Search results for: cross-domain data access control

Authors: Jessica M. Black

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Although much of natural and social science research aims to enhance human flourishing and address social problems, the training within the two fields is significantly different across theory, methodology, and implementation of results. Social scientists are trained in social, psychological, and to the extent that it is relevant to their discipline, spiritual development, theory, and accompanying methodologies. They tend not to receive training or learn about accompanying methodology related to interrogating human development and social problems from a biological perspective. On the other hand, those in the natural sciences, and for the purpose of this work, human biological sciences specifically – biology, neuroscience, genetics, epigenetics, and physiology – are often trained first to consider cellular development and related methodologies, and may not have opportunity to receive formal training in many of the foundational principles that guide human development, such as systems theory or person-in-environment framework, methodology related to tapping both proximal and distal psycho-social-spiritual influences on human development, and foundational principles of equity, justice and inclusion in research design. There is a need for disciplines heretofore siloed to know one another, to receive streamlined, easy to access training in theory and methods from one another and to learn how to build interdisciplinary teams that can speak and act upon a shared research language. Team science is more essential than ever, as are transdisciplinary approaches to training and research design. This study explores the use of a methodological toolbox that natural and social scientists can use by employing a decision-making tree regarding project aims, costs, and participants, among other important study variables. The decision tree begins with a decision about whether the researcher wants to learn more about social sciences approaches or biological approaches to study design. The toolbox and platform are flexible, such that users could also choose among modules, for instance, reviewing epigenetics or community-based participatory research even if those are aspects already a part of their home field. To start, both natural and social scientists would receive training on systems science, team science, transdisciplinary approaches, and translational science. Next, social scientists would receive training on grounding biological theory and the following methodological approaches and tools: physiology, (epi)genetics, non-invasive neuroimaging, invasive neuroimaging, endocrinology, and the gut-brain connection. Natural scientists would receive training on grounding social science theory, and measurement including variables, assessment and surveys on human development as related to the developing person (e.g., temperament and identity), microsystems (e.g., systems that directly interact with the person such as family and peers), mesosystems (e.g., systems that interact with one another but do not directly interact with the individual person, such as parent and teacher relationships with one another), exosystems (e.g., spaces and settings that may come back to affect the individual person, such as a parent’s work environment, but within which the individual does not directly interact, macrosystems (e.g., wider culture and policy), and the chronosystem (e.g., historical time, such as the generational impact of trauma). Participants will be able to engage with the toolbox and one another to foster increased transdisciplinary work

Keywords: methodology, natural science, social science, transdisciplinary

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Authors: Lauren G. Coggins

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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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Authors: Getachew Kuma Watiro

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The need for solar energy is constantly increasing and it is widely available on the earth’s surface. Photovoltaic technology is one of the most capable of all viable energy technology and is seen as a promising approach to the control era as it is readily available and has zero carbon emissions. Inexpensive and versatile solar cells have achieved the conversion efficiency and long life of dye-sensitized solar cells, improving the conversion efficiency from the sun to electricity. DSSCs have received a lot of attention for Various potential commercial uses, such as mobile devices and portable electronic devices, as well as integrated solar cell modules. The systematic reviews were used to show the critical impact of additive C-dots in the Dye-Sensitized solar cell for energy application technology. This research focuses on the following methods to synthesize nanoparticles such as facile, polyol, calcination, and hydrothermal technique. In addition to these, there are additives C-dots by the Hydrothermal method. This study deals with the progressive development of DSSC in photovoltaic technology. The applications of single and heterojunction structure technology devices were used (ZnO, NiO, SnO2, and NiO/ZnO/N719) and applied some additives C-dots (ZnO/C-dots /N719, NiO/C-dots /N719, SnO2 /C-dots /N719 and NiO/ZnO/C-dots/N719) and the effects of C-dots were reviewed. More than all, the technology of DSSC with C-dots enhances efficiency. Finally, recommendations have been made for future research on the application of DSSC with the use of these additives.

Keywords: dye-sensitized solar cells, heterojunction’s structure, carbon dot, conversion efficiency

Procedia PDF Downloads 113

Authors: Aleema Rahman

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Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.

Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development

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Authors: Yuki Hara

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Healthy assets are recognized as important for all people in the world through experiencing COVID-19. Each part of life and work is important to be changed against the preceding wide-spreading of COVID-19. Furthermore, it is necessary to innovate the whole structure of a city upon the sum of the parts. This study aims at creating a comprehensive strategy from a small practice of making healthier lives with collaborating local actors for a city. This paper employs action research as the research framework. The core practice is the 'Ken’iku Festival' at Ken’iku Festival Committee. The field locates the urban-rural fringe in the northwest part of Fujisawa city, Kanagawa prefecture, Japan. The data is collected through the author's practices for three years from the observations and interviews at meetings and discussions among stakeholders, texts in municipal reports, books, and movies, 3 questionnaires for customers and stakeholders at the Ken’iku Festival. These data are analysed by qualitative methods. The results show that couples in their 40s with children and couples or friends over the 70s are at the heart of promoting healthy lifestyles. In contrast, 40% of the visitors at the festival are the people who have no idea or no interest in healthier actions, which the committee has to suggest healthy activities through more pleasing services. The committee could organize staff and local actors as the core parties involved through gradually expanding its tasks relating to the local practices. This private sectoral activity from health promotion is covering a part of the whole-city planning of Fujisawa municipality by including many people over organisations into one community. This paper concludes from local practice networking through the festival that a comprehensive strategy for a healthy city is both a practical approach easily applied to each partner and one of the holistic services.

