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Anesthetic management of thoracoscopic resection of lung lesions in small children

Mohtar S, Hui TWC, Irwin MG

Paediatr Anaesth, 2018 11;28(11):1035-1042.
PMID: 30281181 DOI: 10.1111/pan.13502

BACKGROUND: Video-assisted thoracoscopic surgery has dramatically increased over the last decade because of both medical and cosmetic benefits. Anesthesia for video-assisted thoracoscopic surgery in small children is more challenging compared to adults due to the considerable problems posed by small airway dimensions and ventilation. The optimal technique for one-lung ventilation has yet to be established and the use of remifentanil infusion in this setting is not well described.
AIMS: This study investigated the use of extraluminal bronchial blocker placement for one-lung ventilation and the effect of infusion of remifentanil in infants and small children undergoing video-assisted thoracoscopic surgery.
METHODS: We retrospectively reviewed the technique of one-lung ventilation and the hemodynamic effects of remifentanil infusion in 31 small children during elective video-assisted thoracoscopic surgery for congenital lung lesions under anesthesia with sevoflurane or isoflurane, oxygen, and air. Patients' heart rate, blood pressure, and endtidal carbon dioxide at baseline (after induction of anesthesia), immediately after one-lung ventilation, during carbon dioxide insufflation, and at the end of one-lung ventilation were extracted from the database and analyzed. The use of vasopressors or dexmedetomidine was also recorded and analyzed.
RESULTS: Extraluminal placement of a bronchial blocker alongside the tracheal tube was successfully performed in 90.3% of cases (28 patients) without any serious complications or arterial oxygen desaturation. There was no significant rise in blood pressure or heart rate even with the rise of endtidal carbon dioxide concentration during video-assisted thoracoscopic surgery. In 58% of patients (18 patients), phenylephrine was administered to maintain the blood pressure within 20% of the baseline value. There was no significant change in the heart rate of all patients at each time point.
CONCLUSION: One-lung ventilation with an extraluminal parallel blocker was used effectively in this series of young children undergoing thoracoscopic excision of congenital pulmonary lesions. Remifentanil infusion attenuated surgical stress effectively in infants and small children undergoing video-assisted thoracoscopic surgery.
Fulltext Mobile learning: research context, methodologies and future works towards middle-aged adults - a systematic literature review

Mohtar S, Jomhari N, Mustafa MB, Yusoff ZM

Multimed Tools Appl, 2023;82(7):11117-11143.
PMID: 36035325 DOI: 10.1007/s11042-022-13698-y

Over the past several years, mobile learning concepts have changed the way people perceived on mobile devices and technology in the learning environment. In earlier days, mobile devices were used mainly for communication purposes. Later, with many new advanced features of mobile devices, they have opened the opportunity for individuals to use them as mediated technology in learning. The traditional way of teaching and learning has shifted into a new learning dimension, where an individual can execute learning and teaching everywhere and anytime. Mobile learning has encouraged lifelong learning, in which everyone can have the opportunity to use mobile learning applications to gain knowledge. However, many of the previous studies on mobile learning have focused on the young and older adults, and less intention on middle-aged adults. In this research, it is targeted for the middle-aged adults which are described as those who are between the ages of 40 to 60. Middle-aged adults typically lead very active lives while at the same time are also very engaged in self-development programs aimed at enhancing their spiritual, emotional, and physical well-being. In this paper, we investigate the methodology used by researchers based on the research context namely, acceptance, adoption, effectiveness, impact, intention of use, readiness, and usability of mobile learning. The research context was coded to the identified methodologies found in the literature. This will help one to understand how mobile learning can be effectively implemented for middle-aged adults in future work. A systematic review was performed using EBSCO Discovery Service, Science Direct, Google Scholar, Scopus, IEEE and ACM databases to identify articles related to mobile learning adoption. A total of 65 journal articles were selected from the years 2016 to 2021 based on Kitchenham systematic review methodology. The result shows there is a need to strengthen research in the field of mobile learning with middle-aged adults.
Fulltext The usability evaluation on mobile learning apps with gamification for middle-aged women

Mohtar S, Jomhari N, Omar NA, Mustafa MBP, Yusoff ZM

Educ Inf Technol (Dordr), 2023;28(1):1189-1210.
PMID: 35912038 DOI: 10.1007/s10639-022-11232-z

Mobile learning and gamification are becoming increasingly popular, especially in education. Numerous researches suggest that mobile learning apps with gamification can improve student learning. However, there are fewer studies that analyze the gamification effects and usability of mobile apps for middle-aged women. The aim of this study is to propose a new mobile learning app with gamification aspects for the use of middle-aged women in memorizing Arabic words. In the preliminary study, pre and post-tests were conducted to determine the effect of the use of the gamification application on 61 middle-aged women using Kahoot! game. The results from the Kahoot! game shows that participants enjoy learning and can memorize Arabic words effectively, indicating that gamification can motivate learning among middle-aged women. Then the usability of a new mobile app prototype containing learning notes and quizzes for user self-learning purposes was evaluated using three (3) criteria namely effectiveness, efficiency, and satisfaction. The considered indicators to measure the application's effectiveness are (a) tapping behaviour (number of taps used to perform a specific task), (b) number of attempts (how many times users tried to complete the task successfully), and (c) quiz score (score obtained by user after self-learning using the mobile app). Two variables were used to measure the efficiency of the application: the duration of task completion and the number of requests for help. In order to evaluate the satisfaction, a questionnaire was used to determine how respondents rated the mobile app's usability. The usability evaluation results show that the proposed mobile app was effective as users could utilize all the modules provided and successfully answer the quiz questions.
Extraction and characterization of lignin from oil palm biomass via ionic liquid dissolution and non-toxic aluminium potassium sulfate dodecahydrate precipitation processes

Mohtar SS, Tengku Malim Busu TN, Md Noor AM, Shaari N, Yusoff NA, Bustam Khalil MA, et al.

Bioresour Technol, 2015 Sep;192:212-8.
PMID: 26038325 DOI: 10.1016/j.biortech.2015.05.029

The objective of this study is to extract and characterize lignin from oil palm biomass (OPB) by dissolution in 1-butyl-3-methylimidazolium chloride ([bmim][Cl]), followed by the lignin extraction through the CO2 gas purging prior to addition of aluminum potassium sulfate dodecahydrate (AlK(SO4)2 · 12H2O). The lignin yield, Y(L) (%wt.) was found to be dependent of the types of OPB observed for all precipitation methods used. The lignin recovery, RL (%wt.) obtained from CO2-AlK(SO4)2 · 12H2O precipitation was, however dependent on the types of OPB, which contradicted to that of the acidified H2SO4 and HCl solutions of pH 0.7 and 2 precipitations. Only about 54% of lignin was recovered from the OPB. The FTIR results indicate that the monodispersed lignin was successfully extracted from the OPT, OPF and OPEFB having a molecular weight (MW) of 1331, 1263 and 1473 g/mol, and degradation temperature of 215, 207.5 and 272 °C, respectively.