Omental plug using double horizontal mattress suture for gastric perforation on elderly patients with boey score 3: A case series

Gastric perforation is a life-threatening condition. Patients with gastric perforation with Boey score 3 has very high mortality rate. Immediate source control is required for primary repair and preventing further complications. Furthermore, elderly patients pose a greater risk of morbidity and mortality in cases of gastric perforation, especially during and after emergency surgery. Case presentation We present two cases of elderly patients with gastric perforation with Boey score 3. We performed omental plugging technique with double horizontal mattress suture type. In these cases, we decided not to perform biopsy and margin freshening of the perforation. Discussion We performed omental plugging technique because we are confident that it could cover the perforation completely without causing gastric outlet obstruction. An emergency source control surgery can be effectively done with this omental plugging procedure. During surgery, margin freshening and biopsy is not performed to perform source control more quickly. This surgical procedure aligned with “quick in-quick out” concept that we adopted for treating patients with gastric perforation. Omental plugging also allows patient to undergo ERAS program for better and faster recovery. The patients were discharged from the hospital without further complications and long-term follow-up showed good results. Conclusion Omental plugging has the least risk of complications than other perforation repair techniques and can be done for small and large perforation. Based on our case series, omental plug with double mattress suture is an effective and safe procedure to be performed in elderly patients with gastric perforation with Boey score 3.

Effectiveness of tutorial videos combined with online classes in surgical knotting course during COVID-19 pandemic: A cohort study

The application of WhatsApp to support online learning during the COVID-19 pandemic in Indonesia

Usability evaluation of a nursing information system by applying cognitive walkthrough method

BACKGROUND AND OBJECTIVEThe user interface usability of the nursing information system (NIS) should be such that the nurses can learn and interact with it easily and quickly. Therefore, it is necessary to identify and solve the usability problems of these systems. The present study aimed to evaluate the usability of a NIS using the cognitive walkthrough (CW) evaluation method.METHODSBased on five selected scenarios, five evaluators evaluated the NIS in Shafa Hospital Information System. After identifying the problems, the evaluators assigned each problem to one of the usability attributes. The severity of each identified problem was determined by the evaluators and five real users of the system.RESULTSIn total, 24 unique problems were identified. The average severity of the problems was determined by the evaluators (2.77) and the actual users (2.82) in the "major problem" category. The highest number of problems were assigned to the scenarios 3 and 2 with 15 and 14 problems, respectively. The highest average severity in terms of evaluations and actual users was related to the scenario 5 (3.06 and 2.94, respectively), which was in the "major problem" category. The highest number of problems were associated with learnability (8 problems) and efficiency (6 problems).CONCLUSIONSince most of the nurses do not have enough time for learning the system, and given that the selected scenarios for evaluation were based on the most frequent daily tasks that nurses performed using the NIS; The correction of usability problems in the scenarios 3 and 2 that had the highest number of problems and the scenario 5 that had the highest average severity and execution time; it can reduce the nurses' cognitive load and the learning time of the system and increase the efficiency of nurses.

Organ at Risk Dose Constraints in Stereotactic Ablative Radiotherapy: A Systematic Review of Active Clinical Trials

Nutritional functions and antioxidative enzymes in juice extract from two different maturity stages of low temperature stored phalsa (Grewia subinaequalis D.C.) fruit

Semi-supervised classification of radiology images with NoTeacher: A Teacher that is not Mean

Deep learning models achieve strong performance for radiology imageclassification, but their practical application is bottlenecked by the need forlarge labeled training datasets. Semi-supervised learning (SSL) approachesleverage small labeled datasets alongside larger unlabeled datasets and offerpotential for reducing labeling cost. In this work, we introduce NoTeacher, anovel consistency-based SSL framework which incorporates probabilisticgraphical models. Unlike Mean Teacher which maintains a teacher network updatedvia a temporal ensemble, NoTeacher employs two independent networks, therebyeliminating the need for a teacher network. We demonstrate how NoTeacher can becustomized to handle a range of challenges in radiology image classification.Specifically, we describe adaptations for scenarios with 2D and 3D inputs, uniand multi-label classification, and class distribution mismatch between labeledand unlabeled portions of the training data. In realistic empirical evaluationson three public benchmark datasets spanning the workhorse modalities ofradiology (X-Ray, CT, MRI), we show that NoTeacher achieves over 90-95% of thefully supervised AUROC with less than 5-15% labeling budget. Further, NoTeacheroutperforms established SSL methods with minimal hyperparameter tuning, and hasimplications as a principled and practical option for semisupervised learningin radiology applications.

Application of Permeable Pavement as Low Impact Development (LID) in Improving Water Quality in Semarang River

The Semarang River is a flushing channel for the city of Semarang which is located in the Semarang River Drainage Sub-System. This river has the potential to become a water tourism area with the application of the Historical River Front City Walk concept. However, the water contained in the Semarang River still comes from the inlet of the residential drainage system which still uses a mixed system. The largest land uses are in the form of trade and service areas as well as high-density housing. This study aims to determine the percentage reduction in pollutant loads in the Semarang River Drainage Sub-System by implementing Low Impact Development in the form of a permeable pavement along the Semarang River Inspection road. The research method used SWMM software with the wash off function in the form of EMC. There are 11 observation points in the study area, starting from the Simongan Weir Bridge upstream of the river to the Berok 2 Bridge in the Kota Lama Semarang area. The simulation results show that permeable pavement can reduce pollution load with an average % decrease in TSS by 2,01%, COD by 4,48%, BOD 5% and Nitrate by 0,96%.

Inhibition of Candida albicans hypha formation in biofilm formation by Ruta angustifolia extract

IoT-based Knowledge Repository Design for Supporting Knowledge Integration within the Marine Information System Study Program

Knowledge repository is commonly used to store and manage explicit knowledge from knowledge worker. The development of internet of things (IoT) in Industry 4.0 enables the improvement of quality and quantity of knowledge repository. This study focuses on developing IoT-based knowledge repository as a means to support knowledge integration within The Marine Information System Study Program. The study provides architectural designs of a knowledge repository that consists of 5 knowledge domains of marine information system and the design of IoT-based knowledge repository, both of which are based on reviews on relevant literatures and focus group discussion. The solution offered by the current study allows knowledge integration through Community of Practice as the provider and the user of the knowledge.