Search results for: post operative

Authors: Raf E. Ul Shougat, Ezazul Haque Sabuz, G. M. Najmul Quader, Monon Mahboob

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Since there are lots of ways for building and post processing of parts or models in 3D printing technology, the main objective of this research is to provide an understanding how mechanical characteristics of 3D printed parts get changed for different building orientations and infiltrates. Tensile, compressive, flexure, and hardness test were performed for the analysis of mechanical properties of those models. Specimens were designed in CAD software, printed on Z-printer 450 with five different build orientations and post processed with four different infiltrates. Results show that with the change of infiltrates or orientations each of the above mechanical property changes and for each infiltrate the highest tensile strength, flexural strength, and hardness are found for such orientation where there is the lowest number of layers while printing.

Keywords: 3D printing, building orientations, infiltrates, mechanical characteristics, number of layers

Procedia PDF Downloads 260

Authors: Neerja Gupta

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Objective-Reconstruction of large cavities of the breast without contralateral symmetrisation Background- Reconstruction of breast includes a wide spectrum of procedures from displacement to regional and distant flaps. The pedicled Perforator flaps cover a wide spectrum of reconstruction surgery for all quadrants of the breast, especially in patients with comorbidities. These axial flaps singly or adjunct are based on a near constant perforator vessel, a ratio of 2:1 at its entry in a flap is good to maintain vascularity. The perforators of lateral chest wall viz LICAP, LTAP have overlapping perfurosomes without clear demarcation. LTAP is localized in the narrow zone between the lateral breast fold and anterior axillary line,2.5-3.8cm from the fold. MICAP are localized at 1-2 cm from sternum. Being 1-2mm in diameter, a Single perforator is good to maintain the flap. LICAP has a dominant perforator in 6th-11th spaces, while LTAP has higher placed dominant perforators in 4th and 5th spaces. Methodology-Six consecutive patients who underwent reconstruction of the breast with pedicled perforator flaps were retrospectively analysed. Selections of the flap was done based on the size and locations of the tumour, anticipated volume loss, willingness to undergo contralateral symmetrisation, cosmetic expectations, and finances available.3 patients underwent vertical LTAP, the distal limit of the flap being the inframammary crease. 3 patients underwent MICAP, oriented along the axis of rib, the distal limit being the anterior axillary line. Preoperative identification was done using a unidirectional hand held doppler. The flap was raised caudal to cranial, the pivot point of rotation being the vessel entry into the skin. The donor area is determined by the skin pinch. Flap harvest time was 20-25 minutes. Intra operative vascularity was assessed with dermal bleed. The patient immediate pre, post-operative and follow up pics were compared independently by two breast surgeons. Patients were given a breast Q questionnaire (licensed) for scoring. Results-The median age of six patients was 46. Each patient had a hospital stay of 24 hours. None of the patients was willing for contralateral symmetrisation. The specimen dimensions were from 8x6.8x4 cm to 19x16x9 cm. The breast volume reconstructed range was 30 percent to 45 percent. All wide excision had free margins on frozen. The mean flap dimensions were 12x5x4.5 cm. One LTAP underwent marginal necrosis and delayed wound healing due to seroma. Three patients were phyllodes, of which one was borderline, and 2 were benign on final histopathology. All other 3 patients were invasive ductal cancer and have completed their radiation. The median follow up is 7 months the satisfaction scores at median follow of 7 months are 90 for physical wellbeing and 85 for surgical results. Surgeons scored fair to good in Harvard score. Conclusion- Pedicled perforator flaps are a valuable option for 3/8th volume of breast defects. LTAP is preferred for tumours at the Central, upper, and outer quadrants of the breast and MICAP for the inner and lower quadrant. The vascularity of the flap is dependent on the angiosomalterritories; adequate venous and cavity drainage.

Keywords: breast, oncoplasty, pedicled, perforator

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Authors: Hansraj Riteesh Bookun, Emily Maree Stevens, Jarryd Leigh Solomon, Anthony Chan

