Search results for: K. Case

Authors: Gerard Bray, Arya Bahadori, Sachinka Ranasinghe

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Renal cell carcinoma (RCC) is among the top 10 most common cancers worldwide, where metastatic disease carries a poor prognosis. Herein, we present a 74-year-old male presenting with asymptomatic solitary metachronous metastasis to the gall bladder 4 years following nephrectomy for clear cell RCC. Solitary RCC metastasis to the gall bladder following nephrectomy is rarely reported in the literature and brings with it a clinical conundrum of whether surgical resection or systemic therapy should be utilized. In this case, surgical excision with cholecystectomy was employed without systemic therapy. We, therefore, contribute a rare and interesting case that highlights that metastasectomy of a solitary metastasis can improve survival according to current literature.

Keywords: renal cell carcinoma, gall bladder metastasis, solitary metastasectomy, metachronous

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Authors: Merab Mamuladze, Mixeil Lejava, Fadiko Abuselidze

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At present, where most of the soils of Georgia have a small contour, the demand for small-capacity technical means, in particular motoblocks, has increased. Motoblocks perform agricultural work for various purposes, where the work process is performed by the operator, who experiences various magnitudes of vibration, impact, noise, and in general, as a result of long-term work production, causes body damage, dynamic load, and respiratory diseases in people. In the scientific paper, the dependence on the vibration of different types of diesel fuel is investigated in the case of five different revolutions in the internal combustion engine. Studies have shown that fuel and engine speed are the only risk factors that contradict the ISO 5349-2(2004) international standard. The experience of four years of work studies showed that 10% of operators received various types of injuries as a result of working with motoblocks. Experiments also showed that the amount of vibration decreases when the number of revolutions of the engine increases, and in the case of using biodiesel fuel, the damage risk factor is 5-10%, and in the case of using conventional diesel, this indicator has gone up to 20%.

Keywords: engine, vibration, biodiesel, high risk factor, working conditions

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Authors: Yaojun Wang, Yaoqing Wang

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Stock selection is an important decision-making problem. Many machine learning and data mining technologies are employed to build automatic stock-selection system. A profitable stock-selection system should consider the stock’s investment value and the market timing. In this paper, we present a hybrid system including both engage for stock selection. This system uses a case-based reasoning (CBR) model to execute the stock classification, uses a decision-tree model to help with market timing and stock selection. The experiments show that the performance of this hybrid system is better than that of other techniques regarding to the classification accuracy, the average return and the Sharpe ratio.

Keywords: case-based reasoning, decision tree, stock selection, machine learning

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Authors: Aya M. Aboudesouky

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Covid-19 has changed and affected the whole world dramatically in a new way that the entire world, even scientists, have not imagined before. The educational institutions around the world have been fighting since Covid-19 hit the world last December to keep the educational process unchanged for all students. E-learning was a must for almost all US universities during the pandemic. It was specifically more challenging to use online case-based learning instead of regular classes among nursing students who take practical education. This study aims to examine the difference in performance and satisfaction between nursing students taking traditional education and those who take virtual case-based education during their practical study. This study enrolls 40 last-year nursing undergraduates from a mid-sized university in Western Pennsylvania. The study uses a convenient sample. Students will be divided into two groups; a control group that is exposed to traditional teaching strategy and a treatment group that is exposed to a case-based teaching strategy. The module designed for this study is a total parenteral nutrition (TPN) module that will be taught for one month. The treatment group (n=20) utilizes the virtual simulation of the CBL method, while the control group (n=20) uses the traditional lecture-based teaching method. Student evaluations are collected after a month by using the survey to attain the students’ learning satisfaction and self-evaluation of the course. The post-test is used to assess the end of the course performance.

Keywords: virtual case-based learning, traditional education, nursing education, Covid-19 crisis, online practical education

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Authors: M. van der Bank

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This study involves a legal analysis of the case Earthlife Africa Johannesburg v Minister of Environmental Affairs and Others. The case considered the impact of the Thabametsi Power Project if it operated to the expected year 2060 on the global climate and ever-changing climate, in South Africa. This judgment highlights the significance, place and principles of climate change and where climate change impacts the South African environmental law which has its founding principles in the Constitution of the Republic of South Africa, 1996. This paper seeks to examine the advances for climate change regulation and application in terms of international law, in South Africa, through a qualitative study involving comparative national and international case law. A literature review study was conducted to compare and contrast the various aspects of law in order to support the argument undertaken. The paper presents a detailed discussion of the current legislation and the position as it currently stands with reference to international law and interpretation. The relevant protections as outlined in the National Environmental Management Act will be discussed. It then proceeds to outline the potential liability of the Minister in the interpretation and application of international law.

