• Journal of Chest Surgery
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• 제52권2호
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• pp.100-104
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• 2019

Shone complex is a rare congenital disorder that involves 4 obstructive lesions of the left heart, as follows: parachute mitral valve, supravalvular mitral ring, subaortic stenosis, and coarctation of the aorta. Incomplete forms with 2 or 3 of these lesions in adult patients have been rarely reported in the literature, meaning that insufficient general data exist concerning the surgical strategy and clinical follow-up. Herein, we report the case of a 31-year-old woman with a diagnosis of incomplete form of Shone complex with parachute mitral valve and coarctation of the aorta who underwent successful single-stage surgical repair.

• Structural Engineering and Mechanics
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• 제83권2호
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• pp.179-193
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• 2022

The shear behaviour of reinforced concrete members has been studied over the past decades by various researchers, and it can be simulated by analysing shear panel elements which has been regarded as a basic element of reinforced concrete members subjected to in-plane biaxial stresses. Despite various experimental studies on shear panel element which have been conducted so far, there are still a lot of uncertainties related to what influencing factors govern the shear behaviour and affect failure mechanism in reinforced concrete members. To identify the uncertainties, a finite element analysis can be used, which enables to investigate the impact of specific variables such as the reinforcement ratio, the shear retention factor, and the material characteristics including aggregate interlock, tension stiffening, compressive softening, and shear behaviour at the crack surface. In this study, a non-linear probabilistic analysis was conducted on reinforced concrete panels using a finite element method optimized for reinforced concrete members and advanced sampling techniques so that probabilistic analysis can be performed effectively. Consequently, this study figures out what analysis methodology and input parameters have the most influence on shear behaviour of reinforced concrete panels.

• International Journal of Knowledge Content Development & Technology
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• 제13권1호
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• pp.43-58
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• 2023

This article is a spinoff of a doctoral study that was completed at the University of KwaZulu-Natal (South Africa) in 2018 on provision of information services to persons with visual and physical impairments in public university libraries in Kenya. The article examined how ICTs such as internet, e-resources and e-databases, word processing, websites and more were being used in public university libraries to provide access to information by visually and physically impaired persons. Data were collected from the visually and physically impaired students, University Librarians, Systems librarians, staff from disability departments and library staff who provided services to visually and physically impaired persons. The findings revealed that the visually and physically impaired persons in most of the libraries could not access information owing to lack of the necessary assistive and adaptive technologies and weak institutional support and framework. The study recommend that the libraries improve assistive technology infrastructure, embrace new assistive technologies such as telepresence robots, virtual realities and more, and put in place enabling policies and capacity building programmes for library staff to enable them to provide services to persons with impairments.

• Computers and Concrete
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• 제3권4호
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• pp.213-233
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• 2006

Over the past years techniques for non-linear analysis have been enhanced significantly via improved solution procedures, extended finite element techniques and increased robustness of constitutive models. Nevertheless, problems remain, especially for real world structures of softening materials like concrete. The softening gives negative stiffness and risk of bifurcations due to multiple cracks that compete to survive. Incremental-iterative techniques have difficulties in selecting and handling the local peaks and snap-backs. In this contribution, an alternative method is proposed. The softening diagram of negative slope is replaced by a saw-tooth diagram of positive slopes. The incremental-iterative Newton method is replaced by a series of linear analyses using a special scaling technique with subsequent stiffness/strength reduction per critical element. It is shown that this event-by-event strategy is robust and reliable. First, the model is shown to be objective with respect to mesh refinement. Next, the example of a large-scale dog-bone specimen in direct tension is analyzed using an isotropic version of the saw-tooth model. The model is capable of automatically providing the snap-back response. Subsequently, the saw-tooth model is extended to include anisotropy for fixed crack directions to accommodate both tensile cracking and compression strut action for reinforced concrete. Three different reinforced concrete structures are analyzed, a tension-pull specimen, a slender beam and a slab. In all cases, the model naturally provides the local peaks and snap-backs associated with the subsequent development of primary cracks starting from the rebar. The secant saw-tooth stiffness is always positive and the analysis always 'converges'. Bifurcations are prevented due to the scaling technique.

• International Journal of Knowledge Content Development & Technology
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• 제11권2호
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• pp.55-75
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• 2021

This article examines the accessibility and usability of library websites to students with visual and physical disabilities in public universities in Kenya. The study used survey research design and adopted a mixed methods approach. Data were gathered using survey questionnaire, focus group discussions, structured interviews, and observation. The study population consisted of six public universities that had a longstanding tradition of enrolling students with disabilities. Census was used to obtain a study sample comprising of students with visual disabilities (86), students with physical disabilities (91), University Librarians (6), Personnel from Disability Mainstreaming departments (6), Systems Librarians (6) and Library Personnel who provided information services to students with disabilities (133). The Social Model of Disability and IFLA Access to Libraries for Persons with Disabilities checklist were used as conceptual and theoretical framework in the study. Study results revealed that all the libraries had library websites. However, the websites did not have disability services page or information specific to individuals with disabilities. Also a section of students with disabilities lacked awareness of the existence of library websites and e-resources available through them. Additionally, the website design posed various access challenges. The study concluded that people with disabilities were excluded from access and use of library websites in public universities. The authors recommended that library websites must contain disability services page containing information specific to persons with disabilities. Moreover, libraries should evaluate their websites to ensure compliance with W3C requirements for web content accessibility. Additionally, libraries should develop disability policy to provide guidance on provision of information services to persons with disabilities.