Keywords: communal practice network, healthy cities, health & development, health promotion, with and after COVID-19

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Authors: Hui Ling Chen

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This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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Authors: Nirmala Lama

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The construction of high dams has led to significant challenges in managing flow rates discharging over spillways, resulting in cavitation damages on hydraulic surfaces. To address this, aerator devices were designed and installed to promote fore aeration, thereby controlling and mitigating damages caused by cavitation. Consequently, these aerator types, three-dimensional aerators (3DAEs), have demonstrated superior efficiency in introducing forced air into the flow.This research focuses on the installation and evaluation of three-dimensional aerator devices at the high discharge spillway surface. In the laboratory, the air concentration downstream of the hydraulic structures was extensively measured, and the data were analyzed in details.Multiple flow scenarios and structural arrangements of the aerators were adopted for the study. The outcomes of these experiments are listed as In terms of air concentration value, the comparison between 3 DAE (three-dimensional aerator) with offset only and offset with ramp reveals significant differences. The concentration value on the side wall was justified. The side cavity length was found to increase with higher approach Froude numbers and lateral enlargement widths. Furthermore, 3DAE exhibited shorter side cavity lengths compared to three-dimensional aerator devices without ramps (3DAD), a beneficial features for controlling water fins. An empirical formula to express the side cavity length was derived from the measured data. Also, the comparison were made on the basis of water fin formation between the different arrangements of 3D aerators. In conclusion, this research provides valuable insights into the performance of three-dimensional aerators in mitigating cavitation damages and controlling water fins in high dam spillways. The findings offer practical implications for designers and engineers seeking to enhance the efficiency and safety of hydraulic structures subjected to high flow rates.

Keywords: three-dimension aerator, cavity, water fin, air entrainment

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Authors: László L. Lippai

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In addition to the fact that mental health bears great significance to a particular individual, it can also be regarded as an organizational, community and societal resource. Within the Szeged Health Promotion Research Group, we conducted mental health surveys on two levels: The inhabitants of a medium-sized Hungarian town and students of a Hungarian university with a relatively big headcount were requested to participate in surveys whose goals were to define local government priorities and organization-level health promotion programmes, respectively. To facilitate professional decision-making, we defined three, pragmatically relevant, groups of the target population: the mentally healthy, the vulnerable and the endangered. In order to determine which group a person actually belongs to, we designed a simple and quick measurement tool, which could even be utilised as a smoothing method, the Mental State Questionnaire validity of the above three categories was verified by analysis of variance against psychological quality of life variables. We demonstrate the pragmatic significance of our method via the analyses of the scores of our two mental health surveys. On town level, during our representative survey in Hódmezővásárhely (N=1839), we found that 38.7% of the participants was mentally healthy, 35.3% was vulnerable, while 16.3% was considered as endangered. We were able to identify groups that were in a dramatic state in terms of mental health. For example, such a group consisted of men aged 45 to 64 with only primary education qualification and the ratios of the mentally healthy, vulnerable and endangered were 4.5, 45.5 and 50%, respectively. It was also astonishing to see to what a little extent qualification prevailed as a protective factor in the case of women. Based on our data, the female group aged 18 to 44 with primary education—of whom 20.3% was mentally healthy, 42.4% vulnerable and 37.3% was endangered—as well as the female group aged 45 to 64 with university or college degree—of whom 25% was mentally healthy, 51.3 vulnerable and 23.8% endangered—are to be handled as priority intervention target groups in a similarly difficult position. On organizational level, our survey involving the students of the University of Szeged, N=1565, provided data to prepare a strategy of mental health promotion for a university with a headcount exceeding 20,000. When developing an organizational strategy, it was important to gather information to estimate the proportions of target groups in which mental health promotion methods; for example, life management skills development, detection, psychological consultancy, psychotherapy, would be applied. Our scores show that 46.8% of the student participants were mentally healthy, 42.1% were vulnerable and 11.1% were endangered. These data convey relevant information as to the allocation of organizational resources within a university with a considerable headcount. In conclusion, The Mental State Questionnaire, as a valid smoothing method, is adequate to describe a community in a plain and informative way in the terms of mental health. The application of the method can promote the preparation, design and implementation of mental health promotion interventions. 

Keywords: health promotion, mental health promotion, mental state questionnaire, psychological well-being

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Authors: Rosa Buxeda, Lorenzo Saliceti-Piazza, Rodolfo J. Romañach, Luis Ríos, Sandra L. Maldonado-Ramírez

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Biopharmaceuticals manufacturing is one of the major economic activities worldwide. Ninety-three percent of the workforce in a biomanufacturing environment concentrates in production-related areas. As a result, strategic collaborations between industry and academia are crucial to ensure the availability of knowledgeable workforce needed in an economic region to become competitive in biomanufacturing. In the past decade, our institution has been a key strategic partner with multinational biotechnology companies in supplying science and engineering graduates in the field of industrial biotechnology. Initiatives addressing all levels of the educational pipeline, from K-12 to college to continued education for company employees have been established along a ten-year span. The Amgen BioTalents Program was designed to provide undergraduate science and engineering students with training in biomanufacturing. The areas targeted by this educational program enhance their academic development, since these topics are not part of their traditional science and engineering curricula. The educational curriculum involved the process of producing a biomolecule from the genetic engineering of cells to the production of an especially targeted polypeptide, protein expression and purification, to quality control, and validation. This paper will report and describe the implementation details and outcomes of the first sessions of the program.

