Evaluation and management of blunt injury abdomen based on focussed assessment with sonography in trauma

Background: The initial evaluation of patient with multiple trauma is a challenging task. FAST (focussed assessment with sonography in trauma) provides a viable alternative to computed tomography in blunt abdominal trauma patient. The aim of this study was to find the accuracy and utility of FAST in clinical decision making, as well as limitations.Methods: A total of 100 patients with blunt abdominal trauma who underwent FAST examination were included. Positive scan was defined as the presence of free intraperitoneal fluid. The sonographic scoring for operating room triage in trauma (SSORTT Score) was calculated using cumulative sum of ultrasound score, systolic blood pressure, and pulse rate. FAST findings were compared with computed tomography findings and in operated cases compared with surgical findings & clinical outcome.Results: We determined SSORTT score in all 100 cases. In our study, the sensitivity, specificity, positive and negative predictive values for FAST in identifying intraabdominal injuries were 93.9%, 94.2%, 87.5%, and 97.2%. In our study we found out that patients with a SSORTT score of 2 and above had a high likelihood of requiring a therapeutic laparotomy.Conclusions: In our study we found that FAST is a rapid, reproducible, portable and non-invasive bedside test, and can be performed at the same time as resuscitation. Ultrasound is limited mainly by its low sensitivity in directly demonstrating solid organs injuries

A QUANTITATIVE INQUIRY INTO THE RELATIONSHIP BETWEEN LEARNING STYLES, PSYCHOLOGICAL TYPES AND STANDARDIZED ACHIEVEMENT EXAMINATION PERFORMANCE OF NURSE AIDE STUDENTS.

The purpose of this research study was to explore the relationship between learning styles, psychological types and multiple-choice standardized achievement examination performance of nurse aide students with typology being the gross indicator using a non-experimental, comparative and descriptive approach. The study sample included nurse aide students (N = 326) seeking nurse aide certification selected through a stratified random sampling technique. The participation rate for completed MBTI® inventory was 58.42% (N = 326). The learning styles and psychological types were measured against the Myers-Briggs Type Indicator® Form M in North American English. The multiple-choice standardized achievement examination performance of nurse aide students was determined by Illinois Nurse Aide Competency Examination (INACE) conducted in January 2017. All the research questions and hypotheses compared mean of overall test scores and means of overall test scores based on specific duty areas (i.e. communicating information, performing basic nursing skills, performing personal skills, performing basic restorative skills, providing mental health and social service needs, and providing for residents’ rights) between different groups using one-way analysis of variance (ANOVA) and one-way multivariate analysis of variance (MANOVA). The findings of the study indicated a statistically significant relationship between mean scores of nurse aide students with Sensing (S) and Intuition (N) learning preferences by perception on overall test performance and test performance based on specific duty areas of the INACE with the mean of nurse aide students with the Sensing (S) learning preference being numerically highest (M = 81.85) than Intuition (N) learning preference (M = 79.96%). Additionally, there were no statistically significant relationships between learning preferences by source of energy (Extraversion – E and Introversion – N), learning preferences by reaction to information or making decisions (Thinking – T and Feeling – F), learning preferences by preference to life style (Judging – J and Perceiving – P), learning preference combinations by orientation to energy and perception (IS, IN, ES, and EN), learning preference combinations by perception and attitude (SP, SJ, NP, and NJ), learning preference combinations by mental process (ST, SF, NF, and NT), and 16 psychological or personality types or learning approaches (ISTJ, ISFJ, INFJ, INTJ, ISTP, ISFP, INFP, INTP, ESTP, ESFP, ENFP, ENTP, ESTJ, ESFJ, ENFJ, and ENTJ) and Illinois Nurse Aide Competency Examination (INACE) performance among nurse aide students. The findings suggested that students with Introversion (I), Sensing (S), Thinking (T), and Perceiving (P) learning preferences had better overall test score on the Illinois Nurse Aide Competency Examination (INACE). Further research with a larger sample is recommended. The findings from the study and review of literature will guide nurse aide trainers and students, improve Illinois Nurse Aide Competency Examination; and increase nurse aide students’ retention efforts by utilizing the MBTI® assessment tool along with understanding and implementing the underlying concepts. Keywords: Personality Type, Psychological Type, Academic Achievement, Academic Aptitude, Type Theory, Standardized MCQ Tests, Standardized Tests, Cognitive Attribute, Academic Success, Achievement Tests, Learning Styles, Myers-Briggs Type Indicator

