Average Length Of Time Research Articles

Clinical and Radiographic Outcomes Following Anatomic Coracoclavicular Ligament Reconstruction Using Four-Strand Taped Suspensory Fixation in an Active-Duty Military Population

BackgroundAcromioclavicular (AC) joint injuries are common in young, active populations. However, there is a paucity of literature reporting surgical outcomes following the treatment of AC joint injuries in the military population. Therefore, the purpose of this study was to evaluate the clinical and radiographic outcomes of active-duty military members who underwent arthroscopic-assisted anatomic coracoclavicular ligament reconstruction using a four-strand suspensory fixation with taped sutures for treatment of high-grade AC joint injuries with a minimum 1-year follow-up. MethodsA retrospective review was performed on all patients with Rockwood grade IIIB-V AC joint separations who underwent anatomic coracoclavicular ligament reconstruction using a four-strand suspensory fixation with taped sutures at a single military treatment facility between January 2015 and May 2022. Clinical outcome measures included the Single Assessment Numeric Evaluation (SANE) score and patient satisfaction using the Likert Scale (LS). Radiographic outcomes were measured by classifying the amount of residual AC joint separation on postoperative radiographs utilizing the Rockwood classification. ResultsCoracoclavicular ligament reconstruction a using four-strand suspensory fixation with taped sutures was performed in 15 consecutive patients, all of which were active-duty military males with a mean age of 35.8 years. Preoperatively, there were 10 patients with grade IIIB injuries, 1 patient with a grade IV injury, and 4 patients with grade V injuries. The average preoperative SANE score was 40.0. The average length of time from injury to surgery was 46.5 weeks. Patient reported outcomes were available for 12 of the 15 patients (80%) at an average of 4.9 years postoperatively with an average postoperative SANE score of 77.1 (p=0.0002); 11 of these 12 patients (92%) reported they were either satisfied or extremely satisfied with the outcome of the surgery. Postoperative radiographs were available for 14 of the 15 patients (93%) at an average of 2.7 years postoperatively revealing 13 patients had maintained grade I reduction while 1 patient had a grade III separation. ConclusionCoracoclavicular ligament reconstruction a using four-strand suspensory fixation with taped sutures resulted in significantly improved radiographic and patient reported outcomes in this retrospective review of active-duty military members with grade IIIB-V AC joint separations.

A multi-center retrospective cohort analysis of age and racial disparities in patients undergoing repeat ablation for recurrent atrial fibrillation

Abstract Introduction Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, and its prevalence has been increasing worldwide. Current data shows that AF is more common in white males compared to blacks despite blacks having multiple cardiovascular comorbidities. There is paucity of data showing the recurrence of AF re-ablation after index ablation specifically as it pertains to race, gender, and age. We sought to explore the rates of recurrent AF re-ablation in this retrospective cohort analysis. Methods Using a multi-center database, we examined 23,558 encounters and 10,530 had readmission records i.e. readmitted within 3 years. The encounters included adults (18+) who had an ablation procedure for atrial fibrillation between 1/1/2018-06/30/2020. We used binary logistic regression models and Tukey-Kramer procedure to analyze pairwise comparisons among different subgroups of race, sex, and age group. The primary endpoint was recurrence of repeat ablation. Secondary endpoints included non-fatal stroke and myocardial infarction. Results Our sample size was 23,558 patients, 20,276 were white patients (86%) and 3,282 were non-white patients (14%). The average age was 66.29 years (SD 10.43) and average age at the time of repeat ablation was 65.97 years. The average BMI was 21.55. Out of the 23,558 patients, 14.30% (N= 3368) had re-ablation within 3 years of the index ablation. The odds ratio of re-ablation for patients in their 50s is 1.4229 (95% CI [1.1172, 1.8122]) compared to patients in their 80s. Similarly, the odds ratio is 1.4330 (95% CI [1.1466, 1.7909]) for the 60-69 group, 1.3075 (95%CI [1.0458, 1.6346]) for the 70-79 group and 1.3443 (95% CI [1.0088, 1.7914]) for patients below 50 compared to over 80 group. The LR for re-ablation was 0.8438 (p=0.3583) in females. The incidence of non-fatal stroke and MI were 0.27% (N= 63) and 0.19% (N= 45). Average length of time to re-ablation was 415.5 days. Discussion When controlling for age group and sex, race was not significantly associated with an increased likelihood of repeat ablation. When controlling for race and age group, sex was not significantly associated with an increased likelihood of repeat ablation. When controlling for race only, females were not at a higher risk of re-ablation. However, when controlling for race and sex, patients in their 50s are 42.3% more likely to have re-ablation when compared to patients in their 80s. In contrast, the age of patients at their first ablation increased, there appeared to be a rising trend indicating a higher chance of AF recurrence within 3 years when controlling for race and sex. Conclusion The incidence of repeat AF ablation is not higher in racial minorities when compared to whites. Interestingly, there appears to be an decreasing rate of AF re-ablation in older patients despite a higher rate of AF recurrence as age increases possibly owing to more conservative therapeutic approach such as medical management.

