Search results for: global surgery

Authors: Uchenna Patricia Ekwugha, Cornelius Aghadiegwu Ukwueze

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Global communication has changed life at the international scene affecting on the whole social, cultural and political life of individuals in a global community. It has brought about a changing trend in the field of communication and allowed people to learn, create and process information through mainline media and new media technologies. The paper debates that music is an integral form of global communication that cannot be overlooked because it is a beautiful and powerful tool in relating information to the people which they gladly imbibe. It is worrisome that through global communication there has been consistent clash of values on information’s disseminated to the global community of which the developing countries like Nigerians are the sufferers. Particularly involved in this vicious social dogma are the Nigerian youths, who learn defiant behaviour through global communication and lose touch of African cultural values.

Keywords: global communication, trends, impact, unbalanced information

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

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This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: electrocardiography, monitoring, surgery, wireless system

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Authors: Farhad Fakoursevom

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Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

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Authors: Luksanaporn Krungkraipetch

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Currently, surgery is the only known effective treatment for pterygium. In certain groups, the probability of recurrence after basic sclera excision is very significant. Tissue grafting is substantially more time-consuming and challenging than keeping the sclera uncovered, but it reduces the chance of recurrence. Conjunctival autograft surgery is older than amniotic membrane graft surgery. The purpose of this study was to compare pterygium surgery with conjunctival autograft against an amniotic membrane transplant. In the study, a randomized controlled trial was used. Four cases were ruled out (two for failing to meet inclusion criteria and the other for refusing to participate). Group I (n = 40) received the intervention, whereas Group II (n = 40) served as the control. Both descriptive and inferential statistical approaches were used, including data analysis and data analysis statistics. The descriptive statistics analysis covered basic pterygium surgery information as well as the risk of recurrent pterygium. As an inferential statistic, the chi-square was used. A p-value of 0.05 is statistically significant. The findings of this investigation were the majority of patients in Group I were female (70.0%), aged 41–60 years, had no underlying disease (95.0%), and had nasal pterygium (97.5%). The majority of Group II patients were female (60.0%), aged 41–60 years, had no underlying disease (97.5%) and had nasal pterygium (97.5%). Group I had no recurrence of pterygium after surgery, but Group II had a 7.5% recurrence rate. Typically, the recurrence time is twelve months. The majority of pterygium recurrences occur in females (83.3%), between the ages of 41 and 60 (66.7%), with no underlying disease. The recurrence period is typically six months (60%) and a nasal pterygium site (83.3%). Pterygium recurrence after surgery is associated with nasal location (p =.002). 16.7% of pterygium surgeries result in complications; one woman with nasal pterygium underwent autograft surgery six months later. The presence of granulation tissue at the surgical site is a mild complication. A pterygium surgery recurrence rate comparison of conjunctival autograft and amniotic membrane transplantation revealed that conjunctival autograft had a higher recurrence rate than amniotic membrane transplantation (p =.013).

Keywords: pterygium, pterygium surgery, conjunctival autograft, amniotic membrane transplantation

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Authors: Wen-Yu Chen, Chia-Yuan Hsu, Sasinee Vongsrikul

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The present study is to explore the perception of Taiwanese females towards medical tourism in Thailand for the development of applicable marketing strategy, integrating travel motivation and cosmetic surgery trend to attract potential medical tourists from Taiwan. Since previous studies relevant to this research issue are limited, qualitative study is firstly employed by using one focus group interview and in-depth interviews with Taiwanese females. Moreover, the present research collected questionnaires from 290 Taiwanese females to provide greater understanding of research results. The top three factors that affect Taiwanese females’ decision for not going to Thailand for medical tourism are “physicians and nurses cannot speak Chinese”, “low quality of the cosmetic surgery product that I want to do”, and “the county does not have laws to protect medical tourists’ right”. The finding of the empirical part would suggest the area in medical tourism industry which Thailand should promote and emphasizes in order to increase its presence as a hub for cosmetic surgery and attract Taiwanese female market. Therefore, the study contributes to the potential development of marketing strategy for medical tourism, specifically in the area of cosmetic surgery in Thailand while targeting Taiwan market.

