Search results for: surgical history

Authors: Anna Camille V. Flores

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Comics in the Philippines has taken on many uses for the Filipino people. They have been sources of entertainment, education, and political and social commentaries. History has been witnessed to the rise and fall of Philippine comics but the 21^st century is seeing a revival of the medium and the industry. It is within this context that an inquiry about Filipino identity is situated. Employing the analytical framework of postcolonialism, particularly Homi K. Bhabha’s concepts of Hybridity and the Third Space, this study analyzes three contemporary Philippine comics, Trese, Filipino Heroes League, and Dead Balagtas. The study was able to draw three themes that represent how Filipinos inhabit hybrid worlds and hybridized identities. First, the third space emerged through the use of hybrid worlds in the comics. Second, (re)imagined communities are established through the use of intertextual signifiers. Third, (re)negotiated identities are expressed through visual and narrative devices such as the use of Philippine mythology, historical and contemporary contexts, and language. In conclusion, comics can be considered as Third Space where these identities have the agency and opportunity to be expressed and represented.

Keywords: comics, hybridity and third space, Philippine comics, postcolonialism

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: F. Bosca, F. Foglietta, F. Turci, E. Calcio Gaudino, S. Mana, F. Dosio, R. Canaparo, L. Serpe, A. Barge

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In recent years, medical science has improved chemotherapy, radiation therapy and adjuvant therapy and has developed newer targeted therapies as well as refining surgical techniques for removing cancer. However, the chances of surviving the disease depend greatly on the type and location of the cancer and the extent of the disease at the start of treatment. Moreover, mainstream forms of cancer treatment have side effects which range from the unpleasant to the fatal. Therefore, the continuation of progress in anti-cancer therapy may depend on placing emphasis on other existing but less thoroughly investigated therapeutic approaches such as Sonodynamic Therapy (SDT). SDT is based on the local activation of a so called 'sonosensitizer', a molecule able to be excited by ultrasound, the radical production as a consequence of its relaxation processes and cell death due to different mechanisms induced by radical production. The present work deals with synthesis, characterization and preliminary in vitro test of Single Walled Carbon Nanotubes (SWCNT) decorated with porphyrins and biological vectors. The SWCNT’s surface was modified exploiting 1, 3-dipolar cycloaddition or Dies Alder reactions. For this purpose, different porphyrins scaffolds were ad-hoc synthesized using also non-conventional techniques. To increase cellular specificity of porphyrin-conjugated SWCNTs and to improve their ability to be suspended in aqueous solution, the modified nano-tubes were grafted with suitable glutamine or hyaluronic acid derivatives. These nano-sized sonosensitizers were characterized by several methodologies and tested in vitro on different cancer cell lines.

Keywords: sonodynamic therapy, porphyrins synthesis and modification, SWNCT grafting, hyaluronic acid, anti-cancer treatment

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Authors: Alex Lundy

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As the suburban landscape has evolved over time, it has been slowly stripped down to the absolute bare essentials of housing. This has resulted in the loss of core elements of the built environment which previously supported community no longer being present in most neighborhoods. As a result, this work will explore how current and past designers have successfully introduced these concepts in similar settings, in an effort to re-implement them into the contemporary subdivision. Ultimately, this will result in a reimagining suburban design through elements like identity, adaptability, place, and social spaces to improve community interaction and cohesion. Overall, this thesis asserts that contemporary subdivisions don’t support the growing need for community in daily life and should be improved through the implementation of historical neighborhood design and select modern urban concepts to better suit living needs.

Keywords: suburbia, community, social connection, identity, adaptability, neighborhood, place, unity, leasure, social ties, third place, learning from history

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Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

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Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

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Authors: Usman Khan

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The article discusses mass migration, which has been a problem throughout history. People moved for a variety of reasons, including better job opportunities, prosperous, healthy lifestyles, and other basic needs. This research focuses on the issues and challenges that immigrants face when they arrive at their destination countries especially Saudi Arab. Among these issues are the Kapala system, irregular salaries, living conditions, document seizure, and so on. The primary data sources for this qualitative anthropological study include in-depth interviews and focus group discussions (FGDs). The research was carried out in the villages of Zulam and Shagokas in Khyber Pakhtunkhwa's Dir Lower District. The article concludes by stating that the agents and employers treated labor migrants/workers inhumanely. Throughout the process, they have been subjected to severe exploitation and suffering. Finally, the migrants sent back remittances that aided the region's economic and infrastructure development.