Keywords: biomanufacturing curriculum, interdisciplinary learning, workforce development, industry-academia partnering

Procedia PDF Downloads 279

Authors: Sky Chou, Joseph C. Chen

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This paper focuses on using six sigma methodologies to reach the desired shrinkage of a manufactured high-density polyurethane (HDPE) part produced by the injection molding machine. It presents a case study where the correct shrinkage is required to reduce or eliminate defects and to improve the process capability index Cp and Cpk for an injection molding process. To improve this process and keep the product within specifications, the six sigma methodology, design, measure, analyze, improve, and control (DMAIC) approach, was implemented in this study. The six sigma approach was paired with the Taguchi methodology to identify the optimized processing parameters that keep the shrinkage rate within the specifications by our customer. An L9 orthogonal array was applied in the Taguchi experimental design, with four controllable factors and one non-controllable/noise factor. The four controllable factors identified consist of the cooling time, melt temperature, holding time, and metering stroke. The noise factor is the difference between material brand 1 and material brand 2. After the confirmation run was completed, measurements verify that the new parameter settings are optimal. With the new settings, the process capability index has improved dramatically. The purpose of this study is to show that the six sigma and Taguchi methodology can be efficiently used to determine important factors that will improve the process capability index of the injection molding process.

Keywords: injection molding, shrinkage, six sigma, Taguchi parameter design

Procedia PDF Downloads 170

Authors: Azizza Mala, Babo Fadlalla, Elnour Mohamed, Siran Wang, Junfeng Li, Tao Shao

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Sweet sorghum is considered one of the best plants for silage production and is now a more important feed crop in many countries worldwide. It is simple to ensile because of its high water-soluble carbohydrates (WSC) concentration and low buffer capacity. This study investigated the effect of adding Pediococcus acidilactici AZZ5 and Lactobacillus plantarum AZZ4 isolated from elephant grass on the fermentation quality of sweet sorghum silage. One commercial bacteria Lactobacillus Plantarum, Ecosyl MTD/1(C.B.)), and two strains were used as additives Pediococcus acidilactici (AZZ5), Lactobacillus plantarum subsp. Plantarum (AZZ4) at 6 log colony forming units (cfu)/g of fresh sweet sorghum grass in laboratory silos (1000g). After 15, 30, and 60 days, the silos for each treatment were opened. All of the isolated strains enhanced the silage quality of sweet sorghum silage compared to the control, as evidenced by significantly (P < 0.05) lower ammonia nitrogen (NH3-N) content and undesirable microbial counts, as well as greater lactic acid (L.A.) contents and lactic acid/acetic acid (LA/AA) ratios. In addition, AZZ4 performed better than all other inoculants during ensiling, as evidenced by a significant (P < 0.05) reduction in pH and ammonia-N contents and a significant increase in lactic acid contents.

Keywords: fermentation, lactobacillus plantarum, lactic acid bacteria, pediococcus acidilactic, sweet sorghum

Procedia PDF Downloads 74

Authors: Mohammed Al-Bloushi, Sanghyun Jeong, Torove Leiknes

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Biofouling in the open recirculating cooling water systems may cause biological corrosion, which can reduce the performance, increase the energy consummation and lower heat exchange efficiencies of the cooling tower. Seawater cooling towers are prone to biofouling due to the presences of organic and inorganic compounds in the seawater. The availability of organic and inorganic nutrients, along with sunlight and continuous aeration of the cooling tower contributes to an environment that is ideal for microbial growth. Various microorganisms (algae, fungi, and bacteria) can grow in a cooling tower system under certain environmental conditions. The most commonly being used method to control the biofouling in the cooling tower is the addition of biocides such as chlorination. In this study, algae containing diatom and green algae were added to the cooling tower basin, and its viability was monitored in the recirculating cooling seawater loop as well as in the cooling tower basin. Continuous addition of biocides was employed in pilot-scale seawater cooling towers, and it was operated continuously for 2 months. Three different types of oxidizing biocides, namely chlorine, chlorine dioxide and ozone, were tested. The results showed that all biocides were effective in keeping the biological growth to the minimum regardless of algal addition. Amongst the biocides, ozone could reduce 99% of total live cells of bacteria and algae, followed by chlorine dioxide at 97%, while the conventional chlorine showed only 89% reduction in the bioactivities.

