Search results for: Carina Hermansson

Authors: Carina Hermansson

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This presentation focuses a development project aiming at developing and documenting the steps taken at a multilingual, multicultural K-5 school, with the aim to improve the achievement levels of the pupils by focusing language and literacy development across the schedule in a digital classroom, and in all units of the school. This pre-formulated aim, thus, may be said to adhere to neoliberal educational and accountability policies in terms of its focus on digital learning, learning results, and national curriculum standards. In particular the project aimed at improving the collaboration between the teachers, the leisure time unit, the librarians, the mother tongue teachers and bilingual study counselors. This is a school environment characterized by cultural, ethnic, linguistic, and professional pluralization. The overarching aims of the research project were to scrutinize and analyze the factors enabling and obstructing the implementation of the Language Policy in a digital classroom. Theoretical framework: We apply multi-level perspectives in the analyses inspired by Uljens’ ideas about interactive and interpersonal first order (teacher/students) and second order(principal/teachers and other staff) educational leadership as described within the framework of discursive institutionalism, when we try to relate the Language Policy, educational policy, and curriculum with the administrative processes. Methodology/research design: The development project is based on recurring research circles where teachers, leisure time assistants, mother tongue teachers and study counselors speaking the mother tongue of the pupils together with two researchers discuss their digital literacy practices in the classroom. The researchers have in collaboration with the principal developed guidelines for the work, expressed in a Language Policy document. In our understanding the document is, however, only a part of the concept, the actions of the personnel and their reflections on the practice constitute the major part of the development project. One and a half years out of three years have now passed and the project has met with a row of difficulties which shed light on factors of importance for the progress of the development project. Field notes and recordings from the research circles, a survey with the personnel, and recorded group interviews provide data on the progress of the project. Expected conclusions: The problems experienced deal with leadership, curriculum, interplay between aims, technology, contents and methods, the parents as customers taking their children to other schools, conflicting values, and interactional difficulties, that is, phenomena on different levels, ranging from school to a societal level, as for example teachers being substituted as a result of the marketization of schools. Also underlying assumptions from actors at different levels create obstacles. We find this study and the problems we are facing utterly important to share and discuss in an era with a steady flow of refugees arriving in the Nordic countries.

Keywords: early childhood education, language policy, multicultural school, school development project

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Authors: Karine B. de Oliveira, Carina F. Dorneles

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The structure level matching is the problem of combining elements of a structure, which can be represented as entities, classes, XML elements, web forms, and so on. This is a challenge due to large number of distinct representations of semantically similar structures. This paper describes a structure-based matching method applied to search for different representations in data sources, considering the similarity between elements of two structures and the data source context. Using real data sources, we have conducted an experimental study comparing our approach with our baseline implementation and with another important schema matching approach. We demonstrate that our proposal reaches higher precision than the baseline.

Keywords: context, data source, index, matching, search, similarity, structure

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Authors: Patricia Portugal Marques de Carvalho Lourenco

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Money, status, beauty, popularity, widespread public adulation, glitz and glamour portray a perfumed stress-free existence yet not every rock that glitters is a gold nugget and mental disorders are not an exclusivity of middle/low societal classes. Mental illnesses do not discriminate, and behind the superficial visual wealth of the upper-class, there are human beings who experience the ups and downs of life like any other person, except that publicly rather than privately and with an array of fingers pointing at them instead of a mere few. Sammi Cheung, Carina Lau, Fiona Sit, Kara Hui and Louis Cheung are a number of Hong Kong artists that have battled mental disorders, overcame them and used the process to openly discuss the still existing taboo.

Keywords: mental disorders, mental health, public communication, depression, hong kong artists

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Authors: Joseph Roberson, Carina Kleynhans, Willie Coetzee

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The low entry barriers of the restaurant industry lead to an extremely competitive business environment. In this volatile business sector it is of the utmost importance to implement a strategy of quality differentiation. Vital aspects of a quality differentiation strategy are total quality management, benchmarking and service quality management. Ultimately, restaurant success depends on the continuous support of customers. Customers select restaurants based on their expectations of quality. If the customers' expectations are met, they perceive quality service and will re-patronize the restaurant. The restaurateur can manage perceptions of quality by influencing expectations while ensuring that those expectations are not inflated. The management of expectations can be done by communicating service quality to customers. The aim of this research paper is to describe the development of a grading process for restaurants. An assessment of the extensive body of literature on grading was conducted through content analysis. A standardized method for developing a grading system would assist in successful grading systems that could inform both customers and restaurateurs of restaurant quality.

