Acute Abdomen caused by Perforated Jejunal Diverticulitis

Jejunal diverticulum accounts for only 25% of small bowel diverticula, and approximately 7% of these will present as complicated jejunal diverticulitis or perforation. Here, we described a case of jejunal diverticular perforation presented as acute abdominal peritonitis. The computed tomography of the abdomen suggested small bowel perforation and therefore, emergency surgical exploration was performed. Intraoperatively, multiple jejunal diverticulae were found with one forming a localised diverticular abscess. Segmental resection of the diseased segment with primary anastomosis was performed. The patient made an uneventful post-operative recovery. Although complicated jejunal diverticulitis is rare, emergency surgery is often warranted if perforation occurs. Computed tomography is valuable in the diagnosis and preoperative planning especially in an emergency surgical conundrum when there is equivocal clinical peritonitis or perforation

Systems-thinking skills exhibited by UITM Sarawak diploma students in solving problems / Foo Kien Kheng … [et al.]

This study examines the conceptual and theoretical basis for developing a framework to measure systems-thinking skills and subsequently designs scoring rubrics to measure the performance level of the respondents’ problem solving and systems thinking. It is hypothesized that systems thinking can play a leading role by facilitating the attainment of important problem-solving skills. As part of the initial effort to determine if there is any basis for saying so, this exploratory study seeks to investigate whether an association exists between problem-solving and systems-thinking skills. It employed the survey methodology to gather data through a paper-and-pencil test and questionnaire. Four performance tasks were constructed to measure these skills. Following that, two scoring rubrics were created based on two pre-determined frameworks. Findings indicated that the general population performed poorly for problem solving and systems thinking. The mean score for systems thinking was even lower than that of problem solving. These skills were also analyzed according to three selected demographic characteristics. It was found that problem solving was not affected by gender and Gugusan where as CGPA did show dependency

Systems-thinking skills exhibited by UiTM Sarawak Diploma students in solving non-routine problems / Chin-Ying Liew ... [et al.]

It is hypothesized that systems thinking can play a leading role in facilitating the attainment of important problem-solving skills especially in the context of solving ill-defined problems involving uncertainties and dynamic complexities. As part of an initial effort to determine if there is any basis for saying so, this exploratory study seeks to investigate the systems-thinking skills that are exhibited by two hundred thirty-three UiTM Sarawak Diploma students in solving non-routine problems. Moreover, it also aims to investigate the influence of three demographic factors, that is, gender, Gugusan and Cumulative Grade Point Average (CGPA) on systems-thinking skills. A framework for categorizing systems-thinking skills was developed to measure these aforementioned skills as the respondents solved four non-routine problems. This study used the survey research design to gather data through apaper-and-pencil test and questionnaire. Four performance tasks were used to measure these skills. Following that, the performance of each respondent was calculated based on an analytical scoring rubric for the identified systems thinking skills. Both descriptive and inferential data analysis were carried out. Findings indicated that the respondents score poorly in systems-thinking performance. The mean score for systems thinking was found to be only 11.76 out of a possible 50. With regard to the three preselected demographic factors, it was found that systems-thinking skills show no dependency with respect to gender (t = .202, P > .05) but was found to be dependent upon Gugusan (F = 4.500, P<.05) andCGPA (F = 5.554, P < .05). The limitations of this study were also discussed. The findings have implications of great importance in the teaching of systems thinking to students. The study ended with some suggestions for future research

Acute Abdomen caused by Perforated Jejunal Diverticulitis

Jejunal diverticulum accounts for only 25% of small bowel diverticula, and approximately 7% of these will present as complicated jejunal diverticulitis or perforation. Here, we described a case of jejunal diverticular perforation presented as acute abdominal peritonitis. The computed tomography of the abdomen suggested small bowel perforation and therefore, emergency surgical exploration was performed. Intraoperatively, multiple jejunal diverticulae were found with one forming a localised diverticular abscess. Segmental resection of the diseased segment with primary anastomosis was performed. The patient made an uneventful post-operative recovery. Although complicated jejunal diverticulitis is rare, emergency surgery is often warranted if perforation occurs. Computed tomography is valuable in the diagnosis and preoperative planning especially in an emergency surgical conundrum when there is equivocal clinical peritonitis or perforation.</jats:p