Keywords: algae, biocide, biofouling, seawater cooling tower

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Authors: Nail Nazarov, Vladimir Zobov, Alexandra Vyshtakalyuk, Vyacheslav Semenov, Irina Galyametdinova, Vladimir Reznik

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There have been studied effects of xymedon and six new pyrimidine derivatives, that are close and distant analogs of xymedon, on rats' working capacity in the test 'swimming to failure'. It has been shown that a single administration of the studied compounds did not have a statistically significant effect in the test. In the conditions of multiple intraperitoneal administration of the studied pyrimidine derivatives, the compound L-ascorbate, 1-(2-hydroxyethyl)-4.6-dimethyl-1.2-dihydropyrimidine-2-one had the lowest toxicity and the most pronounced actoprotective effect. Introduction in the dose of 20 mg/kg caused a statistically significant increase 440 % in the duration of swimming of rats on the 14th day of the experiment compared with the control group. Multiple administration of the compound in the conditions of physical load did not affect leucopoiesis but stimulates erythropoiesis resulting in an increase in the number of erythrocytes and a hemoglobin level. The substance introduction under mixed exhausting loads prevented such changes of blood biochemical parameters as reduction of glucose, increased of urea and lactic acid levels, what indicates improvement in the animals' tolerability of loads and an anti-catabolic effect of the compound. Absence of hepato and cardiotoxic effects of the substance has been shown. This work was performed with the financial support of Russian Science Foundation (grant № 14-50-00014).

Keywords: actoprotectors, physical working capacity, pyrimidine derivatives, xymedon

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Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

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Authors: Omogoriola Hannah Omoloye

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Fish is a key ingredient on the global menu, a vital factor in the global environment and an important basis for livelihood worldwide1. The length – weight relationships (LWRs) is of great importance in fishery assessment2,3. Its importance is pronounced in estimated the average weight at a given length group4 and in assessing the relative well being of a fish population5. Length and weight measurement in conjunction with age data can give information on the stock composition, age at maturity, life span, mortality, growth and production4,5,6,7. In addition, the data on length and weight can also provides important clues to climatic and environmental changes and the change in human consumption practices8,9. However, the size attained by the individual fish may also vary because of variation in food supply, and these in turn may reflect variation in climatic parameters and in the supply of nutrient or in the degree of competition for food. Environment deterioration, for example, may reduce growth rates and will cause a decrease in the average age of the fish. The condition factor and the relative condition factor10 are the quantitative parameters of the well being state of the fish and reflect recent feeding condition of the fish. It is based on the hypothesis that heavier fish of a given length are in better condition11. This factor varies according to influences of physiological factors, fluctuating according to different stages of the development. Condition factor has been used as an index of growth and feeding intensity12. Condition factor decrease with increase in length 12,13 and also influences the reproductive cycle in fish14. The objective here is to determine the length-weight relationships and condition factor for direct use in fishery assessment and for future comparisons between populations of the same species at different locations. To provide quantitative information on the biology of marine fish species trawl from Nigeria coastal water.

Keywords: condition factor, growth pattern, marine fish species, Nigerian Coastal water

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Authors: Adel Khorramrouz, Monireh Ahmadi Bani, Ehsan Norouzi, Morvarid Lalenoor

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Background: Plantar pressure distribution measurement has been used for a long time to assess foot disorders. Plantar pressure is an important component affecting the foot and ankle function and Changes in plantar pressure distribution could indicate various foot and ankle disorders. Morphologic and mechanical properties of the foot may be important factors affecting the plantar pressure distribution. Accurate and early measurement may help to reduce the prevalence of pes planus. With recent developments in technology, new techniques such as machine learning have been used to assist clinicians in predicting patients with foot disorders. Significance of the study: This study proposes a neural network learning-based flat foot classification methodology using static foot pressure distribution. Methodologies: Data were collected from 895 patients who were referred to a foot clinic due to foot disorders. Patients with pes planus were labeled by an experienced physician based on clinical examination. Then all subjects (with and without pes planus) were evaluated for static plantar pressures distribution. Patients who were diagnosed with the flat foot in both feet were included in the study. In the next step, the leg length was normalized and the network was trained for plantar pressure mapping images. Findings: From a total of 895 image data, 581 were labeled as pes planus. A computational neural network (CNN) ran to evaluate the performance of the proposed model. The prediction accuracy of the basic CNN-based model was performed and the prediction model was derived through the proposed methodology. In the basic CNN model, the training accuracy was 79.14%, and the test accuracy was 72.09%. Conclusion: This model can be easily and simply used by patients with pes planus and doctors to predict the classification of pes planus and prescreen for possible musculoskeletal disorders related to this condition. However, more models need to be considered and compared for higher accuracy.

Keywords: foot disorder, machine learning, neural network, pes planus

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Authors: Pouriya Darabiyan, Hadis Nazari, Kourosh Zarea, Saeed Ghanbari, Zeinab Raiesifar, Morteza Khafaie, Hanna Tuvesson