Keywords: Thailand, Taiwanese female tourists, medical tourism, cosmetic surgery

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Authors: Bruno Di Pace, Roxanne H. Padley

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Aims: The recent increase in remote video interaction has increased the number of requests for teleconsultations with plastic surgeons in private practice (70% in the UK and 64% in the USA). This study investigated the motivations for such an increase and the underlying psychological impact on patients. Method: An anonymous web-based poll of 8 questions was designed and distributed to patients seeking cosmetic surgery through social networks in both Italy and the UK. The questions gathered responses regarding 1. Reasons for pursuing cosmetic surgery; 2. The effects of delays caused by the SARS-COV-2 pandemic; 3. The effects on mood; 4. The influence of video conferencing on body-image perception. Results: 85 respondents completed the online poll. Overall, 68% of respondents stated that seeing themselves more frequently online had influenced their decision to seek cosmetic surgery. The types of surgeries indicated were predominantly to the upper body and face (82%). Delays and access to surgeons during the pandemic were perceived as negatively impacting patients' moods (95%). Body-image perception and self-esteem were lower than in the pre-pandemic, particularly during lockdown (72%). Patients were more inclined to undergo cosmetic surgery during the pandemic, both due to the wish to improve their “lockdown face” for video conferencing (77%) and also due to the benefits of home recovery while in smart working (58%). Conclusions: Overall, findings suggest that video conferencing has led to a significant increase in requests for cosmetic surgery and the so-called “Zoom Boom” effect.

Keywords: cosmetic surgery, remote communication, telehealth, zoom boom

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Authors: Loveneet Kaur

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Introduction: Osteoarthritis (OA) is one of the leading causes of disability, and the knee is the most commonly affected joint in the body. The last resort for treatment of knee OA is Total Knee Replacement (TKR) surgery. Despite numerous advances in prosthetic design, patients do not reach normal function after surgery. Current surgical decisions are made on 2D radiographs and patient interviews. Aims: The aim of this study was to compare knee kinematics pre and post-TKR surgery using computer-animated images of patient-specific models under everyday conditions. Methods: 7 subjects were recruited for the study. Subjects underwent 3D gait analysis during 4 everyday activities and medical imaging of the knee joint pre- and one-month post-surgery. A 3D model was created from each of the scans, and the kinematic gait analysis data was used to animate the images. Results: Improvements were seen in a range of motion in all 4 activities 1-year post-surgery. The preoperative 3D images provide detailed information on the anatomy of the osteoarthritic knee. The postoperative images demonstrate potential future problems associated with the implant. Although not accurate enough to be of clinical use, the animated data can provide valuable insight into what conditions cause damage to both the osteoarthritic and prosthetic knee joints. As the animated data does not require specialist training to view, the images can be utilized across the fields of health professionals and manufacturing in the assessment and treatment of patients pre and post-knee replacement surgery. Future improvements in the collection and processing of data may yield clinically useful data. Conclusion: Although not yet of clinical use, the potential application of 3D animations of the knee joint pre and post-surgery is widespread.

Keywords: Orthoporosis, Ortharthritis, knee replacement, TKR

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Authors: Lubomir Vecera, Tomas Gabrhelik, Benjamin Tolmaci, Josef Srovnal, Emil Berta, Petr Prasil, Petr Stourac

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Cancer is the second leading cause of death worldwide and colon cancer is the second most common type of cancer. Currently, there are only a few studies evaluating the effect of postoperative analgesia on the prognosis of patients undergoing radical colon cancer surgery. Postoperative analgesia in patients undergoing colon cancer surgery is usually managed in two ways, either with strong opioids (morphine, piritramide) or epidural analgesia. In our prospective study, we evaluated the effect of postoperative analgesia on the presence of circulating tumor cells or minimal residual disease after colon cancer surgery. A total of 60 patients who underwent radical colon cancer surgery were enrolled in this prospective, randomized, two-center study. Patients were randomized into three groups, namely piritramide, morphine and postoperative epidural analgesia. We evaluated the presence of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20) mRNA positive circulating tumor cells in peripheral blood before surgery, immediately after surgery, on postoperative day two and one month after surgery. The presence of circulating tumor cells was assessed by quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR). In the priritramide postoperative analgesia group, the presence of CEA mRNA positive cells was significantly lower on a postoperative day two compared to the other groups (p=0.04). The value of CK-20 mRNA positive cells was the same in all groups on all days. In all groups, both types of circulating tumor cells returned to normal levels one month after surgery. Demographic and baseline clinical characteristics were similar in all groups. Compared with morphine and epidural analgesia, piritramide significantly reduces the amount of CEA mRNA positive circulating tumor cells after radical colon cancer surgery.

