Gangrenous Cholecystitis From Gallbladder Volvulus With a Hiatal Hernia

Gallbladder volvulus is a rare condition involving the rotation of the gallbladder about the cystic duct and vascular pedicle, compromising biliary drainage and blood flow. This report describes a case of gallbladder volvulus presenting in an 88-year-old female with acute onset of right upper quadrant abdominal pain, nausea, and vomiting. Complete work-up included a physical exam, laboratory studies, and computed tomography (CT), which was notable for a markedly distended gallbladder with circumferential wall thickening, pericholecystic fluid, a 12 mm common bile duct, and a hiatal hernia. Given that her initial presentation was consistent with acute cholecystitis, we elected to perform laparoscopic cholecystectomy. The definitive diagnosis of gallbladder volvulus was made intraoperatively after decompression of the gallbladder and visualization of counterclockwise rotation of the gallbladder around the hilum and the infundibulum. This case illustrates the challenge in preoperative diagnosis of gallbladder volvulus, which requires high clinical suspicion to provide prompt surgical intervention.

New Stage in the Geopolitical Struggle around the Caspian Sea after 1991

For almost three centuries, starting with the campaign of Peter the Great in 1721-1722, Russia has traditionally played a key role in the Caspian Sea. The situation changed dramatically with the collapse of the USSR in 1991 and the emergence of three new regional players-Azerbaijan, Kazakhstan and Turkmenistan. For Russia, this meant a significant reduction in influence in the region and the loss of control over most of the water area and the sea and its resources. In the historiography devoted to the region, the emphasis is placed on assessing the new round of geopolitical struggle, the position and interests of Western and regional powers. The author of this article provides a critical analysis of changes in Russian policy towards the Caspian Sea over the past 30 years and assesses the effectiveness of these changes. The difficult transition from the role of a dominant player in a region closed to external competitors to an open geopolitical confrontation over resources, their transportation routes, and political influence at the first stage was not in favor of Russia. Russia could not defend the principle of a condominium for joint development of hydrocarbon resources of the sea. With the active assistance of Western competitors, Russia lost its status as a monopoly transit country for oil and gas from the region. At the same time, thanks to diplomatic efforts and increased political dialogue with its neighbors in the region, Russia managed to resolve all territorial issues at sea by 2003, maintain the closed status of the sea for the military forces of third countries, and by 2018 complete work on the Convention on the international legal status of the sea, which established the principles of cooperation in the region that are important for the Russian Federation. Thus, official Moscow managed to achieve the strategic goals adapted after the collapse of the USSR by using the traditional strengths of its foreign policy and consolidate its status as the most influential player in the region.

Unleashing the Potential of Crowd Work: The Need for a Post-Taylorism Crowdsourcing Model

Paid crowdsourcing connects task requesters to a globalized, skilled workforce that is available 24/7. In doing so, this new labor model promises not only to complete work faster and more efficiently than any previous approach but also to harness the best of our collective capacities. Nevertheless, for almost a decade now, crowdsourcing has been limited to addressing rather straightforward and simple tasks. Large-scale innovation, creativity, and wicked problem-solving are still largely out of the crowd’s reach. In this opinion paper, we argue that existing crowdsourcing practices bear significant resemblance to the management paradigm of Taylorism. Although criticized and often abandoned by modern organizations, Taylorism principles are prevalent in many crowdsourcing platforms, which employ practices such as the forceful decomposition of all tasks regardless of their knowledge nature and the disallowing of worker interactions, which diminish worker motivation and performance. We argue that a shift toward post-Taylorism is necessary to enable the crowd address at scale the complex problems that form the backbone of today’s knowledge economy. Drawing from recent literature, we highlight four design rules that can help make this shift, namely, endorsing social crowd networks, encouraging teamwork, scaffolding ownership of one’s work within the crowd, and leveraging algorithm-guided worker self-coordination.