ANALISIS KORELASI ANTARA SUDUT SIMPANGAN DAN WAKTU RATAAN PADA BANDUL FISIS DENGAN LATIN SQUARE DESIGN

This study aims to examine the relationship between the angle of deviation and the average time length of a physical pendulum. This study uses primary data, namely practicum report data in a physics laboratory. Data collection was conducted under closed conditions with control variables (shaft length, number of oscillations, and radius of gyration) and dependent variables (angle of deviation and average time). The analysis technique used is a statistical approach technique, namely Latin Square Design analysis. The findings of this study indicate that the variables of deviation angle and average time on the physical pendulum have a strong and unidirectional correlation relationship. This result is evident from the value of F0 > Fcritical and the value of Pr (> P) > 0, 05(significant level) where both of these prove that there is a strong reason to reject H0 which means that there is at least 1 difference in the effect of the angle of deviation on the average time. It shows that the angle of deviation affects the average time of the physical pendulum

Developing the future academic workforce: A descriptive cross-sectional study of the experiences of early career academics from registered health and social care professions

BackgroundHealthcare academics are generally recruited for their expertise as practitioners, however this may not always convert into expertise in higher education. ObjectiveInvestigate experiences of academics who transitioned from clinical roles by:1.Ascertaining prior understanding of the academic role.2.Understanding motivations to transition to academia.3.Determining whether expectations reflected reality.4.Identifying support needs for a successful transition. DesignDescriptive cross-sectional survey. Participants122 survey responses; 103 females, 89.3 % UK participants, 65.6 % nurses. Average years as clinician was 14.49 (SD 8.44), average age at time of transition was 39.99 (SD 8.28), average length of time in academia was 4.36 years (SD 6.51) and most were currently employed as a senior lecturer (36.9 %) or lecturer (28.7 %). MethodsAn electronic survey using an amended version of the Career Transition Inventory (CTI), the HEXACO personality trait measure, and open questions for elaboration.Descriptive and inferential statistics were performed on statistical data and open questions were analysed thematically. Results73 % of participants agreed they felt like a novice again and were overwhelmed in their first year of academia. Most felt they received support from their line manager and the transition was the right decision. Higher levels of extraversion were associated with a positive transition, and those open to new experiences were more likely to feel ready and confident in their career transition.The qualitative data identified four themes: the need to do something different, expectations not reflecting reality, levels of support, and it being a transformative experience. ConclusionsReasons for transitioning from clinical to academic roles are multifaceted. There is a lack of prior understanding around the complexities of the role, and expectations rarely reflect reality. Academic roles require extensive support and development, and time to transition into the role effectively.

A crisis awareness chain warning management model for patients with difficulties cooperating with magnetic resonance examinations.

This case-control study tested a crisis awareness-based chain warning management model for patients with difficulties cooperating with magnetic resonance imaging (MRI) examinations. All participants experienced difficulties cooperating with MRI examinations and underwent cranial magnetic resonance spectroscopy (MRS) and MRI at the same hospital in China. The control group (n = 1233) underwent examinations from January to June 2023 and received routine nursing care (pre-examination safety notification, instructions on cooperating during the examination, post-examination observation). A crisis awareness chain warning management model was implemented for the intervention group (n = 1352), who underwent examinations from July to December 2023. The groups were compared on average time for examination completion, quality of care and occurrence of complications. Data were collected using a self-devised data collection form. The average length of time to complete MRS and MRI was shorter for intervention group patients than for control group patients. The intervention group showed better pre-examination preparation, examination success rate, image quality attainment rate, and one-time examination success rate, and lower incidence of examination-related complications. This management model could increase MRI examination efficiency, improve quality of care, reduce complications and increase nurses' understanding of nursing continuity and crisis awareness.

