Search results for: post operative

Authors: Asaad Alhabsi, Alyaqdan Algafri

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Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.

Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty

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Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

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Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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Authors: Gurmeet Singh Cheema, Navjotinder Singh, Gurjinder Singh, Amardeep Singh

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Aluminium and its alloys play have excellent corrosion resistant properties, ease of fabrication and high specific strength to weight ratio. In this investigation an attempt has been made to study the effect of different post weld heat treatment methods on the mechanical and metallurgical properties of TIG welded joints of the commercial aluminium alloy. Three different methods of post weld heat treatments are, solution heat treatment, artificial aged and combination of solution heat treatment and artificial aging are given to TIG welded aluminium joints. Mechanical and metallurgical properties of as welded and post weld treated joints of the aluminium alloys was examined.

Keywords: aluminium alloys, TIG welding, post weld heat treatment

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Authors: Eghosa Morgan, Bourtarbouch Mahjouba, Heida El Ouahabi, Poluyi Edward, Diawarra Seylan

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Non-AIDS lymphoma, a type of primary central nervous system (CNS) lymphoma is an uncommon aggressive infiltrative malignant tumour involving several sites in the central nervous system, such as the periventricular region and leptomeninges. In this article, the authors presented a 26-year old man with painless progressive right exophthalmos and scalp swelling with no symptoms and signs of intracranial hypertension and hyperthyroidism. Magnetic resonance imaging (MRI) done revealed isointense masses with brilliant homogenous enhancement on contrast administration resembling a meningioma, with a dura tail – like attachment as seen in meningioma. He had surgery for the right orbital tumour and histopathological diagnosis confirmed our suspicion of lymphoma (B type). Steroid was given in the post-operative period which led to significant regression of the tumours, hence its description as ‘vanishing tumour’. He is presently receiving methotrexate-based chemotherapy and subsequently planned for radiotherapy.

Keywords: central nervous system (CNS), meningioma, non-aids lymphoma, orbital

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Authors: Kittivate Boonyopakorn

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The purposes of this study were to find the English competence of the public health volunteers and to develop the use of their English. The samples for the study were 41 public health village volunteers at Ban Prasukchai, in Thailand. The findings showed that the sum of all scores for the pre-test was 452, while the score for the post-test was 1,080. Therefore, the results of the experiment confirm that the post-test scores (1,080) significantly are higher than the pre-test (452). The mean score (N=41) for the pre-test was 11.02 while the mean score (N=41) for the post-test was 18.10. The standard deviation for the pre-test was 2.734; however, for the post-test it was 1.934. In addition to the experts-evaluated research tools, the results of the evaluation for the structured interviews (IOC) were 1 in value. The evaluation of congruence for the content with learning objectives (IOC) were 0.66 to 1.00 in value. The evaluation of congruence for the pre and post-test with learning objectives (IOC) are 1 in value.

Keywords: finding the English competency, developing public health, village volunteers

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Authors: Özgür Bahadir, Meltem Kurtuncu

