Search results for: diaphragmatic aspiration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 147

Search results for: diaphragmatic aspiration

117 Diffable’s Aspiration Dreams in Spatial Planning

Authors: Tety Widyaningrum, Sapnah Rahmawati, Abdulmuluk Attim

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Space was a container that includes land space, sea space and air space, including space in the earth as a whole region, where humans and other living creatures, operate and maintain its survival. Whereas spatial planning was a form of the structure of space and spatial pattern. At this time, the arrangement of space became a matter of considerable concern because through spatial planning was what will determine how the future city hall, how the welfare of the population that is in it, and how space can be a comfortable space to live. This spatial arrangement became a subject that must be considered not only by the Government as policy makers but also of concern to the entire community in it. As a place to stay, this space should be able to ensure the safety and comfort of the whole community, even people with disabilities, though. For development and spatial planning in Indonesia. It was still very low which was still concerned about the disabled. The spatial arrangement made generalizations. This caused the right for disabled people was less fulfilled. In accordance with the Declaration on the Rights of Persons with Disabilities who explains that people with disabilities had the right to be able to facilitate their efforts to become self-sufficient or not depends on the other party. It was also strengthened by According to the Law of the Republic of Indonesia No. 4 of 1997 on Persons with Disabilities; disabilities were part of the Indonesian people who had the status, rights, obligations and the same role with other Indonesian community in all aspects of life and livelihood. As observed, during the disabled were still used as objects that hadn’t been involved in the formulation of development planning of space in Indonesia, so the infrastructure space was still very far from the concept of friendly to the disabled. As an example of a sidewalk in Indonesia were still in bad condition, potholes, and uneven and don’t meet the eligibility standards. In addition, there were sidewalks that abused become a trade causing run down and chaotic atmosphere. In addition, pedestrians are also disturbed because the sidewalks were often still used as a parking lot or flowers to decorate the layout of the city, so the legroom was becoming increasingly limited. The development of infrastructure for pedestrians was also still concerned with aspects of aesthetic than functional. Therefore, the participation of disabled people must be involved in spatial planning exist. It aims to achieve spatial and environmentally friendly to the disabled. These dream space activities carried out by giving questionnaires and the dream images to the disabled about how the layout of the space they want what they want and what development was also in line with the principle of their convenience. This then will be taken into consideration for government in planning layout that was friendly to the whole community.

Keywords: diffable, aspiration, spatial, planning

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116 Cystic Ganglionosis in Child: Rare Entity

Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar

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Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.

Keywords: radiology, rare, cystic ganglionosis, child

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115 Smashed Mirror: Immigrant Students’ Constructions of South Africa

Authors: Vandeyar Saloshna, Vandeyar Hirusellvan

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The image of post-apartheid South African Society that is reflected in the social mirror of the world is largely one of hope, faith, and aspiration. But is this reality? Utilizing social constructivism, case study approach and narrative inquiry, this chapter set out to explore the reflection of South African students from the lens of immigrant students. The picture that unfolds is troublesome in its negativity. In this chapter, we establish in detail what this picture is about and what implications it holds for South African Society.

Keywords: immigrant students, social mirror, xenophobia, identity formation, makwerekwere, expectations

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114 Two Kinds of Self-Oscillating Circuits Mechanically Demonstrated

Authors: Shiang-Hwua Yu, Po-Hsun Wu

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This study introduces two types of self-oscillating circuits that are frequently found in power electronics applications. Special effort is made to relate the circuits to the analogous mechanical systems of some important scientific inventions: Galileo’s pendulum clock and Coulomb’s friction model. A little touch of related history and philosophy of science will hopefully encourage curiosity, advance the understanding of self-oscillating systems and satisfy the aspiration of some students for scientific literacy. Finally, the two self-oscillating circuits are applied to design a simple class-D audio amplifier.