Keywords: climate change; environment, environmental review, international law; and principles

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Authors: S. M. Mahbobur Rahman

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Whole building energy simulation models are widely used for predicting future energy consumption, performance diagnosis and optimum control.  Black box building energy modeling approach has been heavily studied in the past decade. The thermal response of a building can also be modeled using a network of interconnected resistors (R) and capacitors (C) at each node called R-C network. In this study, a model building, Case 600, as described in the “Standard Method of Test for the Evaluation of Building Energy Analysis Computer Program”, ASHRAE standard 140, is studied along with a 3R2C thermal network model and the ASHRAE clear sky solar radiation model. Although building an energy model involves two important parts of building component i.e., the envelope and internal mass, the effect of building internal mass is not considered in this study. All the characteristic parameters of the building envelope are evaluated as on Case 600. Finally, monthly building energy consumption from the thermal network model is compared with a simple-box energy model within reasonable accuracy. From the results, 0.6-9.4% variation of monthly energy consumption is observed because of the south-facing windows.

Keywords: ASHRAE case study, clear sky solar radiation model, energy modeling, thermal network model

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Authors: Mohammad Alqattan, Tala Alkhunani, Reema Al, Aldawish, Felwa Almurshard, Abdullah Alzahrani

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: Poland’s Syndrome is a congenital anomaly with two clinical features : unilateral agenesis of the pectoralis major and ipsilateral hand symbrachydactyly. Case presentation: We report a rare case of bilateral Poland’s syndrome with several unique features. Discussion: Poland’s syndrome is thought to be due to a vascular insult to the subclavian axis around the 6th week of gestation. Our patient has multiple rare and unique features of Poland’s syndrome. Conclusion: To our best knowledge, for the first time in the literature we associate Poland’s syndrome with cone-shaped epiphysis of the metacarpals of all fingers. Bilaterality, cleft hand deformity, and dextrocardia, were also rare features in our patient.

Keywords: Poland's syndrome, cleft hand deformity, bilaterality, dextrocardia, cone-shaped epiphysis

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Authors: Chui Ka Shing

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This case study research attempts to examine the use of the Bar Model Method approach in learning and teaching mathematics in a primary school in Hong Kong. The objectives of the study are to find out to what extent (a) the Bar Model Method approach enhances the construction of students’ mathematics concepts, and (b) the school-based mathematics curriculum development with adopting the Bar Model Method approach. This case study illuminates the effectiveness of using the Bar Model Method to solve mathematics problems from Primary 1 to Primary 6. Some effective pedagogies and assessments were developed to strengthen the use of the Bar Model Method across year levels. Suggestions including school-based curriculum development for using Bar Model Method and further study were discussed.

Keywords: bar model method, curriculum development, mathematics education, problem solving

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Authors: Viktória Sugár, Zoltán Laczó, András Horkai, Gyula Kiss, Attila Talamon

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The majority of the building stock of Budapest inner districts was built around the turn of the 19^th and 20^th century. Although the structural stability of the buildings is not questioned, as the load bearing structures are in sufficient state, the secondary structures are aged, resulting unsatisfactory energetic state. The renovation of these historical buildings requires special methodology and technology: their ornamented facades and custom-made fenestration cannot be insulated or exchanged with conventional solutions without damaging the heritage values. The present paper aims to introduce and systematize the possible technological solutions for heritage respecting energy retrofit in case of a historical residential building stock. Through case study, the possible energy saving potential is also calculated using multiple renovation scenarios.

Keywords: energy efficiency, heritage, historical building, renovation

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Authors: Anu S. Krishna

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The paper tries to analyse the UN involvement/intervention in the case of intra-state armed conflict of El Salvador and Nepal comparatively. The peace mission in El Salvador is considered to be the most successful missions of UN ever since it started involving in the peace-building activities. Meanwhile, in the armed conflict of South Asian country, Nepal, the result seemed to be disappointing in comparison with its counterpart. The study on this paper takes three variables as the success or failure of international mediation, i.e., a) signing of the peace agreement, b) disarmament/demobilization and c) constitutional mechanism. A significant amount of scholarship looks at the case of ONUSAL (United Nations Mission in El Salvador). Meanwhile, the armed conflict of Nepal and the role of UNMIN (United Nations Mediation in Nepal) are under researched so far. The paper thus tries to throw light on these cross-regional contexts that share certain similarities and dissimilarities in the nature of conflict. In addition, the international third-party involvement and their way of approaching both the cases differ, which again affected the mediation outcome. The paper tries to argue that, since the approach of the UN led international mediation in theses peace missions were contextual and varied from case to case, thus, finally affected the mediation outcome too.