Keywords: benchmarking, restaurants, grading, service quality, total quality management

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Authors: Rui G. Serôdio, Carina Martins, Alexandra Serra, José A. Lima, Luísa Catita, Paula Lopes

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Building on social identity approach, we tested the impact of social categorization and comparison in the psychosocial process by which social entrepreneurs define their group identity. Specifically, we address how both differentiation and assimilation processes are set of in the context of constructing a novel, distinctive and socially salient – social entrepreneurs. As part of a larger research line, a quasi-experimental study with Social and Business Entrepreneurs, as well as “Lay People” provided evidence consistent with our predictions: (1) Social Entrepreneurs, in contrast with Lay People and Business Entrepreneurs, value more strongly social identity than personal identity, and the later is the only group that values Personal Differentiation; (2) unlike Entrepreneurs, Social Entrepreneurs display an ingroup bias across group evaluations; (3) Lay People, display a self-serving bias, although, overall, they allocate a more positive image to the target groups; (4) combining own vs. others evaluations across all groups, Social Entrepreneurs receive the more positive value. From the standpoint of social identity and self-categorization theories and their approach to group process, we discuss the processes of intergroup comparison and differentiation as core processes in the construction of a positive social identity. We illustrate it within the context of social entrepreneurship, a political and social “wave” that flows across Europe at this time.

Keywords: group processes, social entrepreneurship, social identity, business entrepreneurs

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Authors: Mauricio Filho, Carina Castro

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The object of this project is to analyze long-time public agents that passed through several governments and see themselves in the position of having to deliberate with new agents, recently settled in the public administration. For theoretical ends, internal deliberation is understood as the one practiced on the public administration agencies, without any direct participation from the general public in the process. The assumption is: agents with longer periods of public service tend to step away from momentary political discussions that guide the current administration and seek to concentrate on institutionalized routines and procedures, making the most politically aligned individuals with the current government deliberate with less "passion" and more exchanging of knowledge and information. The theoretical framework of this research is institutionalism, which is guided by a more pragmatic view, facing the fluidity of reality in ways showing the multiple relations between agents and their respective institutions. The critical aspirations of this project rest on the works of professors Cass Sunstein, Adrian Vermeule, Philipp Pettit and in literature from both institutional theory and economic analysis of law, greatly influenced by the Chicago Law School. Methodologically, the paper is a theoretical review and pretends to be unfolded, in a future moment, in empirical tests for verification. This work has as its main analytical tool the appeal to theoretical and doctrinaire areas from the Juridical Sciences, by adopting the deductive and analytical method.

Keywords: institutions, state, law, agencies

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Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

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A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

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Authors: Aba-Carina Pârlog

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On translating, reading against the grain results in a wrong effect in the TL. Quine’s ocular irradiation plays an important part in the process of understanding and translating a text. The various types of textual radiation must be rendered by the translator by paying close attention to the types of field that produce it. The literary work must be seen as an indirect cause of an expressive effect in the TL that is supposed to be similar to the effect it has in the SL. If the adaptive transformative codes are so flexible that they encourage the translator to repeatedly leave out parts of the original work, then a subversive pattern emerges which changes the entire book. In this case, the translator is a writer per se who decides what goes in and out of the book, how the style is to be ciphered and what elements of ideology are to be highlighted. Figurative language must not be flattened for the sake of clarity or naturalness. The missing figurative elements make the translated text less interesting, less challenging and less vivid which reflects poorly on the writer. There is a close connection between style and the writer’s person. If the writer’s style is very much changed in a translation, the translation is useless as the original writer and his / her imaginative world can no longer be discovered. Then, a different writer appears and his / her creation surfaces. Changing meaning considered as a “negative shift” in translation defines one of the faulty transformative codes used by some translators. It is a dangerous tool which leads to adaptations that sometimes reflect the original less than the reader would wish to. It contradicts the very essence of the process of translation which is that of making a work available in a foreign language. Employing speculative aesthetics at the level of a text indicates the wish to create manipulative or subversive effects in the translated work. This is generally achieved by adding new words or connotations, creating new figures of speech or using explicitations. The irradiation patterns of the original work are neglected and the translator creates new meanings, implications, emphases and contexts. Again s/he turns into a new author who enjoys the freedom of expressing his / her ideas without the constraints of the original text. The stimulus meaning of a text is very important for a translator which is why reading against the grain is unadvisable during the process of translation. By paying attention to the waves of the SL input, a faithful literary work is produced which does not contradict general knowledge about foreign cultures and civilizations. Following personal common sense is essential in the field of translation as well as everywhere else.

