Search results for: rare presentation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2057

Search results for: rare presentation

1847 Men's Intimate Violence: Theory and Practice Relationship

Authors: Omer Zvi Shaked

Abstract:

Intimate Partner Violence (IPV) is a widespread social problem. Since the 1970's, and due to political changes resulting from the feminist movement, western society has been changing its attitude towards the phenomenon and has been taking an active approach to reduce its magnitude. Enterprises in the form of legislation, awareness and prevention campaigns, women's shelters, and community intervention programs became more prevalent as years progressed. Although many initiatives were found to be productive, the effectiveness of one, however, remained questionable throughout the years: intervention programs for men's intimate violence. Surveys outline two main intervention models for men's intimate violence. The first is the Duluth model, which argued that men are socialized to be dominant - while women are socialized to be subordinate - and men are therefore required by social imperative to enforce, physically if necessary, their dominance. The Duluth model became the chief authorized intervention program, and some states in the US even regulated it as the standard criminal justice program for men's intimate violence. However, meta-analysis findings demonstrated that based on a partner's reports, Duluth treatment completers have 44% recidivism rate, and between 40% and 85% dropout range. The second model is the Cognitive-Behavioral Model (CBT), which is a highly accepted intervention worldwide. The model argues that cognitive misrepresentations of intimate situations precede violent behaviors frequently when anger predisposition exists. Since anger dysregulation mediates between one's cognitive schemes and violent response, anger regulation became the chief purpose of the intervention. Yet, a meta-analysis found only a 56% risk reduction for CBT interventions. It is, therefore, crucial to understand the background behind the domination of both the Duluth model and CBT interventions. This presentation will discuss the ways in which theoretical conceptualizations of men's intimate violence, as well as ideologies, had contributed to the above-mentioned interventions' wide acceptance, despite known lack of scientific and evidential support. First, the presentation will review the prominent interventions for male intimate violence, the Duluth model, and CBT. Second, the presentation will review the prominent theoretical models explaining men's intimate violence: The Patriarchal model, the Abusive Personality model, and the Post-Traumatic Stress model. Third, the presentation will discuss the interrelation between theory and practice, and the nature of affinity between research and practice regarding men's intimate violence. Finally, the presentation will set new directions for further research, aiming to improve intervention's efficiency with men's intimate violence and advance social work practice in the field.

Keywords: intimate partner violence, theory and practice relationship, Duluth, CBT, abusive personality, post-traumatic stress

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1846 Liquid-Liquid Extraction of Rare Earths Elements by Use of Ionic Liquids

Authors: C. Lopez, S. Dourdain, G. Arrachart, S. Pellet-Rostaing

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Ionic liquids (ILs) are considered a good alternative for organic solvents in extractive processes; however, the higher or lower extraction efficiency in ILs remains difficult to predict because a lack of understanding of the extraction mechanisms in this class of diluents, making their application difficult to generalize. We have studied the extraction behavior of La(III) and Eu(III) from aqueous solution into n-dodecane and two ionic liquids (ILs), 1-ethyl-1-butylpiperidinium bis (trifluoromethylsulfonyl)imide [EBPip⁺] [NTf₂⁻] and 1-ethyl-1-octylpiperidinium bis (trifluoromethylsulfonyl)imide [EOPip⁺] [NTf₂⁻], at room temperature using N,N’- dimethyl- N,N’-dioctylhexylethoxymalonamide (DMDOHEMA) as extractant. Fe(III) was introduced to the aqueous phase in order to study the selectivity toward La(III) and Eu(III) and the effect of variation of PH was investigated by using of several HNO₃ concentrations. We found that the ionic liquid with shorter alkyl chain [EBPip⁺] [NTf₂⁻] showed a higher extraction ability than [EOPip⁺] [NTf₂⁻] and that the use of ILs as organic solvent instead n-dodecane, greatly enhanced the extraction percentage of the target metals with a good selectivity. Cation ([EBPip⁺] or [EOPip⁺]) and anion ([NTf₂⁻]) concentration in the aqueous phase, has been determined in order to elucidate the extraction mechanism.

Keywords: extraction mechanism, ionic liquids, rare earths elements, solvent extraction

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1845 A Rare Case of Taenia solium Induced Ileo-Cecal Intussusception in an Adult

Authors: Naraporn Taemaitree, Pruet Areesawangvong, Satchachon Changthom, Tanin Titipungul

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Adult intussusception, unlike childhood intussusception, is rare. Approximately 5-15% of cases are idiopathic without a lead point lesion. Secondary intussusception is caused by pathological conditions such as inflammatory bowel disease, postoperative adhesions, Meckel’s diverticulum, benign and malignant lesions, metastatic neoplasms, or even iatrogenically due to the presence of intestinal tubes, jejunostomy feeding tubes or after gastric surgery. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms. Computed tomography is the most sensitive diagnostic modality and can help distinguish between intussusceptions with and without a lead point and lesion localization. This report presents the case of a 49-year-old man presented with increasing abdominal pain over the past three days, loss of appetite, constipation, and frequent vomiting. Computed tomography revealed distal small bowel obstruction at the right lower quadrant with thickened outer wall and internal non-dilated small bowel loop. Emergency exploratory laparotomy was performed to clear the obstruction, which upon inspection was caused by extremely long Taenia solium parasites.