Under the Radar: Muslims Deported, Detained, and Denied on Unsubstantiated Terrorism Allegations

Through the targeted use of a wide set of immigration and law enforcement policies and actions, the U.S. government has cast Muslims as dangerous threats to national security, leaving Muslim communities across the United States vulnerable to discrimination and discriminatory profiling. This Briefing Paper by the Center for Human Rights and Global Justice (CHRGJ) and the Asian American Legal Defense and Education Fund (AALDEF) documents the U.S. government's deployment of lower evidentiary standards and lack of due process guarantees in the immigration system against Muslims to further marginalize this targeted group in the name of national security and counterterrorism. A number of particular immigration programs and practices -- such as the National Security Entry-Exit Registration System (NSEERS),the Federal Bureau of Investigation (FBI) name-check system in the naturalization process, and racial profiling at U.S. borders have received critical attention for their discriminatory impacts on Muslim communities. This Briefing Paper draws on interviews with immigration and criminal defense attorneys and community-based groups, court documents, and media accounts to identify five key under-documented patterns of government practices that appear to be targeting Muslim communities through the immigration system

Machine Learning and Finance: A Review using Latent Dirichlet Allocation Technique (LDA)

The aim of this paper is provide a first comprehensive structuring of the literature applying machine learning to finance. We use a probabilistic topic modelling approach to make sense of this diverse body of research spanning across the disciplines of finance, economics, computer sciences, and decision sciences. Through the topic modelling approach, a Latent Dirichlet Allocation Technique (LDA), we can extract the 14 coherent research topics that are the focus of the 6,148 academic articles during the years 1990-2019 analysed. We first describe and structure these topics, and then further show how the topic focus has evolved over the last two decades. Our study thus provides a structured topography for finance researchers seeking to integrate machine learning research approaches in their exploration of finance phenomena. We also showcase the benefits to finance researchers of the method of probabilistic modelling of topics for deep comprehension of a body of literature, especially when that literature has diverse multi-disciplinary actors

Abdominal incisional hernia: retrospective study

Background: Incisional hernia presents as herniation or protrusion occurring along a prior abdominal scar. It is a known complication of abdominal surgery. They are the second most common type of hernia after inguinal hernias. This study was undertaken to study the incidence and various risk factors leading to incisional hernia.Methods: It is a retrospective study done in Gandhi Medical College, Bhopal; Department of Surgery during January 2017 to January 2018. All the cases were analyzed in various aspects like age, sex, relative incidence, clinical presentation, nature of previous operation, site of previous scar, precipitating factors like obesity, wound infection, abdominal distension.Results: The incidence is around 18.5%. Patients in the age group of 30-50 years found to have highest incidence of incisional hernia. Females outnumbered the males with the ratio of 6:1. Incisional hernia was more common in patients with previous history of gynecological operation. Most of the patients presented with incisional hernia in the infra umbilical region.Conclusions: Incisional hernias can be prevented by avoidance of midline incisions, especially in the infra umbilical region. Mesh repair results in less post-operative complications provided drains are used

Simulation study of wettability alteration enhanced oil recovery during co-current spontaneous imbibition

Naturally fractured reservoirs are highly dependent on capillary forces to recover hydrocarbons during water injection. Water can spontaneously imbibe and expel oil if positive capillary forces exist; purely counter-current if all sides of the matrix blocks are exposed to water; and predominantly co-current with some counter-current production if the blocks are exposed to water and oil simultaneously. The latter is referred to as a co-current spontaneous imbibition (SI) setup. Wettability alteration (WA) has been identified as a key mechanism to improve oil recovery from naturally fractured reservoirs, however almost all experimental and modeling studies on WA during SI have focused on counter-current SI. Our review indicates limited systematic experimental work on co-current SI using nonzero initial saturation, mixed wettability or WA processes and This modeling study will investigate enhanced oil recovery by WA during co-current SI where a brine with a general WA component imbibes and causes the system to become more water-wet. We model a 1D oil-saturated core exposed to water at one end (inlet) and oil at the other end (outlet), thus facilitating co-current SI. The core is initially preferentially (not strongly) oil-wet with low SI potential. The component is both transported by the imbibing brine and diffuses towards the imbibition front. Adsorption of the component is assumed to improve the water-wetness of the porous medium and hence the SI potential. The model is parameterized using consistent capillary pressure and relative permeabilities from previous history matching of brine-dependent porous disc experiments. The behavior of co-current SI at mixed-wet state is examined and compared to that of literature strongly water-wet behavior. Both secondary and tertiary enhanced recovery by SI with WA component is then considered in the simulations. Important parameters such as mobility ratio (as via oil viscosity), capillary back pressure, WA component concentration, adsorption and time of WA component exposure are investigated. Under mixed-wet conditions, favorable and unfavorable mobility ratios do not limit oil production as can be the case for strongly wetted media at unfavorable mobility ratio. This is due to oil preserving mobility at all obtained saturations. A third or more of the total production was counter-current, which is high compared to strongly wetted media. It was shown that half the oil could be produced counter-currently as an upper limit. High oil mobility is preserved in the twophase region near the inlet and was found to ensure a high minimum fraction of counter-current production. Twice as much of the incremental oil from WA was produced counter-currently as co-currently, explained by increased oil relative permeability in the WA affected inlet region. Sensitivity analysis revealed that an opposite shift would reduce the incremental counter-current production despite raised local capillary forces. Capillary back pressure resists oil production at the inlet without limiting water from imbibing. As a result, capillary back pressure had significant impact on co-current SI simulations with fixed and changing wettability. The trends discovered in this study, both for mixed-wet and wettability alternating systems, are hoped to inspire future experimental measurements.acceptedVersio