Sensory Analysis for Cow Milk Product Development Using High Pressure Processing (HPP) in the Dairy Industry

High pressure processing (HPP) can be applied as an alternative thermal treatment of milk to maintain its natural and original sensory quality. Milk was processed at 600 MPa for 10 min or given thermal treatment at 125 &deg;C for 4 s. Sensory evaluation of treated milk samples was conducted using the triangle and the acceptance and preference tests. The triangle test was used as a discriminative test to check whether there was a noticeable difference between both treated milk samples. The acceptance and preference test determined attributes of milk including colour, milkiness, creaminess, mouthfeel, and aftertaste based on the 5-point just-about-right (JAR) scale. In the triangle test, 89.5% of panellists were able to identify the odd sample and differentiate milk processed using high pressure from heat treatment. For the acceptance and preference test, 61% of panellists gave higher overall preference for the high pressure processed milk over heat-treated milk. The JAR evaluation showed no significant differences (p &gt; 0.05) in all evaluated milk attributes which included milkiness, creaminess, mouthfeel, and aftertaste, with the exception of colour. Overall, high pressure processed milk scored better in terms of organoleptic properties as the penalty value for most attributes including colour, milkiness, mouthfeel, and aftertaste were lower than the penalty of heat-treated milk, except for creaminess. Therefore, to improve the acceptance and preference of high pressure processed milk, future development needs to focus on increasing creaminess of high pressure processed milk

Systems-thinking skills exhibited by UiTM Sarawak Diploma students in solving non-routine problems

It is hypothesized that systems thinking can play a leading role in facilitating the attainment of important problem-solving skills especially in the context of solving ill-defined problems involving uncertainties and dynamic complexities. As part of an initial effort to determine if there is any basis for saying so, this exploratory study seeks to investigate the systems-thinking skills that are exhibited by two hundred thirty-three UiTM Sarawak Diploma students in solving non-routine problems. Moreover, it also aims to investigate the influence of three demographic factors, that is, gender, Gugusan and Cumulative Grade Point Average (CGPA) on systems-thinking skills. A framework for categorizing systems-thinking skills was developed to measure these aforementioned skills as the respondents solved four non-routine problems. This study used the survey research design to gather data through apaper-and-pencil test and questionnaire. Four performance tasks were used to measure these skills. Following that, the performance of each respondent was calculated based on an analytical scoring rubric for the identified systems thinking skills. Both descriptive and inferential data analysis were carried out. Findings indicated that the respondents score poorly in systems-thinking performance. The mean score for systems thinking was found to be only 11.76 out of a possible 50. With regard to the three preselected demographic factors, it was found that systems-thinking skills show no dependency with respect to gender (t = .202, P &gt; .05) but was found to be dependent upon Gugusan (F = 4.500, P&lt;.05) andCGPA (F = 5.554, P &lt; .05). The limitations of this study were also discussed. The findings have implications of great importance in the teaching of systems thinking to students. The study ended with some suggestions for future research.</jats:p

Microbiological, Physicochemical and Nutritional Properties of Fresh Cow Milk Treated with Industrial High-Pressure Processing (HPP) during Storage

The safety, shelf life, and quality of fresh cow milk treated using industrial High-Pressure Processing (HPP) treatment at 600 MPa for 10 min was studied to identify the novelty of this non-thermal technology in milk processing. Changes in microbiological and physicochemical properties, including nutritional values of vitamins and amino acid profiles, were measured for a 60-day storage period at 6 °C +/− 1 °C. The HPP treatment produced milk that met all microbial safety requirements and exhibited a shelf life beyond 60 days in a hot and humid region. High physicochemical stability was achieved, with consistent pH and undetectable titratable acidity. The HPP treatment successfully retained all vitamins and minerals, including calcium (99.3%), phosphorus (99.4%), and magnesium (99.1%). However, the 60-day storage caused some degradation of Vitamin A (25%), B3 (91%), B5 (35%), B6 (80%), and C (85%), and minerals, including potassium (5%) and zinc (18%) when compared with fresh milk. This research has shown that the adoption of advanced treatment with HPP is very beneficial to the dairy industry in preserving milk quality in terms of its physicochemical and nutritional properties and extending its storage shelf life beyond 60 days.</jats:p

Sensory Analysis for Cow Milk Product Development Using High Pressure Processing (HPP) in the Dairy Industry

