Power Relation in Memoirs of Geisha and the Dancer

This article aims at comparing the ideas of power relation between themain female character and ―Mother‖ in Arthur Golden‘s Memoirs ofGeisha and Ahmad Tohari‘s The Dancer. These two novels share thesame main female character of traditional entertainers, as a Japanesegeisha and a Javanese traditional dancer, respectively. As an entertainerin the traditional sphere, they are bounded with the other women andbuild close interaction as well as power relation with them who are called―Mother‖ in the Geisha and ―ronggeng shaman‖ in The Dancer. Thepower relation between them are unique and dynamics. This is analyzedthrough Foucault‘s theory of power. The result of the analysis shows thatthe power relation is not stable, and the power practiced by each of themis influenced by the symbolic capital and economic capital they have.The negotiation and contestation come up between the actors in dailypractices as geisha and the mother, as the ―ronggeng‖ and the shaman. Asthe entertainers, the geisha and ―ronggeng‖ build and shape their bodyand performance to attract men. This geisha and ronggeng culturereproduce many other cultural product such as ―mizuage‖ in geisha, and―bukak klambu‖ in ―ronggeng‖ both of which refer to the same thing, selling the woman‘s virginity to the highest bidder. In geisha it is used tobenefit the Mother of Okiya and no rebellion of the geisha. On the otherhand, Srintil does rebellious action in this ―bukak klambu‖ occasion.There seems to be different message from these two novels, The Dancer is much more questioning the norms covering the ―ronggeng‖ traditionwhile the Memoirs of Geisha tends to be accepting the geisha tradition as what it is.Artikel ini bertujuan untuk membandingkan relasi kuasa antara karakterutama perempuan Geisha dan ―Mother‖ dalam Memoirs of Geisha danSrintil, penari ronggeng dan Nyi Kartareja (dukun ronggeng) dalam TheDancer karya Ahmad Tohari. Kedua novel ini dibandingkan karenakeduanya sama-sama mempunyai karakter utama perempuan mudapenghibur, geisha dan ronggeng, dalam budaya hiburan tradisional.Sebagai penghibur, keduanya sama-sama terkait erat dengan tokohperempuan lain yang disebut ―Mother‖ dalam Memoirs of Geisha andNyai Kartareja dalam The Dancer. Relasi kuasa di antara keduanyasangat unik dan berjalan secara dinamis. Relasi kuasa inilah yangdianalisis dengan menggunakan teori kuasa Foucault. Hasil penelitian inimenunjukkan bahwa relasi kuasa di antara keduanya berjalan tidak tetap,kuasa yang dijalankan oleh masing-masing tokoh dipengaruhi oleh modalsimbolik dan modal ekonomi yang dimiliki. Negosiasi dan kontestasimuncul di antara tokoh-tokoh tersebut dalam praktik sehari-hari, dalamrelasi Sayuri sebagai geisha dan ―mother‖, dan antara Srintil si ronggengdan dukun ronggeng. Sebagai geisha dan ronggeng, para perempuan inimembentuk tubuh dan penampilannya untuk menarik dan menghiburlaki-laki. Budaya geisha dan ronggeng ini mereproduksi berbagai kulturlainnya seperti mizuage dalam geisha, dan ―bukak klambu‖ dalamronggeng, yang keduanya sama-sama bermakna menjual keperawananperempuan kepada penawar tertinggi. ―Mother‖ pemilik Okiyadiuntungkan oleh praktik ini, di sisi lain, Srintil berhasil mengelabuhiorang lain dalam peristiwa ―bukak klambu‖. Muncul pesan yang berbedadari kedua novel ini, dalam The Dancer norma-norma dalam tradisi―ronggeng‖ dipertanyakan sementara Memoirs of Geisha cenderungmenerima tradisi geisha sebagaimana adanya

