Abstract:Aim: \nIn this article we present a rare complication of laparoscopic adjustable gastric banding: Emphysematous gastritis with gastric necrosis secondary to superior mesenteric artery syndrome. Which unlike the rest of the articles, it is explained the cause that led to this syndrome. \nCase presentation:\nA 29 –year-old French woman with a bariatric history (BMI= 55.9; Height=166cm, weight = 154) underwent laparoscopic gastric banding for morbid obesity and was emergency re-operated for band slippage and regained weight. In 2017 she experienced acute abdominal pain associated with nausea without being able to vomit for which she was admitted to the emergency hospital. The computed tomographic revealed a massive distension of her stomach and duodenum, pneumatosis and portal venous gas. A junction syndrome at 3rd level of the duodenum linked to a superior mesenteric artery syndrome. Surgery treatment was needed considering the massive gastric necrosis for which a total gastrectomy with Roux en Y eophagojejunostomy anastomosis was performed. Due to fear of a possible rupture of the duodenum remaining part may occur, a 2cm latero-later duodenojejunostomy anastomosis was performed to ensure a good biliary drainage of the duodenum. The patient was discharged from the hospital within 10 days.\nConclusion\nThe fastest way to treat the patient was to prescribe her parenteral nutrition with the intention of gaining weight but because gastric emptying cannot be achieved the SMA can become a lethal complication due to the gastric necrosis.
Abstract:The paper presents the elucidation of the concept of migration and theories describing the process of migration, determines the issue of openness to immigration and presents its theoretical explanation. The factors determining the attitude towards immigration and immigrants are examined by dividing the factors into the main groups of economic and social-cultural factors. Analysis of immigration trends in Lithuania is presented. The paper aims to develop theoretical framework for assessment of employer openness to immigrants by revealing the main factors determining the attitudes of employers to labour immigrants and apply this framework in order to determine whether it is possible to integrate labour immigrants into the labour market in Lithuania.
Abstract:Co-ordinately embedding machine learning and optimization in the Monte Carlo simulation is proposed as a new framework for reliability evaluation, which is becoming more challenging due to the joining of variability and intermittency of the renewable generation and components’ ageing. As a machine learning method, the dynamic Bayesian belief network predicts the renewable outputs by generating their probability distributions through historical data to overcome the defect of rarely grasping the low-probability events in the traditional methods, which either predict a single-point value or presume a parametric probability distribution. As the internal operation module of the framework, the rolling-horizon unit commitment maintains the complexity of the operation model and meantime punctually updates the predicted renewable generation and the components’ ageing. The dynamic Bayesian belief network and the rolling-horizon unit commitment traverse time step after time step throughout the horizon, and thus form one bid of the Monte Carlo simulation. In each time step, the dynamic Bayesian belief network extracts the probability distributions of the renewable generation, from which the boundary of the commitment is sampled, and the impact of scheduling the generators on their ageing is then accumulated from the commitment. The proposed framework has its effectiveness proved on a microgrid.
Abstract:Livestock grazing is the most important factor in the destruction of rangeland. The aim of this study was to investigate dung changes in terms of numbers and weight in different grazing zones and the feasibility of modeling changes in the grazing gradient. For this purpose, random plots settled at regular intervals 50,150, 350, 650, and 1050 meters and after counting, dung was transported to the laboratory for drying and determining the dry weight. The result showed that the distance from the sheepfold and reduce grazing pressure, the weight of dung shows a declining trend. Duncan test results showed that had a significant difference (P-value =0.05) in terms of the number and weight of dungs. Also, to predict changes of dung numbers compare to grazing gradient, Quadratic regression showed best fit the coefficient of determination 0.91. Changes of dung dry weight along the grazing gradient with the third grade of regression have a 0.89 coefficient of determination. We can conclude that grazing zones changes are visible, significantly, through the calculation of livestock dung parameters. According to the model\'s results, considering the number of dung is a better method to determine the grazing intensity.
Abstract:The Coronavirus (COVID-19) pandemicmanaged to overturn the entire organization of the medical system and changed all medical protocolsincluding surgical ones. Elective and otherroutine operations have been cancelled or postponedwhichled to congestionand hazard between long-established appointments andnew appointments during the COVID-19 pandemic. Small hernias repair should be carefully done respecting all the reported recommendationsfor Coronavirus (COVID-19).