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Introduction Since the beginning of mobile phone addiction, alexithymia, depression, anxiety and stress have been stated as risk factors for Internet addiction, so this study was conducted with the aim of investigating the relationship between Alexithymia and Mobile phone addiction along with the mediating role of anxiety, stress and depression. Materials and methods In this descriptive-analytical and cross-sectional study in 2022, 412 students School of Nursing & Midwifery of Ahvaz Jundishapur University of Medical Sciences were included in the study using available sampling method. Data collection tools were: Demographic Information Questionnaire, Toronto Alexithymia Scale (TAS-20), Depression, Anxiety, Stress Scale (DASS-21) and Mobile Phone Addiction Index (MPAI). Frequency, Pearson correlation coefficient test and linear regression were used to describe and analyze the data. Also, structural equation models and path analysis method were used to investigate the direct and indirect effects as well as the total effect of each dimension of Alexithymia on Mobile phone addiction with the mediating role of stress, depression and anxiety. Statistical analysis was done by SPSS version 22 and Amos version 16 software. Results Alexithymia was a predictive factor for mobile phone addiction. Also, Alexithymia had a positive and significant effect on depression, anxiety and stress. Depression, anxiety and stress had a positive and significant effect on mobile phone addiction. Depression, anxiety and stress variables played the role of a relative mediating variable between Alexithymia and mobile phone addiction. Alexithymia through depression, anxiety and stress also has an indirect effect on Internet addiction. Conclusion Alexithymia is a predictive factor for mobile phone addiction; And the variables of depression, anxiety and stress play the role of a relative mediating variable between Alexithymia and mobile phone addiction.

Keywords: alexithymia, mobile phone, depression, anxiety, stress

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Authors: Nuur Insan Tangkelangi

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Needs on academic writing competence as the primary focus in higher education encourage the university institutions around the world to provide academic writing courses to support their students dealing with their tasks pertaining to this competence. However, a pilot study conducted previously in one of the universities in Palopo, a city in South Sulawesi, revealed that even though the institution has provided academic writing courses, supported by some workshops related to academic writing and some supporting facilities at campus, the students still face difficulties in completing their assignments related to academic writing, particularly in writing their theses. The present study focuses on investigating the specific needs of the students in the same institution in terms of competences required in academic writing. It is also carried out to examine whether the syllabus exists and accommodates the students’ needs or not. Questionnaire and interview were used to collect data from sixty students of sixth semester and two lecturers of the academic courses. The results reveal that the students need to learn all aspects of linguistic competence (language features, lexical phrases, academic language and vocabulary, and proper language) and some aspects in discourse competence (how to write introduction, search for appropriate literature, design research method, write coherent paragraphs, refer to sources, summarize and display data, and link sentences smoothly). Regarding the syllabus, it is found that the academic writing courses provided in the institution, where this study takes place, do not have syllabus. This condition is different from other institutions which provide syllabi for all courses. However, at the commencement of the course, the students and the lecturers have negotiated their learning goals, topics discussed, learning activities, and assessment criteria for the course. Therefore, even though the syllabus does not exist, but the elements of the syllabus are there. The negotiation between the students and the lecturers contributes to the students’ attitude toward the courses. The students are contented with the course and they feel that their needs in academic writing have been accommodated. However, some suggestions for the next academic writing courses are stated by the students. Considering the results of this study, a syllabus is then proposed which is expected to accommodate the specific needs of students in that institution.

Keywords: Students' needs, academic writing, syllabus design for instruction, case study

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Authors: Abdulaziz Alsadhan, Naveed Khan

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In recent years intrusions on computer network are the major security threat. Hence, it is important to impede such intrusions. The hindrance of such intrusions entirely relies on its detection, which is primary concern of any security tool like Intrusion Detection System (IDS). Therefore, it is imperative to accurately detect network attack. Numerous intrusion detection techniques are available but the main issue is their performance. The performance of IDS can be improved by increasing the accurate detection rate and reducing false positive. The existing intrusion detection techniques have the limitation of usage of raw data set for classification. The classifier may get jumble due to redundancy, which results incorrect classification. To minimize this problem, Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA), and Local Binary Pattern (LBP) can be applied to transform raw features into principle features space and select the features based on their sensitivity. Eigen values can be used to determine the sensitivity. To further classify, the selected features greedy search, back elimination, and Particle Swarm Optimization (PSO) can be used to obtain a subset of features with optimal sensitivity and highest discriminatory power. These optimal feature subset used to perform classification. For classification purpose, Support Vector Machine (SVM) and Multilayer Perceptron (MLP) used due to its proven ability in classification. The Knowledge Discovery and Data mining (KDD’99) cup dataset was considered as a benchmark for evaluating security detection mechanisms. The proposed approach can provide an optimal intrusion detection mechanism that outperforms the existing approaches and has the capability to minimize the number of features and maximize the detection rates.

Keywords: Particle Swarm Optimization (PSO), Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA), Local Binary Pattern (LBP), Support Vector Machine (SVM), Multilayer Perceptron (MLP)

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Authors: Mohamed Aboelghar, Ayman Abou Hadid, Usama Albehairy, Asmaa Khater

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Sustainable agricultural development of the desert areas of Egypt under the pressure of irrigation water scarcity is a significant national challenge. Existing water harvesting techniques on the northwest coast of Egypt do not ensure the optimal use of rainfall for agricultural purposes. Basin-scale hydrology potentialities were studied to investigate how available annual rainfall could be used to increase agricultural production. All data related to agricultural production included in the form of geospatial layers. Thematic classification of Sentinal-2 imagery was carried out to produce the land cover and crop maps following the (FAO) system of land cover classification. Contour lines and spot height points were used to create a digital elevation model (DEM). Then, DEM was used to delineate basins, sub-basins, and water outlet points using the Soil and Water Assessment Tool (Arc SWAT). Main soil units of the study area identified from Land Master Plan maps. Climatic data collected from existing official sources. The amount of precipitation, surface water runoff, potential, and actual evapotranspiration for the years (2004 to 2017) shown as results of (Arc SWAT). The land cover map showed that the two tree crops (olive and fig) cover 195.8 km2 when herbaceous crops (barley and wheat) cover 154 km2. The maximum elevation was 250 meters above sea level when the lowest one was 3 meters below sea level. The study area receives a massive variable amount of precipitation; however, water harvesting methods are inappropriate to store water for purposes.