• International Journal of Knowledge Content Development & Technology
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• 제11권4호
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• pp.7-34
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• 2021

The purpose of the study was to explore the uses and gratification of social media among first-year student groups at a satellite campus of a public university in Ghana. The study employed a descriptive survey design. The study involved all 1061 first-year university students in six academic departments of the College. A total of 680 (64%) participants returned validly completed copies of the questionnaire. Descriptive statistics and thematic analysis were employed for data analysis. The findings indicate that WhatsApp was the most popular application for social media groups, while a need for information-sharing, peer-tutoring and learning, and finding and keeping friends were the primary motivations for joining social media groups. First-year students are involved mainly in reactive activities, as most engage when solving an academic assignment through group discussions. Though challenges persist, such as posting of unwanted images, inadequate participation, and ineffective and irrelevant communication, most are willing to continue their social media groups' membership in the long term. This study provides valuable insight into transitioning students' lived experiences on social media from the group perspective. These insights are valuable conceptually and practically to academic counsellors, librarians and student affairs officers who are expected to provide on-going education on (social) media literacy to first-year students to enhance the adjustment process. The study is the first of its kind in Ghana that investigates social media group participants' exit intentions.

• Journal of Chest Surgery
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• 제51권4호
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• pp.247-253
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• 2018

Background: Early extubation after cardiovascular surgery has some clinical advantages, including reduced hospitalization costs. Herein, we review the results of ultra-fast-track (UFT) extubation, which refers to extubation performed on the operating table just after the operation, or within 1-2 hours after surgery, in patients with congenital cardiac disease. Methods: We performed UFT extubation in patients (n=72) with a relatively simple congenital cardiac defect or who underwent a simple operation starting in September 2016. To evaluate the feasibility and effectiveness of our recently introduced UFT extubation strategy, we retrospectively reviewed 195 patients who underwent similar operations for similar diseases from September 2015 to September 2017, including the 1-year periods immediately before and after the introduction of the UFT extubation protocol. Propensity scores were used to assess the effects of UFT extubation on length of stay (LOS) in the intensive care unit (ICU), hospital LOS, and medical costs. Results: After propensity-score matching using logistic regression analysis, 47 patients were matched in each group. The mean ICU LOS ($16.3{\pm}28.6$ [UFT] vs. $28.0{\pm}16.8$ [non-UFT] hours, p=0.018) was significantly shorter in the UFT group. The total medical costs ($182.6{\pm}3.5$ [UFT] vs. $187.1{\pm}55.6$ [non-UFT] ${\times}100,000$ Korean won [KRW], p=0.639) and hospital stay expenses ($48.3{\pm}13.6$ [UFT] vs. $54.8{\pm}29.0$ [non-UFT] ${\times}100,000KRW$, p=0.164) did not significantly differ between the groups. Conclusion: UFT extubation decreased the ICU LOS and mechanical ventilation time, but was not associated with postoperative hospital LOS or medical expenses in patients with simple congenital cardiac disease.

• Journal of Chest Surgery
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• 제53권2호
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• pp.64-72
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• 2020

Background: It is generally agreed that using a bilateral internal thoracic artery (BITA) composite graft improves long-term survival after coronary artery bypass grafting (CABG). Although the left internal thoracic artery (LITA)-based Y-composite graft is widely adopted, technical or anatomical difficulties necessitate complex configurations. We aimed to investigate whether BITA configuration impacts survival or patency in patients undergoing coronary revascularization. Methods: Between January 2006 and June 2017, 1,161 patients underwent CABG at Seoul National University Bundang Hospital, where the standard technique is a LITA-based Y-composite graft with the right internal thoracic artery (RITA) sequentially anastomosed to non-left anterior descending (LAD) targets. Total of 160 patients underwent CABG using BITA with modifications. Their medical records and imaging data were reviewed retrospectively to investigate technical details, clinical outcomes, and graft patency. Results: Modifications of the typical Y-graft (group 1, n=90), LITA-based I-graft (group 2, n=39), and RITA-based composite graft (group 3, n=31) were used due to insufficient RITA length (47%), problems using LITA (28%), and target vessel anatomy (25%). The overall 30-day mortality rate was 1.9%. Among 116 patients who underwent computed tomography or conventional angiography at a mean interval of 29.9±33.1 months postoperatively, the graft patency rates were 98.7%, 95.3%, and 83.6% for the LAD, left circumflex artery, and right coronary artery territories, respectively. Patency rates for the inflow, secondary, and tertiary grafts were 98.2%, 90.5%, and 80.4%, respectively. The RITA-based graft (group 3) had the lowest patency rate of the various configurations (p<0.011). Conclusion: LITA-based Y composite graft, showed satisfactory clinical outcomes and patency whereas modifications of RITA- based composite graft had the lowest patency and 5-year survival rates. Therefore, when using RITA-based composite graft, other options should be considered before proceeding atypical configurations.

• Safety and Health at Work
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• 제11권1호
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• pp.33-40
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• 2020

Background: Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers. Methods: Cross-sectional study of 711 men aged 30-65 years and working as either farmers or agricultural workers in 2009-2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models. Results: Forty-four men {5.6% [95% confidence interval (CI) 4.0-7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0-4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1-5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8-14.3), p = 0.044] in comparison with the no-exposure group. Conclusions: This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.