Exploring the Telephone Call Experience of Patients with Non-English Language Preference in Primary Care vs. Specialty.

Latine people, comprising 18.5% of the US population, constitute the largest ethnic minority group, with nearly one-third self-identifying as having non-English language preference (NELP). Despite the importance of the telephone in health care access, there is limited understanding of how NELP patients navigate telephone calls with primary and specialty care clinics. This qualitative study aims to capture how Spanish speakers with NELP characterize their telephone call experiences with primary and specialty care clinics. Semi-structured interviews were conducted with 24 Spanish-speaking participants from primary care clinics with a sizeable proportion of patients who prefer to communicate in a language other than English at an urban academic medical center in Boston, MA. Participants were selected from primary care clinics that were well-equipped to serve Spanish-speaking patients. A total of 24 Spanish-speaking patients with NELP, mainly women (83%), with a mean age of 55.8years, participated. They represented diverse countries of origin, with an average length of time in the USA of 21.7years. Interview questions prompted participants to describe their telephone call experiences with front desk staff, with attention to interpreter availability, ancillary assistance, health outcomes stemming from a lack of language services, and emotional consequences of language discordance on calls. Patients perceived primary care clinics as providing familiarity and language concordance during telephone interactions, contrasting with specialty care clinics, seen as sources of monolingual English communication. Participants utilized various strategies, such as requesting interpreters, using concise English phrases, or seeking assistance from acquaintances, relatives, or primary care clinic staff, to mitigate language barriers. The findings underscore significant challenges faced by Spanish-speaking patients with NELP in ambulatory specialty care telephone calls. The study emphasizes the importance of creating inclusive multilingual telephone environments, standardizing interpreter access, and reflecting the diversity of the communities served.

Effect of melatonin on insomnia and daytime sleepiness, in patients with obstructive sleep apnea and insomnia (COMISA): A randomized double-blinded placebo-controlled trial

BackgroundCOMISA is a common disorder that results in nighttime awakenings ,daytime sleepiness and PAP intolerance. Cognitive behavioral therapy for insomnia is used to improve PAP adherence and no medication has been evaluated in such population yet. Melatonin with its chronobiotic and antioxidant effects may have potential benefits on COMISA consequences at the appropriate dose and time. This study aimed to evaluate the effect of melatonin on sleep quality, daytime sleepiness and PAP Compliance in patients with COMISA.MethodsThis double-blind placebo trial randomly assigned eligible OSA patients who suffered from insomnia despite using PAP for over a month to receive either melatonin 10 mg or placebo. The primary outcomes were measured by changes in the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Functional Outcomes of Sleep Questionnaire (FOSQ-10) over one month. Adherence to PAP was measured by the results of the PAP device reports on the average length of time and number of nights that the device was used.ResultsThirty patients were enrolled in the study after randomization. The melatonin arm showed significant improvement in all four primary outcomes compared to the placebo arm. The PSQI score was 3.836±1.839 in the melatonin arm versus 10.522±3.626 in the placebo arm (Pvalue<0.001). The ISI score was 8.476±3.568 in the melatonin arm versus 14.47±4.50 in the placebo arm (Pvalue<0.001). The ESS score was 6.854±4.334 in the melatonin arm versus 13.298±5.119 in the placebo arm (Pvalue<0.001). The FOSQ-10 score was 24.93±5.02 in the melatonin arm versus 19.87±4.24 in the placebo arm (Pvalue= 0.006). Additionally, nighttime consequences such as sleep latency and awakenings showed significant improvement in the melatonin arm. PAP devices results revealed improvement in duration of PAP use overnight. ConclusionsAdministering melatonin has been shown to improve self-reported sleep quality and PAP adherence in patients with COMISA.Trial registrationRegistration number IRCT20220105053635N1 was issued by the Iranian Registry of Clinical Trials (IRCT).