Keywords: cancer progression, colon cancer, minimal residual disease, perioperative analgesia.

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Ruth Gerritsen-McKane, Mimi Sodhi, Lisa Gray, Donette Considine, Henry Kronner, Tameca Harris-Jackson

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During these extraordinary times amid a global pandemic, political/civil unrest, and natural disasters, the need for appropriately trained professional social workers has never been stronger. Needs do not diminish but are heightened during such remarkable times. All too often, “developed” countries see the crisis in developing countries as uniquely theirs; 2020 has shown, there are no “others”; there is only us. Consequently, engaging in meaningful collaboration worldwide is essential! This presentation speaks to the fundamentals of global collaboration and, more importantly, how an in these trying times, the development of strong international partnerships can create opportunities for social work students across the planet to engage in meaningful field education opportunities. Accomplished by multiple modalities, a deeper understanding and response to social work students becoming formidable global citizens can be achieved.

Keywords: global citizens, global crisis, global collaboration, modalities

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Authors: Abdullah Kattan, Khalid Alzahrani, Saud Alsaleh, Loui Ezzat, Khalid Murad, Bader Alghamdi

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Background and Significance: Patients are often bothered by the excess skin laxity and redundancy that they are left with after losing weight. Body-contouring surgery offers a solution to this problem; however, there is scarce literature on the psychological and social effects of these surgeries. This study was conducted to assess the psychosocial impact of body-contouring surgery on patients after weight loss. Methodology: In this cross-sectional study, a specifically designed questionnaire was administered to forty three patients whom have undergone body-contouring surgery. All included patients had lost no less than 20 Kg before body-contouring surgery, and were interviewed at least 6 months after surgery. The twenty-question interviewer based questionnaire was used to assess the psychosocial status of the patients before and after undergoing body-contouring surgery. The questionnaire assessed the quality of life (social life, job performance and sexual activity), presence of symptoms of depression and overall satisfaction. Data was analyzed as paired variables in SPSS using McNemar’s test. Results: Among the 43 participants, 19 (44.2%) have undergone mammoplasty, 12 (27.9%) have undergone abdominoplasty and the remainder of the patients have undergone other various procedures including brachioplasty, thigh lifts and nick liposuction. The mean age of patients was 34 +/- 10, the sample included 24 (55.8%) females and 19 (44.2%) males. The patients’ quality of life significantly improved in the following areas; social life (P<0.001), job performance (P<0.002) and sexual activity (P<0.001). Moreover, 17 (39.5%) patients suffered symptoms of depression before body-contouring surgery; however, only 1 (2.3%) patient suffered symptoms of depression after surgery. Overall satisfaction rate was found to be 62.8%; with mammoplasty being the highest satisfaction rate procedure (66.6 %). Conclusion: Body-contouring surgery after weight loss has shown to improve the psychological and social aspects in patients. These findings have been found to be consistent with the majority of relevant published studies, further increasing reliability of our study.

Keywords: abdominoplasty, body-contouring, mammoplasty, psychosocial

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Authors: David Lindström

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We evaluate the performance of a numerical method for global optimization of expensive functions. The method is using a response surface to guide the search for the global optimum. This metamodel could be based on radial basis functions, kriging, or a combination of different models. We discuss how to set the cycling parameters of the optimization method to get a balance between local and global search. We also discuss the eventual problem with Runge oscillations in the response surface.

