Shock Situation Research Articles

Study on transient electric shock characteristics between human body and metal clothes hanger on residential platform near UHV AC transmission lines

AbstractWith the development of ultra‐high‐voltage (UHV) and extra‐high‐voltage transmission lines in China, the transmission lines are gradually approaching the residential areas. The phenomenon of induced electric shock caused by electrostatic induction effect can cause dissatisfaction and complaints from nearby residents. In this paper, a full‐size steel‐framed residential test platform was constructed near a 1000‐kV UHV alternating current (AC) transmission line, the transient shock characteristics of human bodies and metal hangers in different scenarios was investigated, then the relationship between transient shock energy and subjective perception of the human body was discussed. In addition, the shielding effect of shielding wires for transient electric shock situations is analyzed. It was found that the worst‐case scenario occurred when the grounded human body came into contact with the insulated metal clothes hanger, even eliciting a noticeable sensation of pain. In addition, increasing metal shielding wire number has a significant effect on weakening induced electric shocks.

Інституційна ефективність у контексті євроінтеграційних перспектив України. Стаття друга: Інституційні євроінтеграційні перспективи України

The article provides a few evaluations of institutional efficiency in Ukraine according to the methodology of the World Bank Worldwide Governance Indicators. The presented institutional dynamics give reasons to assess institutional efficiency in Ukraine as low not only in relation to the average European level, but also in relation to European countries with low institutional efficiency (Bulgaria and Romania). According to the vast majority of indicators of institutional efficiency, downward institutional dynamics are observed. In order to determine the factors of effective institutional adaptation of Ukraine, the work displays the experience of successful (Estonia) and less successful (Bulgaria) EU member states. On this basis, institutional risks are shown and it is substantiated that a rational European integration strategy should include appropriate approaches from the point of view of integration risk management, including the creation of national reserves and maintaining the ability to maneuver in case of shock situations. It is shown that for the successful implementation of European integration processes, it is necessary to create one's own institutional architecture, adequate to the nationally rooted type of economic development, based on Ukrainian identity.

Mechanical circulatory support in high-risk PE for more than a decade

Abstract Funding Acknowledgements None. Background/Introduction Absence of solid evidence in clinical practice guidelines on the management of patients with a severe pulmonary thromboembolism (PTE) in a situation of cardiogenic shock requiring mechanical circulatory support (veno-arterial ECMO). A registry has been carried out in a tertiary hospital of patients admitted to the Cardiological Critical Care Unit (CCCU) with a diagnosis of high-risk PTE and V-A ECMO implantation. Purpose The objective is to describe the experience of our center due to the paucity of evidence from current guidelines in this area iin terms of morbimortality and expected outcomes. Methods Data were collected from all patients admitted with a diagnosis of high-risk PE in the CCCU from 05/01/2010 to 05/01/2023. Of these, only those in whom V-A ECMO was implemented during admission were analyzed and described below. Clinical, analytical and survival variables were explored. Results A total of 11 patients were included, 3 (27.27%) being women. The mean age was 53 years (SD 10.64). Every V-A ECMO cannulation was performed in a femoro-femoral configuration by a surgical approach. The mean length of stay in the Critical Care Unit, total hospital stay length and circulatory support time were respectively: 8 days (SD 5.5); 20.7 days (DS 16.5) and 3 days (DS 1.9). The indication for the implantation of V-A ECMO was in a situation of SCAI-E in 7 patients (in 2 of them, V-A ECMO was implanted during cardiac arrest, and a 100% of mortality was described in the first 24 hours). On the other hand, in the remaining 4 patients, the indication for support was a deteriorating evolution despite amines. Of these, in 2 of them, there was a formal contraindication for the administration of systemic fibrinolytic treatment (recent major surgery, in one of them oncology). It should be noted that VA ECMO without adjuvant fibrinolysis was used in 6 of the patients (54.5%), and in 1 of them (16%) of them died (anoxic encephalopathy). However, the remaining 5 patients received combined VA ECMO therapy and systemic fibrinolysis (45.5%), with 2 deaths reported in this subgroup (40%). Those deceases happened both due to adequacy of the therapeutic effort in the context of multiple organ failure. No major bleeding was reported, even in the combination therapy group. Conclusions Support with V-A ECMO has allowed survival >70% in patients diagnosed with high-risk pulmonary embolism, including in those cases with absolute contraindication for systemic fibrinolysis. High safety profile in terms of bleeding even in those patients with a combined approach.

