Search results for: quality revision

Authors: O. O. Onafowokan, K. Anderson, M. R. Norton, R. G. Middleton

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Revision total hip arthroplasty (THA) is known to be a challenging procedure with potential for poor outcomes. Due to its lack of metaphyseal encroachment, hip resurfacing arthroplasty (HRA) is classified as a bone conserving procedure. Although the literature postulates that this is an advantage at time of revision surgery, there is no evidence to either support or refute this claim. We identified 129 hips that had undergone HRA and 129 controls undergoing first revision THA. We recorded the clinical assessment and survivorship of implants in a multi-surgeon, single centre, retrospective case control series for both arms. These were matched for age and sex. Data collected included demographics, indications for surgery, Oxford Hip Score (OHS), length of surgery, length of hospital stay, blood transfusion, implant complexity and further surgical procedures. Significance was taken as p < 0.05. Mean follow up was 7.5 years (1 to 15). There was a significant 6 point difference in postoperative OHS in favour of the revision resurfacing group (p=0.0001). The revision HRA group recorded 48 minutes less length of surgery (p<0.0001), 2 days less in length of hospital stay (p=0.018), a reduced need for blood transfusion (p=0.0001), a need for less complexity in revision implants (p=0.001) and a reduced probability of further surgery being required (P=0.003). Whilst we acknowledge the limitations of this study our results suggest that, in contrast to THA, the bone conservation element of HRA may make for a less traumatic revision procedure with better functional outcomes. Use of HRA has seen a dramatic decline as a result of concerns regarding metallosis. However, this information remains of relevance when counselling young active patients about their arthroplasty options and may become pertinent in the future if the promise of ceramic hip resurfacing is ever realized.

Keywords: hip resurfacing, metallosis, revision surgery, total hip arthroplasty

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Authors: Filiz Ersoz, Deniz Merdin, Taner Ersoz

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The objective of this study provides an insight into enterprises, who need to carry on their sustainability in harmony with the changing competition conditions, technology and laws, regarding the ISO 9001:2015. In the study, ISO 9001:2015, which is planned to be put in force and exists as a draft, was studied and its differences from the previous standard, ISO 9001:2008, were determined. To find out the differences, a survey was conducted among enterprises that implement a quality system. According to the findings obtained at the end of the study, it was observed that the enterprises attach importance to quality and follow the developments about quality management system, and they find the changes in the new draft document necessary.

Keywords: ISO 9001, quality, quality management system, quality revision

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Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

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Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

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Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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Authors: Musbah Abdussayed

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The washback effect refers to the influence of assessment on teaching and learning, and this washback effect can either be positive or negative. This study implemented, sequentially, self-assessment (SA) and peer assessment (PA) and examined the washback effect of self and peer assessment (SPA) activities on the writing growth during the revision phase in the writing process. Twenty advanced Arabic as a second language learners from a private school in the USA participated in the study. The participants composed and then revised a short Arabic story as a part of a midterm grade. Qualitative data was collected, analyzed, and synthesized from ten interviews with the learners and from the twenty learners’ post-reflective journals. The findings indicate positive washback effects on the learners’ writing growth. The PA activity enhanced descriptions and meaning, promoted creativity, and improved textual coherence, whereas the SA activity led to detecting editing issues. Furthermore, both SPA activities had washback effects in common, including helping the learners meet the writing genre conventions and developing metacognitive awareness. However, the findings also demonstrate negative washback effects on the learners’ attitudes during the revision phase in the writing process, including bias toward self-evaluation during the SA activity and reluctance to rate peers’ writing performance during the PA activity. The findings suggest that self-and peer assessment activities are essential teaching and learning tools that can be utilized sequentially to help learners tackle multiple writing areas during the revision phase in the writing process.