Keywords: intussusception, tape worm, Taenia solium, abdominal pain

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1844 Seismic Behavior and Loss Assessment of High–Rise Buildings with Light Gauge Steel–Concrete Hybrid Structure

Authors: Bing Lu, Shuang Li, Hongyuan Zhou

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The steel–concrete hybrid structure has been extensively employed in high–rise buildings and super high–rise buildings. The light gauge steel–concrete hybrid structure, including light gauge steel structure and concrete hybrid structure, is a new–type steel–concrete hybrid structure, which possesses some advantages of light gauge steel structure and concrete hybrid structure. The seismic behavior and loss assessment of three high–rise buildings with three different concrete hybrid structures were investigated through finite element software, respectively. The three concrete hybrid structures are reinforced concrete column–steel beam (RC‒S) hybrid structure, concrete–filled steel tube column–steel beam (CFST‒S) hybrid structure, and tubed concrete column–steel beam (TC‒S) hybrid structure. The nonlinear time-history analysis of three high–rise buildings under 80 earthquakes was carried out. After simulation, it indicated that the seismic performances of three high–rise buildings were superior. Under extremely rare earthquakes, the maximum inter–storey drifts of three high–rise buildings are significantly lower than 1/50. The inter–storey drift and floor acceleration of high–rise building with CFST‒S hybrid structure were bigger than those of high–rise buildings with RC‒S hybrid structure, and smaller than those of high–rise building with TC‒S hybrid structure. Then, based on the time–history analysis results, the post-earthquake repair cost ratio and repair time of three high–rise buildings were predicted through an economic performance analysis method proposed in FEMA‒P58 report. Under frequent earthquakes, basic earthquakes and rare earthquakes, the repair cost ratio and repair time of three high-rise buildings were less than 5% and 15 days, respectively. Under extremely rare earthquakes, the repair cost ratio and repair time of high-rise buildings with TC‒S hybrid structure were the most among three high rise buildings. Due to the advantages of CFST-S hybrid structure, it could be extensively employed in high-rise buildings subjected to earthquake excitations.

Keywords: seismic behavior, loss assessment, light gauge steel–concrete hybrid structure, high–rise building, time–history analysis

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1843 Reflection of Development of Production Relations in Museums: Case of Gobustan Museum

Authors: Fikrat Abdullayev, Narmin Huseynli

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Archaeology is a science that learns ancient people’s life and household on the basis of samples of material culture. The key research object of this science is artefacts, which are acquired during archaeological excavations. These artefacts can be seen in museums. Museums are the main institutions that give impressions of daily life and household of people in ancient times. Therefore, systematization, exhibition and presentation of archaeological items in museums should be adapted to trace the development of productive forces and its reflection on the household of people. In Gobustan museum which was commissioned in 2011, you can get information about the life and household, as well as religious beliefs, of people at all stages of history from the end of the Upper Palaeolith to the Middle Ages through archaeological items, rock inscriptions and modern technologies. The main idea of museum exposition is to give an idea to visitors about the environment, society and production relations during the Stone and Metal Age. Stimulation of development of production factors and production relationships of environmental factors that are influenced by natural forces can be easily seen through exhibits of Gobustan Museum. At the same time, creating of new ideological attributes in the changing society and the process of transforming people into a dominant position in a belief system can be seen in the substitution of motives of rock carvings in the chronological context. The historical and cultural essence of rock carvings in Gobustan Museum is demonstrated through modern technological means and traditional museum concepts. In addition, Gobustan Preserve is one of the rare places where visitors can directly contact with rock carvings.

Keywords: Gobustan, rock art, museum, productive forces

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1842 Bioengineering of a Plant System to Sustainably Remove Heavy Metals and to Harvest Rare Earth Elements (REEs) from Industrial Wastes

Authors: Edmaritz Hernandez-Pagan, Kanjana Laosuntisuk, Alex Harris, Allison Haynes, David Buitrago, Michael Kudenov, Colleen Doherty

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Rare Earth Elements (REEs) are critical metals for modern electronics, green technologies, and defense systems. However, due to their dispersed nature in the Earth’s crust, frequent co-occurrence with radioactive materials, and similar chemical properties, acquiring and purifying REEs is costly and environmentally damaging, restricting access to these metals. Plants could serve as resources for bioengineering REE mining systems. Although there is limited information on how REEs affect plants at a cellular and molecular level, plants with high REE tolerance and hyperaccumulation have been identified. This dissertation aims to develop a plant-based system for harvesting REEs from industrial waste material with a focus on Acid Mine Drainage (AMD), a toxic coal mining product. The objectives are 1) to develop a non-destructive, in vivo detection method for REE detection in Phytolacca plants (REE hyperaccumulator) plants utilizing fluorescence spectroscopy and with a primary focus on dysprosium, 2) to characterize the uptake of REE and Heavy Metals in Phytolacca americana and Phytolacca acinosa (REE hyperaccumulator) in AMD for potential implementation in the plant-based system, 3) to implement the REE detection method to identify REE-binding proteins and peptides for potential enhancement of uptake and selectivity for targeted REEs in the plants implemented in the plant-based system. The candidates are known REE-binding peptides or proteins, orthologs of known metal-binding proteins from REE hyperaccumulator plants, and novel proteins and peptides identified by comparative plant transcriptomics. Lanmodulin, a high-affinity REE-binding protein from methylotrophic bacteria, is used as a benchmark for the REE-protein binding fluorescence assays and expression in A. thaliana to test for changes in REE plant tolerance and uptake.

Keywords: phytomining, agromining, rare earth elements, pokeweed, phytolacca

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1841 Jalovchat Gabbroic Intrusive of the Caucasus: Petrological Study, Geochemical Peculiarities and Formation Conditions

Authors: Giorgi Chichinadze, David Shengelia, Tamara Tsutsunava, Nikoloz Maisuradze, Giorgi Beridze

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The Jalovchat intrusive is built up of hornblende gabbros, gabbro-norites and norites. Within the intrusive hornblende-bearing gabbro-pegmatites are widespread. That is a coarse-grained rock with gigantic hornblende crystals. By its unusual composition, the Jalovchat intrusive has no analogue in the Caucasus. However, petrologically and geochemically, the intrusive rocks were studied insufficiently. For comprehensive investigations, the authors applied appropriate methodologies: Microscopic study of thin sections, petro- and geochemical analyses of the samples and also different petrogenic, rare and rare earth elements diagrams and spidergrams. Analytical study established that the Jalovchat intrusive by its composition corresponds mainly to the mid-ocean ridge basalts and according to geodynamic type belongs to the subduction type. In general, it is an anomalous phenomenon, as in the rocks of such composition crystallization of hornblende and especially of its gigantic crystals is atypical. The authors believe that the water-rich magma reservoir, which was necessary for the crystallization of gigantic hornblende crystals, appeared as a result of melting of water-rich mid-ocean ridge basaltic rocks during the subduction process in Bajocian time.