Tourism and Hospitality Industry Employees' Experiences of Career Shocks and Career Resilience

Employees in the tourism and hospitality industry (THI) have experienced a wide range of sudden changes that have had various impacts on their careers. Career shocks are disruptive and extraordinary events often caused by factors outside the focal individual’s control and that trigger a deliberate thought process concerning one’s career. Although career shocks are usually difficult to predict, we can prepare ourselves in advance by developing career resilience. Career resilience refers to an individual's ability to adapt to new situations, overcome negative ones and recover from changes. Research is exceptionally important, especially from the perspective of the THI, which has suffered from a wide range of crises which have caused a significant decrease in workforce engagement and labour shortages. This research aimed to study the experiences of THI employees in career shock situations and how career resilience has affected these situations. The research questions were: What kind of career shocks have employees experienced during their careers? What kind of consequences have these career shocks had on employees’ careers? How have career shock situations strengthened their career resilience? This study was conducted based on a narrative approach and the data consisted of 30 career narrative writings of the students of the Tourism and Hospitality Management master’s degree programme. A three-phase qualitative inductive content analysis was used as an analysis method. The results suggest that employees have experienced a wide range of career shocks during their careers, partly because the THI and workplaces have been sensitive to change. According to the data, career shocks could be categorised into global, organisational, and individual level shocks. Employees experienced career shocks and their consequences mainly positively. In addition, the experiences of surviving career shock situations strengthened individuals’ career resilience in many ways. This study highlights the importance of understanding individuals' experiences of career shocks and the ways to prevent uncertainty to retain employees in the workplaces and an industry suffering from labour shortages.

Mechanism and Prevention of Main Roadway Roof Shock in Strong-Bump Coal Seam with Asymmetric Goaf

In response to the increasingly severe situation of main roadway shock in coal seams, with a focus on the strong-bump coal seam in main roadways under an asymmetric goaf in a certain mine, theoretical analysis, numerical simulation, and engineering practices were employed. This study investigated factors influencing main roadway roof shock damage, changes in roof stress, and characteristics of overlying strata movement. This research unveiled the mechanism and prevention of roof shock in main roadways of strong-bump coal seams in an asymmetric goaf. The research results indicate that the influencing factors of main roadway roof shock damage can be divided into two categories: “strata-support” structure strength and surrounding rock stress. For the determination of the “strata-support” structure, in the case of strong bumps in coal seam roadways influenced by the asymmetric goaf, the key factors contributing to shock damage are the side abutment pressure on the coal pillar in the goaf and the activity level of the roof strata. The distribution of roof stress in the main roadway undergoes continuous changes as district faces are sequentially mined. When the goaf area on the west side gradually increases towards the south, the roof stress in the main roadway consistently rises, and the stress increment follows a pattern of initial increase followed by a decrease. The strata structure of the main roadway roof gradually transforms from an “asymmetric T” shape to a “symmetric T” shape in the transverse profile, and with the evolution of the roof rock layer structure, the mutual feedback effect of strata activity on both sides of the roadway gradually strengthens. Affected by the asymmetric goaf, the main roadway in the district undergoes three different stages: one side of subcritical mining influence → both sides of subcritical mining influence → one side of subcritical mining and one side of critical mining influence. In addition, comprehensively considering the impact of various factors in different stages, the theoretical criteria for roof shock failure in the main roadway are determined. The formulation of an optimized position for the main roadway and a scheme for depressurization through deep-hole blasting in the roof reduce the stress level in the surrounding rock of the main roadway, effectively preventing the occurrence of roof shock in the asymmetric goaf of the coal seam main roadway.