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Objective: This was a retrospective cross-sectional study evaluating the safety and efficacy of femoral endarterectomy using the eversion technique with transection as opposed to the conventional endarterectomy technique with either vein or synthetic patch arterioplasty. Methods: Between 2010 to mid 2017, 19 patients with mean age of 75.4 years, underwent eversion femoral endarterectomy with transection by a single surgeon. There were 13 males (68.4%), and the comorbid burden was as follows: ischaemic heart disease (53.3%), diabetes (43.8%), stage 4 kidney impairment (13.3%) and current or ex-smoking (73.3%). The indications were claudication (45.5%), rest pain (18.2%) and tissue loss (36.3%). Results: The technical success rate was 100%. One patient required a blood transfusion following bleeding from intraoperative losses. Two patients required blood transfusions from low post operative haemogloblin concentrations – one of them in the context of myelodysplastic syndrome. There were no unexpected returns to theatre. The mean length of stay was 11.5 days with two patients having inpatient stays of 36 and 50 days respectively due to the need for rehabilitation. There was one death unrelated to the operation. Conclusion: The eversion technique with transection is safe and effective with low complication rates and a normally expected length of stay. It poses the advantage of not requiring a synthetic patch. This technique features minimal extraneous dissection as there is no need to harvest vein for a patch. Additionally, future endovascular interventions can be performed by puncturing the native vessel. There is no change to the femoral bifurcation anatomy after this technique. We posit that this is a useful adjunct to the surgeon’s panoply of vascular surgical techniques.

Keywords: endarterectomy, eversion, femoral, vascular

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Authors: Carolyn Whyte, Tina Halai, Sonita Koshal

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Aim: There are many methods available to assess the potential difficulty of third molar surgery. This study investigated various factors to assess whether they had a bearing on the difficulties encountered. Study design: A retrospective study was completed of 62 single mandibular third molar teeth removed under day case general anaesthesia between May 2016 and August 2016 by 3 consultant oral surgeons. Method: Data collection was by examining the OPG radiographs of each tooth and recording the necessary data. This was depth of impaction, angulation, bony impaction, point of application in relation to second molar, root morphology, Pell and Gregory classification and Winters Lines. This was completed by one assessor and verified by another. Information on medical history, anxiety, ethnicity and age were recorded. Case notes and surgical entries were examined for any difficulties encountered. Results: There were 5 cases which encountered surgical difficulties which included fracture of root apices (3) which were left in situ, prolonged bleeding (1) and post-operative numbness >6 months(1). Four of the 5 cases had Pell and Gregory classification as (B) where the occlusal plane of the impacted tooth is between the occlusal plane and the cervical line of the adjacent tooth. 80% of cases had the point of application as either coronal or apical one third (1/3) in relation to the second molar. However, there was variability in all other aspects of assessment in predicting difficulty of removal. Conclusions: Of the cases which encountered difficulties they all had at least one predictor of potential complexity but these varied case by case.

Keywords: impaction, mandibular third molar, radiographic assessment, surgical removal

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Authors: Lemi Tolu

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Background: Postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. Objective: This study assesses the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methodology: An institution-based cross-sectional study was conducted from January 1 to June 30, 2017. The six months of study were used as strata, and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariable logistic regressions were fitted to identify determinants of post-partum family planning uptake. An OR with 95% CIs was calculated, and p values set at 005 were used to determine the statistical significance of associations. Results: Four hundred and twenty-two post-partum women were interviewed. Two hundred sixty-eight (63%) women received counselling on family planning, and 241 (66.8 %) got information about contraception. One hundred and fifty-two (45%) of the women accepted long-term and permanent contraception on their immediate postpartum period before discharge. Contraceptive counselling (OR = 2.13, 95% CI 1.004-3.331), getting information from the health facility (OR = 15.15, 95% CI 1.848-19.242), and partner support (OR = 1.367, 95% CI 1.175-2.771) were significantly associated with long-term and permanent contraception uptake. Conclusion: Postpartum counselling on family planning and provision of contraception information improve immediate postpartum FP acceptance, and, hence postpartum programs need to strengthen such services.

Keywords: contraception, immediate postpartum, long-term family planning, post-partum family planning

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Authors: Vartan Agopian

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Millions of Syrian families have been displaced since the beginning of the Syrian war, and the negative effects of post-war trauma have shown detrimental effects on the mental health of refugee children. While educational strategies have focused on vocational training and academic achievement, little has been done to include music in the school curriculum to help these children improve their mental health. The literature of music education and psychology, on the other hand, shows the positive effects of music on traumatized children, especially when it comes to dealing with stress. This paper presents a brief literature review of trauma, music therapy, and music in the classroom, after having introduced the Syrian war and refugee situation. Furthermore, the paper highlights the benefits of using music with traumatized children from the literature and offers strategies for teachers (such as singing, playing an instrument, songwriting, and others) to include music in their classrooms to help Syrian refugee children deal with post-war trauma.