Keywords: gabbro-pegmatite, intrusive, petrogenesis, petrogeochemistry, the Caucasus

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1840 Etiologies of Megaloblastic Anemia in a Pediatric Hospital

Authors: Atitallah Sofien, Bouyahia Olfa, Mohsen S., Boussetta Khadija, Khemiri Monia, Fitouri Zohra, Boukthir Samir

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Introduction: Megaloblastic anemia (MA) is rare in children. The diversity of its etiologies can lead to misdiagnosis and may, therefore, delay the treatment. The aim of this study was to describe the epidemiological and etiological characteristics of children followed for MA at the Tunis children's hospital. Methodology: This is a retrospective study over a period of 25 years of all cases of MA in children in the Children's Hospital of Tunis. The diagnosis of MA was confirmed by myelogram in all patients. Results: We collected 29 observations, with an incidence of 1.2 cases/year and a sex ratio of 1. Sixty percent of the children were aged between 3 months and 2 years. The consultation time was between 15 and 30 days in a third of the patients. The clinical examination showed hypotrophy in 13% of cases, hepatosplenomegaly in 6% of cases, neurological or neurosensory damage in 23% of cases, and cardiac damage in 10% of children. MA was associated with thrombocytopenia in 65% of cases and leukoneutropenia in 24% of cases. One in 5 children had pancytopenia. The etiologies were mainly thiamine deficiency, Immerslund disease (20%), nutritional deficiency (13%), and Biermer anemia (13%). One of the patients presented an MA revealing visceral leishmaniasis. The outcome under vitamin B12, the dose of which was adapted to each etiology, was favorable for all patients. Conclusion: MA is rare in children with multiple etiologies that are mainly dominated by hereditary conditions and nutritional deficiencies, mainly in vitamin B12. The association with visceral leishmaniasis seems to be a particularity in our country not reported in the literature.

Keywords: megaloblastic anemia, children, vitamin B12, anemia

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1839 Combining Laser Scanning and High Dynamic Range Photography for the Presentation of Bloodstain Pattern Evidence

Authors: Patrick Ho

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Bloodstain Pattern Analysis (BPA) forensic evidence can be complex, requiring effective courtroom presentation to ensure clear and comprehensive understanding of the analyst’s findings. BPA witness statements can often involve reference to spatial information (such as location of rooms, objects, walls) which, when coupled with classified blood patterns, may illustrate the reconstructed movements of suspects and injured parties. However, it may be difficult to communicate this information through photography alone, despite this remaining the UK’s established method for presenting BPA evidence. Through an academic-police partnership between the University of Warwick and West Midlands Police (WMP), an integrated 3D scanning and HDR photography workflow for BPA was developed. Homicide scenes were laser scanned and, after processing, the 3D models were utilised in the BPA peer-review process. The same 3D models were made available for court but were not always utilised. This workflow has improved the ease of presentation for analysts and provided 3D scene models that assist with the investigation. However, the effects of incorporating 3D scene models in judicial processes may need to be studied before they are adopted more widely. 3D models from a simulated crime scene and West Midlands Police cases approved for conference disclosure are presented. We describe how the workflow was developed and integrated into established practices at WMP, including peer-review processes and witness statement delivery in court, and explain the impact the work has had on the Criminal Justice System in the West Midlands.

Keywords: bloodstain pattern analysis, forensic science, criminal justice, 3D scanning

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1838 Antepartum and Postpartum Pulmonary Cryptococcosis: A Case Report and Systematic Review

Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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1837 Women Educational Leaders in an Age of Accountability

Authors: Ann Vibert, Heather Hemming

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This paper presentation summarizes the findings and implications of research on the plight and practices of women educational leaders in public school systems and in one university. The authors, both women university administrators, are also scholars and researchers of education. The research project on which this paper presentation is based proposed to examine how women educational leaders imagined, experienced, and carried out their leadership roles in the context of a growing local and global accountability-based performativity discourse which is reshaping educational work especially for women, we argue, in both public school and post-secondary sites. The research employed critical ethnographic interviews with 20 women educational leaders in P-12 school systems and three women university level educational leaders. Data were collected on women educational leaders’ perceptions of the effects of accountability and performativity discourses on the nature of their work. Specifically, leaders were asked to speak to whether they experienced a growth in managerial work as a consequence of increased accountability demands; how they experienced their work changing as a consequence of accountability and performativity demands; how these changes impacted the central values they enacted in their work as women educational leaders changes; and how they responded to/negotiated/accommodated changes in the nature of their work developing as a consequence of accountability and performativity frameworks. Findings from the research data and analyses confirm and extend recent scholarly work on the gendered nature of performativity and accountability discourses and frameworks, and their differential effects across differing genders. The oral presentation we propose here focusses on those findings in terms of similarities for women educational leaders across different educational contexts.

Keywords: women in educational leadership, gender and educational performativity, accountability and women leaders, gender and educational leadership

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1836 A Case Report on Diaphragm Disease of Small Bowel Following Usage of Non-Steroidal Anti-Inflammatory Drugs

Authors: Shivani Kuttuva, Bridget Fergie, Andrew Mishreki, Shovkat Mir, Fintan Bergin

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Diaphragm disease (DD) of the small bowel is a condition wherein the bowel lumen is divided into a series of short compartments by multiple circumferential membranes of mucosa and submucosa, leading to pinhole lumen and subsequent obstruction. It is a rare condition commonly attributed to non-steroidal anti-inflammatory drugs (NSAIDs) usage. Herein we present a 31-yr-old-female with a history of NSAIDs usage for one year following neurosurgery, who presented with recurrent idiopathic small bowel obstruction, recalcitrant anaemia, and impaction of capsule endoscope on investigating for anaemia. The capsule endoscopy images demonstrated multiple circumferential strictures with ulcers at its tip and villous atrophy in the proximal bowel, suggestive of NSAIDs related damage. However, due to the lack of awareness of the detrimental effects of NSAIDs on bowel mucosa distal to the duodenum, the underlying aetiology of this clinical presentation remained a mystery for a significant duration. The patient had to undergo repeated laparotomies in order to relieve the symptoms of recurring acute small bowel obstruction. Upon examining the resected specimen under microscopy, the histopathological hallmark of expanded, fibrotic, and congested submucosa was picked up, leading to the confirmation of diaphragm disease. Thus, this case report aims to widen the awareness among clinicians and aid surgeons in devising a management plan for young individuals presenting with recurring episodes of obstruction due to Diaphragm disease.