Keywords: self-oscillation, sigma-delta modulator, pendulum clock, Coulomb friction, class-D amplifier

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113 Synthesis and Evaluation of Heterogeneous Nano-Catalyst: Cr Loaded in to MCM-41

Authors: A. Salemi Golezania, A. Sharifi Fateha

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In this study a nano-composite catalyst was synthesized by incorporation of chromium into the framework of MCM-41 as a base catalyst. Mesoporous silica molecular sieves MCM-41 were synthesized under Hydrothermal Continues pH Adjusting Path Way. Then, MCM-41 was impregnated by chromium nitrate aqueous solution for several times under water aspiration. Raw powder was cured by heat treatment in vacuum furnace at 500°C. Phase formation, morphology and gas absorption properties of resulted materials were characterized by XRD, TEM and BET analysis, respectively. The results showed that high quality hexagonal meso structure as a matrix and Cr as a second phase has been formed with a narrow size pore diameter distribution and high surface area in Cr/MCM-41 nano-composite structure. The specific surface and total volume of porosity of the synthesized nanocomposite are obtained 931m^2/gr and 1.12 cm^3/gr, respectively.

Keywords: nano-catalyst, MCM-41, Cr/MCM-41, Marine Science and Engineering

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112 Performance Shortfalls and Corporate Recidivism: A Contingency Approach

Authors: Kepeng Li

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This paper examines the phenomenon of recidivism in the Chinese stock market, emphasizing the significance of mitigating repeat offences within the corporate domain. Using a contingency model and data from Chinese publicly listed companies (1999-2018), the study investigates the impact of underperformance, governance factors, and managerial traits on unethical conduct. The research suggests that persistently unmet economic objectives can foster problem-focused exploration, potentially leading to misconduct. Furthermore, the study considers the unique cultural context of China, where “guanxi” and corruption may influence corporate behavior. It concludes that governance mechanisms play a pivotal role in regulating corporate behavior, underscoring the necessity for enhanced oversight and enforcement of corporate governance standards.

Keywords: recidivism, corporate misbehavior, BTOF, aspiration level, corporate governance, individual characteristics

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111 Frequency of Tube Feeding in Aboriginal and Non-aboriginal Head and Neck Cancer Patients and the Impact on Relapse and Survival Outcomes

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: Head and neck cancer and treatments are known for their profound effect on nutrition and tube feeding is a common requirement to maintain nutrition. Aim: We aimed to evaluate the frequency of tube feeding in Aboriginal and non-Aboriginal patients, and to examine the relapse and survival outcomes in patients who require enteral tube feeding. Methods: We performed a retrospective cohort analysis of 320 head and neck cancer patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. Data collected included patient demographics, tumour features, treatment details, and cancer and survival outcomes. Results: Aboriginal and non-Aboriginal patients required feeding tubes at similar rates (42.5% vs 46.2% respectively), however Aboriginal patients were far more likely to fail to return to oral nutrition, with 26.3% requiring long-term tube feeding versus only 15% of non-Aboriginal patients. In the overall study population, 27.5% required short-term tube feeding, 17.8% required long-term enteral tube nutrition, and 45.3% of patients did not have a feeding tube at any point. Relapse was more common in patients who required tube feeding, with relapses in 42.1% of the patients requiring long-term tube feeding, 31.8% in those requiring a short-term tube, versus 18.9% in the ‘no tube’ group. Survival outcomes for patients who required a long-term tube were also significantly poorer when compared to patients who only required a short-term tube, or not at all. Long-term tube-requiring patients were half as likely to survive (29.8%) compared to patients requiring a short-term tube (62.5%) or no tube at all (63.5%). Patients requiring a long-term tube were twice as likely to die with active disease (59.6%) as patients with no tube (28%), or a short term tube (33%). This may suggest an increased relapse risk in patients who require long-term feeding, due to consequences of malnutrition on cancer and treatment outcomes, although may simply reflect that patients with recurrent disease were more likely to have longer-term swallowing dysfunction due to recurrent disease and salvage treatments. Interestingly long-term tube patients were also more likely to die with no active disease (10.5%) (compared with short-term tube requiring patients (4.6%), or patients with no tube (8%)), which is likely reflective of the increased mortality associated with long-term aspiration and malnutrition issues. Conclusions: Requirement for tube feeding was associated with a higher rate of cancer relapse, and in particular, long-term tube feeding was associated with a higher likelihood of dying from head and neck cancer, but also a higher risk of dying from other causes without cancer relapse. This data reflects the complex effect of head and neck cancer and its treatments on swallowing and nutrition, and ultimately, the effects of malnutrition, swallowing dysfunction, and aspiration on overall cancer and survival outcomes. Tube feeding was seen at similar rates in Aboriginal and non-Aboriginal patient, however failure to return to oral intake with a requirement for a long-term feeding tube was seen far more commonly in the Aboriginal population.