Keywords: children, music, refugees, Syria, war

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Authors: W. Hajuthman, R. Warner, S. Rahman, M. Abraham, H. Helliwell, D. Bodiwala

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Context: Prostate cancer is a prevalent cancer in males in Europe and the US, with diagnosis primarily relying on PSA testing, mpMRI, and subsequent biopsies. However, this diagnostic strategy may lead to complications for patients. Research Aim: The aim of this study is to assess compliance with trust guidelines for antibiotic prophylaxis in patients undergoing transperineal template biopsies of the prostate and evaluate the rate of post-procedure complications. Methodology: This study is conducted retrospectively over an 8-month period. Data collection includes patient demographics, compliance with trust guidelines, associated risk factors, and post-procedure complications such as infection, haematuria, and urinary retention. Findings: The audit includes 100 patients with a median age of 66.11. The compliance with pre-procedure antibiotics was 98%, while compliance with antibiotic prophylaxis recommended by trust guidelines was 68%. Among the patients, 3% developed post-procedure sepsis, with 2 requiring admission for intravenous antibiotics. No evident risk factors were identified in these cases. Additionally, post-procedure urinary retention occurred in 3% of patients and post-procedure haematuria in 2%. Theoretical Importance: This study highlights the increasing use of transperineal template biopsies across UK centres and suggests that having a standardized protocol and compliance with guidelines can reduce confusion, ensure appropriate administration of antibiotics, and mitigate post-procedure complications. Data Collection and Analysis Procedures: Data for this study is collected retrospectively, involving the extraction and analysis of relevant information from patient records over the specified 8-month period. Question Addressed: This study addresses the following research questions: (1) What is the compliance rate with trust guidelines for antibiotic prophylaxis in transperineal template biopsies of the prostate? (2) What is the rate of post-procedure complications, such as infection, haematuria, and urinary retention? Conclusion: Transperineal template biopsies are becoming increasingly prevalent in the UK. Implementing a standardized protocol and ensuring compliance with guidelines can reduce confusion, ensure proper administration of antibiotics, and potentially minimize post-procedure complications. Additionally, considering that studies show no difference in outcomes when prophylactic antibiotics are not used, the reminder to follow trust guidelines may prompt a re-evaluation of antibiotic prescribing practices.

Keywords: prostate, transperineal template biopsies of prostate, antibiotics, complications, microbiology, guidelines

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Authors: Didem Venus Yildiz, Murat Hocaoglu, Murat Dursun, Taner Akkan

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The shoulder joint is a more complex structure than the hip or knee joints. In addition to the overall complexity of the shoulder joint, two different factors influence the insufficient outcome of shoulder replacement: the shoulder prosthesis design is far from fully developed and it is difficult to place these shoulder prosthesis due to shoulder anatomy. The glenohumeral joint is the most complex joint of the human shoulder. There are various treatments for shoulder failures such as total shoulder arthroplasty, reverse total shoulder arthroplasty. Due to its reverse design than normal shoulder anatomy, reverse total shoulder arthroplasty has different physiological and biomechanical properties. Post-operative achievement of this arthroplasty is depend on improved design of reverse total shoulder prosthesis. Designation achievement can be increased by several biomechanical and computational analysis. In this study, data of human both shoulders with right side fracture was collected by 3D Computer Tomography (CT) machine in dicom format. This data transferred to 3D medical image processing software (Mimics Materilise, Leuven, Belgium) to reconstruct patient’s left and right shoulders’ bones geometry. Provided 3D geometry model of the fractured shoulder was used to constitute of reverse total shoulder prosthesis by 3-matic software. Finite element (FE) analysis was conducted for comparison of intact shoulder and prosthetic shoulder in terms of stress distribution and displacements. Body weight physiological reaction force of 800 N loads was applied. Resultant values of FE analysis was compared for both shoulders. The analysis of the performance of the reverse shoulder prosthesis could enhance the knowledge of the prosthetic design.

Keywords: reverse shoulder prosthesis, biomechanics, finite element analysis, 3D printing

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Authors: Wesam El Bana

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The current research aimed at designing a training program for improving specific muscular strength through using the especial strength and identifying its effects on the performance level skills of hockey players. The researcher used the quasi-experimental approach (two – group design) with pre- and post-measurements. Sample: (n= 35) was purposefully chosen from sharkia sports club. Five hockey player were excluded due to their non-punctuality. The rest were divided into two equal groups (experimental and control). The researcher concluded the following: The traditional training program had a positive effect on improving the physical variables under investigation as it led to increasing the improvement percentages of the physical variables and the performance level skills of the control group between the pre- and post-measurement. The recommended training program had a positive effect on improving the physical variables under investigation as it led to increasing the improvement percentages of the physical variable and the performance level skills of the experimental group between the pre- and post-measurements. Exercises using the especial strength training had a positive effect on the post-measurement of the experimental group.