Sodium potassium pump: A novel O-GlcNAc protein beneficial in hemorrhagic shock situation

Sodium potassium pump: A novel O-GlcNAc protein beneficial in hemorrhagic shock situation

The European Green Deal Agenda After the Attack on Ukraine: Exogenous Shock Meets Policy‐Making Stability

The present article investigates how the EU climate and energy governance framework launched by the European Green Deal has been affected by the exogenous shock of the Russian war of aggression on Ukraine. Harnessing punctuated equilibrium theory, the theoretical approach applies its conceptual triad of policy images, venues, and feedback to the adoption of the current REPowerEU program as a critical test case of highly stable policy-making encountering a situation of exogenous shock. In the empirical part, a mixed-method content analysis of policy documents issued by the European Council and Commission from the adoption of the European Green Deal in 2019 to the current stage is presented to gauge the impact of the Russian attack on agenda-setting at the macro and meso-political levels of the EU. A second step evaluates how the expanded and more geopolitical policy image of the REPowerEU agenda is applied to extant governance processes. In this regard, the analysis identifies three factors limiting the impact of exogenous shock: the availability of three separate policy subsystems for the parallel processing of policy components, institutional safeguards for maintaining policy stability through supranational rules and provisions, and the critical function of the Commission in limiting revisions to a few targeted proposals. In conclusion, policy stability outweighs aspects of disruption and change, while the more diverse set of policy processes creates new challenges for the coherence of efforts to achieve decarbonization.

Verification & validation of CFD predictions regarding pressurized thermal shock (PTS) situations in ROCOM installation: Comparison with IAEA benchmark

The current paper documents the Computational Fluid Dynamics (CFD) code validation activity, carried out at the Nuclear Research Center of Birine relevant of Atomic Energy Commission of Algeria as part of International Atomic Energy Agency (IAEA) Coordinated Research Project (CRP): Application of Computational Fluid Dynamics Codes for Nuclear Power Plant Design to assess the current capabilities of these codes and to contribute to technological progress in their verification and validation. A set of ROCOM CFD-grade test data of Pressurized Thermal Shock test (PTS) specifications was made available in the framework of this (CRP) by Helmholtz Zentrum Dresden-Rossendorf, (HZDR) Germany, to perform detailed calculations of the proposed test. The reference point is the injection of relatively cold core cooling water (ECC), which can induce buoyant stratification. The data obtained from the PTS experiment were compared with the results of Ansys-CFX calculations in this paper. Unsteady Reynolds-Averaged Navier-Stokes (URANS) model is used to examine the buoyancy-influenced flows in the reactor pressure vessel for condition where natural circulation is a dominant factor. The Shear Stress Transport (SST k-ω) turbulence model is used to take into account the turbulence effects on the mean flow. Calculation results show a good qualitative and quantitative agreement with the experiment data.

Food security and resilience: An experimental study of household food consumption in the central region of Mali

Mali is a Sahelian country and structurally vulnerable to food insecurity and malnutrition caused by the recent humanitarian crises the country has faced. The aim of the present study was to assess household food consumption and identify the essential determinants for increasing household dietary diversity and improving one of the pillars of food security for local populations in the locality of Bankass and Koro. The data from the household survey around 1396 households was subjected to an ordinal probit model to perform the econometric analysis. The results showed that the evaluation of household consumption was necessary to properly guide the household food basket in decision making. Our analysis showed a statistically significant relationship for households in Koro at 1% for households that consume fruit, meat and dairy products at Bankass, leaves, sour foods, oil and fats are also consumed by very few households, but only fruit at the 5% and 10% thresholds. However, households in the study area have access to five food groups to ensure their household food consumption. A total demand for cereals, tubers and vegetables was observed to be unavailable to households. About 90% are not able to satisfy the essential food needs of their household. In conclusion the base of daily meals is essentially composed of cereals, fats, sugars and condiments and complemented by the consumption of animal proteins and leafy vegetables. Opportunities for diversifying household diets in a crisis or shock situation in a community still remains an issue despite the humanitarian response households need to support their socio-economic reintegration.