Keywords: Migration, Exploitation, labour, Middle East, Kafala and Tanazol System.

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Authors: Pierre Mintom, Armel Assiene Agamou, Leslie Toukem, William Dakam, Christine Fernande Nyangono Biyegue

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Context: Hyperuricemia, the presence of high levels of uric acid in the blood, is a known precursor to the development of gout. Recent studies have suggested a strong association between hyperuricemia and disorders of lipoprotein metabolism, specifically hypercholesterolemia. Understanding the factors associated with these conditions in gout patients is essential for effective treatment and management. Research Aim: The objective of this study was to determine the prevalence of hyperuricemia, hypercholesterolemia, and the double burden of hyperuricemia-hypercholesterolemia in the gouty population. Additionally, the study aimed to identify the factors associated with these conditions. Methodology: The study utilized a database from a survey of 150 gouty patients recruited at the Laquintinie Hospital in Douala between August 2017 and February 2018. The database contained information on anthropometric parameters, biochemical markers, and the food and drugs consumed by the patients. Hyperuricemia and hypercholesterolemia were defined based on specific serum uric acid and total cholesterol thresholds, and the double burden was defined as the co-occurrence of hyperuricemia and hypercholesterolemia. Findings: The study found that the prevalence rates for hyperuricemia, hypercholesterolemia, and the double burden were 61.3%, 76%, and 50.7% respectively. Factors associated with these conditions included hypertriglyceridemia, atherogenicity index TC/HDL ratio, atherogenicity index LDL/HDL ratio, family history, and the consumption of specific foods and drinks. Theoretical Importance: The study highlights the strong association between hyperuricemia and dyslipidemia, providing important insights for guiding treatment strategies in gout patients. Additionally, it emphasizes the significance of nutritional education in managing these metabolic disorders, suggesting the need to address eating habits in gout patients. Data Collection and Analysis Procedures: Data was collected through surveys and medical records of gouty patients. Information on anthropometric parameters, biochemical markers, and dietary habits was recorded. Prevalence rates and associated factors were determined through statistical analysis, employing odds ratios to assess the risks. Question Addressed: The study aimed to address the prevalence rates and associated factors of hyperuricemia, hypercholesterolemia, and the double burden in gouty patients. It sought to understand the relationships between these conditions and determine their implications for treatment and nutritional education. Conclusion: Findings show that it’s exists an association between hyperuricemia and hypercholesterolemia in gout patients, thus creating a double burden. The findings underscore the importance of considering family history and eating habits in addressing the double burden of hyperuricemia-hypercholesterolemia. This study provides valuable insights for guiding treatment approaches and emphasizes the need for nutritional education in gout patients. This study specifically focussed on the sick population. A case–control study between gouty and non-gouty populations would be interesting to better compare and explain the results observed.

Keywords: gout, hyperuricemia, hypercholesterolemia, double burden

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Authors: Fahad Ahmed Qureshi

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There were abundant renowned financial markets in Pre-Islamic Arabs. Most of those were patterned and settled during pre-particularized sunshine. Those markets were classified either as vernacular markets helping the neighboring clans, or habitual markets that people sojourned to from all articulations of the Arabian Peninsula, such as Okaz near Mecca. Some of those markets had leading significance due to their geographical positions, such as Prime market of Eden, because of their entanglement in international trade i.e. with the markets of Sub-Continent, Abyssinia, Persia and China. Other markets such as Market of Yamamah annex its gist from being situated on the caravan crossroads. Islamic worldview and Islamic epistemology base of Financial Market’s realistic theory, pragmatic model and operative approach is moderately constrained in terms of its growth. The existent situation only parasol the form of accommodative-modification and splendid-methodologies, which due to depleted and decorous endeavor in explaining Islamic financial market theoretically. This is the demand of time that particular studies should be conduct to magnify the devours in developing theoretical framework for Islamic Financial Market.