Keywords: water catchements, remote sensing, GIS, sustainable agricultural development

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Authors: Moen Torill, Rismark Marit, Astrid M. Solvberg

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In Norway, every municipality shall provide an educational psychological service, EPS, to support kindergartens and schools in their work with children and youths with special needs. The EPS focus its work on individuals, aiming to identify special needs and to give advice to teachers and parents when they ask for it. In addition, the service also give priority to prevention and system intervention in kindergartens and schools. To master these big tasks university courses are established to support EPS counsellors' continuous learning. There is, however, a need for more in-depth and systematic knowledge on how they experience the courses they attend. In this study, EPS counsellors’ reflection logs during a particular course are investigated. The research question is: what are the content and priorities of the reflections that are communicated in the logs produced by the educational psychological counsellors during a post-graduate course? The investigated course is a credit course organized over a one-year period in two one-semester modules. The altogether 55 students enrolled in the course work as EPS counsellors in various municipalities across Norway. At the end of each day throughout the course period, the participants wrote reflection logs about what they had experienced during the day. The data material consists of 165 pages of typed text. The collaborating researchers studied the data material to ascertain, differentiate and understand the meaning of the content in each log. The analysis also involved the search for similarity in content and development of analytical categories that described the focus and primary concerns in each of the written logs. This involved constant 'critical and sustained discussions' for mutual construction of meaning between the co-researchers in the developing categories. The process is inspired by Grounded Theory. This means that the concepts developed during the analysis derived from the data material and not chosen prior to the investigation. The analysis revealed that the concept 'Useful' frequently appeared in the participants’ reflections and, as such, 'Useful' serves as a core category. The core category is described through three major categories: (1) knowledge sharing (concerning direct and indirect work with students with special needs) with colleagues is useful, (2) reflections on models and theoretical concepts (concerning students with special needs) are useful, (3) reflection on the role as EPS counsellor is useful. In all the categories, the notion of useful occurs in the participants’ emphasis on and acknowledgement of the immediate and direct link between the university course content and their daily work practice. Even if each category has an importance and value of its own, it is crucial that they are understood in connection with one another and as interwoven. It is the connectedness that gives the core category an overarching explanatory power. The knowledge from this study may be a relevant contribution when it comes to designing new courses that support continuing professional development for EPS counsellors, whether for post-graduate university courses or local courses at the EPS offices or whether in Norway or other countries in the world.

Keywords: constructing and circulating knowledge, educational-psychological counsellor, higher education, professional development

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Authors: Mustapha Achibane, Imane Allam

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Since the nineties, all Moroccan banking institutions have to respect an arsenal of prudential ratios. The respect of these prudential measures aims to ensure the financial system stability. In order to do so, regulatory authorities tried to reduce the financial and operational risks incurred by the banking entities. Meanwhile, regulatory authorities demanded a balance sheet management work from banks. They also asked them to establish a management control system to manage operational risk, as well as an effort in terms of incurred risk-based commitments. Therefore, the prudential approach has a macroeconomic nature and it is presented as a determinant of the operational, microeconomic approach. This operational approach takes the form of a strategy that each banking entity must develop to manage the different banking risks. This study seeks to analyze the problem of risk management between the prudential and the operational approaches. It was processed through a literature review followed by an analysis of the Moroccan banking sector’s performance. At first, we will reconcile the inductive logic and then, the analytical one. The first approach consists of analyzing the phenomenon from a normative and conceptual perspective, while the second one will consist of considering the Moroccan banking system and analyzing the behavior of Moroccan banking entities in terms of risk management and performance. The results identified a favorable growth in terms of performance, despite the huge provisioning effort made to meet the international standards and the harmonization of the regulations.

Keywords: banking performance, financial intermediation, operational approach, prudential standards, risk management

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Authors: Walaa Diab, Baher Atlam, Nadia El Nimer

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Egypt faces many obvious economic challenges, and it is so clear that a real economic transformation is needed to address those problems, especially after the recent decisions of floating the Egyptian pound and the gradual subsidy cuts that are trying to meet the needed conditions to get the IMF support of (a £12bn loan) for its economic reform program. Following the post-2008 revival of the interest in the fiscal policy and its vital role in speeding up or slowing down the economic growth. Here comes the value of this paper as it seeks to analyze the macroeconomic effects of fiscal policy in Egypt by applying A Bayesian SVAR Approach. The study uses the Bayesian method because it includes the prior information and no relevant information is omitted and so it is well suited for rational, evidence-based decision-making. Since the study aims to define the effects of fiscal policy shocks in Egypt to help the decision-makers in determining the proper means to correct the structural problems in the Egyptian economy, it has to study the period of 1990s economic reform, but unfortunately; the available data is on an annual frequency. Thus, it uses annual time series to study the period 1991: 2005 And quarterly data over the period 2006–2016. It uses a set of six main variables includes government expenditure and net tax revenues as fiscal policy arms affecting real GDP, unemployment, inflation and the interest rate. The study also tries to assess the 'crowding out' effects by considering the effects of government spending and government revenue shocks on the composition of GDP, namely, on private consumption and private investment. Last but not least the study provides its policy implications regarding the needed role of fiscal policy in Egypt in the upcoming economic reform building on the results it concludes from the previous reform program.