Keywords: stimulus meaning, substance of expression, transformative code, translation

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Authors: Aarti Agarwal, Ajmal Khan

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Background and Objective: Breathing difficulty is most distressing symptom for the patient and their caregivers providing palliative care to individuals with advanced malignancy. It needs to be tackled effectively and sometimes preemptively to provide relief from respiratory obstruction. Interventional procedures like tracheal stenting are becoming increasingly popular as a part of palliation for respiratory symptoms. We present a case of esophageal tumor earlier stented by Gastroenterologist to maintain esophageal patency, but the tumor outgrew to produce tracheal infiltration and thereby causing airway obstruction. Method and Result: 62-year-old man presented with unresectable Carcinoma oesophagus with inability to swallow. A metallic stent was placed by the gastroenterologist, to maintain esophageal patency and enable patient to swallow. Two months later, the patient returned to hospital in emergency with respiratory distress. CT neck and thorax revealed tumor infiltration through posterior tracheal wall. Lower extent of the tumor was till 1 cm above the carina. Airway stenting with Tracheo bronchial stent with Y configuration was planned under general anaesthesia with airway blocks. Superior Laryngeal Nerve Block, Glossopharyngeal block and Trans tracheal infiltration of local anaesthetics were performed. The patient was sedated with Fentanyl, Midazolam and propofol infusion but was breathing spontaneously. Once the rigid bronchoscope was placed inside trachea, breathing was supported with oxygen and sevoflurane. Initially, the trachea was cleared of tumor by coring. After creating space, tracheal stent was positioned and deployed. After stent placement patient was awakened, suctioned and nebulized. His respiratory stridor relieved instantaneously and was shifted to recovery. Conclusion: Airway blocks help in decreasing the incidence and severity of coughing during airway instrumentation thereby help in proper stent placement. They also reduce the requirement of general anaesthetics and hasten the post stenting recovery. Airway stent provided immediate relief to patient from symptoms of respiratory difficulty. Decision for early tracheal stenting may be taken for a select group of patients with high propensity for local spread, thereby avoiding respiratory complications and providing better quality of life in patients with inoperable malignancy.

Keywords: tracheal stent, respiratory difficulty, esophageal tumor, anaesthetic management

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Authors: Annette Cosgrove, Carina Ginty, Tony Hall, Cornelia Connolly

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The objectives of this research study is to examine the impact of professional development in Technology Enhanced Learning (TEL) and the digitization of learning in teaching communities across multiple higher education sites in the ATU (Atlantic Technological University *) ( 2020-2025), including the proposal of an evidence-based digital teaching model for use in a future pandemic. The research strategy undertaken for this study is a multi-site study using mixed methods. Qualitative & quantitative methods are being used in the study to collect data. A pilot study was carried out initially, feedback was collected and the research instrument was edited to reflect this feedback before being administered. The purpose of the staff questionnaire is to evaluate the impact of professional development in the area of TEL, and to capture the practitioner's views on the perceived impact on their teaching practice in the higher education sector across ATU (West of Ireland – 5 Higher education locations ). The phenomenon being explored is ‘ the impact of professional development in the area of technology-enhanced learning and on teaching practice in a higher education institution. The research methodology chosen for this study is an Action based Research Study. The researcher has chosen this approach as it is a prime strategy for developing educational theory and enhancing educational practice. This study includes quantitative and qualitative methods to elicit data that will quantify the impact that continuous professional development in the area of digital teaching practice and technologies has on the practitioner’s teaching practice in higher education. The research instruments/data collection tools for this study include a lecturer survey with a targeted TEL Practice group ( Pre and post covid experience) and semi-structured interviews with lecturers. This research is currently being conducted across the ATU multi-site campus and targeting Higher education lecturers that have completed formal CPD in the area of digital teaching. ATU, a West of Ireland university, is the focus of the study. The research questionnaire has been deployed, with 75 respondents to date across the ATU - the primary questionnaire and semi-formal interviews are ongoing currently – the purpose being to evaluate the impact of formal professional development in the area of TEL and its perceived impact on the practitioners teaching practice in the area of digital teaching and learning. This paper will present initial findings, reflections and data from this ongoing research study.