The effect of hydrogen on transient flow of hydrogen natural gas mixture

Hydrogen is a high pressure gas, hence hydrogen natural gas mixture require an accurate prediction of transient flow parameter. The reduce order modelling is used in analysis of transient flow, where viscosity change is neglected thereby reducing the governing equations to Euler equation based on the assumption. The hydrogen natural gas mixture is homogenous, with pressure and velocity considered as principal dependent variable where polytrophic process is admitted. For improvement on the accurate prediction of flow parameters on the analysis of transient flow of hydrogen natural gas mixture in pipeline implicit Steger-Warming flux vector splitting method (FSM) used in the construction of efficient reduce order model. The result shows significant improvement on efficiency, accuracy and uniqueness when compared to normal conventional numerical techniques. The effect of heat transfer is observed on heat flux and internal energy of transient flow. The methods of reduced order with and without static correction show significant agreement for different gas ratio. The prediction of flow parameter along the pipeline can improvegas delivery and the analysis of transient flow behaviour at any point during the flow

Review of mathematical models for production planning under uncertainty due to lack of homogeneity: proposal of a conceptual model

[EN] Lack of homogeneity in the product (LHP) appears in some production processes that confer heterogeneity in the characteristics of the products obtained. Supply chains with this issue have to classify the product in different homogeneous subsets, whose quantity is uncertain during the production planning process. This paper proposes a generic framework for reviewing in a unified way the literature about production planning models dealing with LHP uncertainty. This analysis allows the identification of similarities among sectors to transfer solutions between them and gaps existing in the literature for further research. The results of the review show: (1) sectors affected by LHP inherent uncertainty, (2) the inherent LHP uncertainty types modelled, and (3) the approaches for modelling LHP uncertainty most widely employed. Finally, we suggest a conceptual model reflecting the aspects to be considered when modelling the production planning in sectors with LHP in an uncertain environment.This research was initiated within the framework of the project funded by the Ministerio de Economía y Competitividad [Ref. DPI2011-23597] entitled ‘Methods and models for operations planning and order management in supply chains characterised by uncertainty in production due to the lack of product uniformity’ (PLANGES-FHP) already finished. After, the project leading to this application has received funding from the European Union’s research and innovation programme under the H2020 Marie Skłodowska-Curie Actions with the grant agreement No 691249, Project entitled ’Enhancing and implementing Knowledge based ICT solutions within high Riskand Uncertain Conditions for Agriculture Production Systems’ (RUC-APS).Mundi, I.; Alemany Díaz, MDM.; Poler, R.; Fuertes-Miquel, VS. (2019). 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Home parenteral nutrition with an omega-3-fatty-acid-enriched MCT/LCT lipid emulsion in patients with chronic intestinal failure (the HOME study):study protocol for a randomized, controlled, multicenter, international clinical trial

BACKGROUND: Home parenteral nutrition (HPN) is a life-preserving therapy for patients with chronic intestinal failure (CIF) indicated for patients who cannot achieve their nutritional requirements by enteral intake. Intravenously administered lipid emulsions (ILEs) are an essential component of HPN, providing energy and essential fatty acids, but can become a risk factor for intestinal-failure-associated liver disease (IFALD). In HPN patients, major effort is taken in the prevention of IFALD. Novel ILEs containing a proportion of omega-3 polyunsaturated fatty acids (n-3 PUFA) could be of benefit, but the data on the use of n-3 PUFA in HPN patients are still limited. METHODS/DESIGN: The HOME study is a prospective, randomized, controlled, double-blind, multicenter, international clinical trial conducted in European hospitals that treat HPN patients. A total of 160 patients (80 per group) will be randomly assigned to receive the n-3 PUFA-enriched medium/long-chain triglyceride (MCT/LCT) ILE (Lipidem/Lipoplus® 200 mg/ml, B. Braun Melsungen AG) or the MCT/LCT ILE (Lipofundin® MCT/LCT/Medialipide® 20%, B. Braun Melsungen AG) for a projected period of 8 weeks. The primary endpoint is the combined change of liver function parameters (total bilirubin, aspartate transaminase and alanine transaminase) from baseline to final visit. Secondary objectives are the further evaluation of the safety and tolerability as well as the efficacy of the ILEs. DISCUSSION: Currently, there are only very few randomized controlled trials (RCTs) investigating the use of ILEs in HPN, and there are very few data at all on the use of n-3 PUFAs. The working hypothesis is that n-3 PUFA-enriched ILE is safe and well-tolerated especially with regard to liver function in patients requiring HPN. The expected outcome is to provide reliable data to support this thesis thanks to a considerable number of CIF patients, consequently to broaden the present evidence on the use of ILEs in HPN. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03282955. Registered on 14 September 2017