Keywords: fiscal policy, government spending, structural vector autoregression, taxation

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Authors: Hyuk-Hoon Kim, Young Gi Min

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Background: In carbon monoxide (CO) intoxication, the pathophysiology of delayed neurological sequelae (DNS) is very complex and remains poorly understood. And predicting whether patients who exhibit resolved acute symptoms have escaped or will experience DNS represents a very important clinical issue. Brain magnetic resonance (MR) imaging has been conducted to assess the severity of brain damage as an objective method to predict prognosis. And co-ingestion of a second poison in patients with intentional CO poisoning occurs in almost one-half of patients. Among patients with co-ingestions, 66% ingested ethanol. We assessed the effects of ethanol on neurologic sequelae prevalence in acute CO intoxication by means of abnormal lesion in brain MR. Method: This study was conducted retrospectively by collecting data for patients who visited an emergency medical center during a period of 5 years. The enrollment criteria were diagnosis of acute CO poisoning and the measurement of the serum ethanol level and history of taking a brain MR during admission period. Official readout data by radiologist are used to decide whether abnormal lesion is existed or not. The enrolled patients were divided into two groups: patients with abnormal lesion and without abnormal lesion in Brain MR. A standardized extraction using medical record was performed; Mann Whitney U test and logistic regression analysis were performed. Result: A total of 112 patients were enrolled, and 68 patients presented abnormal brain lesion on MR. The abnormal brain lesion group had lower serum ethanol level (mean, 20.14 vs 46.71 mg/dL) (p-value<0.001). In addition, univariate logistic regression analysis showed the serum ethanol level (OR, 0.99; 95% CI, 0.98 -1.00) was independently associated with the development of abnormal lesion in brain MR. Conclusion: Ethanol could have neuroprotective effect in acute CO intoxication by sedative effect in stressful situation and mitigative effect in neuro-inflammatory reaction.

Keywords: carbon monoxide, delayed neuropsychological sequelae, ethanol, intoxication, magnetic resonance

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Authors: Kyung Min Kwom, Young Joo Lee

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Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.

Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer

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Authors: Nantale Prossy Nabatte, Josephat Nyagero, Elizabeth Kemigisha

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Background: Human Papilloma Virus (HPV) is a prevalent sexually transmitted infection (STI) in the world. It is important to screen for HPV so that women found positive receive early treatment to prevent the development of cervical cancer. The broad aim of the research was to explore the types, occurrence, and associated correlates of HPV infection by genotyping Human papillomavirus among a cohort of WLHIV attending an antiretroviral therapy clinic in Mukono, Uganda. Methods: A cross-sectional study was used to collect data for socio-demographic, sexual practices, and medical history factors associated with HPV genotypes using a pretested interview guide subjected to 342 WLHIV. The respondents’ results for HPV genotypes were obtained retrospectively from respective laboratory records. Data was entered in Epidata v4.6 and analysed using STATA V14. The prevalence of hr-HPV was estimated as a proportion of the entire sample size. Analysis for the correlates of hr-HPV infection was done using a modified Poisson regression model. Results: Slightly more than a half of respondents were aged below 35 years (56.7%), married (52.6%), and with a primary level of education (51.2%). The prevalence of hr-HPV was 39.8% at a 95% confidence interval (CI: 34.40- 44.78). The hr-HPV was higher among those between 30-34 years of age (n= 41, 30.2%) than those between the age of 45-49 years (n=16, 11.8%). In terms of associated correlates, age 45-49 years (aPR: 1.95, 95% CI: 1.41- 2.69), being married (aPR: 1.30, 95% CI: 1.00, 1.69), use of condoms (aPR: 1.31, 95% CI: 1.00 -1.71) and age of sexual debut (aPR: 1.42, 95% CI: 1.08-1.87) were significantly associated with Human papillomavirus genotypes. Conclusion and Recommendation: The prevalence of hr-HPV infection was high, indicative of a risk to the health of WLHIV in Mukono, Uganda, and worldwide at large. The correlates are age 45-49 years, being married, use of condoms, and age of sexual debut. Based on the results, it is recommended that the implementing teams in such projects put more emphasis on the diagnosis of hr-HPV infection and monitoring the treatment. More research is required to determine the effect of ART therapy on hr-HPV persistence.