The use of a distributed hydrologic model to predict dynamic landslide susceptibility for a humid basin in Puerto Rico

Thesis (Env. E.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 2009."September 2009." Cataloged from PDF version of thesis.Includes bibliographical references (p. 86-91).This thesis describes the use of a distributed hydrology model in conjunction with a Factor of Safety (FS) algorithm to predict dynamic landslide susceptibility for a humid basin in Puerto Rico. The Mameyes basin, located in the Luquillo Experimental Forest in Puerto Rico, was selected for modeling based on the rich ensemble of soil, vegetation, topographical, meteorological and historic landslide data available. The basin was parameterized into the TIN-based Real-time Integrated Basin Simulator (tRIBS) with particular emphasis on vegetation parameters for broadleaf evergreen trees in tropical climates. The basin was forced with precipitation data that included a synthesized rainfall event likely to result in a landslide based on rainfall intensity-duration thresholds. The basin's response was assessed mainly in terms of soil moisture and values of selected vegetation parameters, which served as the dynamic inputs into the FS algorithm.(cont.) An off-line FS algorithm was developed and tested using typical values for parameters encountered in the Mameyes basin. Sensitivity analyses indicated that slope angle, soil cohesion and soil moisture were the most sensitive parameters in this FS algorithm. When the tRIBS / FS Algorithm combination was employed over the entire basin, landslides were indicated in 48 out of 13,169 modeled locations. The spatial distribution of landslides compared favorably to a static landslide susceptibility map developed in previous work by Lepore et al. (2008b) while the temporal distribution of landslides was correlated with rainfall events. Landslides were predicted over a range of slope angle values, including on relatively gentle slopes where the modeled soil moisture drove the instability. The results demonstrate that the tRIBS/FS algorithm combination developed in this work is able to capture the key dynamics associated with slope stability, specifically the interactions between the slope angle and the soil moisture state.by Sameer A. Kamal.Env.E

Development of a landslide hazard map for the island of Puerto Rico

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 2008."June 2008."Includes bibliographical references (leaves 46-48).This thesis describes the development of a landslide hazard map for the island of Puerto Rico through the use of Graphical Information System (GIS) tools. Parameters considered in this study are elevation, slope aspect, slope angle and land use. This study employed data for a total of 2,966 landslides. The elevation and land use analysis was conducted on the entire landslide dataset, while the slope aspect and slope angle analysis was conducted on a smaller subset (366 landslides). This work builds on previous landslide studies in Puerto Rico by employing a 5-m Digital Elevation Model (DEM) for the slope angle and slope aspect analysis. The major steps involved in the landslide hazard map generation are: a categorization analysis to determine relative hazards for each parameter, assignment of weights to each parameter based on their range of relative hazard values, and a consolidation of results from each parameter that is analogous to a multi-factorial analysis. Results indicate that slope angle is the dominant factor (87.5%) in determining landslide hazard, followed by elevation, slope aspect and land use. The slope angle results were found to be very sensitive on the choice of sampling methodology and data resolution. . In particular, the 5-m DEM provides significantly more detail than available for previous analyses and results in much greater sensitivity of risk to slope angle. Further study is recommended into issues relating to the resolution at which the landslide data is obtained and normalized, as well as an inclusion of other parameters (such as soil type and geology) into this landslide hazard assessment.by Sameer A. Kamal.M.Eng