Keywords: Nepal, UNMIN, El Salvador, ONUSAL, international mediation, armed conflict

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Authors: Seyed Abolhassan Naeini, Maedeh Akhavan Tavakkoli

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Evaluating the shear wave velocity (V_s) and primary wave velocity (Vₚ) is necessary to identify the ground type of the site. Identifying the soil type based on different codes can affect the dynamic analysis of geotechnical properties. This study aims to separate the underground layers at the project site based on the shear wave and primary wave velocity (Sₚ) in different depths and determine dynamic elastic modulus based on the shear wave velocity. Bandar Anzali is located in a tectonically very active area. Several active faults surround the study site. In this case, a field investigation of downhole testing is conducted as a geophysics method to identify the ground type.

Keywords: downhole, geophysics, shear wave velocity, case-study

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Authors: Chen Li-Ching

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The multinomial logistic regression model is used popularly for inferring the relationship of risk factors and disease with multiple categories. This study based on the discrepancy between the nonparametric maximum likelihood estimator and semiparametric maximum likelihood estimator of the cumulative distribution function to propose a Kolmogorov-Smirnov type test statistic to assess adequacy of the multinomial logistic regression model for case-control data. A bootstrap procedure is presented to calculate the critical value of the proposed test statistic. Empirical type I error rates and powers of the test are performed by simulation studies. Some examples will be illustrated the implementation of the test.

Keywords: case-control studies, goodness-of-fit test, Kolmogorov-Smirnov test, multinomial logistic regression

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Authors: Mahawish Masud, Muhammad Iqbal, M. U. Khan, Farooque Azam

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Manual writing of test cases from functional requirements is a time-consuming task. Such test cases are not only difficult to write but are also challenging to maintain. Test cases can be drawn from the functional requirements that are expressed in natural language. However, manual test case generation is inefficient and subject to errors.  In this paper, we have presented a systematic procedure that could automatically derive test cases from user stories. The user stories are specified in a restricted natural language using a well-defined template.  We have also presented a detailed methodology for writing our test ready user stories. Our tool “Test-o-Matic” automatically generates the test cases by processing the restricted user stories. The generated test cases are executed by using open source Selenium IDE.  We evaluate our approach on a case study, which is an open source web based application. Effectiveness of our approach is evaluated by seeding faults in the open source case study using known mutation operators.  Results show that the test case generation from restricted user stories is a viable approach for automated testing of web applications.

Keywords: automated testing, natural language, restricted user story modeling, software engineering, software testing, test case specification, transformation and automation, user story, web application testing

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Authors: Bhushan Bhalgat, Suresh Singh, Phanindra Swain, Kamal Kishore Lakhera

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Carcinoma of cervix and carcinoma of vulva have been associated with common predisposing factors like human papillomavirus and smoking. Skip metastases and metachronous appearance of both these tumours have been reported. There is no case report showing synchronous appearance of these tumours in English literature. We herewith report a case report of a middle aged female patient who presented with per vaginal bleeding, and on examination, a cervical mass was palpable. Also, a proliferative growth was seen over her left vulva. Biopsy of both lesions came out to be squamous cell carcinoma and carcinoma in situ, respectively. A radical hysterectomy and bilateral pelvic and paraaortic lymph nodal dissection was performed along with left simple vulvectomy. This thereby underscores that any lesion over vulva appearing during or after treatment of cervical carcinoma should be biopsied to rule out vulvar carcinoma.