Keywords: human papillomavirus genotypes, and their correlates, among women living with HIV, attending antiretroviral clinic

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Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

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Successful achievement of strategic goals requires an effective performance management system, i.e. determining the appropriate indicators measuring the rate of goal achievement. Assuming that the goal of the owners is to grow the assets they invested in, it is vital to identify the key performance indicators, which contribute to value creation. These indicators are known as value drivers. Based on the undertaken literature search, a value driver is defined as any factor that affects the value of an enterprise. The important factors are then monitored by both financial and non-financial indicators. Financial performance indicators are most useful in strategic management, since they indicate whether a company's strategy implementation and execution are contributing to bottom line improvement. Non-financial indicators are mainly used for short-term decisions. The identification of value drivers, however, is problematic for companies which are not publicly traded. Therefore financial ratios continue to be used to measure the performance of companies, despite their considerable criticism. The main drawback of such indicators is the fact that they are calculated based on accounting data, while accounting rules may differ considerably across different environments. For successful enterprise performance management it is vital to avoid factors that may reduce (or even destroy) its value. Among the known factors reducing the enterprise value are the lack of capital, lack of strategic management system and poor quality of production. In order to gain further insight into the topic, the paper presents results of the research identifying factors that adversely affect the performance of mechanical engineering enterprises in the Czech Republic. The research methodology focuses on both the qualitative and the quantitative aspect of the topic. The qualitative data were obtained from a questionnaire survey of the enterprises senior management, while the quantitative financial data were obtained from the Analysis Major Database for European Sources (AMADEUS). The questionnaire prompted managers to list factors which negatively affect business performance of their enterprises. The range of potential factors was based on a secondary research – analysis of previously undertaken questionnaire surveys and research of studies published in the scientific literature. The results of the survey were evaluated both in general, by average scores, and by detailed sub-analyses of additional criteria. These include the company specific characteristics, such as its size and ownership structure. The evaluation also included a comparison of the managers’ opinions and the performance of their enterprises – measured by return on equity and return on assets ratios. The comparisons were tested by a series of non-parametric tests of statistical significance. The results of the analyses show that the factors most detrimental to the enterprise performance include the incompetence of responsible employees and the disregard to the customers‘ requirements.

Keywords: business value, financial ratios, performance measurement, value drivers

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Authors: Muhammad Rafiq Shahid, Ali Hassan, Umm-e- Rubab, Muhammad Nadeem

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Insecticidal property of plant extracts was assessed toward dusky bug of cotton. Plant extracts consisted of bari pata (Ziziphus jajuba), Ak (Calotropis gigantean), Tobacco (Nicotiana tabacum), Bakine (Melia azedarach),Kanar (Nerium oleander),Kurtuma (Mitragyna speciosa) and one Control was also included with distilled water treatment. Forced feeding experiment was used to determine the antibiotic effect of bug plant extracts on dusky bug whereas Multi-choice experiment to determine the antixenosis/ repellent property of botanicals. It is evident from the results that mortality and antibiosis percentage of dusky bug due to the use of botanicals ranged from 15-95% and 20-87.3% respectively that was maximum in tobacoo extract followed by bakain and kurtama, minimum was on Ak, kanair and bakain extract. Non preference ranged from 14.28 to 85.7 where maximum non preference of dusky bug was found on bakain and kurtama followed by ak and kanair however minimum was on Bari pata extract. It was further found that local plant extract possessed insecticidal property toward dusky bug as well as also possesses repellency effect toward dusky bug, thus should be included in integrated pest management program of cotton in order to minimize the ill effects of pesticides it is compulsory to adopt eco-friendly methods of insect pest management.

Keywords: botanical extract, insecticidal and repellency activity, Gossypium hirsutum, oxycarenus laetus

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Authors: Dagim Dessalegn Haile

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This study investigated the interaction between the drivers' socio-demographic background information (age, gender, and driving experience) and the risky events score in the i-DREAMS platform. Further, the relationship between the participants' background driving behavior and the i-DREAMS platform behavioral output scores of risky events was also investigated. The i-DREAMS acronym stands for Smart Driver and Road Environment Assessment and Monitoring System. It is a European Union Horizon 2020 funded project consisting of 13 partners, researchers, and industry partners from 8 countries. A total of 25 Belgian car drivers (16 male and nine female) were considered for analysis. Drivers' ages were categorized into ages 18-25, 26-45, 46-65, and 65 and older. Drivers' driving experience was also categorized into four groups: 1-15, 16-30, 31-45, and 46-60 years. Drivers are classified into two clusters based on the recorded score for risky events during phase 1 (baseline) using risky events; acceleration, deceleration, speeding, tailgating, overtaking, and lane discipline. Agglomerative hierarchical clustering using SPSS shows Cluster 1 drivers are safer drivers, and Cluster 2 drivers are identified as risky drivers. The analysis result indicated no significant relationship between age groups, gender, and experience groups except for risky events like acceleration, tailgating, and overtaking in a few phases. This is mainly because the fewer participants create less variability of socio-demographic background groups. Repeated measure ANOVA shows that cluster 2 drivers improved more than cluster 1 drivers for tailgating, lane discipline, and speeding events. A positive relationship between background drivers' behavior and i-DREAMS platform behavioral output scores is observed. It implies that car drivers who in the questionnaire data indicate committing more risky driving behavior demonstrate more risky driver behavior in the i-DREAMS observed driving data.

Keywords: i-dreams, car drivers, socio-demographic background, risky events

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Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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