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The study was designed as quasi-experimental and conducted to determine the effect of music therapy on anxiety, fear and pain management in 6-12-year-old children undergoing surgery. The present study was carried out between 01.01.2016 and 19.08.2016 in BEU. Application and Research Center. The children aged 6 -12 who applied for surgery between the mentioned dates constituted the universe of the study. In the quasi-experimental study that was conducted in the clinics where children received operational treatment, two groups were formed: experimental group (the children who received musical therapy before the surgery) and control group (the children who were administered surveys and the surgery service routines only). Each group consisted of 30 children, and the participants of the study were 60 children in total. Necessary permissions were obtained from the parents of the children hospitalized before the beginning of the implementation. The data was collected through Child Anxiety Sensitivity Index (CASI), “Fear In Medical Treatment Scale”, Face, Legs, Activity, Cry, Consolability Scale (FLACC), Visual Analog Scale (VAS) and Participant Information Form. In the analysis of the data, Kolmogorov-Smirnov distribution scale was used to examine the normality of the distribution along with descriptive statistics methods (Frequency, Percentage, Mean, Standard Deviation). Data was presented in the tables in numbers and percentages. Means were demonstrated along with the standard deviations. The research compared children received; case and control groups include socio-demographic perspective, non-significant difference statistically among similar groups are intertwined. The general level of fear regarding the medical processes before returning to service after the operation and 30 minutes before getting discharged was found to be significantly low in the experimental group compared to control group (p<0.05). No statistically significant difference was found between experimental and control groups in terms of general level of fear regarding the medical processes before the operation, during the operation day and in the recovery room after the operation (p>0.05). Total CASI AD (anxiety sensitivity) levels before the operation, day of the operation and 30 minutes before the discharge for patients in experimental group was found to be significantly higher than the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in the total CASI AD levels for the post-operative recovery room and for returning to the service room after the operation (p>0.05). VAS levels for patients in the experimental group in the post-operative recovery room was significantly higher than the control group (p>0.05). There was no statistically significant difference between the groups in terms of VAS findings in returning to service room after the operation and in 30 minutes before the discharge (p>0.05). As a result of the research; applied children music therapy in the experimental group anxiety, fear, and pain of the scales, their scores average, is lower than the control group children in this situation an increase in the satisfaction of children and parents was observed. In line with this, music therapy preoperative anxiety, fear, and can be used as an effective method of decreasing postoperative pain clinics is suggested.

Keywords: anxiety, children, fear, music therapy, pain

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Vangelis Papadimitropoulos

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The paper is part of the research project “Techno-Social Innovation in the Collaborative Economy'', funded by the Hellenic Foundation of Research and Innovation for the years 2022-2024. The research project examines the normative and empirical conditions of grassroots technologically driven innovation, potentially enabling the transition towards a commons-oriented post-capitalist economy. The project carries out a conceptually led and empirically grounded multi-case study of the digital commons, open-source technologies, platform cooperatives, open cooperatives and Distributed Autonomous Organizations (DAOs) on the Blockchain. The methodological scope of research is interdisciplinary inasmuch as it comprises political theory, economics, sustainability science and computer science, among others. The research draws specifically on Michel Bauwens and Vasilis Kostakis' model of open cooperativism between the commons, ethical market entities and a partner state. Bauwens and Kostakis advocate for a commons-based counter-hegemonic post-capitalist transition beyond and against neoliberalism. The research further employs Laclau and Mouffe's discourse theory of hegemony to introduce a post-hegemonic conceptualization of the model of open cooperativism. Thus, the paper aims to outline the theoretical contribution of the research project to contemporary political theory debates on post-capitalism and the collaborative economy.

Keywords: open cooperativism, techno-social innovation, post-hegemony, post-capitalism

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Authors: Dahna Alkahtani, Faryal Suraya, Fadah Alanazi