Keywords: self assessment, peer assessment, washback effect, second language writing, writing process

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Authors: Satien Janpla, Radasa Pojard

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The objective of this study is to study bachelor's degree students’ satisfaction towards the course of Science Project based on education quality assurance. It is a case study of the Faculty of Science and Technology, Suan Sunandha Rajabhat University. The findings can be used as a guideline for analysis and revision of the content and the teaching/learning process of the subject. Moreover, other interesting factors such as teaching method can be developed based on education quality assurance. Population in this study included 267 students in year 3 and year 4 of the Faculty of Science and Technology, Suan Sunandha Rajabhat University who registered in the subject of Science Project in semester 1/2556. The research tool was a questionnaire and the research statistics included arithmetic mean and SD. The results showed that the study of bachelor degree students’ satisfaction towards the subject of Science Project based on education quality assurance reported high satisfaction with the average of 3.51. Students from different departments showed no difference in their satisfaction.

Keywords: satisfaction, science project subject, education quality assurance, students

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Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

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Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman

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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.

Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis

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Authors: Rodoula Stavroula Gkarnara, Nikolaos Andreadakis

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The purpose of this paper is to examine the relationship between quality and quality assurance in education. It constitutes a critical review of the bibliography regarding quality and its delimitation in the field of education, as well as the quality assurance in education and the approaches identified for its extensive study. The two prevailing and opposite views on the correlation of the two concepts are that on the one hand there is an inherent distance between these concepts as they are two separate terms and on the other hand they are interrelated and interdependent concepts that contribute to the improvement of quality in education. Finally, the last part of the paper, adopting the second view, refers to the contribution of quality assurance to quality, where it is pointed out that the first concept leads to the improvement of the latter by quality assurance being the means of feedback for the quality achieved.

Keywords: education, quality, quality assurance, quality improvement

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Authors: Expedito Pinto De Paula Junior

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Current systems such as artificial satellites, airplanes, automobiles, turbines, power systems and air traffic controls are becoming increasingly more complex and/or highly integrated as defined in SAE-ARP-4754A (Society Automotive Engineering - Certification considerations for highly-integrated or complex aircraft systems standard). Among other processes, the development of such systems requires careful Change and Configuration Management (CCM) to establish and maintain product integrity. Understand the maturity of CCM process based in historical approach is crucial for better implementation in hardware and software lifecycle. The sense of work organization, in all fields of development is directly related to the order and interrelation of the parties, changes in time, and record of these changes. Generally, is observed that engineers, administrators and managers invest more time in technical activities than in organization of work. More these professionals are focused in solving complex problems with a purely technical bias. CCM process is fundamental for development, production and operation of new products specially in the safety critical systems. The objective of this paper is open a discussion about the historical revision based in standards focus of CCM around the world in order to understand and reflect the importance across the years, the contribution of this process for technology evolution, to understand the mature of organizations in the system lifecycle project and the benefits of CCM to avoid errors and mistakes during the Lifecycle Product.

Keywords: changes, configuration management, historical, revision

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Authors: Nguyen Manh Hien

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Service quality is the highest requirement from users, especially for the service in electronic government. During the past decades, it has become a major area of academic investigation. Considering this issue, there are many researches that evaluated the dimensions and e-service contexts. This study also identified the dimensions of service quality but focused on a new conceptual and provides a new methodological in developing measurement scales of e-service quality such as information quality, service quality and organization quality. Finally, the study will suggest a key factor to evaluate e-government service quality better.

Keywords: dimensionality, e-government, e-service, e-service quality

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Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

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Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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Authors: Souhir Chelly, Chahida Harizi, Aicha Hechaichi, Sihem Aissaoui, Leila Ben Ayed, Maha Bergaoui, Mohamed Kouni Chahed