Keywords: carcinoma of cervix, carcinoma of vulva, synchronous tumours, gynecological oncology

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Authors: Reagan Rodriguez

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The following research is a case study of two white patients with white extremist values and their Latina Clinician. Researchers suggest that white supremacy as an ideology has been documented in the United States since the early 1800s. Ethnicity and race were growing key factors linked to central motives behind hate crimes in U.S., which may suggest that we are living in another wave of white supremacist and domestic terrorism that seek to eradicate a threatening and dangerous “other”. This research seeks to address and contribute a qualitative perspective to white supremacist ideology within a bio-psycho-social framework. The current research seeks to contribute to address the gap in literature on ethnic minority clinicians and white patients with racist ideology. The research also seeks to examine the themes not commonly found in racially matched and gendered matched therapeutic dyads where patients hold white extremist values. This case study examines white supremacist ideology from a psychodynamic perspective, examining themes such as “feeling forgotten”, reduced empathy related to “broken promises”, sexualization of the passing minority counselor, and utilizing minimal autonomy in verbal and non-verbal signals. A thematic analysis of case notes and quotes are used to further contextualize emerging therapeutic themes and the psychodynamic analysis of the manifestation of white supremacist actions ranging from active to passive forms of violence.

Keywords: case study, extremism, race and gender, white supremacist ideology

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Authors: Abdul Rofiq Badril Rizal M. Z.

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This case study examines the experiences of four beginning teachers currently working in New South Wales secondary schools. Data were collected from semi-structured interviews conducted one on one over the period of one month. The data were coded with findings reported through key areas of discovery, which linked to the research presented in the literature review. The participants involved in the case study all reported positive experiences with mentoring, though none were given the opportunity to take part in a formal mentoring program, and all the mentors offered their time voluntarily. The mentoring took different forms, but the support most valued by the participants was the emotional and curriculum related supported received. All participants wished they had greater access to mentoring and felt it would have benefits for most beginning teachers. The study highlights ongoing issues around the lack of access to mentoring, which could be due to factors such as funding, time and training.

Keywords: mentor, mentee, pre-service teacher, beginning teacher

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Authors: Kevin Wongleedee

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This research paper was aimed to examine the reasons associated with hotel employees’ loyalty. This was a case study of 200 hotel employees in Bangkok, Thailand. The population of this study included all hotel employees who were working in Bangkok during January to March, 2014. Based on 200 respondents who answered the questionnaire, the data were complied by using SPSS. Mean and standard deviation were utilized in analyzing the data. The findings revealed that the average mean of importance was 4.40, with 0.7585 of standard deviation. Moreover, the mean average can be used to rank the level of importance from each factor as follows: 1) salary, service charge cut, and benefits, 2) career development and possible advancement, 3) freedom of working, thinking, and ability to use my initiative, 4) training opportunities, 5) social involvement and positive environment, 6) fair treatment in the workplace and fair evaluation of job performance, and 7) personal satisfaction, participation, and recognition.

Keywords: hotel employees, loyalty, reasons, case study

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Authors: Jatuporn Juyjingam, Pitak Siriwong

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This paper presents a study of factors effecting the success and failure of social enterprise in Thailand identifying communication as one of the criteria for measuring the social impact of social enterprise. The study focused on the communication driver of the SCALERS model. The research examines how communication is viewed in Thailand social enterprise. The research aims to determine how selected social enterprise uses communication in their operations. More specifically, the study aims to 1) describe the profile of social enterprise in Thailand, 2) identify the different roles of communication in the operation of social enterprise in Thailand, 3) determine Thailand social enterprise concept of communication. The study made use of the case study and cross case study research designs. For the profiling of the social enterprises, the case study was used. The researchers made use of the cross-case research design in identifying trends across the ten social enterprises and in determining the social entrepreneurs’ concept of communication. Key informant interviews were conducted with the heads or representatives of selected social enterprises, a three-part interview schedule was used to facilitate data gathering. The three parts included are 1) Profile of social enterprise in Thailand 2) How social enterprises apply communication in their operations 3) What is the key success in using communication among social enterprise in Thailand. This study is an exploratory research.

Keywords: communication, social entrepreneurship, social enterprise, sustainability development

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Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel

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Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.

Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst

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Authors: Joeri N. Aulman

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In the remote Indian region of Gulbarga a case study of lean airport infrastructure development is getting ‘cast in stone’; In April the first turbo-props will land, and the optimized terminal building will process its first passengers, using minimal square meters in a facility that is based on a complete dress-down of the core operational processes. Yet the solution that resulted from this case study has such elegance in its simplicity that it has emboldened the local administration to invest in its construction and thus secure this remote region’s connectivity to India’s growth story. This paper aims to provide further background to the Gulbarga case study and its relevance to remote region connectivity, covering the demand that was identified, its practical application and its regulatory context and relevance for today’s airport manager and local administrators. This embodies the scope of the paper. In summary, the paper will give airport managers and regional authorities an overview and background to innovative case studies of lean airport infrastructure developments which combine both optimized CAPEX and running costs/OPEX without losing sight of the aspirational nature of up and coming remote regions; a truly sustainable model.