Keywords: TEL, technology, digital, education

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Authors: Linette van der Merwe

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It is known that visual artists, performing artists, and literary artists have inspired each other since time immemorial. The enduring, symbiotic relationship between the various art genres is evident where words, colours, lines, and sounds act as metaphors, a physical separation of the transcendental reality of art. Simonides of Keos (c. 556-468 BC) confirmed this, stating that a poem is a talking picture, or, in a more modern expression, a picture is worth a thousand words. It can be seen as an ancient relationship, originating from the epigram (tombstone or artefact inscriptions), the carmen figuratum (figure poem), and the ekphrasis (a description in the form of a poem of a work of art). Visual artists, including Michelangelo, Leonardo da Vinci, and Goethe, wrote poems and songs. Goya, Degas, and Picasso are famous for their works of art and for trying their hands at poetry. Afrikaans writers whose fine art is often published together with their writing, as in the case of Andries Bezuidenhout, Breyten Breytenbach, Sheila Cussons, Hennie Meyer, Carina Stander, and Johan van Wyk, among others, are not a strange phenomenon either. Imitating one art form into another art form is a form of translation, transposition, contemplation, and discovery of artistic impressions, showing parallel interpretations rather than physical comparison. It is especially about the harmony that exists between the different art genres, i.e., a poem that describes a painting or a visual text that portrays a poem that becomes a translation, interpretation, and rediscovery of the verbal text, or rather, from the word text to the image text. Poetry-film, as a form of such a translation of the word text into an image text, can be considered a hybrid, transdisciplinary art form that connects poetry and film. Poetry-film is regarded as an intertwined entity of word, sound, and visual image. It is an attempt to transpose and transform a poem into a new artwork that makes the poem more accessible to people who are not necessarily open to the written word and will, in effect, attract a larger audience to a genre that usually has a limited market. Poetry-film is considered a creative expression of an inverted ekphrastic inspiration, a visual description, interpretation, and expression of a poem. Research also emphasises that animated poetry-film is not widely regarded as a genre of anything and is thus severely under-theorized. This paper will focus on Afrikaans animated poetry-films as a multimodal transposition of a poem text to an animated poetry film, with specific reference to animated poetry-films in Filmverse I (2014) and Filmverse II (2016).

Keywords: poetry film, animated poetry film, poetic metaphor, conceptual metaphor, monomodal metaphor, multimodal metaphor, semiotic metaphor, multimodality, metaphor analysis, target domain, source domain

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Authors: Harry J. Witchel, James Ackah, Carlos P. Santos, Nachiappan Chockalingam, Carina E. I. Westling