The impact of seasonal operating room closures on wait times for oral cancer surgery

Background Operating room slowdowns occur at specific intervals in the year as a cost-saving measure. We aim to investigate the impact of these slowdowns on the care of oral cavity cancer patients at a Canadian tertiary care centre. Methods A total of 585 oral cavity cancer patients seen between 1999 and 2015 at the London Health Science Centre (lhsc) Head and Neck Multidisciplinary Clinic were included in this study. Operating room hours and patient load from 2006 to 2014 were calculated. Our primary endpoint was the wait time from consultation to definitive surgery. Exposure variables were defined according to wait time intervals occurring during time periods with reduced operating room hours. Results Overall case volume rose significantly from 2006 to 2014 (p \u3c 0.001), while operating room hours remained stable (p = 0.555). Patient wait times for surgery increased from 16.3 days prior to 2003 to 25.5 days in 2015 (p = 0.008). Significant variability in operating room hours was observed by month, with lowest reported for July and August (p = 0.002). The greater the exposure to these months, the more likely patients were to wait longer than 28 days for surgery (odds ratio per day [or]: 1.07, 95% confidence interval [ci]: 1.05 to 1.10, p \u3c 0.001). Individuals seen in consultation preceding a month with below average operating room hours had a higher risk of disease recurrence and/or death (hazard ratio [hr]: 1.59, 95% ci: 1.10 to 2.30, p = 0.014). Conclusions Scheduled reductions in available operating room hours contribute to prolonged wait times and higher disease recurrence. Further work is needed to identify strategies maximizing efficient use of health care resources without negatively affecting patient outcomes

Insecticidal Evaluation of Some Botanical Leaf Powders On Cowpea Beetle Callosobruchus maculatus (F.) On Stored Bambara Groundnut (Vigna subterranea

Abstract Two Laboratory trials were conducted at the Department of Crop Protection, Faculty o

Mutational analysis of head and neck squamous cell carcinoma stratified by smoking status.

Smoking has historically been recognized as a negative prognostic factor in head and neck squamous cell carcinoma (HNSCC). This study aimed to assess the mutational differences between heavy smokers (\u3e20 pack years) and never smokers among the HNSCC patients within The Cancer Genome Atlas (TCGA). Single nucleotide variation and copy number aberration differences between heavy smokers and never smokers were compared within human papillomavirus-positive (HPV-positive) (n = 67) and HPV-negative (n = 431) TCGA cohorts with HNSCC, and the impact of these mutations on survival were assessed. No genes were differentially mutated between smoking and never-smoking patients with HPV-positive tumors. By contrast, in HPV-negative tumors, NSD1 and COL1A11 were found to be more frequently mutated in heavy smokers, while CASP8 was more frequently altered in never smokers. HPV-negative patients with NSD1 mutations experienced significantly improved overall survival compared with NSD1 WT patients. This improved prognosis was validated in an independent cohort of 77 oral cavity cancer patients and a meta-analysis that included 2 additional data sets (688 total patients, hazard ratio for death 0.44, 95% CI, 0.30-0.65). NSD1 mutations are more common in HPV-negative heavy smokers, define a cohort with favorable prognosis, and may represent a clinically useful biomarker to guide treatment deintensification for HPV-negative patients

Surgical preferences of patients at risk of hip fractures: hemiarthroplasty versus total hip arthroplasty

BACKGROUND: The optimal treatment of displaced femoral neck fractures in patients over 60 years is controversial. While much research has focused on the impact of total hip arthroplasty (THA) and hemiarthroplasty (HA) on surgical outcomes, little is known about patient preferences for either alternative. The purpose of this study was to elicit surgical preferences of patients at risk of sustaining hip fracture using a novel decision board. METHODS: We developed a decision board for the surgical management of displaced femoral neck fractures presenting risks and outcomes of HA and THA. The decision board was presented to 81 elderly patients at risk for developing femoral neck fractures identified from an osteoporosis clinic. The participants were faced with the scenario of sustaining a displaced femoral neck fracture and were asked to state their treatment option preference and rationale for operative procedure. RESULTS: Eighty-five percent (85%) of participants were between the age of 60 and 80 years; 89% were female; 88% were Caucasian; and 49% had some post-secondary education. Ninety-three percent (93%; 95% confidence interval [CI], 87-99%) of participants chose THA as their preferred operative choice. Participants identified several factors important to their decision, including the perception of greater walking distance (63%), less residual pain (29%), less reoperative risk (28%) and lower mortality risk (20%) with THA. Participants who preferred HA (7%; 95% CI, 1-13%) did so for perceived less invasiveness (50%), lower dislocation risk (33%), lower infection risk (33%), and shorter operative time (17%). CONCLUSION: The overwhelming majority of patients preferred THA to HA for the treatment of a displaced femoral neck fracture when confronted with risks and outcomes of both procedures on a decision board

