Child’s Point of View vs.Adult’s in Melville’s Early Two Stories

This paper aims to study the functions of two different points of view from the perspective of narratology,namely,the point of view of the adult and the one of the child,in two of Herman Melville’s early stories.By contrasting these two functions of the different perspectives,the author of this paper draws the conclusion that the child has a unique and significant perspective in Melville’s works.

Reoperation in an adult female with "right-sided" Hirschsprung's disease complicated by refractory hypertension and cough

Hirschsprung's disease(HD) is an intestinal malformation caused by the innate absence of ganglion cells in the neural plexus of the colorectal wall, and is most common in male infants. It is rare in adult, and is usually left-sided. Herein we reported based on the CARE guidelines a case of a 47-year-old adult female suffering from "right-sided" HD complicated by refractory hypertension and cough. The patient with a history of cesarean section and with digestive unfitness(abdominal pain, distention, and constipation) only since 20 years old had recurrence of HD after initial surgery due to the incomplete removal of the HD-affected bowel based on a diagnosis of "chronic ileus", leading to the relapse of the digestive symptoms and the emergence of some intractable circulatory and respiratory complications which could be hardly controlled by conservative treatment. During the long interval before coming to our department for help, she had been re-hospitalized for several times with various misdiagnoses and supplied merely with symptomatic treatment which could only achieve temporary symptomatic relief. At her admission to our department, the imaging examinations strongly indicated recurrent HD which was further supportedb y p a t h o l o g i c a l e x a m i n a t i o n s, a n d r i g h t h e m i-colectomy was performed to remove the remnant aganglionic intestinal segment. Intraoperative and postoperative pathology supported the completeness of the definitive resection. Post-operation, the patient's bowel motility significantly improved, and interestingly, the complications disappeared. For adult patients with long-term constipation combined with cough and hypertension, rare diseases like HD which requires definite surgery and which could be "right-sided" should not be overlooked. It is vital to diagnose and cure HD patients in childhood. Through the comparison of the two surgeries, it is noteworthy that for diagnosed HD, sufficient removal of the non-functional intestine confirmed by intraoperative pathology is essential.

Adult Onset Still’s Disease: Articular Manifestations in Twenty Cases

The adult onset Still’s disease is a rare inflammatory pathology of unknown pathogeny. The clinical features are variable. The diagnosis is difficult since exclusion of infectious, systemic and tumoral pathologies should be done. The articular complications are frequent and can be revelatory of this pathology. The articular prognosis depends on the diagnosis delay and the treatment efficiency. Our study aims to analyze different aspects of articular manifestations complicating adult onset Still’s disease to define epidemiological, clinical and evolving characteristics of these complications. It was a cross-sectional study concerning 20 cases of adult onset Still’s disease diagnosed from 1990 to 2015 in the internal medicine A department of Charles Nicolle Hospital in Tunis, meeting Yamaguchi criteria. We identified clinical, radiological, evolving and therapeutic profile of the articular manifestations occurred in these patients. There were 13 women and 7 men. The average age was 25 years. The arthralgias were reported in all cases;while, the arthritis interested fifteen patients. A hand deformation was found in four patients. A wrist ankylosis was noted in one case and a flexion elbow in one patient. The standard articular radiographs were normal in twelve cases. The treatment associated essentially non-steroidal anti-inflammatory and/or corticosteroids and/or methotrexate. Concerning the evolving profile, the monocyclic form was present in 25% of the cases, the intermittent form in 45% and the chronic articular form in 30% of our patients. The adult onset Still’s disease is rare and heterogeneous. The articular disturbances are frequent and have various outcomes.

Workshops Teach Children, Adults to Stand Up for Children's Rights

She clambers up a rock, reaches both hands onto comers of the shabby cement wall and heaves herself up, being careful not to catch her school bag on the protruding bricks. She straddles the top and then jumps gingerly down onto the pebbled ground beside the railway line.