Keywords: Islam, financial market, history, research, product development

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Authors: Ashutosh Pujari

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The sharing of natural resources is one of the most important aspects of relations between two neighboring countries, especially when it is a resource that has a presence in both the countries in question. River water is an important resource that is shared between India and its neighbors, namely Pakistan and Bangladesh. India shares Indus, Chenab, and Jhelum rivers with Pakistan, while with Bangladesh, it shares Ganges and Brahmaputra. However, it is interesting to note how does India deals with her sharing of water with these two countries. Although water sharing with both the countries has been dotted by irritants over the years, relations with Bangladesh is undoubtedly better in this respect. Given the common history of the region, this paper analyses the reasons behind this difference in the relationship between India and her neighbors and its implications for the present times. Through critical analysis of literature and the official policy of all the governments involved and the narratives present, this paper tries to present understand how India’s relations with its neighbors are a function of geopolitics, culture, and perceptions on both sides.

Keywords: geopolitics, river water sharing, India-Pakistan relations, India-Bangladesh relations

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Authors: Kingfahd Adewale Adedapo, Adekunle Ajisebiyawo

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The focus of this paper is to explore the different theoretical perspectives that underline academic attempts at understanding and explaining the nature of conflicts in Africa. The African environment is riddled with the past history of conflicts among groups either for an economic outlet or imperial space, and most often, such past negative interactions have made it difficult even now for some of these groups to live harmoniously together within the present state system and to trust each other. The paper observed that no one theory or explanatory schema could offer a holistic explanation of conflict in Africa. At best, each of the possible theories can only offer a partial explanation of the causes and nature of conflict in a particular African society or state. This paper, therefore, attempted to synthesize the many sources of theories of conflicts and provided the intellectual background from which these different theories emanated. Therefore, if this paper has done anything at all, it is to offer the basis for assessing different theoretical strands aimed at offering cogent and reliable explanations for most of the conflicts in Africa and especially in the West African sub-region.

Keywords: conflict, functionalism, humanitarianism, structuralism, theory

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Authors: Pegah Ebrahimi, Farshad Oveissi, Iman Manavi-Tehrani, Sina Naficy, David F. Fletcher, Fariba Dehghani, David S. Winlaw

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Despite advances in modern surgery, congenital heart disease remains a medical challenge and a major cause of infant mortality. Cardiovascular prostheses are routinely used in surgical procedures to address congenital malformations, for example establishing a pathway from the right ventricle to the pulmonary arteries in pulmonary valvar atresia. Current off-the-shelf options including human and adult products have limited biocompatibility and durability, and their fixed size necessitates multiple subsequent operations to upsize the conduit to match with patients’ growth over their lifetime. Non-physiological blood flow is another major problem, reducing the longevity of these prostheses. These limitations call for better designs that take into account the hemodynamical and anatomical characteristics of different patients. We have integrated tissue engineering techniques with modern medical imaging and image processing tools along with mathematical modeling to optimize the design of cardiovascular grafts in a patient-specific manner. Computational Fluid Dynamics (CFD) analysis is done according to models constructed from each individual patient’s data. This allows for improved geometrical design and achieving better hemodynamic performance. Tissue engineering strives to provide a material that grows with the patient and mimic the durability and elasticity of the native tissue. Simulations also give insight on the performance of the tissues produced in our lab and reduce the need for costly and time-consuming methods of evaluation of the grafts. We are also developing a methodology for the fabrication of the optimized designs.

Keywords: computational fluid dynamics, cardiovascular grafts, design optimization, tissue engineering

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Authors: Chengyuan Zhu, Zhu Wang

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With the strategy of Rural Rejuvenation proposed in China, the rural has become the focus of all works today. In addition to the support of industry and policy, the rural planning and construction which is the space dependence of Rural Rejuvenation are also very crucial. Based on an analysis of the case of Yangdun Village in Deqing County, this paper summarizes village existing resources and construction status quo. It tries to illuminate the micro-activated organic renewal strategies and methods, based on ecological landscape, history context, industry development and living life requirements. It takes advantage of industrial linkage and then asks for the coordination of both spatial and industrial planning, the revival and remodeling of the rural image can be achieved through shaping the of architectural and landscape nodes as well as the activation of street space.