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Introduction: The International Classification of Primary Care (ICPC) is part of the morbidity classification system. It had 17 chapters, and each is coded by an alphanumeric code: the letter corresponds to the chapter, the number to a paragraph in the chapter. The objective of this study is to show the utility of this classification in the coding of the reasons for demand for care in Primary health care (PHC), its advantages and limits. Methods: This is a cross-sectional descriptive study conducted in 4 PHC in Ariana district. Data on the demand for care during 2 days in the same week were collected. The coding of the information was done according to the CISP. The data was entered and analyzed by the EPI Info 7 software. Results: A total of 523 demands for care were investigated. The patients who came for the consultation are predominantly female (62.72%). Most of the consultants are young with an average age of 35 ± 26 years. In the ICPC, there are 7 rubrics: 'infections' is the most common reason with 49.9%, 'other diagnoses' with 40.2%, 'symptoms and complaints' with 5.5%, 'trauma' with 2.1%, 'procedures' with 2.1% and 'neoplasm' with 0.3%. The main advantage of the ICPC is the fact of being a standardized tool. It is very suitable for classification of the reasons for demand for care in PHC according to their specificity, capacity to be used in a computerized medical file of the PHC. Its current limitations are related to the difficulty of classification of some reasons for demand for care. Conclusion: The ICPC has been developed to provide healthcare with a coding reference that takes into account their specificity. The CIM is in its 10th revision; it would gain from revision to revision to be more efficient to be generalized and used by the teams of PHC.

Keywords: international classification of primary care, medical file, primary health care, Tunisia

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Authors: Nor Fazlina Iryani Abdul Hamid, Mohamad Khatim Hasan

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Evolution of software quality measurement has been started since McCall introduced his quality model in year 1977. Starting from there, several software quality models and software quality measurement methods had emerged but none of them focused on telecommunication industry. In this paper, the implementation of software quality measurement system for telecommunication industry was compulsory to accommodate the rapid growth of telecommunication industry. The quality value of the telecommunication related software could be calculated using this system by entering the required parameters. The system would calculate the quality value of the measured system based on predefined quality metrics and aggregated by referring to the quality model. It would classify the quality level of the software based on Net Satisfaction Index (NSI). Thus, software quality measurement system was important to both developers and users in order to produce high quality software product for telecommunication industry.

Keywords: software quality, quality measurement, quality model, quality metric, net satisfaction index

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Authors: Amirul Adlan, Robert A McCulloch, Neil Jenkins, MIchael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The current antibiotic prophylaxis for oncological patients is based upon evidence from primary arthroplasty despite significant differences in both patient group and procedure. The aim of this study was to compare the microbiology organisms responsible for PJI in patients who underwent two-stage revision for infected primary knee replacement with those of infected oncological endoprostheses of the lower limb in a single institution. This will subsequently guide decision making regarding antibiotic prophylaxis at primary implantation for oncological procedures and empirical antibiotics for infected revision procedures (where the infecting organism(s) are unknown). Patient and Methods: 118 patients were treated with two-stage revision surgery for infected knee arthroplasty and lower limb endoprostheses between 1999 and 2019. 74 patients had two-stage revision for PJI of knee arthroplasty, and 44 had two-stage revision of lower limb endoprostheses. There were 68 males and 50 females. The mean age for the knee arthroplasty cohort and lower limb endoprostheses cohort were 70.2 years (50-89) and 36.1 years (12-78), respectively (p<0.01). Patient host and extremity criteria were categorised according to the MSIS Host and Extremity Staging System. Patient microbiological culture, the incidence of polymicrobial infection and multi-drug resistance (MDR) were analysed and recorded. Results: Polymicrobial infection was reported in 16% (12 patients) from knee arthroplasty PJI and 14.5% (8 patients) in endoprostheses PJI (p=0.783). There was a significantly higher incidence of MDR in endoprostheses PJI, isolated in 36.4% of cultures, compared to knee arthroplasty PJI (17.2%) (p=0.01). Gram-positive organisms were isolated in more than 80% of cultures from both cohorts. Coagulase-negative Staphylococcus (CoNS) was the commonest gram-positive organism, and Escherichia coli was the commonest Gram-negative organism in both groups. According to the MSIS staging system, the host and extremity grade of knee arthroplasty PJI cohort were significantly better than endoprostheses PJI(p<0.05). Conclusion: Empirical antibiotic management of PJI in orthopaedic oncology is based upon PJI in arthroplasty despite differences in both host and microbiology. Our results show a significant increase in MDR pathogens within the oncological group despite CoNS being the most common infective organism in both groups. Endoprosthetic patients presented with poorer host and extremity criteria. These factors should be considered when managing this complex patient group, emphasising the importance of broad-spectrum antibiotic prophylaxis and preoperative sampling to ensure appropriate perioperative antibiotic cover.