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Background: Buccal mucosal graft for urethral augmentation has surpassed other grafting options, and is now considered the standard of choice for substitution Urethroplasty. The graft has gained its popularity due to its excellent short and long-term results, easy harvesting as well as its ability in withstanding wet environments. However, although Buccal mucosal grafts are an excellent option, it is not free of complications, potential intraoral complications are bleeding, pain, swelling, injury to the nerve resulting in numbness, lip deviation or retraction. Objectives: The current study aims to evaluate the intraoral complications of buccal mucosa grafts harvested from one cheek, and used in Augmentation Urethroplasty. Methodology: The study was conducted retrospectively using the medical records of patients who underwent open augmentation urethroplasty with a buccal mucosa graft at King Khalid University Hospital, Saudi Arabia. Data collection of demographics included the type of graft used, presence or absence of strictures and its etiological factors. Pre-operative and post-operative evaluations were carried out on the subjects including the medical history, physical examination, uroflowmetry, retrograde urethrography, voiding cystourethrography and urine cultures were also noted. Further, the quality of life and complications of the procedure including the presence or occurrence of bleeding within 3-days post-procedure, the severity of pain, oral swelling after grafting, length of return to normal daily diet, painful surgical site, intake of painkillers, presence or absence of speech disturbance, numbness in the cheeks and lips were documented. Results: Thirty-two male subjects with ages ranging from 15 years to 72 years were included in the current study. Following the procedure, a hundred percent of the subjects returned to their normal daily diet by the sixth postoperative day. Further, the majority of the patients reported experiencing mild pain accounting for 61.3%, and 90.3% of the subjects reported using painkillers to control the pain. Surgical wound Pain was reportedly more common at the perineal site as 48.4% of the subjects experienced it; on the other hand, 41.9% of the patients experienced pain in the oral mucosa. The presence of speech disorders, as assessed through medical history, was found to be present in 3.2% of patients. The presence of numbness in the cheeks and lips was found in 3.2% of patients. Other complications such as parotid duct injury, delayed wound healing, non-healing wound and suture granuloma were rare as 90.3% of the subjects denied experiencing any of them, there were nonetheless reports of parotid duct injury by 6.5% of the patients, and non-healing wound by the 3.2% of patients. Conclusion: Buccal Mucosa Graft in Augmentation Urethroplasty is an ideal source of allograft, although not entirely painless; it is considerably safe with minimal intra-oral complication and undetectable strain on the patients’ quality of life.

Keywords: augmentation, buccal, graft, oral

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Authors: Donghee Noh, Seonhyeong Kim, Junhwan Choi, Heegon Kim, Sooho Jung, Keunho Park

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In this paper, we describe an image post-processing method to enhance the performance of the parcel segmentation method using deep learning-based aerial images conducted in previous studies. The study results were evaluated using a confusion matrix, IoU, Precision, Recall, and F1-Score. In the case of the confusion matrix, it was observed that the false positive value, which is the result of misclassification, was greatly reduced as a result of image post-processing. The average IoU was 0.9688 in the image post-processing, which is higher than the deep learning result of 0.8362, and the F1-Score was also 0.9822 in the image post-processing, which was higher than the deep learning result of 0.8850. As a result of the experiment, it was found that the proposed technique positively complements the deep learning results in segmenting the parcel of interest.

Keywords: aerial image, image process, machine vision, open field smart farm, segmentation

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Authors: Aritras Roy, Rinku Mukherjee

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The current study couples a quasi-steady Vortex Lattice Method and a camber correcting technique, ‘Decambering’ for unsteady post-stall flow prediction. The wake is force-free and discrete such that the wake lattices move with the free-stream once shed from the wing. It is observed that the time-averaged unsteady coefficient of lift sees a relative drop at post-stall angles of attack in comparison to its steady counterpart for some angles of attack. Multiple solutions occur at post-stall and three different algorithms to choose solutions in these regimes show both unsteadiness and non-convergence of the iterations. The distribution of coefficient of lift on the wing span also shows sawtooth. Distribution of vorticity changes both along span and in the direction of the free-stream as the wake develops over time with distinct roll-up, which increases with time.

Keywords: post-stall, unsteady, wing, aerodynamics

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Authors: Nastaran Moosavi, Mohammad Mokhtari

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Seismic inversion is a technique which has been in use for years and its main goal is to estimate and to model physical characteristics of rocks and fluids. Generally, it is a combination of seismic and well-log data. Seismic inversion can be carried out through different methods; we have conducted and compared post-stack and pre- stack seismic inversion methods on real data in one of the fields in the Persian Gulf. Pre-stack seismic inversion can transform seismic data to rock physics such as P-impedance, S-impedance and density. While post- stack seismic inversion can just estimate P-impedance. Then these parameters can be used in reservoir identification. Based on the results of inverting seismic data, a gas reservoir was detected in one of Hydrocarbon oil fields in south of Iran (Persian Gulf). By comparing post stack and pre-stack seismic inversion it can be concluded that the pre-stack seismic inversion provides a more reliable and detailed information for identification and prediction of hydrocarbon reservoirs.