Keywords: rural construction, rural human settlements, micro-activation, organic renewal

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Authors: Prosper Kudzanai Mushauri

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In issues of anomalous experiences commonly referred to as madness or mental illness, attempts have been made to deal with it so that people manage to live their lives in a more functional way. It is in this stance that psychiatry has sort of portraying itself as seeking to ameliorate perturbations which individuals live with via nosological systems and use of medicine to anomalous experiences. It is from this hegemony that has led to the untold harm which people living with madness have endured from antique to contemporary life. The paper reflects via a literature review on the history of psychiatry and argues that it is akin to contemporary psychiatry to be involved in iatrogenic acts. As antique psychiatry meddled with gory issues of inhumanity, deceit and mass murders which some of those the contemporary psychiatry has not weaned itself from such diabolical acts. The objective of the paper is to suggest to psychiatry that it has not comported to the mores of psychological ethics. In doing this, the paper hopes that psychiatry will reflect and reform its curricular and praxis so that it comports to ethical standards in psychological science in ameliorating anomalous experiences.

Keywords: nosology, psychiatry, madness, diagnosis, eugenics

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Authors: Hyungoo Kang, Minsung Kim, Jinkoo Kim

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This study investigates the performance of a 2D and 3D steel moment frame subjected to vehicle collision at a first story column using LS-DYNA. The finite element models of vehicles provided by the National Crash Analysis Center (NCAC) are used for numerical analysis. Nonlinear dynamic time history analysis of the 2D and 3D model structures are carried out based on the arbitrary column removal scenario, and the vertical displacement of the damaged structures are compared with that obtained from collision analysis. The analysis results show that the model structure remains stable when the speed of the vehicle is 40km/h. However, at the speed of 80 and 120km/h both the 2D and 3D structures collapse by progressive collapse. The vertical displacement of the damaged joint obtained from collision analysis is significantly larger than the displacement computed based on the arbitrary column removal scenario.

Keywords: vehicle collision, progressive collapse, FEM, LS-DYNA

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Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

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Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

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Authors: Emna Abid, Linda Chebbi, Yosra Mabrouk, Amel Labidi, Lamia Mansour

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Werner syndrome (WS) is a rare genetic disorder inherited in an autosomal recessive pattern characterized by accelerated aging. While extensive research has been conducted on its systemic manifestations, the specific dental implications of WS remain poorly understood. The medical history and the oral health status of two patients diagnosed with WS were detailed. Our findings revealed a high prevalence of dental problems in both patients, including periodontitis, xerostomia, and temporomandibular joint disorders. This article aims to investigate the dental challenges faced by individuals with WS as well as the prosthetic options envisaged through two clinical cases contributing to a deeper understanding of the dental implications of WS and to choose the appropriate prosthetic solution in this population. Future research should focus on larger scale studies and clinical trials to validate these proposed strategies.

Keywords: adult progeria, clinical symptoms, oral manifestations, dental care, prosthetic management

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Authors: Nigar Sultanova

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Facial morphology is a constant topic of concern for clinicians. When anthropometric methods were introduced into clinical practice to quantify changes in the craniofacial framework, features distinguishing various ethnic group were discovered. Normative data of facial measurements are indispensable to precise determination of the degree of deviations from normal. Establish the reference range of facial proportions in Azerbaijan population by anthropometric measurements of craniofacial complex. The study group consisted of 350 healthy young subjects, 175 males and 175 females, 18 to 25 years of age, from 7 different regions of Azerbaijan. The anthropometric examination was performed according to L.Farkas's method with our modification. In order to determine the morphologic characteristics of seven regions of the craniofacial complex 42 anthropometric measurements were selected. The anthropometric examination. Included the usage of 33 anthropometric landmarks. The 80 indices of the facial proportions, suggested by Farkas and Munro, were calculated: head -10, face - 23, nose - 23, lips - 9, orbits - 11, ears - 4. The date base of the North American white population was used as a reference group. Anthropometric measurements of facial proportions in Azerbaijan population revealed a significant difference between mеn and womеn, according to sexual dimorphism. In comparison with North American whites, considerable differences of facial proportions were observed in the head, face, orbits, labio-oral, nose and ear region. However, in women of the Azerbaijani population, 29 out of 80 proportion indices were similar to the proportions of NAW women. In the men of the Azerbaijani population, 27 out of 80 proportion indices did not reveal a statistically significant difference from the proportions of NAW men. Estimation of the reference range of facial proportions in Azerbaijan population migth be helpful to formulate surgical plan in treatment of congenital or post-traumatic facial deformities successfully.