#593 Prevalence and outcomes of tuberculous peritonitis among CAPD patients in National Kidney and Transplant Institute from January 2016 to January 2023

Abstract Background Continuous ambulatory peritoneal dialysis is a cost effective and efficient modality of renal replacement therapy. However, infectious processes such as peritonitis may lead to peritoneal membrane failure necessitating shift to hemodialysis. Tuberculous peritonitis is an unusual cause of peritonitis, which may lead to risk of hospitalization and significant morbidity and mortality. Aims To determine the prevalence and outcomes of tuberculous peritonitis among patients on continuous ambulatory peritoneal dialysis Method A retrospective, descriptive study of patients on continuous ambulatory peritoneal dialysis with tuberculous peritonitis from January 2016 to January 2023 in National Kidney and Transplant Institute. Demographic, clinical and laboratory data of patients with TB peritonitis were collected via chart review. Results Among 1182 patients on continuous ambulatory peritoneal dialysis, 2.03% had tuberculous peritonitis. Average length of time from development of symptoms to diagnosis is 24.5 days. Majority of presenting symptoms were hazy drain and abdominal pain. 66.7% retained their peritoneal dialysis catheter. PD catheter was removed in 33% of TB peritonitis due to peritoneal dialysis failure and unresolving peritonitis. Mortality was 37.5% after diagnosis of tuberculous peritonitis. Only significant factor associated with mortality was length of time on continuous ambulatory peritoneal dialysis to development of TB peritonitis (p = 0.0332). Conclusion Relative high prevalence of tuberculous peritonitis could be related to high background occurrence of tuberculosis in the country. Majority of cases had resolution of symptoms and effective dialysis during course of anti-tuberculous treatment and did not warrant peritoneal dialysis catheter removal.

Abstract PO5-02-01: Concerning Discrepancies in Estradiol Levels in Premenopausal Women Receiving Abemaciclib and Ovarian Function Suppression

Abstract Background: Adjuvant abemaciclib in combination with endocrine therapy improves outcomes for patients with high-risk, hormone receptor-positive (HR+), HER2-negative early-stage breast cancer. In premenopausal women, the use of an aromatase inhibitor (AI) requires chemical or surgical ovarian function suppression (OFS). Our published case report of a premenopausal woman receiving adjuvant abemaciclib with elevated estradiol levels measured by the Abbott Alinity chemiluminescent microparticle immunoassay (CMIA) despite bilateral salpingo-oophorectomy (BSO) but low estradiol levels using liquid chromatography-mass spectrometry (LC-MS/MS) suggested an interference of abemaciclib with the immunoassay (PMID: 37124155). The aim of this study was to determine discrepancies in estradiol levels using CMIA compared to LC-MS/MS and subsequent treatment changes in a larger patient population. Methods: We conducted an IRB-approved retrospective review of premenopausal women with early-stage HR+ breast cancer treated with adjuvant OFS and abemaciclib at our institution from October 2021 to April 2023 who had at least 1 CMIA estradiol level drawn during abemaciclib therapy. Pathology, treatment plans, and lab data were abstracted from medical records. Postmenopausal estradiol levels were based on reference ranges of &amp;lt; 41 pg/mL using CMIA or &amp;lt; 15 pg/mL using LC-MS/MS. We utilized descriptive statistics to describe the population and management. Results: We identified 22 patients who met criteria for our review. The average age was 42.3 years, all had positive axillary nodes, 6 (27%) received neoadjuvant chemotherapy, and 15 (68%) received adjuvant chemotherapy. There were 14 (64%) patients who received leuprolide and 8 (36%) received goserelin, whereas 19 (86%) received AI and 3 (14%) received tamoxifen as their initial oral antiestrogen therapy. The majority of patients did not have baseline estradiol levels when starting OFS though after starting abemaciclib, 20 patients had CMIA estradiol levels in the premenopausal range, 9 of which had estradiol monitored by both CMIA and LC-MS/MS (Table 1). The average length of time from starting OFS to starting abemaciclib was 144.6 days with 1 patient switching from tamoxifen to OFS and AI after starting abemaciclib. Due to elevated CMIA estradiol, treatment changes included increased OFS dosage (5 patients), change of OFS (2 patients), and change to tamoxifen (3 patients). There were 6 patients who underwent BSO, 3 due to persistently elevated CMIA estradiol levels, 2 due to patient preference, and 1 due to a BRCA mutation. Following surgery, 2 patients had persistently elevated CMIA estradiol but low LC-MS/MS estradiol. The remainder of these patients did not have estradiol levels measured by CMIA. Conclusions: Our retrospective review demonstrated the likely interference of abemaciclib with the Abbott Alinity immunoassay as shown by 9 patients treated with OFS and abemaciclib with simultaneous premenopausal range CMIA estradiol levels and postmenopausal range LC-MS/MS estradiol levels. As up to 91% of patients in our study may have had a false positive estradiol level erroneously suggesting inadequate OFS, monitoring of estradiol levels using the CMIA assay in patients receiving adjuvant abemaciclib in addition to OFS could lead to changes in therapy that may be unnecessary. It is recommended that the LC-MS/MS assay be used when monitoring of estradiol levels is indicated in patients receiving abemaciclib concurrently with OFS. Table 1: Estradiol levels in patients receiving OFS and abemaciclib who had both CMIA and LC-MS/MS assays Citation Format: Alaina Kessler, Rima Patel, Emily Gallagher, Tianxiang Sheng, Damodara Rao Mendu, Amy Tiersten, Paula Klein, Aarti Bhardwaj, Anupama Goel, Joseph Sparano, Theresa Shao, Julie Fasano. Concerning Discrepancies in Estradiol Levels in Premenopausal Women Receiving Abemaciclib and Ovarian Function Suppression [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-02-01.