Keywords: microbiology, periprosthetic Joint infection, knee arthroplasty, endoprostheses

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Authors: A. Vahanyan

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The paper touches upon the problem of revision and modernization of the current curriculum on translation studies at the Armenian Higher Education Institutions (HEIs). In the contemporary world where quality and speed of services provided are mostly valued, certain higher education centers in Armenia though do not demonstrate enough flexibility in terms of the revision and amendment of courses taught. This issue is present for various curricula at the university level and Translation Studies related curriculum, in particular. Technological innovations that are of great help for translators have been long ago smoothly implemented into the global Translation Industry. According to the European Master's in Translation (EMT) framework, translation service provision comprises linguistic, intercultural, information mining, thematic, and technological competencies. Therefore, to form the competencies mentioned above, the curriculum should be seriously restructured to meet the modern education and job market requirements, relevant courses should be proposed. New courses, in particular, should focus on the formation of technological competences. These suggestions have been made upon the author’s research of the problem across various HEIs in Armenia. The updated curricula should include courses aimed at familiarization with various computer-assisted translation (CAT) tools (MemoQ, Trados, OmegaT, Wordfast, etc.) in the translation process, creation of glossaries and termbases compatible with different platforms), which will ensure consistency in translation of similar texts and speeding up the translation process itself. Another aspect that may be strengthened via curriculum modification is the introduction of interdisciplinary and Project-Based Learning courses, which will enable info mining and thematic competences, which are of great importance as well. Of course, the amendment of the existing curriculum with the mentioned courses will require corresponding faculty development via training, workshops, and seminars. Finally, the provision of extensive internship with translation agencies is strongly recommended as it will ensure the synthesis of theoretical background and practical skills highly required for the specific area. Summing up, restructuring and modernization of the existing curricula on Translation Studies should focus on three major aspects, i.e., introduction of new courses that meet the global quality standards of education, professional development for faculty, and integration of extensive internship supervised by experts in the field.

Keywords: competencies, curriculum, modernization, technical literacy, translation studies

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Authors: Matthew Edmunds, Andrew Hunter, Clare Littlewood, Wisha Gul, Gabriel Heppenstall-Harris, Thomas Humphries

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Background: Revision courses for medical students undertaking their final examinations are commonplace throughout the UK. Traditionally these take the form of a series of lectures over multiple weeks or a single day of intensive lectures. The COVID-19 pandemic, however, has required medical educators to create new teaching formats to ensure they adhere to social distancing requirements. It has provided an unexpected opportunity to accelerate the development of students proficiency in the use of ‘technology-enabled communication platforms’, as mandated in the 2018 GMC Outcomes of Graduates. Recent advances in technology have made distance learning possible, whilst also providing novel and more engaging learning opportunities for students. Foundation Year 2 doctors at Aintree University Hospital developed an online series of videos to help prepare medical students in the North West and byond for their final medical school examinations. Method: Eight hour-long videos covering the key topics in medicine and surgery were posted on the Peer Learning Liverpool Youtube channel. These videos were created using new technology such as the screen and audio recording platform, Loom. Each video compromised at least 20 single best answer (SBA) questions, in keeping with the format in most medical school finals. Explanations of the answers were provided, and additional important material was covered. Students were able to ask questions by commenting on the videos, with the authors replying as soon as possible. Feedback was collated using an online Google form. Results: An average of 327 people viewed each video, with 113 students filling in the feedback form. 65.5% of respondents were within one month of their final medical school examinations. The average rating for how well prepared the students felt for their finals was 6.21/10 prior to the course and 8.01/10 after the course. A paired t-test demonstrated a mean increase of 1.80 (95% CI 1.66-1.93). Overall, 98.2% said the online format worked well or very well, and 99.1% would recommend the course to a peer. Conclusions: Based on the feedback received, the online revision course was successful both in terms of preparing students for their final examinations, and with regards to how well the online format worked. Free-text qualitative feedback highlighted advantages such as; students could learn at their own pace, revisit key concepts important to them, and practice exam style questions via the case-based format. Limitations identified included inconsistent audiovisual quality, and requests for a live online Q&A session following the conclusion of the course. This course will be relaunched later in the year with increased opportunities for students to access live feedback. The success of this online course has shown the roll that technology can play in medical education. As well as providing novel teaching modes, online learning allows students to access resources that otherwise would not be available locally, and ensure that they do not miss out on teaching that was previously provided face to face, in the current climate of social distancing.