Keywords: density, p-impedance, s-impedance, post-stack seismic inversion, pre-stack seismic inversion

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Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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Authors: Masood Abdollahi, Seyed Naser Moghaddas Tafreshi

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Expanded polystyrene (EPS) geofoam is a cellular geosynthetic material that can be used to protect lifelines (e.g. pipelines, electricity cables, etc.) below ground. Post and beam system is the most recent configuration of EPS blocks which can be implemented for this purpose. It provides a void space atop lifelines which allows settlement of the loading surface with imposing no pressure on the lifelines system. This paper investigates the efficiency of the configuration of post-beam system subjected to static loading. To evaluate the soil surface settlement, beam deformation and transferred pressure over the beam, laboratory tests using two different densities for EPS blocks are conducted. The effect of geogrid-reinforcing the cover soil on system response is also investigated. The experimental results show favorable performance of EPS post and beam configuration in protecting underground lifelines. 

Keywords: beam deformation, EPS block, laboratory test, post-Beam system, soil surface settlement

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Authors: Christopher Oyediran, Nicola Ubayasiri, Christopher Gough

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Splenic artery aneurysms are often clinically occult, occasionally identified incidentally with imaging. The pathogenesis of aneurysms is complex, but certain factors are thought to contribute to their development. Given the potential fatal complications of rupture, a high index of suspicion is required to make an early diagnosis. We present a case of a 36-year-old female with a history of endometriosis and multiple sclerosis who presented to the Emergency Department with sudden onset epigastric pain and collapse. On arrival, she was pale and clammy with profound tachycardia and hypotension. An ultrasound done in the resuscitation department revealed abdominal free fluid. She was resuscitated with blood and transferred for emergent laparotomy. Laparotomy revealed massive haemoperitoneum from the spleen. She underwent emergency splenectomy and inspection of the spleen revealed a splenic artery aneurysm. She received our massive transfusion protocol followed by a short stay on ITU, making a good post-operative recovery and was discharged home a week later.

Keywords: aneurysm, human chorionic gonadotrophin (hCG), resuscitation, laparotomy

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Authors: Bualak Naksongkaew

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The purposes of this study were to compare pre- and post-test achievement of Thai language skills. The samples consisted of 40 tenth grader of Secondary Demonstration School of Suan Sunandha Rajabhat University in the first semester of the academic year 2010. The researcher prepared the Thai lesson plans, the pre- and post-achievement test at the end program. Data analyses were carried out using means, standard deviations and descriptive statistics, independent samples t-test analysis for comparison pre- and post-test. The study showed that there were a statistically significant difference at α= 0.05; therefore the use multiple intelligences theory can develop Thai languages skills. The results after using the multiple intelligences theory for Thai lessons had higher level than standard.

Keywords: multiple intelligences theory, Thai language skills, development, pre- and post-test achievement

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Authors: Mubarak S. Aldosari

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Transition of adolescents with mild intellectual disabilities (ID) from secondary level to post-school employment level is a critical step for them and their families. Transition of adolescents with mild ID to post secondary levels faces serious difficulties and challenges. The current research highlighted the important factors related to the success of transition of students with mild ID to post-school employment such as vocational training, Self-determination skills, Social skills, and family involvement.

Keywords: adolescents with mild intellectual disabilities, post-school employment, vocational training, self-determination skills, social skills, family involvement

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Authors: A. Barratt, M. H. Granat, S. Buttress, B. Roy