Keywords: head and neck cancer, enteral tube feeding, malnutrition, survival, relapse, aboriginal patients

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110 Development of a Single Drive for the Accessories Components in IC Engine

Authors: R. Rishi Jain, S. V. Viswanath, R. Naveen Vasanthan

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Generally all the IC engines, alternators, air conditioner compressors, oil pumps and coolant pumps are driven by a crankshaft utilizing V-belt drivers. An increase in the number of idle pulleys results in the increase of frictional power. Further, components like idler and belt tensioner are also needed to run the belt drive which adds to the frictional power. The aspiration of this paper is to minimize the friction power by introducing a new system that could combine all the accessories in one shaft within a single casing. This is conceptualized to minimize the friction power, service and maintenance cost, space and also time. The validation of this work can be executed through a simpler drive transmitting power from the crank shaft.

Keywords: single drive, idler pulley, belt tensioner, friction power, casing, space and cost

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109 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines

Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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108 Resource Efficiency within Current Production

Authors: Sarah Majid Ansari, Serjosha Wulf, Matthias Goerke

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In times of global warming and the increasing shortage of resources, sustainable production is becoming more and more inevitable. Companies cannot only heighten their competitiveness but also contribute positively to environmental protection through efficient energy and resource consumption. Regarding this, technical solutions are often preferred during production, although organizational and process-related approaches also offer great potential. This project focuses on reducing resource usage, with a special emphasis on the human factor. It is the aspiration to develop a methodology that systematically implements and embeds suitable and individual measures and methods regarding resource efficiency throughout the entire production. The measures and methods established help employees handle resources and energy more sensitively. With this in mind, this paper also deals with the difficulties that can occur during the sensitization of employees and the implementation of these measures and methods. In addition, recommendations are given on how to avoid such difficulties.

Keywords: implementation, human factors, production plants, resource efficiency

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107 Multi-Resistant Enterobacter Cloacae Dacryocystitis and Preseptal Cellulitis: Case and Review of Literature

Authors: Michael Kvopka, Ezekiel Kingston

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A 61-year-old man with no significant past medical history presented to a quaternary ophthalmic referral center with acute right-sided medial canthal pain, periorbital edema, and erythema despite oral antibiotic therapy. CT imaging confirmed the presence of right preseptal cellulitis and lacrimal sac aspiration identified multi-resistant Enterobacter cloacae. A diagnosis of acute right-sided dacryocystitis with preseptal cellulitis was made. He was successfully treated with broadening of antibiotic therapy to intravenous meropenem. The symptomatic resolution was noted on follow-up without evidence of disease recurrence. To the Authors’ best knowledge, this is the first reported case of multi-resistant E. cloacae dacryocystitis and preseptal cellulitis. The management of this patient required a multi-disciplinary approach, so the Authors believe this report is relevant to general ophthalmologists and oculoplastic sub-specialists.

Keywords: enterobacter, dacryocystitis, preseptal cellulitis, antibiotic resistance

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106 Differences in Innovative Orientation of the Entrepreneurially Active Adults: The Case of Croatia

Authors: Nataša Šarlija, Sanja Pfeifer

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This study analyzes the innovative orientation of the Croatian entrepreneurs. Innovative orientation is represented by the perceived extent to which an entrepreneur’s product or service or technology is new, and no other businesses offer the same product. The sample is extracted from the GEM Croatia Adult Population Survey dataset for the years 2003-2013. We apply descriptive statistics, t-test, Chi-square test and logistic regression. Findings indicate that innovative orientations vary with personal, firm, meso and macro level variables, and between different stages in entrepreneurship process. Significant predictors are occupation of the entrepreneurs, size of the firm and export aspiration for both early stage and established entrepreneurs. In addition, fear of failure, expecting to start a new business and seeing an entrepreneurial career as a desirable choice are predictors of innovative orientation among early stage entrepreneurs.