Knowledge, Attitudes, and Behaviors of Medical Residents towards Traditional and Complementary Medicine: A Cross-sectional Study

Objective: This study aimed to evaluate the knowledge, attitudes, and behaviors of medical residents working at a faculty of medicine hospital about Traditional and Complementary Medicine (TCM). Material-Method: This is a cross-sectional study. The study was conducted with clinical science assistants working at the faculty of medicine between 15 July and 15 December 2021. A survey containing questions to determine the clinical and demographic characteristics of the participants and their knowledge, behavior, and attitudes toward TCM applications was applied to the participants. Results: A total of 261 medical residents participated. The average age was 29.4±2.6 years and 51.7% (n=135) were male. 82% of the participants were studying internal medicine sciences. The average length of time as a physician was found to be 4.4 years, and the average length of time as a physician in the total branch was 2.6 years. Cupping therapy was the most known method with 55.6%. The most frequently used method (19.2%) was phytotherapy; the most frequently recommended (16.5%) was phytotherapy; the most formally trained (4.2%), was cupping therapy; the most desired formal training (41%) was acupuncture; the most frequently declared method (11.9%) as another TCM method was diet. 36.4% of the participants found TCM useful. 82% thought that these methods should only be applied by trained physicians. Conclusion: It was determined that the level of TCM knowledge among assistant physicians was low. Although the majority of participants had a positive attitude towards TCM, they had low rates of application, implementation, and recommendation.

Safety of Home Discharge With a Chest Tube After Bronchoscopic Lung Volume Reduction Complicated by Persistent Airleak.

The incidence of pneumothorax after bronchoscopic lung volume reduction (BLVR) using Zephyr (Pulmonx Corporation) endobronchial valves is ~26%. Many patients who develop a postprocedural pneumothorax require chest tube placement. If a persistent airleak is present, patients tolerating waterseal can be discharged home with a mini-atrium with a low risk of empyema. Data were collected on patients from the Epic (Epic System Corporation) electronic medical record between July 2019 and November 2022. Our retrospective study reviewed a total of 102 BLVR procedures. Twenty-six of these procedures were complicated by a pneumothorax post-BLVR (25%). After 24 procedures, patients were discharged home with a chest tube after a persistent airleak. The primary endpoint of the study was the incidence of intrapleural infection in this population. The secondary endpoint was the average length of time the chest tube was in place until outpatient removal. Out of the 24 discharge events, 2 events (8.3%) were complicated by an intrapleural infection before chest tube removal. The average number of days requiring a chest tube until outpatient removal was 16.9 days, which is similar to the duration observed in patients discharged home with a chest tube after lung volume reduction surgery. Discharging patients home with a chest tube after BLVR therapy is safe and may reduce hospital length of stay. Our study shows the incidence of intrapleural infection after home discharge with a chest tube after BLVR is low.