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Introduction: Physiotherapy is an essential part of the treatment of patients with shoulder problems. The focus of treatment is usually centred on addressing specific physiotherapy goals, ultimately resulting in the improvement in pain and function. This study investigates if computerised physiotherapy using gamification principles are as effective as standard physiotherapy. Methods: Physiotherapy exergames were created using a combination of commercially available hardware, the Microsoft Kinect, and bespoke software. The exergames used were validated by mapping physiotherapy goals of physiotherapy which included; strength, range of movement, control, speed, and activation of the kinetic chain. A multicenter, randomised prospective controlled trial investigated the use of exergames on patients with Shoulder Impingement Syndrome who had undergone Arthroscopic Subacromial Decompression surgery. The intervention group was provided with the automated sensor-based technology, allowing them to perform exergames and track their rehabilitation progress. The control group was treated with standard physiotherapy protocols. Outcomes from different domains were used to compare the groups. An important metric was the assessment of shoulder range of movement pre- and post-operatively. The range of movement data included abduction, forward flexion and external rotation which were measured by the software, pre-operatively, 6 weeks and 12 weeks post-operatively. Results: Both groups show significant improvement from pre-operative to 12 weeks in elevation in forward flexion and abduction planes. Results for abduction showed an improvement for the interventional group (p < 0.015) as well as the test group (p < 0.003). Forward flexion improvement was interventional group (p < 0.0201) with the control group (p < 0.004). There was however no significant difference between the groups at 12 weeks for abduction (p < 0.118067) , forward flexion (p < 0.189755) or external rotation (p < 0.346967). Conclusion: Exergames may be used as an alternative to standard physiotherapy regimes; however, further analysis is required focusing on patient engagement.

Keywords: shoulder, physiotherapy, exergames, gamification

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Authors: Mahyar Maali, Merve Sagiroglu, Mahmut Kilic, Abdulkadir Cuneyt Aydin

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In order to evaluate the residual strength of S235 (St37) steel structures after the fire, an experimental program was undertaken to investigate the post-fire mechanical properties. Tensile coupons taken from S235 sheets were exposed to varying temperatures as 200°C, 400°C, 600°C, and 800 °C. The samples were then allowed to cool down to ambient temperature before they were tested to failure. To obtain the mechanical properties of steels; tensile tests are performed, and the post-fire stress-strain curves are evaluated. The microstructures of the heat-treated specimens were examined by Scanning Electron Microscope (SEM). It is seen that morphology and size of the precipitates in the specimens change, as the heat increases. The modulus of elasticity decreases, and deformation increases with temperature. Energy dissipation decreases due to lower stress according to the stress-strain curves of the specimens. Especially, the mechanical properties were decreased compared with the pre-fire ones. As a result of the post-fire and pre-fire behavior of S235, a set of equations is evaluated to predict the mechanical properties after the fire. These types of equations may allow the structural and/or fire engineers to predict accurately the post-fire behavior of the buildings constructed with S235 type steel.

Keywords: post-fire behavior, stress-strain curves, experimental study, S235 steel

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Authors: Mohammad Mehdizadeh

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COVID-19 forced marketers to change their marketing strategies, focusing less on reactive approaches and more on proactive approaches, primarily social media. The next few years will be dominated by employee engagement and customer experience, leading to businesses focusing more on "long-term customer relationships." A large number of marketing strategies need to be employed in an ever-evolving online environment, which is both filled with opportunities and dangers, as well as being an intimidating platform to use, incorporating new and exciting opportunities for businesses and organizations as it constantly evolves. In this article, we examine the effect of social networks on marketing in post-pandemic environments. A descriptive survey is used as the research method. The results show that social networks have a positive and significant impact on marketing in a post-pandemic environment. Among the social networks studied, Instagram, Facebook, and Twitter have the most positive effect on marketing advancement.

Keywords: COVID-19, customers, marketing, post-pandemic

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Authors: Mohammad Q. M. Momani

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The objective of this study is to examine whether the value relevance of ownership structure changed as the Amman Stock Exchange market conditions changed. Using data from 2005 to 2014, the study finds that the performance of portfolios that contain firms with concentrated ownership structure declines significantly during the post-crisis period. These portfolios exhibit poor performance relative to portfolios that contain firms with dispersed ownership structure during the post-crisis period. The results argue that uninspired performance of the Amman Stock Exchange during the post-crisis period, increased the incentives for controlling shareholders to expropriate. Investors recognized these incentives and discounted firms that were more likely to expropriate.