Keywords: capsule endoscopy, diaphragm disease, NSAIDs, recurrent small bowel obstruction

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1835 Acute Kidney Injury in Severe Trauma Patients: Clinical Presentation and Risk Factor Analysis

Authors: Inkyong Yi

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Acute kidney injury (AKI) in trauma patients is known to be associated with multiple factors, especially shock and consequent inadequate renal perfusion, yet its clinical presentation is little known in severe trauma patients. Our aim was to investigate the clinical presentation of acute kidney injury and its outcome in severe trauma patients at a level I trauma center. A total of 93 consecutive adult trauma patients with an injury severity score (ISS) of more than 15 were analyzed retrospectively from our Level I trauma center data base. Patients with direct renal injury were excluded. Patients were dichotomized into two groups, according to the presence of AKI. Various clinical parameters were compared between two groups, with Student’s T test and Mann-Whitney’s U test. The AKI group was further dichotomized into patients who recovered within seven days, and those who required more than 7days for recovery or those who did not recover at all. Various clinical parameters associated with outcome were further analyzed. Patients with AKI (n=33, 35%) presented with significantly higher age (61.4±17.3 vs. 45.4±17.3, p < 0.0001), incidence of comorbidities (hypertension; 51.5% vs. 13.3%, OR 6.906 95%CI 2.515-18.967, diabetes; 27.3% vs. 6.7%, OR 5.250, 95%CI 1.472-18.722), odds of head and neck trauma (69.7% vs. 41.7%, OR 3.220, 95%CI 1.306-7.942) and presence of shock during emergency room care (66.7% vs 21.7% OR 7.231, 95%CI, 2.798-18.687). Among AKI patients, patients who recovered within 1 week showed lower peak lactate (4.7mmol/L, 95%CI 2.9-6.5 vs 7.3mmol/L, 95%CI 5.0-9.6, p < 0.0287), lesser units of transfusion during first 24 hours (pRBC; 20.4unit, 95%CI 12.5-28.3 vs. 58.9unit, 95%CI 39.4-78.5, p=0.0003, FFP; 16.6unit, 95%CI 6.8-26.4 vs. 56.1unit, 95%CI 26.9-85.2, p=0.0027). In severe trauma patients, patients with AKI showed different clinical presentations and worse outcomes. Initial presence of shock and higher DIC profiles may be important risk factors for AKI in severe trauma patients. In patients with AKI, peak lactate level and amounts of transfusion are related to recovery.

Keywords: acute kidney injury, lactate, transfusion, trauma

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1834 Separation of Lanthanides Ions from Mineral Waste with Functionalized Pillar[5]Arenes: Synthesis, Physicochemical Characterization and Molecular Dynamics Studies

Authors: Ariesny Vera, Rodrigo Montecinos

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The rare-earth elements (REEs) or rare-earth metals (REMs), correspond to seventeen chemical elements composed by the fifteen lanthanoids, as well as scandium and yttrium. Lanthanoids corresponds to lanthanum and the f-block elements, from cerium to lutetium. Scandium and yttrium are considered rare-earth elements because they have ionic radii similar to the lighter f-block elements. These elements were called rare earths because they are simply more difficult to extract and separate individually than the most metals and, generally, they do not accumulate in minerals, they are rarely found in easily mined ores and are often unfavorably distributed in common ores/minerals. REEs show unique chemical and physical properties, in comparison to the other metals in the periodic table. Nowadays, these physicochemical properties are utilized in a wide range of synthetic, catalytic, electronic, medicinal, and military applications. Because of their applications, the global demand for rare earth metals is becoming progressively more important in the transition to a self-sustaining society and greener economy. However, due to the difficult separation between lanthanoid ions, the high cost and pollution of these processes, the scientists search the development of a method that combines selectivity and quantitative separation of lanthanoids from the leaching liquor, while being more economical and environmentally friendly processes. This motivation has favored the design and development of more efficient and environmentally friendly cation extractors with the incorporation of compounds as ionic liquids, membrane inclusion polymers (PIM) and supramolecular systems. Supramolecular chemistry focuses on the development of host-guest systems, in which a host molecule can recognize and bind a certain guest molecule or ion. Normally, the formation of a host-guest complex involves non-covalent interactions Additionally, host-guest interactions can be influenced among others effects by the structural nature of host and guests. The different macrocyclic hosts for lanthanoid species that have been studied are crown ethers, cyclodextrins, cucurbituryls, calixarenes and pillararenes.Among all the factors that can influence and affect lanthanoid (III) coordination, perhaps the most basic of them is the systematic control using macrocyclic substituents that promote a selective coordination. In this sense, macrocycles pillar[n]arenes (P[n]As) present a relatively easy functionalization and they have more π-rich cavity than other host molecules. This gives to P[n]As a negative electrostatic potential in the cavity which would be responsible for the selectivity of these compounds towards cations. Furthermore, the cavity size, the linker, and the functional groups of the polar headgroups could be modified in order to control the association of lanthanoid cations. In this sense, different P[n]As systems, specifically derivatives of the pentamer P[5]A functionalized with amide, amine, phosphate and sulfate derivatives, have been designed in terms of experimental synthesis and molecular dynamics, and the interaction between these P[5]As and some lanthanoid ions such as La³+, Eu³+ and Lu³+ has been studied by physicochemical characterization by 1H-NMR, ITC and fluorescence in the case of Eu³+ systems. The molecular dynamics study of these systems was developed in hexane as solvent, also taking into account the lanthanoid ions mentioned above, and the respective comparison studies between the different ions.