Mutations in TOP3A Cause a Bloom Syndrome-like Disorder

Bloom syndrome, caused by biallelic mutations in BLM, is characterized by prenatal-onset growth deficiency, short stature, an erythematous photosensitive malar rash, and increased cancer predisposition. Diagnostically, a hallmark feature is the presence of increased sister chromatid exchanges (SCEs) on cytogenetic testing. Here, we describe biallelic mutations in TOP3A in ten individuals with prenatal-onset growth restriction and microcephaly. TOP3A encodes topoisomerase III alpha (TopIIIα), which binds to BLM as part of the BTRR complex, and promotes dissolution of double Holliday junctions arising during homologous recombination. We also identify a homozygous truncating variant in RMI1, which encodes another component of the BTRR complex, in two individuals with microcephalic dwarfism. The TOP3A mutations substantially reduce cellular levels of TopIIIα, and consequently subjects’ cells demonstrate elevated rates of SCE. Unresolved DNA recombination and/or replication intermediates persist into mitosis, leading to chromosome segregation defects and genome instability that most likely explain the growth restriction seen in these subjects and in Bloom syndrome. Clinical features of mitochondrial dysfunction are evident in several individuals with biallelic TOP3A mutations, consistent with the recently reported additional function of TopIIIα in mitochondrial DNA decatenation. In summary, our findings establish TOP3A mutations as an additional cause of prenatal-onset short stature with increased cytogenetic SCEs and implicate the decatenation activity of the BTRR complex in their pathogenesis

Comparing the costs and outcomes of an integrated twin compression screw (ITCS) nail with standard of care using a single lag screw or a single helical blade cephalomedullary nail in patients with intertrochanteric hip fractures

© 2018 The Author(s). Background: Surgical treatment is the optimal strategy for managing intertrochanteric fractures as it allows for early rehabilitation and functional recovery. The purpose of the study was to assess the cost-effectiveness of commonly used cephalomedullary nails for the treatment of unstable intertrochanteric hip fractures. Methods: A decision analytic model was developed from a US payer's perspective using clinical data from a pairwise meta-analysis of randomised controlled trials (RCTs) and comparative observational studies comparing the integrated twin compression screw (ITCS) nail versus two single-screw or blade cephalomedullary nails [single lag screw (SLS) nail and single helical blade (SHB) nail]. The model considered a cohort of 1000 patients with a mean age of 76, as reported in the clinical studies over a 1-year time period. Cost data was obtained from the Center for Medicare and Medicaid Services website and published literature and adjusted for inflation. One-way and probabilistic sensitivity analyses were conducted to assess the effect of uncertainty in model parameters on model conclusions. Results: The model estimated 0.546 quality-adjusted life years (QALYs) and 0.78 complications avoided by using the ITCS nail and 0.455 QALYs and 0.67 complications avoided for the standard of care, using SLS or SHB nails. The cost per patient was $34,336 for patients treated with an ITCS nail and$37,036 for patients treated with the standard of care respectively, resulting in a cost saving of $2700 in favour of the ITCS nail. More savings were observed when the ITCS nail was compared to the SHB ($3280 per patient) and SLS ($1652 per patient). The findings were robust to a range of both one-way and the probabilistic sensitivity analyses. Conclusion: In conclusion, the ITCS nail can be considered a cost saving intervention in patients undergoing intertrochanteric fracture fixation with an intramedullary device. Clinicians and policy makers should be encouraged to adopt healthcare technologies such as ITCS that will help them to provide quality healthcare despite falling budgets