially in the public and social security. On the other hand, the true economic development (generally) and the growth of the tourism industry (dedicated) are a security generating and supporting for it, because a dynamic economic infrastructure prevents the formation of centers of crime and illegal activities by providing a context for socio-economic development for all segments of society in a fair and humane. This relationship is a formula of the complexity between the two concept of economy and security. Police as a revealed or people-oriented organization in the field of security directly has linked with the economy of a community and is very effective In the face of the tourism industry. The relationship between security and national crime index, and economic indicators especially ones related to tourism is confirming above discussion that is notable. According to understanding processes about security and economic as two key and vital concepts are necessary and significant for sovereignty of governments.

Keywords: economic, police, tourism, social security

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Authors: Gláucio de Castro Júnior, Daniela Prometi, Patrícia Tuxi

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The project 'Inventory Signs-terms of the cultural heritage field in Libras' provides for the establishment of an inventory of signs, terms relating to the field of cultural heritage in Libras, from the results of research in progress as the pilot project' Accessibility Communication, Translation and Interpretation to the Application Portal Libras Heritage 'and the Pilot Project' registration-signal terms for the preparation of bilingual lexicon Libras / Portuguese terms available in the Portal Heritage. The project's goal is to spread the lexicographical rules on the use of technologies in video graphic records of sign language and foster the training of undergraduate students and graduate to the registration of the linguistic diversity of Libras through social and communicative interaction with the community deaf and enable access to Deaf information relating to the field of cultural heritage in Libras. As a result, we expect the spread of the inventory of cultural heritage-signs in terms Libras in application usage 'Portal Heritage'. To achieve the proposed objectives are accomplished technical consulting and continuous training for the production of academic material through theoretical and practical meetings, taught by experts Libras LIP / UNB in partnership with some institutions. The Inventory project signals-Terms under Heritage in Libras field initially took place in Rio de Janeiro in order to allow its development in the Midwest region, due to technical, elected some cities in Brazil, including Manaus in Amazon Macapa in Amapa, Salvador Bahia, Goiás and Goiânia in Florianopolis in Santa Catarina. At the end of all this process, the assessment by preparing a technical report presenting all the advances and points achieved in the project looking for social improvement, economic, environmental and language in the use of technology will be conducted.

Keywords: signs-terms, equity-cultural accessibility, technology, sign language

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Authors: Aamna Tufail, Kajal Kotecha, Iordanis Toursounidis, Ravinder Pabla

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Introduction/Aims: Acute Myeloid Leukaemia (AML) is a part of leukaemic group of hematopoietic disorders with a varying range of presentations, including oro-facial manifestations. Early recognition and management are essential for favourable outcomes. Materials and Methods: We present our experience, clinical presentation, and clinical photographs of a patient with previously undiagnosed AML who presented with oral symptoms to the emergency department of our hospital. An analysis of clinical characteristics, diagnostic investigations, and management modalities was performed. Results/Statistics: A 58-year-old man presented to A&E reporting an 11-day history of right sided facial swelling, acute TMJ symptoms, and oral discomfort. A dentist ruled out acute dental causes one day post onset of symptoms. Initial assessment was anatomically inconsistent and did not reveal a routine oral or maxillofacial etiology. Detailed clinical examination demonstrated fever, generalised pallor, swelling and erythema of right nasolabial region, bilateral masseteric tenderness, intraoral palatal ecchymosis, palatal ulceration, buccal and labial petechiae, cervical lymphadenopathy, and haematoma on dorsum of right hand overlying right 2nd metacarpal joint. Suspecting a systemic medical cause, we requested haematological investigations, which revealed neutropenia, thrombocytopenia, and anaemia. Flow cytometry confirmed CD34 + AML. Oral discomfort was managed symptomatically. The patient was referred to a tertiary care centre for acute haematologic care, where he was treated with IV antibiotics and continuing cycles of chemotherapy. Conclusions/Clinical Relevance: Oro-facial manifestations may be the first clinical sign of AML. Awareness of its features is vital in early diagnosis. In this context, dentists and oral medicine specialists can play an important role in detecting clinical signs of haematological disorders such as AML.