Efficacy of an Intensive Exposure Intervention for Individuals With Persistent Concussion Symptoms Following Concussion: A Concurrent Multiple Baseline Single-Case Experimental Design (SCED) Study.

After a concussion, 1 in 3 patients report persistent symptoms and experience long-term consequences interfering with daily functioning, known as persistent concussion symptoms (PCS). Evidence suggests PCS is (partly) maintained by anxious thoughts about brain functioning, recovery, and experienced symptoms, leading to avoidance behaviors, which may prevent patients from meeting life demands. We aimed to investigate the efficacy of a newly developed intensive exposure intervention for individuals with PCS after concussion aimed to tackle avoidance behavior. Participants took part in the intervention at the Maastricht University faculty. Four participants who experienced PCS after concussion partook in the exploratory study. Participants' age ranged between 20 and 32 (mean = 26.5, SD = 5.9) years, with an average length of time after the concussion of 9.8 months. A concurrent multiple-baseline single-case design was conducted. The baseline period (A phase) length was randomly determined across participants (3, 4, 5, or 6 weeks). The exposure intervention (B phase) was conducted by psychologists over a 4-week period and consisted of 3 stages: exploration (2 sessions), active exposure (12 sessions conducted over 1 week), and 2 booster sessions. Participants answered daily questions on a visual analog scale related to symptom experience, satisfaction with daily functioning, and degree of avoidance of feared activities. Additional outcomes included symptom severity, catastrophizing, fear of mental activity, anxiety, depression, and societal participation. Tau-U yielded significant effects ( P < .05) for all participants on all measures when comparing baseline and intervention phases. The pooled standardized mean difference was high for all measures (symptom experience = 0.93, satisfaction of daily functioning = 1.86, and activity avoidance = -2.05). The results show efficacy of the newly developed intensive exposure treatment for PCS after concussion, which is based on the fear avoidance model. Replication in a larger heterogeneous sample is warranted and needed.

Digitally Recording Comfort Observations in the Last Days of Life.

Background: 37.5% of deaths in our area occur in hospital. There are known high unmet needs of adult patients dying in hospital, this unmet need can be reduced by using an individualised care plan and specialist palliative care review. Intervention: In 2022 UHSussex developed an electronic comfort observation chart and individualised care plan, with a centralised dashboard allowing Palliative Care Teams (SPCT) to view trends, target interventions, and a rolling prospective audit. Results: 3000 patients have had their care supported with electronic comfort observations (e-comfort obs). Over 72% of all deaths in the Trust in the last 3months have been on e-comfort obs, with 2/3 of all deaths in the first 12months on e-comfort obs. The average length of time on e-comfort obs is 4days resulting in 70,000 sets of e-comfort obs recorded since launch. Seven percent of e-comfort obs record moderate or severe symptoms. We have identified benefits to people who are dying, those important to them, ward staff, SPCT and on a systems level. Conclusion: E-comfort obs can be successfully embedded in a large acute Trust. This development should improve quality of end of life care in our hospitals both for individuals and for future patients, through on-going targeted education and intervention. Further work is needed to develop the system further including integrating data from electronic prescribing.

Self-compassion and self-coldness and their relationship with psychological distress and subjective well-being among community-based Hazaras in Australia.

Hazaras are a newly emerging community in Australia and limited research has explored their mental health. The first aim of this study was to explore levels of psychological distress and subjective well-being reported by Hazaras in Australia, and whether scores on psychosocial variables (self-compassion, self-coldness, acculturation, resilience, spirituality), psychological distress and domains of subjective well-being differed by sociodemographic groups. The second aim had two parts: (a) to examine bivariate relationships between the psychosocial variables, psychological distress and subjective well-being; and (b) to examine whether the psychosocial predictor variables independently contributed to subjective well-being and psychological distress when controlling for sociodemographic characteristics. Seventy-two Hazaras (58 men and 14 women), with a mean age of 28.82 years (SD = 8.84) and average length of time residing in Australia of 10.17 years (SD = 4.11), completed an online survey. There were sociodemographic differences in relation to key variables of interest; for example, participants who did not have family members in Australia reported lower levels of global life satisfaction. Moderate negative relationships were found between self-compassion and psychological distress and between self-coldness and subjective well-being. Self-coldness, self-compassion, resilience and acculturation contributed uniquely to psychological distress and subjective well-being when controlling for sociodemographic variables. Although migration programmes that provide permanent residency and allow family members to join refugees in Australia are limited, they appear important. Many of the difficulties facing Hazaras are ongoing, external and beyond their control (e.g. visa status); however, there is a possibility that self-compassion can play a role as a protective factor.