Keywords: COVID-19 pandemic, Medical School, Online learning, Revision course

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Authors: Hakim Derradji, M’Hammedi Yousra, Sabrou Abdelmalek, Tabet Nacer

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Introduction: This is a retrospective study carried out at the Central Hospital of Army from 2017 to 2022. Its objective is to demonstrate the best surgical method for the management of obstructive hydrocephalus secondary to a posterior fossa tumor in children, in pre, per, and post-operative. Patients and Methods: During this period, 24 children (over 1 year old) were admitted for treatment of the posterior fossa tumor with obstructive secondary hydrocephalus and the majority of whom benefited from VCS followed by surgery and excision, the rest, received after evacuation from other hospital structures, were managed there beforehand with ventriculoperitoneal diversion or external drainage. We found that the way hydrocephalus is managed has implications for subsequent management, hence the need for this study to determine the effectiveness of different surgical procedures used in the treatment of hydrocephalus in these patients. The evaluation is made on the basis of revision rate, complications, survival, and radiological evaluation. Results: 6 patients (25%) received a ventriculoperitoneal shunt (VPD), 15 patients (62%) underwent a ventriculocysternostomy (VCS), and 3 patients (12.5%) received temporary ventricular drainage before or during tumor excision. The post-operative results were almost similar. Nevertheless, a high failure rate (25%) was observed. No deaths are recorded. In total, 75% of children who had a DVP were reoperated. The revision by VCS was performed, in addition to the 4 patients benefiting from a DVP, with one patient having received external drainage, and only one revision of a VCS was recorded. In the two patients who received external drainage, restoration of CSF outflow was observed following tumor resection. Conclusion: VCS is indicated in the first intention in the treatment of hydrocephalus secondary to a posterior fossa tumor, in view of the satisfactory results obtained and the high failure rate in DVP, especially with the presence of metastatic cells in the peritoneum, but can be considered as a second-line treatment.

Keywords: posterior fossa tumor, obstructive hydrocephalus, DVP, VCS

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Authors: Amal M. Alrayes

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Data and system quality play a central role in organizational success, and the quality of any existing information system has a major influence on the effectiveness of overall system performance.Given the importance of system and data quality to an organization, it is relevant to highlight their importance on organizational performance in the Kingdom of Bahrain. This research aims to discover whether system quality and data quality are related, and to study the impact of system and data quality on organizational success. A theoretical model based on previous research is used to show the relationship between data and system quality, and organizational impact. We hypothesize, first, that system quality is positively associated with organizational impact, secondly that system quality is positively associated with data quality, and finally that data quality is positively associated with organizational impact. A questionnaire was conducted among public and private organizations in the Kingdom of Bahrain. The results show that there is a strong association between data and system quality, that affects organizational success.