Keywords: airport, CAPEX, lean, sustainable, air connectivity, remote regions

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Authors: Nurdan Yildirim, Arif Hepbasli

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Heating, cooling and lighting appliances in buildings account for more than one third of the world’s primary energy demand. Therefore, main components of the building heating systems play an essential role in terms of energy consumption. In this context, efficient energy and exergy utilization in HVAC-R systems has been very essential, especially in developing energy policies towards increasing efficiencies. The main objective of the present study is to assess the performance of a family house with a volume of 326.7 m3 and a net floor area of 121 m2, located in the city of Izmir, Turkey in terms of energetic, exergetic and sustainability aspects. The indoor and exterior air temperatures are taken as 20°C and 1°C, respectively. In the analysis and assessment, various metrics (indices or indicators) such as exergetic efficiency, exergy flexibility ratio and sustainability index are utilized. Two heating options (Case 1: condensing boiler and Case 2: air heat pump) are considered for comparison purposes. The total heat loss rate of the family house is determined to be 3770.72 W. The overall energy efficiencies of the studied cases are calculated to be 49.4% for Case 1 and 54.7% for Case 2. The overall exergy efficiencies, the flexibility factor and the sustainability index of Cases 1 and 2 are computed to be around 3.3%, 0.17 and 1.034, respectively.

Keywords: buildings, exergy, low exergy, sustainability, efficiency, heating, renewable energy

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Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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

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

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Authors: Salam Abukhadrah

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This research advocates for the use of feminist evaluation (FE) as a tool of great potential in policy and program assessment in relation to women’s empowerment. This research explores the journey of women’s place into the evaluation and international development. Moreover, this research presents a case example of the use of FE on the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), in Ganaparthi village in rural India, in Andhra Pradesh state (AP). This evaluation is formed on the basis of women’s empowerment framework that seeks to examine empowerment as a process and an end in itself rather than as just simplified quantifiable outcomes. This framework is used to conduct in-depth semi-structured interviews that are later cross-validated by a focus group discussion. In addition, this evaluation draws on secondary data from the MGNREGA website and on extracted data from the National Family Health Survey of AP.

Keywords: feminist evaluation, MGNREGA, women’s empowerment, case example, India

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Authors: Roland Benedict Reyes, Marc Edsel Ayes, Regina Berba, Cybele Lara Abad

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Background: Three AIDS-defining malignancies have been associated with the human immunodeficiency virus (HIV): Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and cervical carcinoma. However, new cases of non-AIDS defining malignancies also have been increasingly associated with HIV. One of these is a rare intracranial malignancy, meningeal hemangiopericyotma. Case Description: A 32-year old HIV-positive male, not on highly active antiretroviral therapy, was admitted to our hospital due to generalized weakness and sudden onset hearing loss. Cranial MRI was done, which revealed a temporal nodule with the following considerations: granuloma, meningioma or metastases. A craniotomy was performed and the mass excised. Results from the biopsy showed meningeal hemangiopericytoma. The patient was then started on antiretroviral therapy (Lamivudine, Tenofovir, and Efavirenz) and was discharged for radiation therapy and metastatic work-up as an outpatient. On follow-up seven months later, metastatic work up revealed multiple hepatic foci not previously documented suggestive of metastasis short of biopsy sampling. Conclusions: This case of an intracranial hemangiopericytoma in an HIV-positive patient is the second case thus far presented, based on our systematic and extensive search of the literature.

Keywords: Hemangiopericytoma, Human Immunodeficiency Virus, Meningeal hemangiopericytoma, Neoplasm

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Authors: Pál Mészáros

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The aim of this research topic is to examine civil law consequences caused by crimes committed in the digital space. During the commission of certain crimes, not only the rights of one person are violated, but also the rights of an entire institution, for example, if the information system of a university is attacked. The consequences of these crimes committed in the digital space may also be that the victim himself is liable to other third parties, for example, in the event that health data comes into the possession of unauthorized persons, and it can be proved that the service provider's IT system was inadequate. An interesting question may also be the civil liability of credit institutions if someone becomes a victim of fraud but is not expected from him/her to notice the fraud. In such a case, the liability of the credit institution may arise if they do not respond in time in the case of unauthorized bank transactions. Based on the above, the main topic of the research is the civil liability of the victim, or another person or company related to the victim in the case of damages caused by crimes.