Keywords: hockey, especial strength, performance skills

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Authors: Seyed Ebrahim Hosseini, Shahbaz Pervez

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As people go through aging, maintenance and improvement of the quality of life become more important for them. To know the role of smartphone technology and communications applications on quality of life, a sample group of old people living in Dar-Iran was selected for a quasi-experimental study. The participants were registered senior inhabitants from public health centers in Dar, Iran in 2022. The number of participants was 39. Participants were randomly categorized into intervention and control groups. A validated Persian version of the Control, Autonomy, Self-realisation, Pleasure scale (CASP-19) scale questionnaire was provided for them which answers were used for the quality of life assessment. The paired t-test between pre-and post-test (t= -8.45, p<.00), post-and follow-up-test (t= -2.12, p=.01), and pre-test and the follow-up test (t= -8.27, p<.00) in the intervention group revealed a considerable mean difference. Based on the results of paired t-test for the control group, this was not significant between pre-test and post-test (t= 1.26, p=.15), post-test and follow-up test (t= .33, p=.67) and pre-test and follow-up test (t= 1.85, p=.08) for quality of life. Considering the educational training associated with it, this study aimed at helping families and aging field practitioners to understand the essentiality of modern communication technology teaching in promoting a greater life quality of the elderly’s community.

Keywords: Iranian elderly, quality of life, smartphone, social applications, CASP-19

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Authors: Malihe Motiei, Nor Hidayati Zakaria, Davide Aloini

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This study aims to present a method to develop the failure measurement model for ERP post-implementation. To achieve this outcome, the study firstly evaluates the suitability of Technology-Organization-Environment framework for the proposed conceptual model. This study explains how to discover the constructs and subsequently to design and evaluate the constructs as formative or reflective. Constructs are used including reflective and purely formative. Then, the risk dimensions are investigated to determine the instruments to examine the impact of risk on ERP failure after implementation. Two construct as formative constructs consist inadequate implementation and poor organizational decision making. Subsequently six construct as reflective construct include technical risks, operational risks, managerial risks, top management risks, lack of external risks, and user’s inefficiency risks. A survey was conducted among Iranian industries to collect data. 69 data were collected from manufacturing sectors and the data were analyzed by Smart PLS software. The results indicated that all measurements included 39 critical risk factors were acceptable for the ERP post-implementation failure model.

Keywords: critical risk factors (CRFs), ERP projects, ERP post-implementation, measurement instruments, ERP system failure measurement model

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Authors: Gatot Ciptadi, Mudawamah, R. P. Putra, S. Wahjuningsih, A. M. Munazaroh

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The success rate of Artificial Insemination (AI) application, particularly in the field at the farmer level is highly dependent on the quality of the sperms one post thawing. The objective of this research was to determine the effect of freezing method (-1oC/ minute) using Mr. Frosty system with commercial diluents on the post-thawing quality of Boer goat semen. Method use is experimental design with the completely randomized design (CRD) with 4 treatments of commercial diluter percentage (v/v). Freezing semen was cryopreserved in 2 main final temperatures of –45 oC (Freezer) and –196 oC (liquid nitrogen). Result showed that different commercial diluter is influenced on viability motility and abnormalities of Boer semen. Pre-freezing qualities of viability, motilities and abnormalities was 88.67+4.16 %, 66.33 +1.53 % and 4.67+ 0.57 % respectively. Meanwhile, post-thawing qualities is considered as good as standard qualities at least more than 40 % (51.0+6.5%). The percentage of commercial diluents were influenced highly significant (P<0.01).The best diluents ration is 1:4 (v/v) for both final sperms stocked. However freezing sperm conserved in -196 oC is better than –45 oC (i.e. motility 39.3.94 % vs. 51.0 + 6.5 %). It was concluded that Mr. frosty system was considered as the feasible method for freezing semen in the reason for practical purposes.