P-051 OPEN ABDOMEN MANAGEMENT IN PATIENT WITH ECMO THERAPY

Abstract Management of negative pressure therapy with fascial traction mediated by inlay mesh, in the context of a patient with multiple organ failure (MOF) secondary to sepsis of abdominal origin in treatment with extracorporeal membrane oxygenation therapy (ECMO) We present the case of a 15-year-old female patient, referred to a hospital after continuous consultations in a primary care center. She refers abdominal pain located in the right iliac fossa of 72 hours of evolution. Blood analysis with high infectious parameters, abdomen on a table and scanner compatible with acute appendicitis complicated by perforation. Urgent surgical intervention, where purulent peritonitis was observed in the four quadrants, the abdomen was kept open with NPT. In a situation of MOF, the need for high-dose noradrenaline and acute respiratory failure. During intubation, 2nd pneumothorax due to barotrauma. Given early deterioration, ECMO therapy was started. After completion of treatment, decreased intra-abdominal pressure and no restrictive respiratory compromise. Progressive fascial traction, using inlay mesh for 18 days until complete closure, using 2/0 monofilament suture, small bites technique, 4:1 ratio and placement of wide-pore, onlay polypropylene mesh. Partial dehiscence of the surgical wound as the only complication, NPT at 80mm Hg with definitive closure was prescribed. Satisfactory evolution one year after the intervention. After our experience with this case, we can conclude that NTP in the open abdomen with the help of facial traction mesh, in patients with ECMO therapy in a situation of septic shock, may be an adequate alternative for definitive closure of the abdominal wall.

Mediofacial malignant granuloma: a case report and review of the literature

We report a case of malignant midfacial granuloma or idiopathic midfacial granulomatosis in a 50-year-old male farmer with no previous history. He was admitted to the department in an emergency context. The history was reportedly 18 months old. He presented a symptomatology made of nasal obstruction, fever, headache and rhinorrhea with an altered general state. He consulted several health facilities. The evolution was marked by the aggravation of the symptomatology. The examination at admission noted an alteration of the general state. Examination of the ENT sphere revealed ulcerative-necrotic lesions with a destructive nasal origin, with bone sequestration, midface edema, and extension to the sinuses and hard palate. The CT scan revealed bony and cartilaginous lysis, irregular thickening of the nasal pyramid, continuity of the nasal septum, and isodensity of the maxillary, ethmoidal, and left sphenoidal sinus walls without total filling. Deep biopsies were performed under general anesthesia. Histology was consistent with a granulomatous reaction with progressive tissue destruction. Mycobacterium tuberculosis was absent. Medical treatment was initiated. The evolution was marked by the extension of the lesions, malnutrition and the appearance of generalized oedema. The patient died on the 45th day of his hospitalization in a septic shock situation. Conclusion: Mediofacial granulomatosis is a difficult lesion to diagnose and manage. It requires careful histological exploration in order to differentiate it from other mediofacial destructive lesions. The evolution is most often towards extension and lethal complications.

Benefice of the stimulation of O-GlcNAcylation on sodium potassium pump during hemorrhagic shock

Hemorrhagic shock (HS) is the consequence of an important loss in blood volume leading to an insufficient delivery in oxygen. HS causes metabolic changes, multi-organ dysfunction and inflammation. The acute kidney injury related to HS is associated with hyperkalemia mainly through an alteration of Na/K ATPase pump. In a previous O-GlcNAcylomic study, we have identified Na/K ATPase as potentially O-GlcNAcylated protein. O-GlcNAcylation is a post-translational modification with a putative beneficial effect in shock situation. This study aims at evaluating if Na/K ATPase is O-GlcNAcylated and its potential impact during the early phase of hemorrhagic shock. Wistar rats were subjected to a HS protocol induced via exsanguination and then randomly treated or not with NButGT (10 mg/kg), a O-GlcNAcase inhibitor, to increase O-GlcNAc levels. Blood pressure and heart rate were monitored throughout the experiment. Blood was collected from the animals to perform a complete blood count and a blood gas analysis. Kidney was immediately frozen for histological and biochemical studies. Immunoprecipitation and Wheat Germ Agglutinin (WGA) based lectin affinity gel electrophoresis were used to study the O-GlcNAcylation of Na/K ATPase. NButGT increased by 2 O-GlcNAc levels in heart and kidney. This increase in O-GlcNAc restored mean arterial pressure (MAP) (P < 0.01) and bicarbonates (P < 0.01). In treated group, kalemia (Sham: 4.2 ± 0.1; HS: 4.7 ± 0.1; NButGT: 4.3 ± 0.1 mmol/L; P < 0.05) and natremia (Sham: 141.5 ± 0.4; HS: 139.8 ± 0.5; NButGT: 141.9 ± 0.4 mmol/L; P < 0.01) were restored. The study of the O-GlcNAcylation of the Na/K ATPase by immunoprecipitation and WGA gel validated its O-GlcNAcylation. Histological analysis of kidney revealed that HS reduced NA/K ATPase expression during HS and treatment by NButGT restored it (Sham: 15.1 ± 1.1; HS: 10.3 ± 0.6; NButGT: 13.78 ± 1.1; % area; P < 0.05). Our results demonstrate that increase O-GlcNAcylation during hemorrhagic shock restored MAP and reduced markers of metabolic acidosis. In our study, animal treatment with NButGT to increase O-GlcNAc levels, restored natremia and kalemia. This effect is associated with an increase in Na/K ATPase expression. To our knowledge, our study validates the O-GlcNAcylation of the Na/K ATPase. With regard to our results, now it will be relevant to study the effect of O-GlcNAcylation on the activity and localisation.