High pressure processing (HPP) can be applied as an alternative thermal treatment of milk to maintain its natural and original sensory quality. Milk was processed at 600 MPa for 10 min or given thermal treatment at 125 °C for 4 s. Sensory evaluation of treated milk samples was conducted using the triangle and the acceptance and preference tests. The triangle test was used as a discriminative test to check whether there was a noticeable difference between both treated milk samples. The acceptance and preference test determined attributes of milk including colour, milkiness, creaminess, mouthfeel, and aftertaste based on the 5-point just-about-right (JAR) scale. In the triangle test, 89.5% of panellists were able to identify the odd sample and differentiate milk processed using high pressure from heat treatment. For the acceptance and preference test, 61% of panellists gave higher overall preference for the high pressure processed milk over heat-treated milk. The JAR evaluation showed no significant differences (p &gt; 0.05) in all evaluated milk attributes which included milkiness, creaminess, mouthfeel, and aftertaste, with the exception of colour. Overall, high pressure processed milk scored better in terms of organoleptic properties as the penalty value for most attributes including colour, milkiness, mouthfeel, and aftertaste were lower than the penalty of heat-treated milk, except for creaminess. Therefore, to improve the acceptance and preference of high pressure processed milk, future development needs to focus on increasing creaminess of high pressure processed milk.</jats:p

Microbiological, Physicochemical and Nutritional Properties of Fresh Cow Milk Treated with Industrial High-Pressure Processing (HPP) during Storage

The safety, shelf life, and quality of fresh cow milk treated using industrial High-Pressure Processing (HPP) treatment at 600 MPa for 10 min was studied to identify the novelty of this non-thermal technology in milk processing. Changes in microbiological and physicochemical properties, including nutritional values of vitamins and amino acid profiles, were measured for a 60-day storage period at 6 &deg;C +/&minus; 1 &deg;C. The HPP treatment produced milk that met all microbial safety requirements and exhibited a shelf life beyond 60 days in a hot and humid region. High physicochemical stability was achieved, with consistent pH and undetectable titratable acidity. The HPP treatment successfully retained all vitamins and minerals, including calcium (99.3%), phosphorus (99.4%), and magnesium (99.1%). However, the 60-day storage caused some degradation of Vitamin A (25%), B3 (91%), B5 (35%), B6 (80%), and C (85%), and minerals, including potassium (5%) and zinc (18%) when compared with fresh milk. This research has shown that the adoption of advanced treatment with HPP is very beneficial to the dairy industry in preserving milk quality in terms of its physicochemical and nutritional properties and extending its storage shelf life beyond 60 days

Development and Validation of a Machine Learning Model That Predicts Short Inpatient Stays Among Urgent Admissions

Background/Objectives: This study aimed to explore the feasibility of predicting short stays among urgent admissions to an acute hospital in Singapore. With an increase in the average length of stay (LOS) in hospitals in recent years, accurately predicting short stays could enable hospitals to better manage inpatient demand and reduce emergency department (ED) overcrowding. Methods: This was a retrospective study of urgent admissions to Changi General Hospital, Singapore, from 1 January 2016 to 30 June 2022. To identify potential short stayers, a total of 25 features comprising demographic characteristics, admission and clinical characteristics, and healthcare utilization history were analyzed for each admitted patient at the point when the ED physician decided to admit the patient. The dataset was further split into a development dataset and an external validation dataset based on the year of admission. A CatBoost classifier was trained using 75% of the development dataset. Apart from reporting the model&rsquo;s prediction accuracy, we conducted various analyses and simulations to study the effects of the features crucial to the prediction output. Results: The prediction accuracy of the model was evaluated on both the development test dataset (25%) and the external validation dataset. On the former, the area under the receiver operating characteristic (AUROC) and the area under the precision-recall curve (AUPRC) were 0.803 (95% CI: 0.799, 0.808) and 0.755 (95% CI: 0.749, 0.762), respectively, with the precision = 0.700 (95% CI: 0.694, 0.707) and recall = 0.692 (95% CI: 0.685, 0.699). On the external validation dataset, the performance was similar. The ED diagnosis and whether the admission required a surgical procedure were the most important features for making the prediction. Conclusions: The LOS prediction model could help providers to identify short stayers early in the course of their inpatient journeys so they could make interventions to better manage the overall utilization of hospital beds