Keywords: sperm quality, goat, viability, diluteR

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Authors: Davide Forcellini, James Marshal Kelly

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Seismic isolation using multi-layer elastomeric isolators has been used in the United States for more than 20 years. Although isolation bearings normally have a large factor of safety against buckling due to low shear stiffness, this phenomenon has been widely studied. In particular, the linearly elastic theory adopted to study this phenomenon is relatively accurate and adequate for most design purposes. Unfortunately it cannot consider the large deformation response of a bearing when buckling occurs and the unresolved behaviour of the stability of the post-buckled state. The study conducted in this paper may be viewed as a development of the linear theory of multi-layered elastomeric bearing, simply replacing the differential equations by algebraic equations, showing how it is possible to evaluate the post-buckling behaviour and the interactions at large deformations.

Keywords: multi-layer elastomeric isolators, large deformation, compressive load, tensile load, post-buckling behaviour

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Authors: Divnesh Lingam, Devi Rengamani Seenivasagam, Prashant Chand, Caleb Yee, John Chief, Rajeshkannan Ananthanarayanan

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Telecommuting Post-Pandemic: Barriers, Solutions, and Strategies. Amidst the COVID-19 outbreak in 2020, remote work emerged as a vital business continuity measure. This study investigates telecommuting’s modern work model, exploring its benefits and obstacles. Utilizing Interpretive Structural Modelling uncovers barriers hindering telecommuting adoption. A validated set of thirteen barriers is examined through departmental surveys, revealing interrelationships. The resulting model highlights interactions and dependencies, forming a foundational framework. By addressing dominant barriers, a domino effect on subservient barriers is demonstrated. This research fosters further exploration, proposing management strategies for successful telecommuting adoption and reshaping the traditional workspace.

Keywords: barriers, interpretive structural modelling, post-pandemic, telecommuting

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Authors: Mahmoud S. Zaghloul, Mohammed M. Khalaf, Wael N. Thabet, Haidy N. Asham

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Background. Hypertrophic scarring is a difficult problem for burn patients, and scar management is an essential aspect of outpatient burn therapy. Post-burn pathologic scars involve functional and aesthetic limitations that have a dramatic influence on the patient’s quality of life. The aim was to investigate the use of extracorporeal shock wave therapy (ESWT), which targets the fibroblasts in scar tissue, as an effective modality for scar treatment in burn patients. Subjects and methods: forty patients with post-burn scars were assigned randomly into two equal groups; their ages ranged from 20-45 years. The study group received ESWT and traditional physical therapy program (deep friction massage, stretching exercises). The control group received traditional physical therapy program (deep friction massage, stretching exercises). All groups received two sessions per week for six successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure scar thickness using ultrasonography and Vancouver Scar Scale (VSS) was completed before and after treatment. Results: Post-treatment results showed that there was a significant improvement difference in scar thickness in both groups in favor of the study group. Percentage of improvement in scar thickness in the study group was 42.55%, while it was 12.15% in the control group. There was also a significant improvement difference between results obtained using VSS in both groups in favor of the study group. Conclusion: ESWT is effective in management of pathologic post burn scars.

Keywords: extracorporeal shock wave therapy, post-burn scars, ultrasonography, Vancouver scar scale

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Authors: Adele Broodryk, Cindy Pienaar, Martinique Sparks, Ben Coetzee

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Background: Cold water immersion (CWI) is a popular recovery modality utilised. However, discrepancies exist regarding the results over a 48 hour recovery period. Aim: To evaluate the effects of CWI and passive recovery (PAR) on a range of haematological and physical parameters over a 48-hour using a cross-sectional, pre-post-test design. Subjects and Methods: Both the and physical parameters were evaluated at baseline, after a 15-min fitness session, and at 0, 24 and 48 hours post-recovery in 23 male university rugby players. The CWI group sat in a cold water pool (8°C) for 20 min whereas the PAR group remained seated. Results: At 0 hours post-CWI, three (blood lactate (BLa-), Sodium (Na+) and haemoglobin) returned to baseline values, however Vertical Jump Test (VJT) height results decreased whereas after PAR it improved. From 0 to 24 and/or 48 h, four (Partial Oxygen (PO2) VJT-height, plasma glucose, and Na+) significantly increased (p ≤ 0.05) in either and/or both groups. Significant intergroup differences (p ≤ 0.05) were noticed in the physical tests. Conclusions: PAR is superior as an acute modality (0 hours) due to CWI cooling the body down. However, CWI demonstrates advantageous over a 24-hour period in a wide range of haematological variables.