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Introduction: Proxemics is the study of how people perceive and use space. It is commonly proposed that when people like or engage with a person/object, they will move slightly closer to it, often quite subtly and subconsciously. Music videos are known to add entertainment value to a pop song. Our hypothesis was that by adding appropriately matched video to a pop song, it would lead to a net approach of the head to the monitor screen compared to simply listening to an audio-only version of the song. Methods: We presented to 27 participants (ages 21.00 ± 2.89, 15 female) seated in front of 47.5 x 27 cm monitor two musical stimuli in a counterbalanced order; all stimuli were based on music videos by the band OK Go: Here It Goes Again (HIGA, boredom ratings (0-100) = 15.00 ± 4.76, mean ± SEM, standard-error-of-the-mean) and Do What You Want (DWYW, boredom ratings = 23.93 ± 5.98), which did not differ in boredom elicited (P = 0.21, rank-sum test). Each participant experienced each song only once, and one song (counterbalanced) as audio-only versus the other song as a music video. The movement was measured by video-tracking using Kinovea 0.8, based on recording from a lateral aspect; before beginning, each participant had a reflective motion tracking marker placed on the outer canthus of the left eye. Analysis of the Kinovea X-Y coordinate output in comma-separated-variables format was performed in Matlab, as were non-parametric statistical tests. Results: We found that the audio-only stimuli (combined for both HIGA and DWYW, mean ± SEM, 35.71 ± 5.36) were significantly more boring than the music video versions (19.46 ± 3.83, P = 0.0066 Wilcoxon Signed Rank Test (WSRT), Cohen's d = 0.658, N = 28). We also found that participants' heads moved around twice as much during the audio-only versions (speed = 0.590 ± 0.095 mm/sec) compared to the video versions (0.301 ± 0.063 mm/sec, P = 0.00077, WSRT). However, the participants' mean head-to-screen distances were not detectably smaller (i.e. head closer to the screen) during the music videos (74.4 ± 1.8 cm) compared to the audio-only stimuli (73.9 ± 1.8 cm, P = 0.37, WSRT). If anything, during the audio-only condition, they were slightly closer. Interestingly, the ranges of the head-to-screen distances were smaller during the music video (8.6 ± 1.4 cm) compared to the audio-only (12.9 ± 1.7 cm, P = 0.0057, WSRT), the standard deviations were also smaller (P = 0.0027, WSRT), and their heads were held 7 mm higher (video 116.1 ± 0.8 vs. audio-only 116.8 ± 0.8 cm above floor, P = 0.049, WSRT). Discussion: As predicted, sitting and listening to experimenter-selected pop music was more boring than when the music was accompanied by a matched, professionally-made video. However, we did not find that the proxemics of the situation led to approaching the screen. Instead, adding video led to efforts to control the head to a more central and upright viewing position and to suppress head fidgeting.

Keywords: boredom, engagement, music videos, posture, proxemics

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Authors: Angelis P. Barlampas

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Learning Objectives: The purpose of this study is to inform briefly the reader about the applications of AI in chest radiology. Background: Currently, there are 190 FDA-approved radiology AI applications, with 42 (22%) pertaining specifically to thoracic radiology. Imaging findings OR Procedure details Aids of AI in chest radiology1: Detects and segments pulmonary nodules. Subtracts bone to provide an unobstructed view of the underlying lung parenchyma and provides further information on nodule characteristics, such as nodule location, nodule two-dimensional size or three dimensional (3D) volume, change in nodule size over time, attenuation data (i.e., mean, minimum, and/or maximum Hounsfield units [HU]), morphological assessments, or combinations of the above. Reclassifies indeterminate pulmonary nodules into low or high risk with higher accuracy than conventional risk models. Detects pleural effusion . Differentiates tension pneumothorax from nontension pneumothorax. Detects cardiomegaly, calcification, consolidation, mediastinal widening, atelectasis, fibrosis and pneumoperitoneum. Localises automatically vertebrae segments, labels ribs and detects rib fractures. Measures the distance from the tube tip to the carina and localizes both endotracheal tubes and central vascular lines. Detects consolidation and progression of parenchymal diseases such as pulmonary fibrosis or chronic obstructive pulmonary disease (COPD).Can evaluate lobar volumes. Identifies and labels pulmonary bronchi and vasculature and quantifies air-trapping. Offers emphysema evaluation. Provides functional respiratory imaging, whereby high-resolution CT images are post-processed to quantify airflow by lung region and may be used to quantify key biomarkers such as airway resistance, air-trapping, ventilation mapping, lung and lobar volume, and blood vessel and airway volume. Assesses the lung parenchyma by way of density evaluation. Provides percentages of tissues within defined attenuation (HU) ranges besides furnishing automated lung segmentation and lung volume information. Improves image quality for noisy images with built-in denoising function. Detects emphysema, a common condition seen in patients with history of smoking and hyperdense or opacified regions, thereby aiding in the diagnosis of certain pathologies, such as COVID-19 pneumonia. It aids in cardiac segmentation and calcium detection, aorta segmentation and diameter measurements, and vertebral body segmentation and density measurements. Conclusion: The future is yet to come, but AI already is a helpful tool for the daily practice in radiology. It is assumed, that the continuing progression of the computerized systems and the improvements in software algorithms , will redder AI into the second hand of the radiologist.