Keywords: multilevel determinants of the innovative orientation, Croatian early stage entrepreneurs, established businesses, GEM evidence

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105 Modern Machine Learning Conniptions for Automatic Speech Recognition

Authors: S. Jagadeesh Kumar

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This expose presents a luculent of recent machine learning practices as employed in the modern and as pertinent to prospective automatic speech recognition schemes. The aspiration is to promote additional traverse ablution among the machine learning and automatic speech recognition factions that have transpired in the precedent. The manuscript is structured according to the chief machine learning archetypes that are furthermore trendy by now or have latency for building momentous hand-outs to automatic speech recognition expertise. The standards offered and convoluted in this article embraces adaptive and multi-task learning, active learning, Bayesian learning, discriminative learning, generative learning, supervised and unsupervised learning. These learning archetypes are aggravated and conferred in the perspective of automatic speech recognition tools and functions. This manuscript bequeaths and surveys topical advances of deep learning and learning with sparse depictions; further limelight is on their incessant significance in the evolution of automatic speech recognition.

Keywords: automatic speech recognition, deep learning methods, machine learning archetypes, Bayesian learning, supervised and unsupervised learning

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104 Big Data Analytics and Data Security in the Cloud via Fully Homomorphic Encryption

Authors: Waziri Victor Onomza, John K. Alhassan, Idris Ismaila, Noel Dogonyaro Moses

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This paper describes the problem of building secure computational services for encrypted information in the Cloud Computing without decrypting the encrypted data; therefore, it meets the yearning of computational encryption algorithmic aspiration model that could enhance the security of big data for privacy, confidentiality, availability of the users. The cryptographic model applied for the computational process of the encrypted data is the Fully Homomorphic Encryption Scheme. We contribute theoretical presentations in high-level computational processes that are based on number theory and algebra that can easily be integrated and leveraged in the Cloud computing with detail theoretic mathematical concepts to the fully homomorphic encryption models. This contribution enhances the full implementation of big data analytics based cryptographic security algorithm.

Keywords: big data analytics, security, privacy, bootstrapping, homomorphic, homomorphic encryption scheme

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103 CoP-Networks: Virtual Spaces for New Faculty’s Professional Development in the 21st Higher Education

Authors: Eman AbuKhousa, Marwan Z. Bataineh

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The 21st century higher education and globalization challenge new faculty members to build effective professional networks and partnership with industry in order to accelerate their growth and success. This creates the need for community of practice (CoP)-oriented development approaches that focus on cognitive apprenticeship while considering individual predisposition and future career needs. This work adopts data mining, clustering analysis, and social networking technologies to present the CoP-Network as a virtual space that connects together similar career-aspiration individuals who are socially influenced to join and engage in a process for domain-related knowledge and practice acquisitions. The CoP-Network model can be integrated into higher education to extend traditional graduate and professional development programs.

Keywords: clustering analysis, community of practice, data mining, higher education, new faculty challenges, social network, social influence, professional development

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102 The Impacts of Cultural Event on Networking: Liverpool's Cultural Sector in the Aftermath of 2008

Authors: Yi-De Liu

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The aim of this paper is to discuss how the construct of networking and social capital can be used to understand the effect events can have on the cultural sector. Based on case study, this research sought the views of those working in the cultural sector on Liverpool’s year as the European Capital of Culture (ECOC). Methodologically, this study involves literature review to prompt theoretical sensitivity, the collection of primary data via online survey (n= 42) and follow-up telephone interviews (n= 8) to explore the emerging findings in more detail. The findings point to a number of ways in which the ECOC constitutes a boost for networking and its effects on city’s cultural sector, including organisational learning, aspiration and leadership. The contributions of this study are two-fold: (1) Evaluating the long-term effects on network formation in the cultural sector following major event; (2) conceptualising the impact assessment of organisational social capital for future ECOC or similar events.

Keywords: network, social capital, cultural impact, european capital of culture

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101 Cytotoxic Drugs: Handling Practices and Clinical Manifestations among Hospital Staff

Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

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Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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100 Big Data Analytics and Data Security in the Cloud via Fully Homomorphic Encyption Scheme

Authors: Victor Onomza Waziri, John K. Alhassan, Idris Ismaila, Noel Dogonyara

Abstract:

This paper describes the problem of building secure computational services for encrypted information in the Cloud. Computing without decrypting the encrypted data; therefore, it meets the yearning of computational encryption algorithmic aspiration model that could enhance the security of big data for privacy or confidentiality, availability and integrity of the data and user’s security. The cryptographic model applied for the computational process of the encrypted data is the Fully Homomorphic Encryption Scheme. We contribute a theoretical presentations in a high-level computational processes that are based on number theory that is derivable from abstract algebra which can easily be integrated and leveraged in the Cloud computing interface with detail theoretic mathematical concepts to the fully homomorphic encryption models. This contribution enhances the full implementation of big data analytics based on cryptographic security algorithm.