Keywords: cryotherapy, recuperation, haematological, rugby

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Authors: Jennifer Foss, DNP, RN-BC, NEA-BC

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Stress and burnout in the bedside registered nurse have deleterious consequences for registered nurses, patients, and the hospitals that employ them. The objective of this study was to determine whether a sixty-minute mindfulness workshop was effective in reducing perceived levels of stress and decreasing mindfulness in registered nurses working in the acute care setting. Registered nurses at a community hospital in the Northeast part of the country were recruited through e-mail and flyers in breakrooms. Participants completed the Perceived Stress Scale (PSS) and Mindfulness Attention Awareness Scale (MAAS) two weeks prior to taking part in the intervention and two weeks post intervention. Of the twenty-three registered nurses who completed the baseline questionnaires, 91% were female with an average age between 30-39 years. Sixty-five percent of subjects completed the questionnaires two weeks post intervention. Two weeks post intervention, registered nurses reported a decrease in perception of stress (pre and post PSS was .133) and was not significant (t=1.293, df=14, p=.217). Likewise, an increase in mindful attention .325 was reported two-weeks post intervention and indicated a favorable tendency to enter a mindful state. This finding was also not significant (t=-1.990, df=14, p=.066). In this study, nurses reported decreases in perceived stress and increases in mindfulness after attending a sixty-minute mindfulness workshop. Further research is needed to determine the long-term impact of mindfulness-based training on nurses' stress and mindfulness skills. The results of this study add to the body of literature that supports the benefits of mindfulness-based interventions in the healthcare setting.

Keywords: Stress, burnout, nursing, acute care nursing

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Authors: Catalin-Teodor Dogaru, Ana-Maria Dogaru

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Success means different things to different people. For us, project managers, it becomes even harder to find a definition. Many factors have to be included in the evaluation. Moreover, literature is not very helpful, lacking consensus and neutrality. Post-implementation reviews (PIR) can be an efficient tool in evaluating how things worked on a certain project. Despite the visible progress, PIR is not a very detailed subject yet and there is not a common understanding in this matter. This may be the reason that some organizations include it in the projects’ lifecycle and some do not. Through this paper, we point out the reasons why all project managers should pay proper attention to this important step and to the elements, which can be assessed, beside the already famous triple constraints: cost, budget, and time. It is essential to take notice that PIR is not a checklist. It brings the edge in eliminating subjectivity and judging projects based on actual proof. Based on our experience, our success indicator model, presented in this paper, contributes to the success of the project! In the same time, it increases trust among customers who will perceive success more objectively.

Keywords: project, post implementation, review, success, indicators

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Authors: Miho Yamashita

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In recent years, there have been attempts to introduce Machine Translation (MT) into foreign language teaching, especially in writing instructions. This is because the performance of neural machine translation has improved dramatically since 2016, and some university instructors started to introduce MT translations to their students as a "good model" to learn from. However, MT is still not perfect, and there are many incorrect translations. In order to translate the intended text into a foreign language, it is necessary to edit the original manuscript written in the native language (pre-edit) and revise the translated foreign language text (post-edit). The latter is considered especially difficult for users without a high proficiency level of foreign language. Therefore, the author allowed her students to use MT in her writing class in one of the private universities in Japan and investigated 1) how groups of students with different English proficiency levels revised MT translations when translating Japanese manuscripts into English and 2) whether the post-edit process differed when the students revised alone or in pairs. The results showed that in 1), certain non-post-edited grammatical errors were found regardless of their proficiency levels, indicating the need for teacher intervention, and in 2), more appropriate corrections were found in pairs, and their frequent use of a dictionary was also observed. In this presentation, the author will discuss how MT writing instruction can be integrated effectively in an aim to achieve multimodal foreign language education.

Keywords: machine translation, writing instruction, pre-edit, post-edit

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Authors: Pankaj Kumar Jha, Saroj Sapkota, Dil Bahadur Gurung, Raju Kadel, Neena Amatya Gorkhali, Bhola Shankar Shrestha