Abstract:Surgeons have sufficient knowledge and should be motivated regarding adopting novel surgical devices, techniques, principles in order to provide the best care for the patients. Not everyone can become a great surgeon, but a great surgeon can come from anywhere. The same principle can be applied also in innovation. Surgery involves not only knowledge, concentration and precision but also imagination and creativity and if the imagined device can facilitate your work why not design it. The role of this article is to help any surgeon regardless of which hospital his working: poor hospital with lack of materials or very developed one with everything a surgeon needs. The device created by us is a very cheap one and any hospital can afford it. We have created a prototype (surgical device for safe and fast surgical swans count) that can be diversified or improved by using electronic technology. The role of this surgical device is to facilitate the collection of the used surgical swabs and to reduce the time allocated to the surgical swabs counting, which implies reducing surgical time.
Abstract:Introduction: Metabolic syndrome (MetS) and obesity are important public health problems associated with adipose tissue mass. Asprosin, visfatin, and subfatin are new members of which fate in MetS and obesity has not been fully revealed yet. Thus, this study was to investigate the association between asprosin, visfatin, subfatin, and biochemical values, demographic data, and body composition measurement values in MetS patients with and without obesity. \nMethods: Blood samples were taken from a total of 90 people, including 31 MetS patients with obesity, 29 MetS patients without obesity, and 30 healthy (control). Asprosine, visfatin, and subfatin were studied by the ELISA method. \nResults: There was a negative correlation between asprosin and Body Mass Index (BMI) in the MetS+Obese group. The correlations between asprosin and urea and fasting insulin (FI) levels in the MetS group were positive and statistically significant (p <0.05). While there was a statistically significant negative correlation (p <0.05) between visfatin and BMI in the MetS+Obese group, the correlation with waist circumference in the MetS+Obese and MetS groups was statistically significant and negative (p <0.05). There was a statistically significant negative relationship (p <0.05) between aspartate aminotransferase (AST) value and visfatin. The results between visfatin values and asprosin and subfatin in all groups were significant (p <0.05). \nConclusion: There is a direct relationship between circulating amounts of asprosin, visfatin, and subfatin hormones and age, weight, height, DBP, HDL-C, AST, ALT, and creatinine. Therefore, asprosin, visfatin, and subfatin hormones are the new biomarkers of metabolic turbulence.
Abstract:Travel agent plays a significant role in promoting of tourism and attraction in the country. They will assist the tourists to propose, choose and organize their holiday. They also design the itinerary and provide consultation for finest suggestion to them. Therefore, the aim of this study is to understand the vacation packages based on natural area around travel agents in Petaling Jaya. The objectives of this study are: i) to identify the factor that influence nature-based tourism package by travel agent, ii) to determine the characteristic preferred by travel agent toward nature-based tourism package. This study is using convenient sampling method thru questionnaires as a tools to distributed concerning the travel agent that provide nature-based tourism at study area. The result shows that the most of the travel agent provided nature-based tourism package to fulfill the demand in nature-based tourism area. This study may encourage the travel agent to expand their service as a nature-based tourism area provider to realize the demand of their customer.
Abstract:Introducing societal moral norms in the domain of entrepreneurship stretches the limits of its moral space. Despite the existence of a sundry of research evidence the state of current understanding remains lucid. Current study designed a new scale capturing six distinct dimensions of moral consciousness in entrepreneurship, thus aspiring to offer novel insights into this underdeveloped area through a replication design consisting of four independent waves of data collection. A series of ordinal logistic regression analyses revealed interesting insights. Generation Z (17-25 years old) were found to score lowest for integrity, conscientiousness, knowledge sharing, trustworthy, transparency and accountability. Gender exhibited scattered differences across the six moral consciousness dimensions and respondents from a developed country had much greater odds of scoring higher for knowledge sharing than those from a developing country. Finally, active entrepreneurs had higher moral consciousness than those aspiring.
Abstract:Marginalization is being considered as one of the main root cause of poverty. This study measures poverty in peri-urban and urban areas of Faisalabad, Pakistan using the multidimensional approach. Primary data from 160 households were collected. Poison regression was applied to identified the determinants of multidimentional poverty. The results showed that 68% of the sample households were marginalized in peri-urban and 39% in urban areas, respectively. Education, income and rural assets had positive impact on living standards while family size, poor education, poor housing, poor safe drinking water facility and lack of urban assets had negative impact.