Keywords: expensive function, infill sampling criterion, kriging, global optimization, response surface, Runge phenomenon

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Authors: Piyaphan Changwatchai

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Global value chain is important for current world economy through foreign direct investment. Multinational enterprises' efficient location seeking for each stage of production lead to global production network and more global value chain participation of several countries. Global value chain participation has several effects on participating countries in several aspects including the environment. The effect of global value chain participation on the environment is ambiguous. As a result, this research aims to study the effect of global value chain participation on countries' CO₂ emission and methane emission by using quantitative analysis with secondary panel data of sixty countries. The analysis is divided into two types of global value chain participation, which are forward global value chain participation and backward global value chain participation. The results show that, for forward global value chain participation, GDP per capita affects two types of pollutants in downward bell curve shape. Forward global value chain participation negatively affects CO₂ emission and methane emission. As for backward global value chain participation, GDP per capita affects two types of pollutants in downward bell curve shape. Backward global value chain participation negatively affects methane emission only. However, when considering Asian countries, forward global value chain participation positively affects CO₂ emission. The recommendations of this research are that countries participating in global value chain should promote production with effective environmental management in each stage of value chain. The examples of policies are providing incentives to private sectors, including domestic producers and MNEs, for green production technology and efficient environment management and engaging in international agreements in terms of green production. Furthermore, government should regulate each stage of production in value chain toward green production, especially for Asia countries.

Keywords: CO₂ emission, environment, global value chain participation, methane emission

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Authors: Clovis Ultramari, Lidia Floriani, Debora Cicioli

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This paper is a preliminary discussion on the constituency of contemporary global urban scenarios. It is based on secondary sources, mostly from the topics mostly currently discussed by global studies institutes, academic material on the possible components of this phenomenon, and a list of possible scenarios preliminarily proposed by these authors. It also discusses one of these possible scenarios (urban insurgencies) through the lens of a global perspective. Main objective of the research presented in this paper is to produce insights for international aid and development agencies as well as to respond to an increasing interest in the urban studies field in discussing global topics. This paper also results from discussions held in seminars offered by the authors in the graduate program of Urban Management along 2021 and 2022. It is part of a research project that puts together an international team of researches, mostly from the Global South. Results so far obtained refer to conceptual aspects for the determination of global urban scenarios and the presentation of urban insurgencies as worldwide trending urban phenomenon. Presentation in the seminar is part of an ongoing discussion.

Keywords: urban global scenarios, contemporary cities, global south, urban insurgencies

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Authors: Luksanaporn Krungkraipetch

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Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Nike Jacobs, Elizelle Juanee Cilliers

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In recent decades there has been an increasing strive towards broader sustainable planning practices. A wide range of literature suggests that nature-based solutions (including Green Infrastructure planning) may lead towards socio-economically and environmentally sustainable urban communities. Such research is however mainly based on practices from the Global North with very little reference to the Global South. This study argues that there is a need for Global North knowledge to be translated to Global South context, and interpreted within this unique environment, acknowledging historical and cultural differences between Global North and Global South, and ultimately providing unique solutions for the unique urban reality. This research primarily focuses on nature-based solutions for sustainable urban communities and considers a broad literature review on Global North knowledge regarding such, substantiated by an analysis of purposefully selected case studies. The investigation identifies best practices which could be translated and place such in the context of current Global South perspectives.

Keywords: global south, green infrastructure planning, nature-based solutions, sustainable urbanism, urban sustainability

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Authors: Hendra Wibowo, Suprayitno Wardoyo, Dhama Shinta

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Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB.

Keywords: pediatric, pulmonary, surgery, therapy, tuberculosis

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Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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Authors: Assia Haif, Djelloul Achouri, Zineddine Soualili

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Introduction: Laparoscopic treatment of liver echinococcosis cyst has become popular. In parallel, the diagnostic approach of cystic liver lesions is based on the number of lesions and their distribution. The etiologies of cystic masses in children are different, and the role of imaging in their characterization and pre-therapeutic evaluation is essential. The main differential diagnoses of hepatic hydatid cysts can be discovered intraoperatively by minimally invasive surgery. Methods: The clinical data contained seven patients with hepatic cystic who underwent laparoscopic surgery in the Department of Pediatric Surgery, SETIF, Algeria, from 2015 to 2022. Results: Of reported seven patients, five are male, and the remaining two are female. Abdominal pain was the most frequent clinical signs. Biological parameters were within normal limits, Abdominal ultrasound, practiced in all cases, completed by abdominal computed tomography (CT), showed a hydatid cystic. For all patients, surgical procedures were performed under laparoscopy. Total cystectomy in four patients, fenestration or subtotal cystectomy in three patients, respectively. A histopathological feature confirmed the nature of the cysts. During the follow-up period, there was no recurrence. Conclusions: Laparoscopic liver surgery is a safe and effective approach, it is an alternative to conventional surgery and a reproducible method. Laparoscopic surgery approach should follow the same principals with those of open surgery. This surgical technique can rectify the diagnosis of hydatid cyst, the histopathological examination confirms the nature of the cystic lesion.