Keywords: big data analytics, security, privacy, bootstrapping, Fully Homomorphic Encryption Scheme

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99 Industrial Ecology Perspectives of Food Supply Chains: A Framework of Analysis

Authors: Luciano Batista, Sylvia Saes, Nuno Fouto, Liam Fassam

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This paper introduces the theoretical and methodological basis of an analytical framework conceived with the purpose of bringing industrial ecology perspectives into the core of the underlying disciplines supporting analyses in studies concerned with environmental sustainability aspects beyond the product cycle in a supply chain. Given the pressing challenges faced by the food sector, the framework focuses upon waste minimization through industrial linkages in food supply chains. The combination of industrial ecology practice with basic LCA elements, the waste hierarchy model, and the spatial scale of industrial symbiosis allows the standardization of qualitative analyses and associated outcomes. Such standardization enables comparative analysis not only between different stages of a supply chain, but also between different supply chains. The analytical approach proposed contributes more coherently to the wider circular economy aspiration of optimizing the flow of goods to get the most out of raw materials and cuts wastes to a minimum.

Keywords: by-product synergy, food supply chain, industrial ecology, industrial symbiosis

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98 Robotic Mini Gastric Bypass Surgery

Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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97 Using Multi-Specialist Team to Care for a Breast Cancer Patient Who Received Total Mastectomy during Pregnancy

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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96 Moving Beyond the Limits of Disability Inclusion: Using the Concept of Belonging Through Friendship to Improve the Outcome of the Social Model of Disability

Authors: Luke S. Carlos A. Thompson

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The medical model of disability, though beneficial for the medical professional, is often exclusionary, restrictive and dehumanizing when applied to the lived experience of disability. As a result, a critique of this model was constructed called the social model of disability. Much of the language used to articulate the purpose behind the social model of disability can be summed up within the word inclusion. However, this essay asserts that inclusiveness is an incomplete aspiration. The social model, as it currently stands, does not aid in creating a society where those with impairments actually belong. Rather, the social model aids in lessening the visibility, or negative consequence of, difference. Therefore, the social model does not invite society to welcome those with physical and intellectual impairments. It simply aids society in ignoring the existence of impairment by removing explicit forms of exclusion. Rather than simple inclusion, then, this essay uses John Swinton’s concept of friendship and Jean Vanier’s understanding of belonging to better articulate the intended outcome of the social model—a society where everyone can belong.

Keywords: belong, community, differently-able, disability, exclusion, friendship, inclusion, normality

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95 Error Analysis of the Pronunciation of English Consonants and Arabic Consonants by Egyptian Learners

Authors: Marwa A. Nasser

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This is an empirical study that provides an investigation of the most significant errors of Egyptian learners in producing English consonants and Arabic consonants, and advice on how these can be remedied. The study adopts a descriptive approach and the analysis is based on audio recordings of two groups of people. The first group includes six volunteers of Egyptian learners belonging to the English Department at Faculty of Women who learn English as a foreign language. The other group includes six Egyptian learners who are studying Tajweed (how to recite Quran correctly). The audio recordings were examined, and sounds were analyzed in an attempt to highlight the most common error done by the learners while reading English or reading (or reciting) Quran. Results show that the two groups of learners have problems with certain phonemic contrasts. Both groups share common errors although both languages are different and not related (e.g. pre-aspiration of fortis stops, incorrect articulation of consonants and velarization of certain sounds).

Keywords: consonant articulations, Egyptian learners of English, Egyptian learners of Quran, empirical study, error analysis, pronunciation problems

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94 Detaching the ‘Criminal Justice Conveyor Belt’: Diversion as a Responsive Mechanism for Children in Kenya

Authors: Sarah Kinyanjui, Mahnaaz Mohamed

Abstract:

The child justice system in Kenya is organically departing from a managerial and retributive model to one that espouses restorative justice. Notably, the Children Act 2001, and the most recent, Children Act 2022, signalled an aspiration to facilitate meaningful interventions as opposed to ‘processing’ children through the justice system. In this vein, the Children Act 2022 formally recognises diversion and provides modalities for its implementation. This paper interrogates the diversion promise and reflects on the implementation of diversion as envisaged by the 2022 Act. Using restorative justice, labelling and differential association theories as well as the value of care lenses, the paper discusses diversion as a meaningful response to child offending. It further argues that while diversion presents a strong platform for the realisation of the restorative and rehabilitative ideals, in the absence of a well-planned, coordinated, and resourced framework, diversion may remain a mere alternative ‘conveyor belt’. Strategic multi-agency planning, capacity building and cooperation are highlighted as essential minimums for the realisation of the goals of diversion.