Quality of Service to Users of Primary Health Care:A Study of Evaluation

The quality of service to people in Primary Healthcare (PHC) is linked to the provision of quality service by professionals who integrate this service in the community. Accordingly, this study aims to evaluate the service given by health professionals in primary health care, from the user’s perception. This is an evaluative and quantitative study, conducted with people who use the PHC service. 180 adults are interviewed in the city of Santa Cruz, Rio Grande do Norte, Brazil. The results show that most respondents are women. The average age is of 36.65, median of 34.00 and standard deviation of 11,554. With regards to the quality of service, it ranges from fair to good. When performing correlation between the quality of service and time spent to reach the service, most people say that they spend between 0 and 15 minutes from their house to the healthcare service unit. About reception, respondents reported being satisfied and that the service has been responsible and quality for health monitoring. Thus, it is noted that the user classifies the quality of the service in primary healthcare as regular, showing weaknesses that need to be corrected to prevent damage in service provision in Primary Healthcare.

THE WAVELET ANALYSISOF EVOKED POTENTIALS

Abstract: In this paper,we use the orthogonal wavelet based on 3-order splines function to processthe somatosensory evoked potentials and cognitive event-related potentials. The experiments onhuman subjects have showed that this method is valuable and practicable.INTRODUCTIONEvoked potentials(EP' s) are electrical responses of the central nervous system to stimulusapplied in a controlled manner. They can not only be used to diagnose the diseases on the sensorypathway and brain but also be frequently monitored intraoperatively to assess the effects ofsurgery or to detect unexpected neurological injury [1][2]. But the Signal-to-Noise ratios (SNRIs) of EP' s are vary low. The: are many methods in order to improve the SNR' S and identify theEP' s signal perfectly with less stimuli such as ensembl averaging,post-wiener filtering,adaptedfiltering and parametric modeling and even single stimulus. The purpose of this paper is to applyrnultiresolution wavelet analysis method for identification of short-latency somatosensory evokedpotentials and long-latency evoked--related potentials.METHODMultiresolution Wavelet analysis and pyramid algorithm was constructed by Mallat [3] andwidely used in signal processing pattern recognition and image processing. Here,we applyed thisto decompose EP' S signal into different frequency bands and reconstructed them with time-varying weight method.Based on 3-order splines functions,we constructed orthogonal wavelet and scale function. According to the dual-scale function,we could get transform function h and its mirror filter g,theyare related by gn(- l)nhn+1. More detail could see Mallat' theory[3]. Through fast pyramid algorithm,the EP' S signal can be decomposed into detail and coarse parts on a dyadic scales by scalefunction like this Here Cj is coarse signal and Dj is detail signal. C, is signal on scale 0 and is the same as originalsignal. With j increasing,the EP' S signal were projected to different frequency bands. The reconstructed function for signal on j scale to j-1 scale isAccording to the character of EP' S signals and their decomposition on different scales ,we choosethe following signal processing principle.To somatosensory EPI S (SEP),we choose coarse and detail signal on scale 6 to reconstructsignalS(t) ~W, (t) o C,(t) +WZ(t) o D,(t)W, and W, are time--varying weight and are decided by the amplitude of detail and coarse signalson scale 6.To Event--related optentials (P300 waveform),because the noise is mainly on high frequencyband gwe choose coarse signal of scale 6 to reconstruct signal.RESULTThere are ten subjects taking part in the experiment. The instrument is SPECTRUM32 ofCADWELL corporation. To SEP signals,The medial nerve of left wrist was stimulated,activeelectrode was attached to Cll (3 cm lateral to the midline and posterior to the coronal suture).reference electrode at Al (left ear) and ground electrode at Fpz according to 'the international 10-20system of electrode placement.Figurel is the original SEPI S signal and processed signal, (a) is the SEPI S signal averaged by250 times. (b) is the signal averaged by 30 times and (c) is the signal of (b) be processed. Fromthe figure,we could see that the method is effectively,noise ate inhibited greatly and the waveform of (c) is almost the same as the signal (a).Figure 2 .The EPRI S signal and processed signalTo ERP,active electrode was attached to Cz.reference electrode at Al and ground electrodeat Fpz. The stimulus is auditory and the probability of target stimulus is 20 percent.FigureZ is the EPR signal, (a) is the signal average 40 times, (b) is the single trial signal and(c) is the processed signal of (b). From the figure, we could say that multiresolution waveletanalysis can get single trial signal of ERP. The signal (c) is almost the same as signal of (a).From the experiments,we could say that the time--varying weighted multiresolution waveletanalysis method is suitable and practicable and may be vary useful in identification of single trialEPI s signal.