Динамика рынка труда Дальневосточного федерального округа: I кв. 2019 г. – II кв. 2023 г.

The article examines trends in the main parameters of the labor market in general and in the context of subject of the Russian Federation within the Far Eastern Federal District. The range of analyzed indicators characterizing the labor market includes the number of labor force aged 15 years and older, the number of employed and the employment rate, the number of unemployed and the unemployment rate. The analysis period is eighteen quarters: starting from Q1 2019 to Q2 2023. Official publications and operational data of Rosstat were used as information sources. The main attention is paid to changes that occurred in key indicators of regional labor markets under the influence of shock situations (COVID-19 pandemic, partial mobilization in the Russian Federation, sanctions). It is shown that, despite their negative impact, as well as the decrease in the labor force, in the Far Eastern regions the employment rate has stabilized, and the unemployment rate continues to decline

Numerical Analysis Related to the ROCOM Pressurized Thermal Shock Benchmark

The development, verification, and validation of Computational Fluid Dynamics (CFD) codes in reference to nuclear power plant (NPP) safety has been a focus of many research organizations over the last few decades. Therefore, a collection of Rossendorf Coolant Mixing Test Facility (ROCOM) CFD-grade experiments was made obtainable to line up a global International Atomic Energy Agency (IAEA) benchmark regarding Pressurized Thermal Shock (PTS) situations. The benchmark experiment describes the complicated flow structures in mixed convection zones of the RPV during PTS events. The experiments were utilized to validate CFD codes. Additionally, an experiment with no buoyancy forces was elite to point out the influence of density variations. Compared to earlier studies, the turbulence models of the CFD code improved a lot. The turbulence modeling approach shows a respectable agreement with the experimental data.

P4.01: Searching New Donation Scenarios: Potencial Receptors “on the Other Side of the Mirror”

Introduction: Advances in the field of extracorporeal circulation have improved the prognosis and survival of patients in situations of respiratory failure or cardiogenic shock. However, due to disease progression or not considering the inclusion on the waiting list, the purpose of extracorporeal support treatment may be considered futile. These patients who were waiting for an organ can become new donation scenarios, placing a potential receptor just “on the other side of the mirror”. The descriptively study analyzed the potential receptor of a thoracic organ with extracorporeal assistance who become donors in controlled asystole. Methodology: Retrospective observational study of those donors who met the aforementioned criteria from January-2016 to September-2021 in a tertiary care hospital. Demographic, clinical, organ traceability, and donation effectiveness variables were collected. Results: 9 real donors were collected. 77.8% were men with a median age of 56 years. 55% had some cardiovascular risk factor. The mean ICU stay was 12.1 days. 7 patients carried veno-arterial ECMO due to: postinfarction cardiogenic shock (4), pulmonary thromboembolism (1), primary heart transplant failure (1), non-ischemic dilated cardiomyopathy (1). 2 patients with veno-venous ECMO due to pulmonary fibrosis pending transplantation. 19 organs were obtained (7 livers and 12 kidneys), which represents a ratio of 2.1 organs per donor and an effectiveness of 88.9%. Conclusion: The shortage of donors forces us to broaden the search for new scenarios of donation. Although this type of “mirror” donor represents a significant change in treatment and emotional stress for their families, it is a source to consider once their care team considers the adequacy of life-sustaining treatment.