Keywords: civil liability, digital crimes, transfer of responsibility, civil law

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Authors: Mohd Jaish Siddiqui

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Laryngeal TB is extremely rare in the pediatric population, accounting for 1% of all cases. Here, we present a case of laryngeal TB with miliary tuberculosis and tuberculous encephalitis, presented with sore throat, hoarseness, severe cough and, acute obstruction the larynx, sputum for AFB was negative, T-SPOT was positive and X-pert was positive, bronchoscopy revealed multiple nodules and edema around the larynx, epiglottis, bilateral arytenopharyngeal folds and vocal cord. Enhanced MRI revealed multiple small nodules in bilateral cerebral hemispheres and right thalamus, however CSF was negative. We reviewed the LTB cases that were published up to 2021. A total of twenty fine cases were identified in English literature. The most common manifestation was hoarseness of voice with 80% followed by stridor 40% of cases. Pulmonary involvement was found in 36% of cases, whereas, 45% of cases had no underlying TB. We did not find any case who developed tuberculous encephalitis in the literature.

Keywords: laryngeal tb, treatment, tuberculous encephalitis, children

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Authors: Kritin K. Verma, Bailey Duhon, Patrick W. Slater

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Objective: To introduce the possible etiological role that the Labyrinthine Venous Vasculature (LVV) has in venous congestion of the cochlear system in Sudden Sensorineural Hearing Loss (SSNHL) patients. Patients: Two patients (62-year-old female, 50-year-old male) presented within twenty-four hours of onset of SSNHL. Intervention: Following failed conservative and salvage techniques, the patients underwent ablation of the labyrinthine venous vasculature ipsilateral to the side of the loss. Main Outcome Measures: Improvement of sudden SSNHL based on an improvement of pure-tone audiometric (PTA) low-tone scoring averages at 250, 500, and 1000 Hz. Word recognition scoring using the NU-6 word list was used to assess quality of life. Results: Case 1 experienced a 51.7 dB increase in low-tone PTA and an increased word recognition scoring of 90%. Case 2 experienced a 33.4 dB increase in low-tone PTA and 60% increase in word recognition score. No major complications noted. Conclusion: Two patients experienced significant improvement in their low-tone PTA and word recognition scoring following the labyrinthine venous vasculature ablation.

Keywords: case report, sudden sensorineural hearing loss, venous congestion, vascular ablation

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Authors: Tom Hickey

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It is difficult to conceive of a case that might more starkly bring the arguments concerning judicial review to the fore than State (Ryan) v Lennon. Small wonder that it has attracted so much scholarly attention, although the fact that almost all of it has been in an Irish setting is perhaps surprising, given the illustrative value of the case in respect of a philosophical quandary that continues to command attention in all developed constitutional democracies. Should judges have power to invalidate legislation? This article revisits Ryan v Lennon with an eye on the importance of the idea of “democracy” in the case. It assesses the meaning of democracy: what its purpose might be and what practical implications might follow, specifically in respect of judicial review. Based on this assessment, it argues for a particular institutional model for the vindication of constitutional rights. In the context of calls for the drafting of a new constitution for Ireland, however forlorn these calls might be for the moment, it makes a broad and general case for the abandonment of judicial supremacy and for the taking up of a model in which judges have a constrained rights reviewing role that informs a more robust role that legislators would play, thereby enhancing the quality of the control that citizens have over their own laws. The article is in three parts. Part I assesses the exercise of judicial power over legislation in Ireland, with the primary emphasis on Ryan v Lennon. It considers the role played by the idea of democracy in that case and relates it to certain apparently intractable dilemmas that emerged in later Irish constitutional jurisprudence. Part II considers the concept of democracy more generally, with an eye on overall implications for judicial power. It argues for an account of democracy based on the idea of equally shared popular control over government. Part III assesses how this understanding might inform a new constitutional arrangement in the Irish setting for the vindication of fundamental rights.