Keywords: artificial intelligence, chest imaging, nodule detection, automated diagnoses

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Authors: Carina Emminger, Umut D. Cakmak, Evrim Burkut, Rene Preuer, Ingrid Graz, Zoltan Major

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Damping accompanies us daily in everyday life and is used to protect (e.g., in shoes) and make our life more comfortable (damping of unwanted motion) and calm (noise reduction). In general, damping is the absorption of energy which is either stored in the material (vibration isolation systems) or changed into heat (vibration absorbers). In case of the last, the damping mechanism can be split in active, passive, as well as semi-active (a combination of active and passive). Active damping is required to enable an almost perfect damping over the whole application range and is used, for instance, in sport cars. In contrast, passive damping is a response of the material due to external loading. Consequently, the material composition has a huge influence on the damping behavior. For elastomers, the material behavior is inherent viscoelastic, temperature, and frequency dependent. However, passive damping is not adjustable during application. Therefore, it is of importance to understand the fundamental viscoelastic behavior and the dissipation capability due to external loading. The objective of this work is to assess the limitation and applicability of viscoelastic material damping for applications in which currently coil-over shock absorbers are utilized. Coil-over shock absorbers are usually made of various mechanical parts and incorporate fluids within the damper. These shock absorbers are well-known and studied in the industry, and when needed, they can be easily adjusted during their product lifetime. In contrary, dampers made of – ideally – a single material are more resource efficient, have an easier serviceability, and are easier manufactured. However, they lack of adaptability and adjustability in service. Therefore, a case study with a remote-controlled sport car was conducted. The original shock absorbers were redesigned, and the spring-dashpot system was replaced by both an elastomer and a thermoplastic-elastomer, respectively. Here, five different formulations of elastomers were used, including a pure and an iron-particle filled thermoplastic poly(urethan) (TPU) and blends of two different poly(dimethyl siloxane) (PDMS). In addition, the TPUs were investigated as full and hollow dampers to investigate the difference between solid and structured material. To get comparative results each material formulation was comprehensively characterized, by monotonic uniaxial compression tests, dynamic thermomechanical analysis (DTMA), and rebound resilience. Moreover, the new material-based shock absorbers were compared with spring-dashpot shock absorbers. The shock absorbers were analyzed under monotonic and cyclic loading. In addition, an impact loading was applied on the remote-controlled car to measure the damping properties in operation. A servo-hydraulic high-speed linear actuator was utilized to apply the loads. The acceleration of the car and the displacement of specific measurement points were recorded while testing by a sensor and high-speed camera, respectively. The results prove that elastomers are suitable in damping applications, but they are temperature and frequency dependent. This is a limitation in applicability of viscous material damper. Feasible fields of application may be in the case of micromobility, like bicycles, e-scooters, and e-skateboards. Furthermore, the viscous material damping could be used to increase the inherent damping of a whole structure, e.g., in bicycle-frames.

Keywords: damper structures, material damping, PDMS, TPU

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Authors: Mariana Stuparu-Cretu, Doina-Carina Voinescu, Rodica-Mihaela Dinica, Daniela Borda, Camelia Vizireanu, Gabriela Iordachescu, Camelia Busila

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Obesity is involved in the etiology or acceleration of progression of important non-communicable diseases, such as: metabolic, cardiovascular, rheumatological, oncological and depression. It is a need to prevent the obesity occurrence, like a key link in disease management. From this point of view, the best approach is to early educate youngsters upon the need for a healthy nutrition lifestyle associated with constant physical activities. The objective of the study was to assess correlations between weight condition, physical activities and food preferences of students from South East Romania. Questionnaires were applied on high school students in Galati: 1006 girls and 880 boys, aged between 14 and 19 years (being approved by Local School Inspectorate and the Ethics Committee of the 'Dunarea de Jos' University of Galati). The collected answers have been statistically processed by using the multivariate regression method (PLS2) by Unscramble X program (Camo, Norway). Multiple variables such as age group, body mass index, nutritional habits and physical activities were separately analysed, depending on gender and general mathematical models were proposed to explain the obesity trend at an early age. The study results show that overweight and obesity are present in less than a fifth of the adolescents who were surveyed. With a very small variation and a strong correlation of over 86% for 99% of the cases, a general preference for sweet foods, nocturnal eating associated with computer work and a reduced period of physical activity is noticed for girls. In addition, the overweight girls consume sweet juices and alcohol, although a percentage of them also practice the gym. There is also a percentage of the normoponderal girls that consume high caloric foods which predispose this group to turn into overweight cases in time. Within the studied group, statistics for the boys show a positive correlation of almost 87% for over 96% of cases. They prefer high calories foods, fast food, and sweet juices, and perform medium physical activities. Both overweight and underweight boys are more sedentary. Over 15% of girls and over a quarter of boys consume alcohol. All these bad eating habits seem to increase with age, for both sexes. To conclude, obesity and overweight assessed in adolescents in S-E Romania reveal nonsignificant percentage differences between boys and girls. However, young people in this area of the country are sedentary in general; a significant percentage prefers sweets / sweet juices / fast-food and practice computer nourishing. The authors consider that at this age, it is very useful to adapt nutritional education by new methods of food processing and market supply. This would require an early understanding of the difference among foods and nutrients and the benefits of physical activities integrated into the healthy current lifestyle, as a measure for preventing and managing non-communicable chronic diseases related to nutritional errors and sedentarism. Acknowledgment— This study has been partial founded by the Francophone University Agency, Project Réseau régional dans le domaine de la santé, la nutrition et la sécurité alimentaire (SaIN), no.21899/ 06.09.2017.