What Matters for Regional Economic Resilience Amid Multi Shock Situations: Structural or Agency? Evidence from Resource-Based Cities in China

This paper contributes to the study of regional economic resilience by analyzing the characteristics and mechanisms of resilience under different shock situations. The paper focuses on the resistance dimension of resilience and analyzes the mechanisms of influence from structural and agency-based factors. Our findings reflect that the regional economic resilience characteristics of resource-based cities in China in response to the 2008 financial crisis and the COVID-19 pandemic vary significantly. We find that the economic resilience has positive spatial autocorrelation characteristics. The regions with strong ability to deal with the shocks can promote resistance in the surrounding regions through their spatial spillover effect. Both structural and agency-based factors play significant roles in regional economic resilience under different shock situations, but the direction of the effect varies significantly. The agency-based factors have a more important role in regional economic resilience. The findings suggest that the nature of different shock situations deserves greater attention in the analysis of regional economic resilience. The mechanisms of structural and agency-based factors may change under different shock situations, and the spatial correlation characteristics of regional economic resilience and the spatial spillover effects should be taken into consideration.

EARLY PREDICTION OF SEPSIS USING MACHINE LEARNING ALGORITHM: A BRIEF CLINICAL PERSPECTIVE

Sepsis is a worldwide cause of death owing to infection and associated immune system response. In situations of septic shock, mortality rates are highest in both developed and underdeveloped countries. Sepsis is a medical illness that requires immediate medical attention but can be avoided with advance warning. Sepsis affects an estimated 30 million people worldwide, with more than 6 million people dying each year. Among them More than 4.2 million new born and children are at risk of contracting the disease. To treat Sepsis, hospitals spend $24 billion (about 13% of all healthcare spending in the United States). The importance of early identification of sepsis in improving sepsis outcomes cannot be overstated. Each hour of delay in treatment increases the risk of death by 4 to 8%. As a result, developing a good model that may be able to tackle this problem becomes urgent and critical. We want to analyse, assess, and design an algorithm that will help us address some of the problems we’ve had when attempting the project. KEYWORDS: Sepsis, Machine learning, early prediction, Supervised learning, KNN.

Age shock index, a better predictor of prognosis for our patients?

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Shock is the main cause of in-hospital mortality in the setting of the Acute Coronary Syndromes (ACS). Shock Index (SI) Has been propposed as an useful predictor of shock and prognosis of the patients admitted because of an ACS. Not only this, a new index, derived from the previous one, which is known as Age Shock Index (ASI) seems to be even more accurate when evaluating these patients. Objetive Our first aim is to test if ASI is more accurate than SI to predict the occurrence of shock in patients admitted to the hospital with the diagnosis of ACS. Our second aim is to check if ASI is more accurate than SI, GRACE score and CRUSADE score to predict the in-hospital mortality of patients admitted to a hospital with the diagnosis of ACS and the presence of shock in the moment of the admission. Material and methods Observational, retrospective and single-center study including patients admitted to a Coronary Critical Care Unit (CCCU) between July 2.011 and March 2.021. ASI was calculated with the following formula: (heart rate x age) / systolic blood pressure. We calculated receptor-operative curves (ROC) of ASI and SI as predictors of shock for patients not presenting shock at the admision. We also calculated ROC of ASI, SI, GRACE and CRUSADE as predictors of in-hospital mortality of patients admitted in shock situation. We compared the area under the curve (AUC) between them. Results For the shock-prediction test we included 2.537 patients, who were admitted in Killip score &amp;lt;4. We found that ASI was a better predictor than SI, with a bigger AUC (0,76 (0,73–079) vs 0,72 (0,68–0,76), p&amp;lt;0,001, Picture 1) , being 44,6 the optimal cut point with better sensibility (0,67) and specificity (0,76). For the in-hospital mortality in shock patients prediction test we included 240 patients admitted in Killip score = 4. As we show in Picture 2, ASI was found to be a better predictor than SI and GRACE score, but not better than CRUSADE score, being 49,2 the optimal cut point with better sensibility (0,71) and specificity (0,53) Conclusion ASI is a better predictor of shock in patients admitted because of ACS than SI and also a better predictor of in-hospital mortality than SI and GRACE score in patients admitted because of ACS and a situation of shock at the admision. Althoug it was not better that CRUSADE score for this purpose, in favour of this index we highlight its simplicity of calculation, which, together with his good prediction capability, make it very useful in the acute setting.