Keywords: diversion for child offenders, restorative justice, responsive criminal justice system, children act 2022 kenya

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93 Catamenial Pneumothorax: Report of Two Cases and Review of the Local Literature

Authors: Angeli Marie P. Lagman, Nephtali M. Gorgonio

Abstract:

Catamenial pneumothorax is defined as a recurrent accumulation of air in the pleural cavity, which occurs in the period of 72 hours before or after menses. In a menstruating woman presenting with the difficulty of breathing and chest pain with concomitant radiographic evidence of pneumothorax, a diagnosis of catamenial pneumothorax should be entertained. Two cases of catamenial pneumothorax were reported in our local literature. This report added two more cases. The first case is 45 years old G1P1, while the second case is 46 years old G2P2. These two patients had a history of pelvic endometriosis in the past. All other signs and symptoms were similar to the previously reported cases. All patients presented with difficulty of breathing associated with chest pain. Imaging studies showed right-sided pneumothorax in all patients. Intraoperatively, subpleural bleb, diaphragmatic fenestrations, and endometriotic implants were found. Three patients underwent video-assisted thoracosurgery (VATS), while one patient underwent open thoracotomy with pleurodesis. Histopathology revealed endometriosis in only two patients. All patients received postoperative hormonal therapy, and there were no recurrences noted in all patients. Endometriosis-related catamenial pneumothorax is a rare condition that needs early recognition of the symptoms. Several theories may be involved to explain the pathogenesis of catamenial pneumothorax. Two cases show a strong significant association between a history of pelvic endometriosis and the development of catamenial pneumothorax, while one case can be explained by the hormonal theory. The difficulty of breathing and chest pain in relation to menses may prompt early diagnosis. One case has shown that pneumothorax may occur even after menstruation. A biopsy of the endometrial implants may not always show endometrial glands and stroma, nor will immunostaining, which will not always show estrogen and progesterone receptors. Video-assisted thoracoscopic surgery is the gold standard in the diagnosis and treatment of catamenial pneumothorax. Postoperative hormonal suppression will further reduce the disease recurrence and facilitate the effectiveness of the surgical treatment.

Keywords: catamenial pneumothorax, endometriosis, menstruation, video assisted thoracosurgery

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92 Being ‘Sciencey’: Scottish, South-Asian and Muslim Young People

Authors: Saima Salehjee, Mike Watts

Abstract:

In our school-based world, we are commonly confronted by young people for whom the study of science is an unpalatable ‘other world’: they simply do not see themselves as science (sciencey) people. To be clear, we are not interested in all young people becoming career scientists – although some small modicum of that would be quite agreeable. We are, though, keen to form or transform (trans(form)) their appreciations of science and retain open minds on matters scientific to develop the feeling of being ‘sciencey’ with or without the aspiration of becoming scientists. Our discussion in this paper draws upon research undertaken in a co-education primary- and lower-secondary school in Scotland, and our arguments chart the trans(formations) of thirty under-representative and under-researched Scottish South-Asian Muslim students (aged 11-13) over a school term. We use science identity theory as the basis for our analysis: what it means to be ‘sciencey’ and whether (or not) structural forces have impacted their decision of being ‘sciencey’. This work offers new insights into how Scottish, South-Asian, and Muslim students perceive and engage with in and out of school science and highlight some science nudges aimed to support their development of being ‘sciencey’.