Keywords: adolescents, body mass index, nutritional habits, obesity, physical activity

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Authors: Elena Parmentier, Henrik Endeman

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Introduction: Large mediastinal masses often present with diagnostic and clinical challenges due to compression of the respiratory and hemodynamic system. We present a case of a mediastinal mass with symptomatic mechanical compression of the trachea, resulting in challenging airway management. Methods: We present a case of 66-year-old male, complaining of progressive dysphagia. Initial esophagogastroscopy revealed a stenosis secondary to external compression, biopsies were inconclusive. Additional CT scan showed a large mediastinal mass of unknown origin, situated between the vertebrae and esophagus. Symptoms progressed and patient developed dyspnea and stridor. A new CT showed quick growth of the mass with compression of the trachea, subglottic to just above the carina. A tracheal covered stent was successfully placed. Endobronchial ultrasound revealed a large irregular mass without tracheal invasion, biopsies were taken. 4 days after stent placement, the patients’ condition deteriorated with worsening of stridor, dyspnea and desaturation. Migration of the tracheal stent into the right main bronchus was seen on chest X ray, with obstruction of the left main bronchus and secondary atelectasis. Different methods have been described in the literature for tracheobronchial stent removal (surgical, endoscopic, fluoroscopyguided), our first choice in this case was flexible bronchoscopy. However, this revealed tracheal compression above the migrated stent and passage of the scope occurred impossible. Patient was admitted to the ICU, high-flow nasal oxygen therapy was started and the situation stabilized, giving time for extensive assessment and preparation of the airway management approach. Close cooperation between the intensivist, pulmonologist, anesthesiologist and otorhinolaryngologist was essential. Results: In case of sudden deterioration, a protocol for emergency situations was made. Given the increased risk of additional tracheal compression after administration of neuromuscular blocking agents, an approach with awake fiberoptic intubation maintaining spontaneous ventilation was proposed. However, intubation without retrieval of the tracheal stent was found undesirable due to expected massive shunting over the left atelectatic lung. As rescue option, assistance of extracorporeal circulation was considered and perfusionist was kept on standby. The patient stayed stable and was transferred to the operating theatre. High frequency jet ventilation under general anesthesia resulted in desaturations up to 50%, making rigid bronchoscopy impossible. Subsequently an endotracheal tube size 8 could be placed successfully and the stent could be retrieved via bronchoscopy over (and with) the tube, after which the patient was reintubated. Finally, a tracheostomy (Shiley™ Tracheostomy Tube With Cuff, size 8) was placed, fiberoptic control showed a patent airway. Patient was readmitted to the ICU and could be quickly weaned of the ventilator. Pathology was positive for rhabdomyosarcoma, without indication for systemic therapy. Extensive surgery (laryngectomy, esophagectomy) was suggested, but patient refused and palliative care was started. Conclusion: Due to meticulous planning in an interdisciplinary team, we showed a successful airway management approach in this complicated case of critical airway compression secondary to a rare rhabdomyosarcoma, complicated by tracheal stent migration. Besides presenting our thoughts and considerations, we support exploring other possible approaches of this specific clinical problem.

Keywords: airway management, rhabdomyosarcoma, stent displacement, tracheal stenosis

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