Keywords: facial morphology, anthropometry, indices of proportion, measurement

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Authors: Donato Maniello, Alessandra Cirafici, Valeria Amoretti

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This paper aims to present a new method that consists in the use of video mapping techniques – that is a particular form of augmented reality, which could produce new tools - different from the ones that are actually in use - for an interactive Museum experience. With the words 'augmented reality', we mean the addition of more information than what the visitor would normally perceive; this information is mediated by the use of computer and projector. The proposed application involves the creation of a documentary that depicts and explains the history of the artifact and illustrates its features; this must be projected on the surface of the faithful copy of the freeze (obtained in full-scale with a 3D printer). This mode of operation uses different techniques that allow passing from the creation of the model to the creation of contents through an accurate historical and artistic analysis, and finally to the warping phase, that will permit to overlap real and virtual models. The ultimate step, that is still being studied, includes the creation of interactive contents that would be activated by visitors through appropriate motion sensors.

Keywords: augmented reality, multimedia, parthenon frieze, video mapping

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Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

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Authors: Asanka U. K. Godamunne

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Road traffic accidents (RTA) are a leading cause of death globally as well as in Sri Lanka and results in a large proportion of disability especially among young people. Ninety-percent of world’s road traffic deaths occur in low- and middle-income countries. The gross disparities in injury outcomes relate to immediate post-crash and hospital management. Emergency management, methods of patient transportation following road traffic accidents and safety measures are important factors to reduce mortality and morbidity. Studies in this area are limited in Sri Lanka. The main objective of this research was to assess the emergency management and proper method of transportation of road traffic accident victims. This offers the best way to explore the ways to reduce the mortality and morbidity and raise the public awareness. This study was conducted as a descriptive cross-sectional study. All the consecutive road traffic accident victims admitted to surgical wards at District General Hospital, Matale, Sri Lanka, over a period of three months were included in the study. Data from 387 victims were analyzed. The majority were in the 20-30 year age group. Seventy six percent of the patients were males. Motorcycles and trishaws were most affected. First-aid was given to only 2% of patients and it was given by non-medical persons. A significant proportion of patients (75%) were transported to the hospital by trishaws and only 1% transported by ambulance. About 86% of the patients were seated while transport and 14% were flat. Limbs and head were the most affected areas of the body. As per this study, immediate post-crash management and patient transportation were not satisfactory. There is a need to strengthen certain road safety laws and make sure people follow them.

Keywords: emergency management, patient transportation, road traffic accident victims, Sri Lanka

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Authors: Shahzad Karim Bhatti

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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.

Keywords: pain, prolapse, Ozone, backpain

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Authors: Adrian Hang Yue Siu, Matthew Holyland, Sharon Carey, Daniel Steffens, Nabila Ansari, Cherry E. Koh