Keywords: lanthanoids, macrocycles, pillar[n]arenes, rare-earth metal extraction, supramolecular chemistry, supramolecular complexes.

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1833 A Generalized Framework for Adaptive Machine Learning Deployments in Algorithmic Trading

Authors: Robert Caulk

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A generalized framework for adaptive machine learning deployments in algorithmic trading is introduced, tested, and released as open-source code. The presented software aims to test the hypothesis that recent data contains enough information to form a probabilistically favorable short-term price prediction. Further, the framework contains various adaptive machine learning techniques that are geared toward generating profit during strong trends and minimizing losses during trend changes. Results demonstrate that this adaptive machine learning approach is capable of capturing trends and generating profit. The presentation also discusses the importance of defining the parameter space associated with the dynamic training data-set and using the parameter space to identify and remove outliers from prediction data points. Meanwhile, the generalized architecture enables common users to exploit the powerful machinery while focusing on high-level feature engineering and model testing. The presentation also highlights common strengths and weaknesses associated with the presented technique and presents a broad range of well-tested starting points for feature set construction, target setting, and statistical methods for enforcing risk management and maintaining probabilistically favorable entry and exit points. The presentation also describes the end-to-end data processing tools associated with FreqAI, including automatic data fetching, data aggregation, feature engineering, safe and robust data pre-processing, outlier detection, custom machine learning and statistical tools, data post-processing, and adaptive training backtest emulation, and deployment of adaptive training in live environments. Finally, the generalized user interface is also discussed in the presentation. Feature engineering is simplified so that users can seed their feature sets with common indicator libraries (e.g. TA-lib, pandas-ta). The user also feeds data expansion parameters to fill out a large feature set for the model, which can contain as many as 10,000+ features. The presentation describes the various object-oriented programming techniques employed to make FreqAI agnostic to third-party libraries and external data sources. In other words, the back-end is constructed in such a way that users can leverage a broad range of common regression libraries (Catboost, LightGBM, Sklearn, etc) as well as common Neural Network libraries (TensorFlow, PyTorch) without worrying about the logistical complexities associated with data handling and API interactions. The presentation finishes by drawing conclusions about the most important parameters associated with a live deployment of the adaptive learning framework and provides the road map for future development in FreqAI.

Keywords: machine learning, market trend detection, open-source, adaptive learning, parameter space exploration

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1832 Solid Oral Leiomyoma: Clinical Case Report

Authors: Hurtado Zuñiga Yonel Marcos, Ferreira Joao Tiago

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Introduction: Leiomyoma is a benign smooth muscle tumor. It is predominantly found between 40-49 years with a small prevalence in men. It is commonly found in the uterus, stomach, and in areas with smooth muscle. It presents as nodular, solitary, variable size, slow growing, and asymptomatic. It is classified into solid, vascular, and epithelioid leiomyoma. Vascular leiomyoma is the most common in the oral cavity. Oral leiomyomas are very rare because a smooth muscle in the oral cavity isn’t common. The most frequent areas of this pathologyaretongue, lip, buccal mucosa, and palate. It may be derived from the vascular walls or excretory ducts of the salivary glands. The diagnosis is made by histologically analysis. The treatment of choice is complete excision. Recurrence is rare. Objective: To report the case of a solid leiomyoma on the dorsum of the tongue and review the literature. Case description: A 78-year-old female patient presented a nodular (ovoid) elevation of 8x6mm, brownish color, with irregular limits and firm consistency located in the dorsal part of the tongue with slight symptoms. An excisional biopsy was performed, photographic record, and 3 weeks post-surgical follow-up. Result: The surgical specimen was submitted to an anatomopathological analysis, resulting in a benign nodule with defined limits compatible with solid leiomyoma of the tongue. Discussion: It is a pathology that presents in a solitary, nodular, well-defined, asymptomatic form; in the oral cavity, leiomyomas are found in the tongue, lip, buccal mucosa, and palate; as in our patient, it was nodular and, in the tongue, with a difference only in the symptomatology. The most prevalent age is 40-49 years and with small predominance in men, unlike our female patient with 78 years. Conclusions: Oral leiomyoma is a rare benign lesion that presents as a solitary nodular nodule; for its diagnosis, an anatomopathological analysis should be performed, and the treatment of choice is total excision with little recurrence.

Keywords: tongue, bening tumor, oral leiomyoma, leiomyoma

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1831 Head and Neck Extranodal Rosai-Dorfman Disease- Utility of immunohistochemistry

Authors: Beverly Wang

Abstract:

Background: Rosai-Dorfman disease (RDD), aka sinus histiocytosis with massive lymphadenopathy, is a rare, idiopathic histiocytic proliferative disorder. Although RDD can be seen involving the head and neck lymph nodes, rarely it can affect other extranodal sites. It present 3 unique cases of RDD affecting the nasal cavity, paranasal sinuses, and ear canal. The initial clinical presentation on two cases mimicked a malignant neoplasm. The 3rd case of RDD co-existed with a cholesteatoma of the ear canal. The clinical presentation, histology and immunohistochemical stains, and radiographic findings are discussed. Design: An overview of 3 cases of RDD affected sinonasal cavity and ear canal from UCI Medical Center was conducted. Case 1: A 61 year old male complaining of breathing difficulty presented with bilateral polypoid sinonasal masses and severe nasal obstruction. The masses elevated the nasal floor, and involved the anterior nasal septum to lateral wall. It was endoscopically excised. At intraoperative consultation, frozen section reported a pleomorphic spindle cell neoplasm with scattered large atypical spindle cells, resembling a high grade sarcoma. Case 2: A 46 year old male presented with recurrent bilateral maxillary chronic sinusitis with mass formation, clinically suspicious for malignant lymphoma. Excisional tissue sample showed large irregular spindled histiocytes with abundant granular and vacuolated cytoplasm. Case 3: A 36 year old female with a history of asthma initially presented with left-sided chronic otalgia, occasional nausea, vertigo, and fluctuating pain exacerbated by head movement and temperature changes. CT scan revealed an external auditory canal mass extending to the middle ear, coexisting with a small cholesteatoma. Results: The morphology of all cases revealed large atypical spindled histiocytes resembling fibrohistiocytic or myofibroblastic proliferative neoplasms. Scattered emperipolesis was seen. All 3 cases were confirmed as extranodal sinus RDD, confirmed by immunohistochemistry. The large atypical cells were positive for S100, CD68, and CD163. No evidence for malignancy was identified. Case 3 showed concurrent RDD co-existing with a cholesteatoma. Conclusion: Due to its rarity and variable clinical presentations, the diagnosis of RDD is seldom clinically considered. Extranodal sinus RDD morphologically can be pitfall as mimicker of spindly neoplasm, especially at intraoperative consultation. It can create diagnostic and therapeutic challenges. Correlation of radiological findings with histologic features will help to reach the diagnosis.