Keywords: data quality, performance, system quality, Kingdom of Bahrain

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Authors: Raymond Puijk, Rachid Rassir, Inger N. Sierevelt, Anneke Spekenbrink-Sporen, Bart G. C. W. Pijls, Rob G. H. H. Nelissen, Peter A. Nolte

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Background: Among uncemented total knee arthroplasty (TKA), a wide variety of metal surface structures (MSS) and coatings exist to enhance implants' biological properties (i.e., bone ingrowth). This study explores the variety of MSS-coating combinations and compares their mid-long-term survivorships with cemented TKAs, by using data from the Dutch Arthroplasty Register. Methods: A total of 235,500 cemented and 11,132 uncemented primary TKAs with a median follow-up of 5.1 years were included. MSS-coating combinations were (1) Porous-uncoated (n=8986), (2) Beaded-hydroxyapatite (HA)(n=1093), (3) Matte-uncoated (n=846), (4) Matte-Titanium-nitride (TiN) (n=207). Five- and 10-year revision-free survival for all-cause revisions, and aseptic loosening of the tibial component, were calculated and compared by using Kaplan-Meier, Log-rank tests, and multivariable Cox proportional hazard regression analyses. Results: Ten-year survival rates with all-cause revisions as an endpoint, were 94.2% for cement, and 94.7%, 96.3%, 92.1%, and 79.0% for porous-uncoated, beaded-HA, matte-uncoated, and Matte-TiN, respectively (p<0.01). Rates for aseptic loosening were 98.8% for cemented, and 98.7%, 99.8%, 97.2%, and 94.9% for the uncemented, respectively (p<0.01).The beaded-HA implants were half the risk for an all-cause revision compared to cemented implants (p<0.01). Matte-uncoated and matte-TiN implants were at more risk of an all-cause revision than cemented implants (p=0.01, p<0.01). Proportions of revisions for aseptic loosening were comparable among most groups. Conclusion: Based on Dutch registry data, four main MSS-coating combinations among uncemented TKAs were found. survivorships for all-cause revisions and aseptic release differed widely between groups. Beaded-HA and porous-uncoated implants had the best survival rates among the uncemented TKAs and were non-inferior to the cemented TKAs.

Keywords: total knee arthroplasty, cement, uncemented, cementless;, metal surface structure, coating

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Authors: Abdoullah Fath-Allah, Laila Cheikhi, Rafa E. Al-Qutaish, Ali Idri

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Many quality models have been used to measure e-government portals quality. However, the absence of an international consensus for e-government portals quality models results in many differences in terms of quality attributes and measures. The aim of this paper is to compare and analyze the existing e-government quality models proposed in literature (those that are based on ISO standards and those that are not) in order to propose guidelines to build a good and useful e-government portals quality model. Our findings show that, there is no e-government portal quality model based on the new international standard ISO 25010. Besides that, the quality models are not based on a best practice model to allow agencies to both; measure e-government portals quality and identify missing best practices for those portals.

Keywords: e-government, portal, best practices, quality model, ISO, standard, ISO 25010, ISO 9126

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Authors: Grmanesh Gidey Kahsay

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In modern technical engineering applications, quality is defined in two ways. The first one is that quality is the parameter that measures a product or service’s characteristics to meet and satisfy the pre-stated or fundamental needs (reliability, durability, serviceability). The second one is the quality of a product or service free of any defect or deficiencies. The American Society for Quality (ASQ) describes quality as a pursuit of optimal solutions to confirm successes and fulfillment to be accountable for the product or service's requirements and expectations. This article focuses on quality engineering tools in modern industrial applications. Quality engineering is a field of engineering that deals with the principles, techniques, models, and applications of the product or service to guarantee quality. Including the entire activities to analyze the product’s design and development, quality engineering emphasizes how to make sure that products and services are designed and developed to meet consumers’ requirements. This episode acquaints with quality tools such as quality systems, auditing, product design, and process control. The finding presents thoughts that aim to improve quality engineering proficiency and effectiveness by introducing essential quality techniques and tools in some selected industries.