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Introduction: Peritoneal malignancies are challenging cancers to manage. While cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) may offer a cure, it’s considered radical and morbid. Pre-emptive identification of deconditioned patients for optimization may mitigate the risks of surgery. However, the difficulty lies in the scarcity of validated predictive tools to identify high-risk patients. In recent times, there has been growing interest in sarcopenia, which can occur as a result of malnutrition and malignancies. Therefore, the purpose of this study was to assess the utility of sarcopenia in predicting post-operative outcomes. Methods: A single quaternary-center retrospective study of CRS and HIPEC patients between 2017-2020 was conducted to determine the association between pre-operative sarcopenia and post-operative outcomes. Lumbar CT images were analyzed using Slice-o-matic® to measure sarcopenia. Results : Cohort (n=94) analysis found that 40% had sarcopenia, with a majority being female (53.2%) and a mean age of 55 years. Sarcopenia was statistically associated with decreased weight compared to non-sarcopenia patients, 72.7kg vs. 82.2kg (p=0.014) and shorter overall survival, 1.4 years vs. 2.1 years (p=0.032). Post-operatively, patients with sarcopenia experienced more post-operative complications (p=0.001). Conclusion: Complex procedures often require optimization to prevent complications and improve survival. While patient biomarkers – BMI and weight – are used for optimization, this research advocates for the identification of sarcopenia status for pre-operative planning. Sarcopenia may be an indicator of advanced disease requiring further treatment and is an emerging area of research. Larger studies are required to confirm these findings and to assess the reversibility of sarcopenia after surgery.

Keywords: sarcopaenia, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, surgical oncology

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

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Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: Rahal Nacer, Beghdad Houda, Tehami Mohamed, Souici Abdelaziz

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Although the shrinkage of the concrete causes undesirable parasitic effects to the structure, it can then harm the resistance and the good appearance of the structure. Long term behaviourmodelling of steel-concrete composite beams requires the use of the time variable and the taking into account of all the sustained stress history of the concrete slab constituting the cross section. The work introduced in this article is a theoretical study of the behaviour of composite beams with respect to the phenomenon of concrete shrinkage. While using the theory of the linear viscoelasticity of the concrete, and on the basis of the rate of creep method, in proposing an analytical model, made up by a system of two linear differential equations, emphasizing the effects caused by shrinkage on the resistance of a steel-concrete composite beams. Results obtained from the application of the suggested model to a steel-concrete composite beam are satisfactory.

Keywords: composite beams, shrinkage, time, rate of creep method, viscoelasticity theory

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Authors: Rebeca V. Tholen, Elaine Bundy

Abstract:

Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

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Authors: Maryam Shahbazi, Amy B. Cerato

Abstract:

The importance of a systems’ natural frequency (fn) emerges when the vibration force frequency is equivalent to foundation's fn which causes response amplitude (resonance) that may cause irreversible damage to the structure. Several factors such as pile geometry (e.g., length and diameter), soil density, load magnitude, pile condition, and physical structure affect the fn of a soil-pile system; some of these parameters are evaluated in this study. Although experimental and analytical studies have assessed the fn of a soil-pile system, few have included individual and grouped helical piles. Thus, the current study aims to provide quantitative data on dynamic characteristics of helical pile-soil systems from full-scale shake table tests that will allow engineers to predict more realistic dynamic response under motions with variable frequency ranges. To evaluate the fn of single and grouped helical piles in dry dense sand, full-scale shake table tests were conducted in a laminar box (6.7 m x 3.0 m with 4.6 m high). Two different diameters (8.8 cm and 14 cm) helical piles were embedded in the soil box with corresponding lengths of 3.66m (excluding one pile with length of 3.96) and 4.27m. Different configurations were implemented to evaluate conditions such as fixed and pinned connections. In the group configuration, all four piles with similar geometry were tied together. Simulated real earthquake motions, in addition to white noise, were applied to evaluate the wide range of soil-pile system behavior. The Fast Fourier Transform (FFT) of measured time history responses using installed strain gages and accelerometers were used to evaluate fn. Both time-history records using accelerometer or strain gages were found to be acceptable for calculating fn. In this study, the existence of a pile reduced the fn of the soil slightly. Greater fn occurred on single piles with larger l/d ratios (higher slenderness ratio). Also, regardless of the connection type, the more slender pile group which is obviously surrounded by more soil, yielded higher natural frequencies under white noise, which may be due to exhibiting more passive soil resistance around it. Relatively speaking, within both pile groups, a pinned connection led to a lower fn than a fixed connection (e.g., for the same pile group the fn’s are 5.23Hz and 4.65Hz for fixed and pinned connections, respectively). Generally speaking, a stronger motion causes nonlinear behavior and degrades stiffness which reduces a pile’s fn; even more, reduction occurs in soil with a lower density. Moreover, fn of dense sand under white noise signal was obtained 5.03 which is reduced by 44% when an earthquake with the acceleration of 0.5g was applied. By knowing the factors affecting fn, the designer can effectively match the properties of the soil to a type of pile and structure to attempt to avoid resonance. The quantitative results in this study assist engineers in predicting a probable range of fn for helical pile foundations under potential future earthquake, and machine loading applied forces.