Keywords: value relevance, ownership structure, portfolio performance, Jordan, ASE

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Authors: Ruqayya Naheed Khan, Romaisa Shamim, Awais Amjad Malik, Awais Naeem, Amina Iqbal Khan, Asad Parvaiz

Abstract:

Objective: Patients undergoing axillary lymph node dissection (ALND) for metastatic lymph nodes in our hospital usually have drains placed in their axilla for a period of 6-10 days. We evaluated the post-op course of patients who underwent breast conservation surgery (BCS) along with ALND. Methods: A prospective cohort study was conducted at Shaukat Khanam Memorial Cancer Hospital from April 2017 to August 2017 including all lymph node positive breast cancer patients undergoing BCS with ALND. Patients were divided into two groups. Group A had no axillary drain while in Group B a drain was placed in axilla. Results: A total of 76 patients were included. 41 patients were included in group A and 35 patients in Group B. Median number of LNs dissected in group A was 17 and in group B was 15 (p value 0.443). Median operative time in group A was 84 min and in group B was 79 min (p value 0.223). Median hospital stay in both groups was 1 day (p value 0.78). At 2 weeks all patients in group A developed seroma as compared to none in group B (p value < 0.001). 3 of these patients in group A required aspiration of seroma due to pressure effects. Rest were managed conservatively. At 6 weeks only 50% patients had a seroma radiologically in Group A as compared to 33% in group B (p value 0.023). No intervention was required in any patients at week 6. QOL at 2 weeks was much better in Group A (7/41 patients had unsatisfactory response) as compared to group B (10/31 had unsatisfactory response). Results were statistically significant (p value 0.045). However, there wasn’t much difference in QOL at 6 weeks. Only 1 patient in group A had an unsatisfactory response. Average pain score at 2 weeks was similar in both groups (4.2 v/s 4.1 p value 0.73). Infection was seen in 1 patient in each group at 2 weeks (p value 0.668) and in only 1 patient in group A at 6 weeks (p value 0.067). Conclusion: We conclude from our study that there isn’t much difference in drain and no drain group in terms of wound infection and pain scores. No drain group is however associated with a better QOL in early post-op period.

Keywords: axillary drainage, axillary lymph node dissection, breast cancer, no drain in axilla

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Authors: Suwarno, D. Jongudomkarn

Abstract:

Family Health Assessment (FHA) is a key process to identify the family health needs, family health problems, and family health history. Assessing the family health is not only from the assessment tool but also from health care provider especially Nurse. Nurses’ have duties to assess the family as holistic view and they have to increase their capacities (knowledge, skills and experiences) in FHA. Thus, the continuing nursing education-training program on using the KKU FHA Tool was aimed to enhance the participant nurses’ capacities in (FHA) based on such tool. The aim of this study was to evaluate the KKU FHA Tool training program on PCU nurses’ capacity before and after training program in Primary Care Unit Bantul, Yogyakarta. The Quasi-Experiment with one group pre-, post-test design as a research design with convenient sampling technique and one group pre- post test formula for Nurses who work in Six PCU Bantul, Yogyakarta as much as fourteen respondents. The research processes were used training program with module, video and handbook KKU FHA Tool, KKU FHA tool form and capacities questionnaires. It was analyzed by descriptive data, Kolmogorov-Smirnov and Paired Sample t-test. The overall comparing analysis of paired sample t-test revealed that the mean values of pre-test were 3.35 with SD 0.417, post-test was 3.86 with SD 0.154 and post-test in later two weeks was 4.00 with SD 0.243. It was found that the p value of among the pre-test, the intermediate post-test and the post–test in later two weeks were 0.000. The p value of the intermediate post-test and post-test in later two weeks was 0.053. KKU FHA Tool training program in PCU Bantul Yogyakarta was enhanced the participant nurses’ capacities significantly. In conclusion, we are recommending KKU FHA Tool forms have to develop and implement with qualitative research as complementary data in PCU Bantul Yogyakarta by Focus Group Discussion.