Keywords: constitutional rights, democracy as popular control, Ireland, judicial power, republican theory, Ryan v Lennon

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Authors: István Fekete, Imre Berki, Áron Béni, Katalin Juhos, Marianna Makádi, Zsolt Kotroczó

Abstract:

The average annual precipitation significantly influences the moisture content of the soils and, through this, the decomposition of the organic substances in the soils, the leaching of nutrients from the soils, and the pH of the soils. Climate change, together with the lengthening of the vegetation period and the increasing CO₂ level, can increase the amount of biomass that is formed. Degradation processes, which accelerate as the temperature increases and slow down due to the drying climate, and the change in the degree of leaching can cancel out or strengthen each other's effects. In the course of our research, we looked for oak forests with climate-zonal soils where the geological, geographical and ecological background conditions are as similar as possible, apart from the different annual precipitation averages and the differences that can arise from them. We examined 5 dry and 5 humid Hungarian oak soils. Climate change affects the soils of drier and wetter forests differently. The aim of our research was to compare the content of carbon, nitrogen and some other nutrients, as well as the pH of the soils of humid and dry forests. Showing the effects of the drier climate on the tested soil parameters. In the case of the examined forest soils, we found a significant difference between the soils of dry and humid forests: in the case of the annual average precipitation values (p≥ 0.0001, for dry forest soils: 564±5.2 mm; for humid forest soils: 716±3.8 mm) for pH (p= 0.0004, for dry forest soils: 5.49±0.16; for wet forest soils: 5.36±0.21); for C content (p= 0.0054, for dry forest soils: 6.92%±0.59; for humid forest soils 3.09%±0.24), for N content (p= 0.0022, dry forest in the case of soils: 0.44%±0.047; in the case of humid forest soils: 0.23%±0.013), for the K content (p=0.0017, in the case of dry forest soils: 5684±732 (mg/kg); in the case of humid forest soils 2169±196 (mg/kg)), for the Ca content (p= 0.0096, for dry forest soils: 8207±2118 (mg/kg); for wet forest soils 957±320 (mg/kg)). No significant difference was found in the case of Mg. In a wetter environment, especially if the moisture content of the soil is also optimal for the decomposing organisms during the growing season, the decomposition of organic residues accelerates, and the processes of leaching from the soil are also intensified. The different intensity of the leaching processes is also well reflected in the quantitative differences of Ca and K, and in connection with these, it is also reflected in the difference in pH values. The differences in the C and N content can be explained by differences in the intensity of the decomposition processes. In addition to warming, drying is expected in a significant part of Hungary due to climate change. Thus, the comparison of the soils of dry and humid forests allows us to predict the subsequent changes in the case of the examined parameters.

Keywords: soil nutrients, precipitation difference, climate change, organic matter decomposition, leaching

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Authors: Vivek Ku, A. K. Janmeja, D. Aggarwal, R. Gupta

Abstract:

Purpose: Pulmonary rehabilitation plays a key role in management of chronic lung diseases. However, pulmonary rehabilitation is an underused modality in the management of interstitial lung disease (ILD). This is because limited information is available in literature and no data is available from India on this issue so far. The study was carried out to evaluate the role of pulmonary rehabilitation on respiratory parameters in ILD patients. Methods: The present study was a prospective randomized non-blind case control study. Total of 40 ILD patients were randomized into 2 groups of 20 patients each viz ‘pulmonary rehabilitation group’ and ‘control group’. Pulmonary rehabilitation group underwent 8 weeks pulmonary rehabilitation (PR) along with medical management as per guidelines and the control group was advised only medical management. Results: Mean age in case group was 59.15 ± 10.39 years and in control group was 62.10 ± 14.54 years. The case and the control groups were matched for age and sex. Mean MRC grading at the end of 8 weeks showed significant improvement in the case group as compared to control group (p= 0.011 vs p = 0.655). Similarly, mean St. George Respiratory Questionnaire (SGRQ) score also showed significant improvement in pulmonary rehabilitation group at the end of the study (p= 0.001 vs p= 0.492). However, FEV1 and FVC had no significant change in the case and control group. Similarly, blood gases also did not show any significant difference in the group. Conclusion: Pulmonary rehabilitation improves breathlessness and thereby improves quality of life in the patients suffering from ILD. However, the pulmonary function values and blood gases are unaffected by pulmonary rehabilitation. Clinical Implications: Further large scale multicentre study is needed to ascertain the association.

Keywords: ILD, pulmonary rehabilitation, quality of life, pulmonary functions

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