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The study was conducted to evaluate the seminal attributes, effectiveness of cooling process and post-thawed semen quality of a Nepalese indigenous Khari buck. Thirty-two ejaculates, 16 from each buck were studied for seminal attributes of fresh semen: volume, color, mass activity, motility, viability, sperm concentration, and morphology. The pooled mean values for each seminal attributes were: volume 0.7±0.3 ml; colour 3.1±0.3 (milky white); mass activity 3.8±0.4 (rapid wave motion with formation of eddies at the end of waves to very rapid wave motion with distinct eddies formation); sperm motility 80.9±5.6%; sperm viability 94.6±2.0%; sperm concentration 2597.0±406.8x106/ml; abnormal acrosome, mid-piece and tail 10.7±1.8% and abnormal head 5±1.7%. For freezing semen, further 6 ejaculates from each buck were studied with Tris based egg yolk citrate extender. The pooled mean values of motility and viability of post diluted semen for 90 and 120 minutes each for cooling and glycerol equilibration were 73.8±4.8%, 88.1±2.6% and 69.2±6.0%, 85.0±1.7%, respectively. The pooled mean values of post thaw motility and viability with advancement of preservation time were: 0hour 49.0±4.6%, 81.2±1.9%; 2nd day 41±2.2%, 79±1%; 5th day 41±2.2%, 78.6±0.9% and 10th day 41±2.2%, 78.6±0.9%. We concluded from the above study that the seminal attributes and results of post-thaw semen quality were satisfactory and in accordance with other work in foreign countries, which indicated the feasibility of cryopreserving buck semen. For more validation, research with large number of bucks, different types of diluents and freezing trials by removing seminal plasma followed by pregnancy rate is recommended.

Keywords: cryopreservation, Nepalese indigenous Khari (Hill goat) buck, post-thaw semen quality, seminal attributes

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Fayiz Saifurahman

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Afghanistan's geopolitically and geo-strategically location has remained the attention of Indian policy. On 11 September 2001, the terrorist attacks in the United States and the announcement of the United States, fight for international war against the Taliban in November 2001 provided India a chance to pursue its foreign policy goals of achieving a good position in the region and emerging as an international power. Therefore, post-9/11, India strengthened its efforts to re-establish its power in Afghanistan. The objectives of this study are to study the India-Afghanistan relation in the post 9/11 and to discuss the initial role of India in Afghanistan. The research method was conducted on a qualitative method based on descriptive. The research findings propose that; Indian foreign policy should be analyzed and increase its soft power. Afghanistan has definitely provided a significant occasion for India to increase its power in Afghanistan. In this linkage, Indian determinations have been to intrude all parts in Afghanistan to make them reliant on Indian cooperation.

Keywords: Afghanistan, war, power, policy.

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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: Neal Rupani

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Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.

Keywords: education environment, surgery, post-graduate education, OREEM

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Authors: Ammar Younas

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This paper is an attempt to explore the legal progression in procedural laws related to “intellectual property protection for the autonomous output of artificial intelligence” in Post-Colonial, Post-Communist and Socialist Countries. An in-depth study of legal progression in Pakistan (Common Law), Uzbekistan (Post-Soviet Civil Law) and China (Socialist Law) has been conducted. A holistic attempt has been made to explore that how the ideological context of the legal systems can impact, not only on substantive components but on the procedural components of the formal laws related to IP Protection of autonomous output of Artificial Intelligence. Moreover, we have tried to shed a light on the prospective IP laws and AI Policy in the countries, which are planning to incorporate the concept of “Digital Personality” in their legal systems. This paper will also address the question: “How far IP of autonomous output of AI can be protected with the introduction of “Non-Human Legal Personality” in legislation?” By using the examples of China, Pakistan and Uzbekistan, a case has been built to highlight the legal progression in General Provisions of Civil Law, Artificial Intelligence Policy of the country and Intellectual Property laws. We have used a range of multi-disciplinary concepts and examined them on the bases of three criteria: accuracy of legal/philosophical presumption, applying to the real time situations and testing on rational falsification tests. It has been observed that the procedural laws are designed in a way that they can be seen correlating with the ideological contexts of these countries.

Keywords: intellectual property, artificial intelligence, digital personality, legal progression

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Authors: Rafenomananjara Tsinjo Nirina, Tomoo Sekito, Andrianaivoravelona Jaconnet Oliva

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Manufacturing a composite material from post-consumer bottles is an interesting outlet since Madagascar is still facing the challenges of managing plastic waste on the one hand and appropriate waste treatment facilities are not yet developed on the other hand. New waste management options are needed to divert End-Of-Life (EOL) soft plastic wastes from landfills and incineration. Waste polyethylene terephthalate (PET) bottles might be considered as a valuable resource and recovered into polymer concrete. The methodology is easy to implement and appropriate to the local context in Madagascar. This approach will contribute to the production of ecological building materials that might be profitable for the environment and the construction sector. This work aims to study the feasibility of using the post-consumer PET bottles as an alternative binding agent instead of the conventional Portland cement and water. Then, the mechanical and physical properties of the materials were evaluated.