Keywords: family health assessment, KKU FHA tool, training program, nurses capacities

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Authors: Sujith Rajashekar Swamy, Meghana Rajashekara Swamy

Abstract:

Although T1-weighted gadolinium-enhanced imaging (T1-Gd) has its established clinical role in diagnosing brain lesions of infectious and metastatic origins, the use of post-contrast susceptibility-weighted imaging (SWI) has been understudied. This observational study aims to explore and compare the prominence of brain parenchymal lesions between T1-Gd and SWI-Gd images. A cross-sectional study design was utilized to analyze 58 patients with brain parenchymal lesions using T1-Gd and SWI-Gd scanning techniques. Our results indicated that SWI-Gd enhanced the conspicuity of metastatic as well as infectious brain lesions when compared to T1-Gd. Consequently, it can be used as an adjunct to T1-Gd for post-contrast imaging, thereby avoiding additional contrast administration. Improved conspicuity of brain lesions translates directly to enhanced patient outcomes, and hence SWI-Gd imaging proves useful to meet that endpoint.

Keywords: susceptibility weighted, T1 weighted, brain lesions, gadolinium contrast

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Authors: Ehsan Kaviani, Azin Golmoradizade

Abstract:

Introduction: Traditionally, tendons are considered to only contain tenocytes that are responsible for the maintenance, repair, and remodeling of tendons. Stem cells, which are termed tendon-derived stem cells, so this study we investigate the effect of transcranial direct current stimulation combined with swallowing training on post-stroke dysphagia. Methods: This review article is about effects of transcranial direct current stimulation (tDCS) on post-stroke dysphagia that were extracted from Science Direct, Pro quest, and Pub med Data Bases. 15 articles had been selected according to inclusion criteria from 2014 to 2019, and 6 of them had been deleted by exclusion criteria. Results: The results of our systematic review suggest that tDCS may represent a promising novel treatment for post-stroke dysphagia. However, to date, little is known about the optimal parameters of tDCS for relieving post-stroke dysphagia. Further studies are warranted to refine this promising intervention by exploring the optimal parameters of tDCS. Conclusion: anodal tDCS over the affected hemisphere may be as effective as cathodal tDCS on the unaffected hemisphere to enhance recovery after subacute ischemic stroke and anodal tdcs applied over the affected pharyngeal motor cortex can enhance the outcome of swallowing training in post-stroke dysphagia.

Keywords: dysphagia, stroke, cortical stimulation, transcranial direct current stimulation

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Authors: Muhammad Naveed Ali, Hamad Bin Rashid, Muhammad Arif Khan, Abdul Basit, Hafiz Muhammad Arshad

Abstract:

Abdominal defects are very common in pigeons. A new technique is known as intraabdominal mesh transplant that give better protection for herniorrhaphy. The aim of this study was to determine the performance of hernia mesh. In this study, an efficacy of two synthetic hernia mesh implants viz. conventional Prolene and a lightweight mesh monofilament polyester were assessed for the abdominal wall repair in pigeons. Twenty four healthy pigeons were selected and randomly distributed into three groups, A, B and C (n=8). In all groups, experimental laparotomy was performed; thereafter, abdominal muscles and peritoneum were sutured together, while, a 2 x 2 cm defect was created in the abdominal muscles. For onlay hernioplasty, the hernia mesh (Prolene mesh: group A; Polyester mesh: group B) was implanted over the external oblique muscles of the abdomen. In group C (control), the mesh was not implanted; instead, the laparotomy incision was closed after a herniorrhaphy. Post-operative pain wound healing, adhesion formation, histopathological findings and formation of hematoma, abscess and seroma were assessed as short-term complications. Post-operatively, pain at surgical site was significantly less (P < 0.001) in group B (Polyester mesh); wound healing was also significantly better and rapid in group B (P < 0.05) than in group A (Prolene mesh). Group B (Polyester mesh) also depicted less than 25% adhesions when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions or flimsy adhesions (n=2) in group B (Polyester mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. There were observed hematoma, seroma and abscess formations in birds treated by Prolene mesh only. Conclusively, the polyester mesh proved superior to the Prolene mesh regarding lesser adhesion, better in wound healing, and no short-term follow-up complications.