Keywords: helical pile, natural frequency, pile group, shake table, stiffness

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Authors: Dursun Kalebaşi

Abstract:

When we examine the history of mankind (from the past up to the present), we see that millions of people died because of the wars. Especially, since the beginning of 19th century, the increase of the human death rate is caused mostly by the regional conflicts and natural disasters rather than the wars. From that point of view, the biggest threat humanity face today is temperature increase and climate change that started to emerge in recent years. When we take into account the natural disasters on one hand and refuges that flee from regional conflicts on the other, it stands out as a dramatic situation because of the huge human losses. In this context, most of the countries started to give more importance to Search and Rescue (SAR) operations to stop the loss of lives or decrease the death rate. This article will tell about the SAR activities in Turkey since 2000 and discuss the Turkey’s contributions to Rescue Missions after the natural disasters in different parts of the world. Moreover, there will be some new highlights to a more habitable and more peaceful world through the SAR missions.

Keywords: search and rescue, natural disasters, migration and world peace, Turkish army forces

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Authors: Emrah Denizhan

Abstract:

Policing studies have drawn attention to the changing role of law enforcement in favour of harsh policing strategies throughout the world. Turkey has become part of this global transition process by restructuring its policing through a series of allegedly democratic amendments to Turkish law. Nevertheless, severe violations of human rights continue to be widely experienced phenomena. This paper suggests problematizing the changing judicial framework of policing together with the persistent aggressive policing in Turkey, by considering Agamben's concept of police as a sovereign entity – sovereign police. In so doing, the paper analytically dissects sovereign police into three premises: the criminalization of the (perceived) enemy, the militarization of the police, and finally, the discretionary use of force. This examination of the state’s early ethno-racial policies and the history of the Turkish police force, and of the changing judicial framework of police-related laws in the 2000s, demonstrates that certain ‘internal enemies’ have been criminalized by increasingly militarized police using escalating discretionary use of force.

Keywords: criminalization, discretionary use of force, policing, sovereignty

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Authors: Soltani Amir, Wang Xuan

Abstract:

The advantage of using non-linear passive damping system in vibration control of two adjacent structures is investigated under their base excitation. The base excitation is El Centro earthquake record acceleration. The damping system is considered as an optimum and effective non-linear viscous damper that is connected between two adjacent structures. A Matlab program is developed to produce the stiffness and damping matrices and to determine a time history analysis of the dynamic motion of the system. One structure is assumed to be flexible while the other has a rule as laterally supporting structure with rigid frames. The response of the structure has been calculated and the non-linear damping coefficient is determined using optimum LQR algorithm in an optimum vibration control system. The non-linear parameter of damping system is estimated and it has shown a significant advantage of application of this system device for vibration control of two adjacent tall building.

Keywords: active control, passive control, viscous dampers, structural control, vibration control, tall building

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Authors: Leszek Chybowski, Artur Bejger, Katarzyna Gawdzińska

Abstract:

Subversion analysis is a tool used in the TRIZ (Theory of Inventive Problem Solving) methodology. This article introduces the history and describes the process of subversion analysis, as well as function analysis and analysis of the resources, used at the design stage when generating possible undesirable situations. The article charts the course of subversion analysis when applied to a fuel injection nozzle of a marine engine. The work describes the fuel injector nozzle as a technological system and presents principles of analysis for the causes of a cracked tip of the nozzle body. The system is modelled with functional analysis. A search for potential causes of the damage is undertaken and a cause-and-effect analysis for various hypotheses concerning the damage is drawn up. The importance of particular hypotheses is evaluated and the most likely causes of damage identified.

Keywords: complex technical system, fuel injector, function analysis, importance analysis, resource analysis, sabotage analysis, subversion analysis, TRIZ (Theory of Inventive Problem Solving)

Procedia PDF Downloads 618