Keywords: children, cyst, echinococcosis, laparoscopic, liver

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Authors: Arvind Aggarwal

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We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

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Authors: Meghana Pandit, Abhishek Chakraborty

Abstract:

There are a multitude of factors that influence the clinical success of bariatric surgery. This study seeks to determine the efficacy of preoperative weight management education. The Food and Fitness Program at Mount Sinai serves to educate patients on topics such as stress management, sleep habits, body image, nutrition, and exercise 5-6 months before their surgeries to slowly decrease their weight. Each month, patients are weighed, and a different topic is presented. To evaluate the longitudinal effects of these lectures, patient’s weights are evaluated at the first appointment, before an informative lecture is presented. Weights are then reevaluated at the last appointment before the surgery. The weights were statistically analyzed using a paired t-test and the results demonstrated a statistically significant difference (p < .0001, n=55). Thus, it is reasonable to conclude that the education paradigm employed successfully empowered patients to maintain and reduce their gross BMI before clinical intervention.

Keywords: bariatric, surgery, weight, education

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Authors: Nonso Ochinanwata, Patrick Oseloka Ezepue

Abstract:

This paper explores the process of creating and capturing born-global firm opportunities. It reviews the key constructs that underpin the establishment of born-global firms in sub-Saharan Africa. These include entrepreneurial orientation, resources and capabilities, collaboration, and contextual influences. The paper discusses how individuals and entrepreneurs in sub-Saharan Africa can establish home-based born-global firms that seek early international markets from inception. The paper suggests that sub-Saharan African governments should make a favourable microeconomics policy that will enable entrepreneurs and firms to acquire some certain minimal resources and capabilities, in order to develop global products and services.

Keywords: born global-firms, collaboration, internationalisation, dynamic capabilities, entrepreneurship, sub-Saharan Africa

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Authors: Wenhao Wang, Xinzhi Xu, Limin Feng, Wei Cong

Abstract:

This paper comprehensively investigates current development status of global power grids and fossil energy pipelines (oil and natural gas), proposes a standard visual platform of global power and fossil energy based on Geographic Information System (GIS) technology. In this visual platform, a series of systematic visual models is proposed with global spatial data, systematic energy and power parameters. Under this visual platform, the current Global Power Grids Map and Global Fossil Energy Pipelines Map are plotted within more than 140 countries and regions across the world. Using the multi-scale fusion data processing and modeling methods, the world’s global fossil energy pipelines and power grids information system basic database is established, which provides important data supporting global fossil energy and electricity research. Finally, through the systematic and comparative study of global fossil energy pipelines and global power grids, the general status of global fossil energy and electricity development are reviewed, and energy transition in key areas are evaluated and analyzed. Through the comparison analysis of fossil energy and clean energy, the direction of relevant research is pointed out for clean development and energy transition.

Keywords: energy transition, geographic information system, fossil energy, power systems

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Authors: Saba Ebrahimi, Saeed Ahmadian, Hedie Ashrafi

Abstract:

Selecting appropriate patients for surgery is one of the main issues in thoracic surgery (TS). Both short-term and long-term risks and benefits of surgery must be considered in the patient selection criteria. There are some limitations in the existing datasets of TS patients because of missing values of attributes and imbalanced distribution of survival classes. In this study, a novel ensemble architecture of deep learning networks is proposed based on stacking different linear and non-linear layers to deal with imbalance datasets. The categorical and numerical features are split using different layers with ability to shrink the unnecessary features. Then, after extracting the insight from the raw features, a novel biased-kernel layer is applied to reinforce the gradient of the minority class and cause the network to be trained better comparing the current methods. Finally, the performance and advantages of our proposed model over the existing models are examined for predicting patient survival after thoracic surgery using a real-life clinical data for lung cancer patients.