Keywords: adhesion, mesh, polyester, prolene

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Authors: Karen Armstrong

Abstract:

This paper considers the importance of acquiring, cultivating, and protecting one’s personal online reputation in a post-truth era. Although the idea of the individual is essential psychological construct, the concept necessarily now includes our online reputation. The idea of this online reputation has expanded to become almost more important than any other factor in terms of our professional, social and psychological development. The discussion will first consider philosophical ideas of the self, followed by an examination of underlying concepts of perception and interpretation in a post-truth world. Then, the idea of the recent shift to a consideration of posted images, through words and photos, in the construction of self, will be discussed. Next, the relation between private personal life and exterior social life, including our reputation in a variety of realms will be addressed. This will include the adoption of specific strategies and behaviors, which facilitate accuracy, currency and necessary modifications with regard to our online reputation. Finally, specific ways in which we can negotiate the fluid dynamic between reputation, and inner and outer selves to optimum effect will conclude the discussion.

Keywords: image, post-truth, privacy, reputation, surveillance

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Authors: Jai Hyung Park, Eugene Kim, Jin Hun Park, Min Joon Oh

Abstract:

Introduction: Subchondral insufficiency fracture of the femoral head (SIF) is a rare complication; however, it has been recognized to cause femoral head collapse. Subchondral insufficiency fracture (SIF) is caused by normal or physiological stress without any trauma. It has been reported in osteoporotic patients after the fixation of the proximal femur with an Intramedullary nail. Case presentation: We reported 5 cases with SIF of the femoral head after proximal femur fracture fixation with Intra-medullary nail. All patients had osteoporosis as an underlying disease. Good reduction was achieved in all 5 patients. SIF was found from about 3 months to 4 years after the initial operation, and all the fractures were solidly united at the final diagnosis. We investigated retrospectively the feature of those cases and several factors that affected the occurrence of SIF. Discussion: There are a few discussions regarding the SIF of the femoral head. These discussions may include the predisposing risk factors, how to diagnose the SIF in osteoporotic patients, and the peri-operative factors to prevent SIF. Conclusion: Subchondral insufficiency fracture of the femoral head is a considerable complication after the internal fixation of the proximal femur. There are several factors that can be modified. If they could be controlled in the peri-operative period, SIF could be prevented or handled in advance. Other options related to arthroplasty can be considered in old osteoporotic patients.

Keywords: insufficiency fracture of femoral head, intra-medullary nail, osteoporosis, proximal femur fracture

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Authors: Carlos Gordon, Patricio Encalada, Henry Lema, Diego Leon, Dennis Chicaiza

Abstract:

The following work presents a proposal of autonomous navigation of mobile robots implemented in an omnidirectional robot Kuka Youbot. We have been able to perform the integration of robotic operative system (ROS) and machine learning algorithms. ROS mainly provides two distributions; ROS hydro and ROS Kinect. ROS hydro allows managing the nodes of odometry, kinematics, and path planning with statistical and probabilistic, global and local algorithms based on Adaptive Monte Carlo Localization (AMCL) and Dijkstra. Meanwhile, ROS Kinect is responsible for the detection block of dynamic objects which can be in the points of the planned trajectory obstructing the path of Kuka Youbot. The detection is managed by artificial vision module under a trained neural network based on the single shot multibox detector system (SSD), where the main dynamic objects for detection are human beings and domestic animals among other objects. When the objects are detected, the system modifies the trajectory or wait for the decision of the dynamic obstacle. Finally, the obstacles are skipped from the planned trajectory, and the Kuka Youbot can reach its goal thanks to the machine learning algorithms.

Keywords: autonomous navigation, machine learning, path planning, robotic operative system, open source computer vision library

Procedia PDF Downloads 150