Keywords: head and neck, extranodal, rosai-dorfman disease, mimicker, immunohistochemistry

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1830 A Clinical Study of Tracheobronchopathia Osteochondroplastica: Findings from a Large Chinese Cohort

Authors: Ying Zhu, Ning Wu, Hai-Dong Huang, Yu-Chao Dong, Qin-Ying Sun, Wei Zhang, Qin Wang, Qiang Li

Abstract:

Background and study aims: Tracheobronchopathia osteochondroplastica (TO) is an uncommon disease of the tracheobronchial system that leads to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules. The aim of this study is to perform a detailed review of this rare disease in a large cohort of patients with TO proven by fiberoptic bronchoscopy from China. Patients and Methods: Retrospective chart review was performed on 41,600 patients who underwent bronchoscopy in the Department of Respiratory Medicine of Changhai Hospital between January 2005 and December 2012. Cases of TO were identified based on characteristic features during bronchoscopic examination. Results: 22 cases of bronchoscopic TO were identified. Among whom one-half were male and the mean age was 47.45 ±10.91 years old. The most frequent symptoms at presentation were chronic cough (n=14) and increased sputum production (n=10). Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with TO such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients. Patients were classified into the following categories based on the severity of bronchoscopic findings: Stage I (n=2), Stage II (n=6) and Stage III(n=14). The result that bronchoscopic improvement was observed in 2 patients administered with inhaled corticosteroids suggested that resolution of this disease is possible. Conclusions: TO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings. Chronic inflammation was thought to be more important than the other existing plausible hypotheses in the course of TO. Inhaled corticosteroids might have some impact on patients at Stage I/II.

Keywords: airway obstruction, bronchoscopy, etiology, Tracheobronchopathia osteochondroplastica (TO), treatment

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1829 Nontraditional Online Student Perceptions of Student Success Conditions

Authors: Carrie Prendergast, Lisa Bortman

Abstract:

The focus of this presentation will be on non-traditional (adult) students as they seek their Bachelors’ degrees online. This presentation will specifically examine nontraditional online student perceptions of Tinto’s success conditions: expectations, support, assessment, and engagement. Expectations include those of the student, the faculty and the institution. Support includes academic, social, and financial support. Feedback and assessment encompasses feedback in the classroom, upon entry, and on an institutional level. The fourth success condition is involvement or engagement of students with their peers and faculty in both academic and social contexts. This program will review and discuss a rich, detailed description of the lived experience of the nontraditional online student to add to the paucity of research on this understudied population and guide higher education professionals in supporting this growing population of students.

Keywords: adult students, online education, student success, vincent tinto

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1828 Massive Intrapartum Hemorrhage Following by Inner Myometrial Laceration during a Vaginal Delivery: A Rare Case Report

Authors: Bahareh Khakifirooz, Arian Shojaei, Amirhossein Hajialigol, Bahare Abdolahi

Abstract:

Laceration of the inner layer of the myometrium can cause massive bleeding during and after childbirth, which can lead to the death of the mother if it is not diagnosed in time. We studied a rare case of massive intrapartum bleeding following myometrial laceration that was diagnosed correctly, and the patient survived with in-time treatments. The patient was a 26 years-old woman who was under observation for term pregnancy and complaint of rupture of membranes (ROM) and vaginal bleeding. Following the spontaneous course of labor and without receiving oxytocin, during the normal course of labor, she had an estimated total blood loss of 750 mL bleeding, which, despite the normal fetal heart rate and with the mother's indication for cesarean section, was transferred to the operating room and underwent cesarean section. During the cesarean section, the amniotic fluid was clear; after the removal of the placenta, severe and clear bleeding was flowing from the posterior wall of the uterus, which was caused by the laceration of the inner layer of the myometrium in the posterior wall of the lower segment of the uterus. The myometrial laceration was repaired with absorbable continuous locked sutures, and hemostasis was established, then, the patient used uterotonic drugs, and after monitoring, the patient was discharged from the hospital in good condition.

Keywords: intrapartum hemorrhage, inner myometrial laceration, labor, Increased intrauterine pressure

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1827 Unveiling the Mystery: Median Arcuate Ligament Syndrome in a Middle-Aged Female Presenting with Abdominal Pain

Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

Abstract:

47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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1826 Gastrointestinal Basidiobolomycosis in a Tertiary Care Center at Saudi Arabia, Makkah: Case Series

Authors: Yaser Meeralam, Walaa Alharthi, Hadeel Ashi, Alaa Bakhsh, Kholood Aljabri, Ebtihal Bin Salim

Abstract:

Background:Basidiobolusranrum causes one of the rare fungal diseases that infects mainly immunocompetent individuals. Gastrointestinal Basidiobolomycosis (GIB) is a rare and uncommon form of this fungal infection. It’s still ambiguous how this fungus is reaching the gastrointestinal tract leading to Gastrointestinal Basidiobolomycosis. Objective: To summarize the clinical features, imaging, and histopathological of patients diagnosed with GIB in our institution. Patients and methods: A series of five cases of patients who diagnosed by basidiobolomycosis in King Abdullah Medical City, Makkah, Saudi Arabia, which reviewed by latest literature related to diagnosis and treatment. Results: Most of the patients were externally evaluated and were initially misdiagnosed. Some of them were suspected of colonic malignancy, other presumed to have hepatic hemangioma and fistulizing crohn’s disease. The definitive diagnosis is often based on histopathological examination and fungal culture of the surgically resected mass. An optimum standardized treatment of basidiobolomycosis has not yet been established. Conclusion: Deeper knowledge of clinical characteristics, diagnosis, and treatment of basidiobolomycosis will allow early initiating of treatment with a subsequent positive impact on the patients’ outcome. More studies are needed to establish a definite treatment.