A CROSS-SECTIONAL STUDY OF STANDARD INTERVENTION OF INTESTINAL OBSTRUCTION IN A TERTIARY HOSPITAL IN CENTRAL INDIA.

Background: A common surgical emergency, intestinal blockage has a high death and morbidity rate. Intestinal blockage accounts for about 15% of all emergency room visits for acute abdominal discomfort. Acute intestinal obstruction can take several forms, ranging from a seemingly normal look with just minor stomach pain and distension to a situation of hypovolemic or septic shock (or both) requiring an emergency treatment.&#x0D; Aim: The goal of this study was to see how our tertiary hospital managed intestinal obstruction operations.&#x0D; Material and Methods: Patients in the current study ranged in age from 21 to 80 and had a surgically treated acute intestinal blockage. Patients with severe signs and symptoms of acute blockage were treated with an appropriate surgical approach after initial resuscitation. All of the data was entered into a spreadsheet and analysed with descriptive statistics.&#x0D; Results: During the study period, 288 patients received surgery for acute intestinal blockage. The most prevalent age group (26 percent) was 51 to 60 years old, followed by 41 to 50 years old (21 percent ). Male patients were 2.8 times more likely than female patients to be afflicted. Previous abdominal surgery (56 percent), diabetes (31%), smoking (25%), hypertension (24%), and bronchial asthma/ COPD (15%) were all discovered to be common co-morbidities in this study. The most common causes of intestinal obstruction in this study were postoperative adhesions (47 percent), malignancy (15 percent), obstructed hernia (11 percent), and Koch's abdomen (8 percent ). The most prevalent surgical procedures in this study were adhesion removal (47 percent), resection and anastomosis (22 percent), diversion colostomy (13 percent), and hernioplasty (13 percent) (11 percent ). Fever (15%) and wound infection (11%) were the most prevalent post-operative problems, respectively. The rate of post-operative death was 13%. There are nine patients in all. The majority of deaths are caused by complications such as septicemia, peritonitis, and lung infection.&#x0D; Conclusion: Postoperative adhesions are a common cause of intestinal blockage. Early surgical techniques, when combined with clinical diagnosis and radiological data, may improve the outcome of acute intestinal obstruction.&#x0D; Keywords: surgical management, acute intestinal obstruction, adhesions, adhesiolysis.

Metasynthesis Regarding the Sociocultural Adaptation of International University

This study centers on the sociocultural adaptation experience of international students in academic life and daily life. Responses to the guiding question of what differences and similarities are discernible in the sociocultural adaptation processes that international university students experience in the university versus outside university in the receiving society. It presents a metasynthesis of 12 empirical studies that apply qualitative methodologies to the study of international university students’ sociocultural adaptation, which were published in scientific journals indexed in Ebscohost, WOS and Scopus from January 2012 to March 2019. The metasynthesis results indicate that sociocultural adaption involves: (1) situations of shock that arise in the two environments of academic and daily life with specific challenges proper to each one, and (2) the deployment of varying intrapersonal and social resources in each context. Academic and daily life can be considered as necessarily linked to sociocultural adaptation given the compensatory function observed in relational dynamics of students as they move between the two settings. The emphasis of the research on presenting sociocultural adaptation as a primarily negative process, the theoretical implications of separating academic life from daily life, and the relevance of exploring the role of social networks in students’ daily life are discussed.