Keywords: science identity, science nudges, transformative moments, south-Asian, Muslim, scottish, sciencey

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91 Cumulus Cells of Mature Local Goat Oocytes Vitrified with Insulin Transferrin Selenium and Heat Shock Protein 70

Authors: Izzatul Ulfana, Angga Pratomo Cahyadi, Rimayanti, Widjiati

Abstract:

Freezing oocyte could cause temperature stress. Temperature stress triggers cell damage. Insulin Transferrin Selenium (ITS) and Heat Shock Protein 70 (HSP70) had been used to prevent damage to the oocyte after freezing. ITS and HSP70 could cause the difference protective effect. The aim of this research was to obtain an effective cryoprotectant for freezing local goat oocyte in cumulus cells change. The research began by collecting the ovary from a local slaughterhouse in Indonesia, aspiration follicle, in vitro maturation and the freezing had been used vitrification method. Examination of the morphology cells by native staining method. Data on the calculation morphology oocyte analyzed by Kruskall-Wallis Test. After the Kruskall-Wallis Test which indicated significance, followed by Mann-Whitney Test to compare between treatment groups. As a result, cryoprotectant ITS has the best culumus cells after warming

Keywords: Insulin Transferrin Selenium, Heat Shock Protein 70, cryoprotectant, vitrification

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90 Assessing the Corporate Identity of Malaysia Universities in the East Coast Region with the Market Conditions in Ensuring Self-Sustainability: A Study on Universiti Sultan Zainal Abidin

Authors: Suffian Hadi Ayub, Mohammad Rezal Hamzah, Nor Hafizah Abdullah, Sharipah Nur Mursalina Syed Azmy, Hishamuddin Salim

Abstract:

The liberalisation of the education industry has exposed the institute of higher learning (IHL) in Malaysia to the financial challenges. Without good financial standing, public institution will rely on the government funding. Ostensibly, this contradicts with the government’s aspiration to make universities self-sufficient. With stiff competition from private institutes of higher learning, IHL need to be prepared at the forefront level. The corporate identity itself is the entrance to the world of higher learning and it is in this uniqueness, it will be able to distinguish itself from competitors. This paper examined the perception of the stakeholders at one of the public universities in the east coast region in Malaysia on the perceived reputation and how the university communicate its preparedness for self-sustainability through corporate identity. The findings indicated while the stakeholders embraced the challenges in facing the stiff competition and struggling market conditions, most of them felt the university should put more efforts in mobilising the corporate identity to its constituencies.

Keywords: communication, corporate identity, market conditions, universities

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89 Choking among Infants and Young Children

Authors: Emad M.Abdullat, Hasan A. Ader-Rahman, Rayyan Al Ali, Arwa.A.Hudaib

Abstract:

This retrospective study aims to determine the epidemiological features of such deaths in one of the general teaching hospitals in Jordan with a focus on weaning practices and its relation to sucking as major factors underlying the mechanism of choking in infants and young children. The study utilized a retrospective design to review the records of forensic cases due to foreign body aspiration examined at the forensic department at the Jordan University Hospital. A total of 27 cases of choking in the pediatric age group were retrieved from the reports of the autopsy cases dissected. All cases of children who died due to chocking by foreign bodies were under 11 years old. Choking by food materials constituted (44.4%) of cases under 3 years of age while choking by non-food material were less prevalent under 3 years of age and comprising 18.5% of the cases. Health care personnel and parents need to be aware that introduction of solid food, unlike exclusive breast or formula-milk feeding, can have serious consequences if occurring in inappropriate timing or consistency during early childhood physical and functional development. Parents need to be educated regarding the appropriate timing and process of weaning.

Keywords: chocking, infants, weaning practices, young children

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88 Therapeutic Journey towards Self: Developing Positivity with Indications of Cluster B and C Personality Traits

Authors: Shweta Jha, Nandita Chaube

Abstract:

The concept of self has a major role to play in the study of personality which drives the current study in its present form. This is a case of Miss S, a 17-year-old Hindu, currently in eleventh standard, with no family history of mental illness but with a past history of inability to manage relationships, multiple emotional and sexual relationships, repeated self harming behaviour, and sexual abuse over a period of 2 months at the age of 10 years. She comes with a psychiatric history of one episode of dissociative fall followed by a stressful event which left the patient with many psychological disturbances matching the criterion of Cluster B and C traits. Current episode precipitated due to the relationship failure, predisposing factor is her personality traits, and poor social and family support. Considering the patient’s aspiration for positivity and demand of the therapy, ventilation sessions were carried out which made her capable of understanding and dealing with her negative emotions, also strengthened mother child bond, helped her maintain meaningful and healthy relationships, also helped her increase her problem solving ability and adaptive coping skills making her feel more positive and acceptable towards herself, family members and others.

Keywords: cluster B and C traits, personality, therapy, self

Procedia PDF Downloads 263