TorsiFlex: an automatic generator of torsional conformers. Application to the twenty proteinogenic amino acids

In this work, we introduce , a user-friendly software written in Python 3 and designed to find all the torsional conformers of flexible acyclic molecules in an automatic fashion. For the mapping of the torsional potential energy surface, the algorithm implemented in combines two searching strategies: preconditioned and stochastic. The former is a type of systematic search based on chemical knowledge and should be carried out before the stochastic (random) search. The algorithm applies several validation tests to accelerate the exploration of the torsional space. For instance, the optimized structures are stored and this information is used to prevent revisiting these points and their surroundings in future iterations. operates with a dual-level strategy by which the initial search is carried out at an inexpensive electronic structure level of theory and the located conformers are reoptimized at a higher level. Additionally, the program takes advantage of conformational enantiomerism, when possible. As a case study, and in order to exemplify the effectiveness and capabilities of this program, we have employed to locate the conformers of the twenty proteinogenic amino acids in their neutral canonical form. has produced a number of conformers that roughly doubles the amount of the most complete work to date. Graphical Abstract

STRATEGI PENANGANAN PANDEMI COVID-19 MELALUI OPTIMALISASI TEKNOLOGI INFORMASI DI KABUPATEN GARUT

Every day the number of cases caused by the Covid-19 pandemic continues to grow. The Covid-19 pandemic has forced the government to formulate policies to reduce the number of its spread. With various policies made by the government, community activities and information dissemination are limited. This paper aims to find out strategies for handling the Covid-19 pandemic through optimizing information technology. We need to know that the Covid-19 pandemic continues to increase every day, which requires people to limit their environment and implement social distancing. Information Technology has the goal of solving a problem, opening up creativity, increasing effectiveness and efficiency in doing work. Information technology innovations continue to be developed as the number of Covid-19 patients increases. Many countries have used information technology to find out information on the development of Covid-19 over long distances by using internet media in preventing Covid-19. The internet also helps Covid-19 patients with doctors, and helps make it easier for people to complete work. Garut Regency, West Java is one of the districts that experienced a significant increase in the number of cases. The local government has also pursued a strategy to deal with Covid-19 by optimizing information technology through the internet. From the data found, it can be concluded that information technology can help in handling Covid-19, especially in Garut Regency. Keywords: Information Technology, Covid-19, Garut Regency

PELATIHAN PENGUASAAN MENGETIK CEPAT 10 JARI DENGAN METODE DRILL DI SMK NEGERI 5 BANDAR LAMPUNG

The purpose of this service is to improve mastery skills and skills in fast typing for students of SMKN 5 Bandar Lampung. For the problems faced by students, namely how to apply fast typing using the drill method in order to complete work related to typing, which can be completed quickly, correctly and on time. The long-term target to be achieved in this activity is closely related to the problem of using the drill method using the typing test application which covers a very wide range for students, teachers and secretaries which leads to improving their performance. The steps taken to master fast typing are through coaching and improving fast typing exercises by using several typing test applications using the drill method. The output of this activity is the scientific article Shinta 4 Lancang Kuning University, activity videos, and service profiles published at the University of Lampung dedication seminar. The methods used are interesting discussions, lectures and practicals, about the drill method in the typing test. By holding fast typing training with the Drill method, it is intended for students of SMKN 5 Bandar Lampung, to be able to further improve their mastery and skills in fast typing.

Princess Elisabeth’s Cautions and Descartes’ Suppression of the Traité de l’Homme

Why did Descartes not publish his chief physiology work during his lifetime? Descartes considered that the physiological and medical conclusions that could be drawn from his philosophy were fundamental to his intellectual project, and an apparently complete work was circulating among friends in 1641 but was only published more than a decade after his death, as De Homine (1662) and Traité de l’Homme (1664). This paper argues that Princess Elisabeth’s careful consideration of his physiology raised questions about whether the common interpretation of his philosophy as dualistic was correct, implicating it in some of the most dangerous arguments of his generation. Her questions served as a warning, in a moment when the personal papers and even the liberty of the Frenchman were threatened. Descartes had no interest in becoming a medical Galileo, and listened to the princess, leaving the work unpublished.