Keywords: essential quality tools, quality systems and models, quality management systems, and quality assurance

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Authors: Pedro Gomes, Luís Sá Castelo, António Lopes, Marta Maio, Pedro Mota, Adélia Avelar, António Marques Dias

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Introduction: Total Knee Arthroplasty (TKA) has contributed to improvement of patient`s quality of life, although it has been associated with some complications including component loosening and polyethylene wear. To prevent these complications various fixation techniques have been employed. Hybrid TKA with cemented tibial and cementless femoral components have shown favourable outcomes, although it still lack of consensus in the literature. Objectives: To evaluate the clinical and radiographic results of hybrid versus cemented TKA with an average 5 years follow-up and analyse the survival rates. Methods: A retrospective study of 125 TKAs performed in 92 patients at our institution, between 2006 to 2008, with a minimum follow-up of 2 years. The same prosthesis was used in all knees. Hybrid TKA fixation was performed in 96 knees, with a mean follow-up of 4,8±1,7 years (range, 2–8,3 years) and 29 TKAs received fully cemented fixation with a mean follow-up of 4,9±1,9 years (range, 2-8,3 years). Selection for hybrid fixation was nonrandomized and based on femoral component fit. The Oxford Knee Score (OKS 0-48) was evaluated for clinical assessment and Knee Society Roentgenographic Evaluation Scoring System was used for radiographic outcome. The survival rate was calculated using the Kaplan-Meier method, with failures defined as revision of either the tibial or femoral component for aseptic failures and all-causes (aseptic and infection). Analysis of survivorship data was performed using the log-rank test. SPSS (v22) was the computer program used for statistical analysis. Results: The hybrid group consisted of 72 females (75%) and 24 males (25%), with mean age 64±7 years (range, 50-78 years). The preoperative diagnosis was osteoarthritis (OA) in 94 knees (98%), rheumatoid arthritis (RA) in 1 knee (1%) and Posttraumatic arthritis (PTA) in 1 Knee (1%). The fully cemented group consisted of 23 females (79%) and 6 males (21%), with mean age 65±7 years (range, 47-78 years). The preoperative diagnosis was OA in 27 knees (93%), PTA in 2 knees (7%). The Oxford Knee Scores were similar between the 2 groups (hybrid 40,3±2,8 versus cemented 40,2±3). The percentage of radiolucencies seen on the femoral side was slightly higher in the cemented group 20,7% than the hybrid group 11,5% p0.223. In the cemented group there were significantly more Zone 4 radiolucencies compared to the hybrid group (13,8% versus 2,1% p0,026). Revisions for all causes were performed in 4 of the 96 hybrid TKAs (4,2%) and 1 of the 29 cemented TKAs (3,5%). The reason for revision was aseptic loosening in 3 hybrid TKAs and 1 of the cemented TKAs. Revision was performed for infection in 1 hybrid TKA. The hybrid group demonstrated a 7 years survival rate of 93% for all-cause failures and 94% for aseptic loosening. No significant difference in survivorship was seen between the groups for all-cause failures or aseptic failures. Conclusions: Hybrid TKA yields similar intermediate-term results and survival rates as fully cemented total knee arthroplasty and remains a viable option in knee joint replacement surgery.

Keywords: hybrid, survival rate, total knee arthroplasty, orthopaedic surgery

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Authors: Audrey Romero-Pelaez, Juan Carlos Morocho-Yunga

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The increasing amount of open educational resources (OER) published on the web for consumption in teaching and learning environments also generates a growing need to ensure the quality of these resources. The low level of OER discovery is one of the most significant drawbacks when faced with its reuse, and as a consequence, high-quality educational resources can go unnoticed. Metadata enables the discovery of resources on the web. The purpose of this study is to lay the foundations for open educational resources to achieve their first quality star within the Quality4OER Framework. In this study, we evaluate the quality of OER metadata and establish the main guidelines on metadata quality in this context.