Keywords: acute myeloid leukaemia, oral symptoms, ulceration, diagnosis, management

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Authors: Yi-Shiuan Chiu

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Deaf signers have been found to have better mental image performance than hearing nonsigners. The goal of this study was to investigate the ability to generate mental images, to maintain them, and to manipulate them in deaf signers of Taiwanese Sign Language (TSL). In the visual image task, participants first memorized digits formed in a cell of 4 × 5 grids. After presenting a cue of Chinese digit character shown on the top of a blank cell, participants had to form a corresponding digit. When showing a probe, which was a grid containing a red circle, participants had to decide as quickly as possible whether the probe would have been covered by the mental image of the digit. The ISI (interstimulus interval) between cue and probe was manipulated. In experiment 1, 24 deaf signers and 24 hearing nonsigners were asked to perform image generation tasks (ISI: 200, 400 ms) and image maintenance tasks (ISI: 800, 2000 ms). The results showed that deaf signers had had an enhanced ability to generate and maintain a mental image. To explore the process of mental image, in experiment 2, 30 deaf signers and 30 hearing nonsigners were asked to do visual searching when maintaining a mental image. Between a digit image cue and a red circle probe, participants were asked to search a visual search task to see if a target triangle apex was directed to the right or left. When there was only one triangle in the searching task, the results showed that both deaf signers and hearing non-signers had similar visual searching performance in which the searching targets in the mental image locations got facilitates. However, deaf signers could maintain better and faster mental image performance than nonsigners. In experiment 3, we increased the number of triangles to 4 to raise the difficulty of the visual search task. The results showed that deaf participants performed more accurately in visual search and image maintenance tasks. The results suggested that people may use eye movements as a mnemonic strategy to maintain the mental image. And deaf signers had enhanced abilities to resist the interference of eye movements in the situation of fewer distractors. In sum, these findings suggested that deaf signers had enhanced mental image processing.

Keywords: deaf signers, image maintain, mental image, visual search

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Authors: Zarine Avetisyan

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The paradigm of Modern Linguistics incorporates disciplines which allow to analyze both language and discourse units and to demonstrate the multi-layeredness of lingo-cultural consciousness. By implementing lingo-cognitive approach to discourse and communication studies, the present paper tries to create the integral linguistic picture of the concept of joy and to analyze the lexico-semantic groups and relevant lexico-semantic variants of its realization in the context of Modern English fiction.

Keywords: concept of joy, lexico-semantic variant, semantic sign, cognition

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Authors: Mara A. C. Lopes

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Hiring a second teacher to accompany deaf students inserted at Brazilian inclusive school system has raised questions about its role in the educational process of deaf students. Federal policies determine that deaf students inserted in regular education are accompanied by sign language interpreters, which leads to the understanding that the second teacher should assume this function. However, what those professionals do is to assume the function of teaching deaf student, instead of the classroom main teacher. Historical-Cultural Psychology was used as a reference for analysis, which aimed to identify the social function of the second teacher in the classroom. Two studies were accomplished in the public schools of Sao Paulo State: In Study 1, videotaped lectures provided by the Department of Education for collective reflection about the second teacher's role were examined, to identify the social meaning of that professional activity. Study 2 aimed to analyze the process of assigning personal sense to the teacher activity, considering the opinions of 21 professionals from Sao Paulo. Those teachers were interviewed individually with the support of a semi-structured interview. The analysis method utilized was: empirical description of data; development of categories, for reality abstraction; identifying the unit analysis; and return to reality, in order to explain it. Study 1 showed that the social meaning of the second teacher's activity is, also, to teach. However, Study 2 showed that this meaning is not shared among professionals of the school, so they understand that they must act as sign language interpreters. That comprehension causes a disruption between social meaning and the personal sense they attach to their activity. It also shows the need of both teachers at the classroom planning and executing activity together. On the contrary, a relationship of subordination of one teacher to another was identified, excluding the second teacher and the deaf student of the main activity. Results indicate that the second teacher, as a teacher, must take the responsibility for deaf student education, consciously, and to promote the full development of the subjects involved.