Multilingualism at the multiplex: a new audience for screen translation?

The phenomenon of subtitling as an aesthetic or political choice within a film, rather than a strategy for the transfer of a complete work, merits further examination at a time when filmmakers are increasingly including substantial segments of subtitled dialogue in mainstream films. The potential impact of this trend on an audience assumed to be resistant to screen translation is considerable. Despite important reservations, it is argued here that the growing visibility of translation within mainstream cinema has the potential to create space for certain forms of resistance to the dominance of English in the entertainment market, and promote the development of a ‘multilingual imagination’ in multiplex cinemagoers.

Bilateral non-bifurcating carotid arteries in a patient with recurrent cerebrovascular events

Introduction Among congenital anomalies of the carotid artery circulation, the presence of a non-bifurcating carotid artery is extremely rare. Relevant cases with unilateral non-bifurcating carotid artery have scarcely been described in the literature. After extensive literature review, only one case with asymptomatic bilateral non-bifurcating carotid arteries associated with persistent proatlantal artery was identified. Methods We present the case of a 40-year-old man with recurrent cerebrovascular events presenting non-bifurcating carotid arteries bilaterally. Results A 40-year-old man presented in the emergency department with a transient ischemic attack. Past medical history included prior ischemic stroke of unknown etiology in the distribution of the left middle cerebral artery, untreated hyperlipidemia and tobacco use. Complete work-up in order to identify the underlying mechanism of the patient’s recurrent cerebrovascular events was negative, except for the finding of non-bifurcating carotid arteries bilaterally, associated with an extensive intracranial anastomosing arterial network. Long-term antiplatelet therapy and statins were administered as secondary stroke prevention therapy. Discussion Previous reports suggest that non-bifurcating carotid arteries may be associated with atherosclerotic plaque formation in symptomatic cases due to shear stress, tortuosity or other local factors. However, in the absence of atherosclerosis, the pathogenic association of bilateral non-bifurcating carotid arteries with cerebrovascular events remains questionable, but may be considered when other stroke etiologies are excluded.

Evaluating Malware Detection System using Machine Learning Algorithms

Malware, is any program or document that is unsafe to a PC client. Kinds of malware can incorporate PC infections, worms, Trojan ponies and spyware. These noxious projects can play out an assortment of capacities like taking, scrambling or erasing touchy information, adjusting or commandeering center processing capacities and observing clients' PC action. Malware identification is the way toward checking the PC and documents to distinguish malware. It is viable at distinguishing malware on the grounds that it includes numerous instruments and approaches. It's anything but a single direction measure, it's very intricate. The beneficial thing is malware identification and evacuation take under 50 seconds as it were. The outstanding development of malware is representing an extraordinary risk to the security of classified data. The issue with a significant number of the current order calculations is their small presentation in term of their capacity to identify and forestall malware from tainting the PC framework. There is a critical need to assess the exhibition of the current Machine Learning characterization calculations utilized for malware identification. This will help in making more hearty and productive calculations that have the ability to conquer the shortcomings of the current calculations. As of late, AI methods have been the main focus of the security specialists to distinguish malware and foresee their families powerfully. Yet, to the best of our information, there exists no complete work that looks at and assesses a sufficient number of machine learning strategies for characterizing malware and favorable examples. In this work, we led a set of examinations to assess AI strategies for distinguishing malware and their classification into respective families powerfully. This investigation did the presentation assessment of some characterization calculations like J45, LMT, Naive Bayes, Random Forest, MLP Classifier, Random Tree, AdaBoost, KStar. The presentation of the calculations was assessed as far as Accuracy, Precision, Recall, Kappa Statistics, F-Measure, Matthew Correlation Coefficient, Receiver Operator Characteristics Area and Root Mean Squared Error utilizing WEKA AI and information mining recreation device. Our test results showed that Random Forest calculation delivered the best exactness of 99.2%. This decidedly shows that the Random Forest calculation accomplishes great precision rates in identifying malware.