Keywords: open educational resources, OER quality, quality metadata

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Authors: M. Stoklasa, H. Starzyczna, K. Matusinska

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This article deals with the perceived quality of regional products in the Moravian-Silesian region in the Czech Republic. Research was focused on finding out what do consumers perceive as a quality product and what characteristics make a quality product. The data were obtained by questionnaire survey and analysed by IBM SPSS. From the thousands of respondents the representative sample of 719 for MS region was created based on demographic factors of gender, age, education and income. The research analysis disclosed that consumers in MS region are still price oriented and that the preference of quality over price does not depend on regional brand knowledge.

Keywords: regional brands, quality products, characteristics of quality, quality over price

Procedia PDF Downloads 384

Authors: Jia Yin Tan, Daniel Rambei, Kate Mann, Samuel price, Ahmed Aboelela

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Introduction: Breastfeeding is a complex process, influenced by various factors. Tongue-tie may lead to breastfeeding difficulties due to an inability to suck effectively, causing sore nipples and poor infant weight gain. In the UK, most frenotomies on infants are performed by doctors, nurses, health visitors or midwives. Objectives: Evaluation of safety and efficacy of a multispecialty nurse-led rapid access tongue-tie service at Sheffield Children’s Hospital, run jointly by the ENT and paediatric surgery departments. Methodology: A retrospective observational study, including all patients attending the ENT and paediatric surgery nurse-led tongue tie clinics between 1/10/2021 and 30/09/2022. Results: During the study period there were 1135 referrals for frenotomy, with a mean of 15 days between referral to clinic episode. 86.8% of referred patients underwent frenotomy, with a complication rate of 0.1% and revision rate of 5.4%. Conclusions: Our findings suggest that our rapid access nurse-led outpatient tongue tie service is safe and efficacious, with low complication and revision rates. This suggests a potential for developing a community-based service, allowing safe and effective care closer to home.

Keywords: tongue tie, frenotomy, cost, nurse-led

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Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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Authors: Asem M. Othman

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The expansion of the hospitality industry is unmistakable. Services, by nature, are intangible. Hence, service quality, in general, is a complicated process to be measured and evaluated. Hotels, as a service sector and part of the hospitality industry, are growing rapidly. This research paper was carried out to identify the quality determinants that may affect hotel guests’ service quality perception. In this research paper, each quality determinant will be discussed, illustrated, and justified thoroughly via a systematic literature review. The purpose of this paper is to set the stage to measure the significant influence of the service quality determinants on guest satisfaction. The knowledge produced from this study will assist practitioners and/or hotel service providers to imply into their policies.

Keywords: service quality, hotel service, quality management, quality determinants

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Authors: Mohamed Idris S. Abozaed, Suliman Mohamed Elrajoubi

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Researches and concerns in power quality gained significant momentum in the field of power electronics systems over the last two decades globally. This sudden increase in the number of concerns over power quality problems is a result of the huge increase in the use of non-linear loads. In this paper, power quality evaluation of some distribution networks at Misurata - Libya has been done using a power quality and energy analyzer (Fluke 437 Series II). The results of this evaluation are used to minimize the problems of power quality. The analysis shows the main power quality problems that exist and the level of awareness of power quality issues with the aim of generating a start point which can be used as guidelines for researchers and end users in the field of power systems.

Keywords: power quality disturbances, power quality evaluation, statistical analysis, electrical distribution networks

Procedia PDF Downloads 500

Authors: N. S. Ajisha

Abstract:

In today’s competitive world the quality of the service you deliver is one of the important factor that determine customer satisfaction. Service quality is considered to be one important determinant to evaluate customer satisfaction and the relationship between service quality and customer satisfaction is considered as the foundation in researches on customer satisfaction. This research examines to do a gap analysis between the perception and expectation of the services delivered and find relation between the service quality and customer satisfaction. Service quality is found out here using the SERVQUAL model. And it finds out the dimension of service quality which is more important to measure customer satisfaction. The dimensions which we measure using SERVQUAL include the tangibles, reliability, responsiveness, assurance, and empathy. This study involves primary data collection like market survey.

Keywords: customer satisfaction, service quality, retail service quality, Kochi

Procedia PDF Downloads 512