Keywords: deep learning, ensemble models, imbalanced classification, lung cancer, TS patient selection

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Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

Abstract:

Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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Authors: Christine Li, Amanda Robertson

Abstract:

Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. They are a rare cause of an umbilical mass, with very few cases previously reported following abdominal surgery. These lesions can present with a range of symptoms, including palpable mass, pain, redness, or discharge. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a six-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. Abdominal computed tomography (CT) scans revealed non-specific soft tissue thickening in the umbilical region. This was successfully treated with complete excision of the lesion. Umbilical lumps are a common presentation but can represent a diagnostic challenge. The differential diagnosis should include an epidermal inclusion cyst, particularly in a patient who has had previous abdominal surgery, including laparoscopic surgery.

Keywords: epidermal inclusion cyst, laparoscopy, umbilical mass, umbilicus

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Authors: Ege Can Onal, Enver Ersen, Meltem Elitas

Abstract:

Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.

Keywords: laparoscope, laparoscopy, low-cost, minimally invasive surgery, robotic-assisted surgery

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Authors: Ayeshmanthe Rathnayake, Ashutosh Hardikar

Abstract:

Introduction: Lung cancer is the most common cause of cancer death in Australia, with more than 13000 cases per year. Until now, there has been a major deficiency of national comprehensive thoracic surgery data. The thoracic workload for surgeons as well as caseload per unit, is highly variable, with some centres performing less than 15 cases per annum, thus raising concerns about optimal care at low-volume sites. This is an attempt to review the outcomes of lung cancer surgery in Tasmania. Method: The objective of this study is to determine the surgical outcomes of lung cancer surgery at Royal Hobart Hospital (RHH) with the primary outcome of surgical mortality. Four hundred fifty-one cases were analysed retrospectively from 2010 to May 2022. Results: A total of 451 patients underwent thoracic surgery with a primary diagnosis of lung cancer. The primary outcome of 30-day mortality was <0.5%. The mean age was 65.3 years, with male predominance and a 4.2% prevalence of Indigenous Australians. The mean LOS was 7.5 days. The surgical approach was either VATS (50.3%) or Thoracotomy (49.7%), with a trend towards the former in recent years with an increase in the proportion of VATS from 18.2% to 51% (p<0.05) in complex resections since 2019. A corresponding reduction in conversion rate to open was observed (18% vs. 5.5%), and there were no deaths within this subgroup. Lung resections were divided into lobectomy (55.4%), wedge resection (36.8%), segmentectomy (2.9%) and pneumonectomy (4.9%). The RHH demonstrates good surgical outcomes for lung cancer and provides a sustainable service for Tasmania. Conclusion: This retrospective study reports the surgical outcomes of lung cancer surgery at the Royal Hobart Hospital, thereby providing insight into the surgical management of lung cancer in the state thus far. The state has been slow to catch up on the minimally invasive program, but the overall results have been comparable to most peers.

Keywords: lung cancer, thoracic surgery, lung resection, surgical outcomes

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Authors: Erik Jon Byker

Abstract:

Government leaders and education policymakers have increasingly focused on ways that teachers can better prepare children for life in a global society. Such preparation includes the development of global citizenship among young people. Yet, scholars point out that many elementary school educators and teacher candidates have limited awareness of being global citizens in an interdependent world. More and more teacher preparation programs aim to integrate global citizenship in their program plans and use educational technology to help develop global citizenship. Many non-governmental organizations (NGOs), like the Asia Society and Partnership for 21st Century Skills, have led the way in creating global citizenship frameworks that prepare teachers and students with global competencies. The development of global citizenship among teachers needs to begin even before teachers sign their first contract. Global citizenship development should start when teacher candidates are being prepared to teach. Using the Critical Cosmopolitan Theory as a conceptual lens, this paper examines the integration of global citizenship curricula in teacher education programs in North Carolina and Texas in the United States of America. Using a case study methodology, the paper describes and compares the teacher candidates’ (n=136) perceptions of the global citizenship curricula delivered with the aid of educational technology. The study found that after participating in the global citizenship curricula, participants: (1) made conceptual leaps in their global citizenship definitions; (2) developed a stronger commitment for their future role as educators in developing global citizens; and (3) were more willing to take action for social justice-related issues in education. In sum, this paper discusses empirical findings related to the ways to integrate educational technology in preparing globally competent teachers.

Keywords: educational technology, global education, intercultural awareness, teacher candidates

Procedia PDF Downloads 180