Keywords: gastrointestinal infection, crohn's mimics, malignancy mimics, fungal infection

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1825 Stability of Solutions of Semidiscrete Stochastic Systems

Authors: Ramazan Kadiev, Arkadi Ponossov

Abstract:

Semidiscrete systems contain both continuous and discrete components. This means that the dynamics is mostly continuous, but at certain instants, it is exposed to abrupt influences. Such systems naturally appear in applications, for example, in biological and ecological models as well as in the control theory. Therefore, the study of semidiscrete systems has recently attracted the attention of many specialists. Stochastic effects are an important part of any realistic approach to modeling. For example, stochasticity arises in the population dynamics, demographic and ecological due to a change in time of factors external to the system affecting the survival of the population. In control theory, random coefficients can simulate inaccuracies in measurements. It will be shown in the presentation how to incorporate such effects into semidiscrete systems. Stability analysis is an essential part of modeling real-world problems. In the presentation, it will be explained how sufficient conditions for the moment stability of solutions in terms of the coefficients for linear semidiscrete stochastic equations can be derived using non-Lyapunov technique.

Keywords: abrupt changes, exponential stability, regularization, stochastic noises

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1824 Influences of Island Characteristics on Plant Community Structure of Farasan Archipelago, Saudi Arabia: Island Biogeography and Nested Pattern

Authors: Khalid Al Mutairi, Mashhor Mansor, Magdy El-Bana, Saud L. Al-Rowaily, Asyraf Mansor

Abstract:

The present study was carried out in 20 islands of Farasan Archipelago in Saudi Arabia to describe the biogeography patterns of plants. A total of 191 species belonging to 129 genera and 53 families were identified. Following island biogeography theory, total plant species richness and their ecological groups were positively influenced by island size, number of habitats,elevation and were not affected by isolation. The high level of nestedness, the strong effect of area on total plant species richness and ecological groups, and the similarity of vegetation composition on the islands has several implications for conservation. In conclusion the large and richest islands in Farasan Archipelago such as Farasan Alkbir would conserve higher diversity than several smaller islands. This island also includes rare habitats like coral rocks and rare species. The invasion of the unique habitats such as wadi channels and water catchments in this island by the exotic tree Prosopis juliflora should be managed to conserve the native biodiversity. The protection of such critical habitats is very important on the other large island (e.g. Zufaf), due to their limited distribution in the country.

Keywords: island biogeography, conservation, farasan archipelago, saudi arabia, plant diversity

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1823 Solving Ill-Posed Initial Value Problems for Switched Differential Equations

Authors: Eugene Stepanov, Arcady Ponosov

Abstract:

To model gene regulatory networks one uses ordinary differential equations with switching nonlinearities, where the initial value problem is known to be well-posed if the trajectories cross the discontinuities transversally. Otherwise, the initial value problem is usually ill-posed, which lead to theoretical and numerical complications. In the presentation, it is proposed to apply the theory of hybrid dynamical systems, rather than switched ones, to regularize the problem. 'Hybridization' of the switched system means that one attaches a dynamic discrete component ('automaton'), which follows the trajectories of the original system and governs its dynamics at the points of ill-posedness of the initial value problem making it well-posed. The construction of the automaton is based on the classification of the attractors of the specially designed adjoint dynamical system. Several examples are provided in the presentation, which support the suggested analysis. The method can also be of interest in other applied fields, where differential equations contain switchings, e.g. in neural field models.

Keywords: hybrid dynamical systems, ill-posed problems, singular perturbation analysis, switching nonlinearities

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1822 Research on Urban Point of Interest Generalization Method Based on Mapping Presentation

Authors: Chengming Li, Yong Yin, Peipei Guo, Xiaoli Liu

Abstract:

Without taking account of the attribute richness of POI (point of interest) data and spatial distribution limited by roads, a POI generalization method considering both attribute information and spatial distribution has been proposed against the existing point generalization algorithm merely focusing on overall information of point groups. Hierarchical characteristic of urban POI information expression has been firstly analyzed to point out the measurement feature of the corresponding hierarchy. On this basis, an urban POI generalizing strategy has been put forward: POIs urban road network have been divided into three distribution pattern; corresponding generalization methods have been proposed according to the characteristic of POI data in different distribution patterns. Experimental results showed that the method taking into account both attribute information and spatial distribution characteristics of POI can better implement urban POI generalization in the mapping presentation.

Keywords: POI, road network, selection method, spatial information expression, distribution pattern

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1821 Facial Infiltrating Lipomatosis, a Rare Cause of Facial Asymmetry to Be Known: Case Report and Literature Review

Authors: Shantanu Vyas, Neerja Meena

Abstract:

Facial infiltrating lipomatosis is a rare lipomatous lesion, first described by Slavin in 1983. It is a benign pseudotumor pathology. It corresponds to a non-encapsulated collection of mature adipocytes infiltrating the local tissue and hyperplasia of underlying bone leading to a craniofacial deformity. Very few cases have been reported in the literature. We report the case of a 19-year-old female patient, who was consulted for a swelling of the right hemiface progressively evolving since birth. Physical examination revealed facial asymmetry. On palpation, the mass was soft, painless, not compressible, not pulsatile, not fluctuating. In view of the asymptomatic nature and slow progression of the lesion, a lipomatous tumour, namely lipoma, was suggested. CT scan image shows a hyperplastic subcutaneous fat on the right hemiface. On the right jugal and temporal areas, there is a subcutaneous formation of fatty density, poorly limited, with no detectable peripheral capsule. It merges with the adjacent fat. In the bone window, there was a hyperplasia of underlying bone. Facial lipomatosis infiltration of the face is a benign pseudotumor pathology. As a result, it can be confused with other disorders, in particular, hemifacial hyperplasia. Combination of physical and radiological findings can establish the diagnosis. Surgical treatment is done for cosmetic purposes.