Keywords: deaf education, historical-cultural psychology, inclusion, teacher function

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Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana

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Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.

Keywords: healthcare, fuzzy logic, MEWS, RFID

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Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni

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Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.

Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage

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Authors: Pavel E. Golosov, Vladimir I. Gorelov, Oksana L. Karelova

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There are visible changes in the world organization, environment and health of national conscience that create a background for discussion on possible redefinition of global, state and regional management goals. Authors apply the sustainable development criteria to a hierarchical management scheme that is to lead the world community to non-contradictory growth. Concrete definitions are discussed in respect of decision-making process representing the state mostly. With the help of system analysis it is highlighted how to understand who would carry the distinctive sign of world leadership in the nearest future.

Keywords: decision-making, information technology, public administration

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Authors: Okoro Ikechukwu Ralph, Fuat Kara

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The discoveries of hydrocarbon reserves has clearly drifted offshore, and in deeper waters - areas where the industry still has limited knowledge; and that were hitherto, regarded as being out of reach. This shift presents significant and increased challenges in technology requirements needed to guarantee safety of personnel, environment and equipment; ensure high reliability of installed equipment; and provide high level of confidence in security of investment and company reputation. Nowhere are these challenges more apparent than on subsea well integrity and production performance. The past two decades has witnessed enormous rise in deep and ultra-deep water offshore field developments for the recovery of hydrocarbons. Subsea installed equipment at the seabed has been the technology of choice for these developments. This paper discusses the role of Subsea Control module (SCM) as a vital factor for deep-water well integrity and production performance. A case study for Deep-water well integrity and production performance is analysed.

Keywords: offshore reliability, production performance, subsea control module, well integrity

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Authors: Kevin Klein-Cardeña

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For Julia Kristeva, contra Lacan, the instinctive body refuses to go away within discourse. Neither is the pre-Oedipal stage of maternal fusion vanquished by the emergence of language and with it, the law of the father. On the contrary, Kristeva argues, the pre-symbolic ambivalently haunts the society of speech, simultaneously animating and threatening the very foundations of signification. Kristeva invents the term “the semiotic” to refer to this continual breaking-through of the material unconscious onto the scene of meaning. This presentation examines Kristeva’s semiotic as a theoretical gesture that itself is a disruption of discourse, re-presenting the ‘return of the repressed’ body in theory—-the breaking-through of the unconscious onto the science of meaning. Faced with linguistic theories concerned with abstract sign-systems as well as Lacanian doctrine privileging the linguistic sign unequivocally over the bodily drive, Kristeva’s theoretical corpus issues the message of a psychic remainder that disrupts with a view toward replenishing theoretical accounts of language and sense. Reviewing Semiotic challenge across these two levels (the sense and science of language), the presentation suggests that Kristeva’s offerings constitute a coherent gestalt, providing an account of the feminist nature of her dual intervention. In contrast to other feminist critiques, Kristeva’s gesture hinges on its restoration of the maternal contribution to subjectivity. Against the backdrop of ‘phallogocentric’ and ‘necrophilic’ theories that strip language of a subject and strip the subject of a body, Kristeva recasts linguistic study through a metaphor of life and birthing. Yet the semiotic fragments the subject it produces, dialoguing with an unconscious curtailed by but also exceeding the symbolic order of signification. Linguistics, too, becomes fragmented in the same measure as it is more meaningfully renewed by its confrontation with the semiotic body. It is Kristeva’s own body that issues this challenge, on both sides of the boundary between the theory and the theorized. The Semiotic becomes comprehensible as a project unified by its concern to disrupt and rehabilitate language, the subject, and the scholarly discourses that treat them.

Keywords: Julia kristeva, the Semiotic, french feminism, psychoanalysic theory, linguistics

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