Keywords: PET recycling, polymer concrete, ecological building materials, pollution mitigation

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Authors: Soheir Weheida, Amal E. Shehata, Samira E. Aboalizm

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The aim of this study was to examine the effect of surgical safety checklist on surgical team’s knowledge and performance in operating room. Subjects: A convenience sample 151 (48 head nurse, 45 nurse, 37 surgeon and 21 anesthesiologist) which available in operating room at two different hospitals was included in the study. Setting: The study was carried out at operating room in Menoufia University and Shebin Elkom Teaching Hospitals, Egypt. Tools: I: Surgical safety: Surgical team knowledge assessment structure interview schedule. II: WHO surgical safety observational Checklist. III: Post Surgery Culture Survey scale. Results: There was statistical significant improvement of knowledge mean score and performance about surgical safety especially in post and follow up than pre intervention, before patients entering the operating, before induction of anesthesia, skin incision and post skin closure and before patient leaves operating room, P values (P < 0.001). Improvement of communication post intervention than pre intervention between surgical team’s (4.74 ± 0.540). About two thirds (73.5 %) of studied sample strongly agreed on surgical safety in operating room. Conclusions: Implementation of surgical safety checklist has a positive effect on improving knowledge, performance and communication between surgical teams and these seems to have a positive effect on improve patient safety in the operating room.

Keywords: knowledge, operating room, performance, surgical safety checklist

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Authors: Saeed Saffar-Heidari

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This article aims to study the recent Iranian national uprising of “Women, Life, Freedom” as a site of memory which renders the political possibility of imagining the post-Islamic futures in Iran. “Women, Life, Freedom” movement in Iran has been arguably the most pervasive social movement since the Islamic Revolution (1979) as it has posed serious issues and conflicts for the present Islamic state in Iran. The core argument of this article, however, is oriented toward the critical role of collective memory as a means of political transition and revolutionary mobilization. “Women, Life, Freedom” movement, among other things, has revitalized the popular binary opposition of pre-1979 and post-1979 Iran through which the Ancien Régime or the pre-1979 era is likely to be interpreted, read, and remembered in terms of present post-1979 cultural and political demands. As remembering involves everyday participation in shaping and reshaping the past through new codes, criteria, and values, it is argued that the presentist refashioning and remembering of the pre-1979 monarchical era has been one of the major facilitatory forces for the on-going revolutionary mobilization in Iran. The construction of the pre-1979 memory and the return of the dynastic specter has played a significant role in revolutionary mobilization as it has provided the protesters with the possible perspectives of post-Islamic regime in Iran. Additionally, the question of compulsory “Hijab” (veiling) as the prime mover of "Women, Life, Freedom” movement in Iran has strongly contributed to the everyday comparative discourse of pre/post 1979 memory. According to this presentist remembering of pre-1979, the Pahlavi dynasty would be conceived as a symbol of modernization, westernization, secularization, and non-compulsory Hijab. While the memory of the pre-revolutionary Iran is genuinely an imaginative as well as a constructed entity that finally culminates in the public condemnation of the very Islamic revolution (1979), it serves the enrichment of the Iranian political imagination as it paves the ways for the revolutionary mobilization and then the overthrowing of the Islamic regime in Iran. This article makes a case for the ways that the public narrative and discourse around the Islamic regime (especially the Islamic Hijab) led to the refashioning of the memory of pre-1979 era and inspired he revolutionary mobilization in Iran.

Keywords: post-islamic, utopias, memory, revolutionary, mobilization, Iran

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Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

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Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

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Authors: Daniel Azizyan, Marina Vardanyan, Astghik Dallakyan

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The objective of this literature review is to bring valuable and much-needed insight into Virtual Reality Exposure Therapy (VRET) for the treatment of Post-Traumatic Stress Disorder (PTSD) among military personnel. As the issues regarding war veterans who suffer from PTSD become more and more widespread, the task of finding possible solutions that would provide alternative approaches to existing methods being used today becomes more relevant than ever. By analyzing the previous applications of VRET, this literature review covers the state of the research done currently on the topic, reviews the known information while identifying the main problems, and aims to use missed opportunities and find potential solutions. It provides the answers to the most relevant questions concerning VRET and leads to important conclusions in the hope of making the technology more practical, widespread, and effective.

Keywords: military PTSD, post-traumatic stress disorder, prolonged exposure, virtual reality exposure therapy, VRE

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