Keywords: cosmetic correction and facial assemetry, aesthetic results, facial infiltration, surgery

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1820 Interactions within the School Setting and Their Potential Impact on the Wellbeing or Educational Success of High Ability Students: A Literature Review

Authors: Susan Burkett-McKee, Bruce Knight, Michelle Vanderburg

Abstract:

The wellbeing and educational success of high ability students are interrelated concepts with each potentially hindering or enhancing the other. A student’s well-being and educational success are also influenced by intrapersonal and interpersonal factors. This presentation begins with an exploration of the literature pertinent to the wellbeing and educational success of this cohort before an ecological perspective is taken to discuss research into the impact of interactions within the school context. While the literature consistently states that interactions exchanged between high ability students and school community members impact the students’ wellbeing or educational success, no consensus has been reached about whether the impact is positive or negative. Findings from the review shared in this presentation inform an interpretative phenomenological study involving senior secondary students enrolled in inclusive Australian schools to highlight, from the students’ perspective, the ways school-based interactions impact their wellbeing or educational success.

Keywords: educational success, interactions, literature review, wellbeing

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1819 Medical Examiner Collection of Comprehensive, Objective Medical Evidence for Conducted Electrical Weapons and Their Temporal Relationship to Sudden Arrest

Authors: Michael Brave, Mark Kroll, Steven Karch, Charles Wetli, Michael Graham, Sebastian Kunz, Dorin Panescu

Abstract:

Background: Conducted electrical weapons (CEW) are now used in 107 countries and are a common law enforcement less-lethal force practice in the United Kingdom (UK), United States of America (USA), Canada, Australia, New Zealand, and others. Use of these devices is rarely temporally associated with the occurrence of sudden arrest-related deaths (ARD). Because such deaths are uncommon, few Medical Examiners (MEs) ever encounter one, and even fewer offices have established comprehensive investigative protocols. Without sufficient scientific data, the role, if any, played by a CEW in a given case is largely supplanted by conjecture often defaulting to a CEW-induced fatal cardiac arrhythmia. In addition to the difficulty in investigating individual deaths, the lack of information also detrimentally affects being able to define and evaluate the ARD cohort generally. More comprehensive, better information leads to better interpretation in individual cases and also to better research. The purpose of this presentation is to provide MEs with a comprehensive evidence-based checklist to assist in the assessment of CEW-ARD cases. Methods: PUBMED and Sociology/Criminology data bases were queried to find all medical, scientific, electrical, modeling, engineering, and sociology/criminology peer-reviewed literature for mentions of CEW or synonymous terms. Each paper was then individually reviewed to identify those that discussed possible bioelectrical mechanisms relating CEW to ARD. A Naranjo-type pharmacovigilance algorithm was also employed, when relevant, to identify and quantify possible direct CEW electrical myocardial stimulation. Additionally, CEW operational manuals and training materials were reviewed to allow incorporation of CEW-specific technical parameters. Results: Total relevant PUBMED citations of CEWs were less than 250, and reports of death extremely rare. Much relevant information was available from Sociology/Criminology data bases. Once the relevant published papers were identified, and reviewed, we compiled an annotated checklist of data that we consider critical to a thorough CEW-involved ARD investigation. Conclusion: We have developed an evidenced-based checklist that can be used by MEs and their staffs to assist them in identifying, collecting, documenting, maintaining, and objectively analyzing the role, if any, played by a CEW in any specific case of sudden death temporally associated with the use of a CEW. Even in cases where the collected information is deemed by the ME as insufficient for formulating an opinion or diagnosis to a reasonable degree of medical certainty, information collected as per the checklist will often be adequate for other stakeholders to use as a basis for informed decisions. Having reviewed the appropriate materials in a significant number of cases careful examination of the heart and brain is likely adequate. Channelopathy testing should be considered in some cases, however it may be considered cost prohibitive (aprox $3000). Law enforcement agencies may want to consider establishing a reserve fund to help manage such rare cases. The expense may stay the enormous costs associated with incident-precipitated litigation.

Keywords: ARD, CEW, police, TASER

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1818 Kissing Cervical Spine Schwannomas in a Young Female from a Low Resource Setting: A Case Report

Authors: Joseph Mary Ssembatya, Blessing Michael Taremwa

Abstract:

Background: Multiple schwannomas are typically associated with neurofibromatosis type 1 (NF1), but rare cases occur independently of neurofibromatosis. Schwannomas are benign, slow-growing tumors, primarily affecting the cervical and lumbar spine. When large, they may extend over multiple vertebral levels, posing surgical challenges. Case Presentation: A 13-year-old Ugandan Munyankore female patient, presented with a 6-year history of progressive quadriparesis, particularly in the lower limbs. Clinical examination showed hypertonia and hyperreflexia, with no indicators of neurofibromatosis or prior trauma. MRI revealed two “kissing” schwannomas extending from C2 to T2 in the cervical spine. Decompressive surgery was performed through laminoplasty and partial lesion resection, and histology confirmed schwannoma. Two weeks postoperatively, the patient experienced cerebrospinal fluid (CSF) leakage, neck pain, and headache, which required re-operation and duraplasty. Following these interventions, the patient’s neurological status stabilized, with noted improvement in lower limb strength. Discussion: “Kissing” schwannomas are most frequently documented in the cerebellopontine angle, rarely in the spine, and even more rarely in children. While multiple schwannomas are often associated with NF2, this case had no family history or clinical signs of the disorder. Giant invasive spinal schwannomas (GISS) that span multiple vertebrae demand intricate surgical approaches due to their proximity to neurovascular structures. Conclusion: This is the first reported case of kissing cervical schwannomas in a young patient from a low- to middle-income country. Surgical decompression, though challenging, is critical for neurological recovery in such advanced cases.

Keywords: kissing schwannoma, cervical spine, low resource, young, uganda

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