Patient-Reported Outcomes for Robot-Assisted Laparoscopic Extravascular Renal Vein Stent Placements for Nutcracker Syndrome.

Introduction: Nutcracker phenomenon is the compression of the left renal vein between the superior mesenteric artery (SMA) and the abdominal aorta. Nutcracker syndrome refers to the presence of nutcracker phenomenon with symptoms. Between 2016 and 2022, we performed 18 robot-assisted laparoscopic extravascular renal vein stent (RALERVS) placements. We sought to assess patient-reported outcomes of RALERVS placement by a single institution. Methods: We performed a single-center retrospective review of 18 patients with a minimum of 3 months follow-up. Symptoms were assessed utilizing a questionnaire conducted with a 5-point Likert scale at a minimum of 3 months postoperatively. Five on the Likert scale was severe while 1 was none. Primary study outcomes compared pre- and postoperative patient-reported symptom scores. Results: Twelve out of 18 patients responded to the survey. The average length of time from date of operation to completion of survey was 2.6 years. Average age of the cohort was 36 years with a mean BMI of 19.4 kg/m2. There was only one man. Mean operative time was 137 minutes and mean estimated blood loss was 12 mL. Mean preoperative SMA angle was 19° and mean postoperative SMA angle was 36°. Patients reported that flank pain, abdominal pain, nausea, headaches, back pain, pelvic pain, and early satiety improved (p < 0.05). Ten of 12 respondents would recommend RALERVS for nutcracker syndrome. Conclusion: RALERVS demonstrates an effective treatment for nutcracker syndrome. Patients reported improved symptoms at 3 months postoperatively across multiple domains. Further studies need to be conducted to assess long-term durability of the extravascular renal vein graft.

Research on the Optimization Strategy of the Content of Civic and Political Education and the Enhancement of the Effectiveness of Practical Educational Training for the Digital Teaching Environment

Abstract This paper focuses on the optimization of the content of ideological and political education from the perspective of optimization and establishes an evaluation model based on Lib-SVM for the effect of optimization. The study proposes optimization strategies for ideological and political education in colleges and universities based on VR technology at three levels. The fundamental task of establishing moral education must be adhered to, while clarifying specific tools for optimizing the content of ideological and political education with VR technology. The value leadership of mainstream consciousness is adhered to, and the framework for optimizing the content of ideological and political education through VR technology is improved. Then, on the basis of the implementation of the optimization strategy, an assessment model based on Lib-SVM was established to analyze the ten statistical data of students’ interpersonal communication ability, organizational ability, adaptability, hands-on ability, teamwork ability, innovation ability, expression ability, enhancement of the sense of responsibility, cognitive ability of the society, and experiencing the hardship of life as the source of input data, and to analyze the correlation between these ten data and the level of enhancement of the effectiveness of practical educating people. Analyzing the correlation between these ten data and the improvement level of practice education effectiveness, the length of students’ social practice has increased, and the average length of time spent on volunteering has reached 236h, and there are different degrees of improvement in the ten competencies. The evaluation of Lib-SVM of the strategy of optimizing the content of Civic and Political Education on the effectiveness of practical education was completed, which proved that the strategy carried out a superior enhancement of the effectiveness of practical education.

Analysis of Mental Ray Rendering Techniques in 3D Animation Film Analisis Teknik Rendering Mental Ray Pada Film Animasi 3D

Rendering is the final stage of the modeling or animation process. It is during this rendering that the polygons that make up a model will be computed on the computer to form an image. Along with the times, there are many rendering provider applications for 3D animation, one of which is Mental Ray. The formulation of the research problem is How long does it take to render a 3D animated film using mental ray and analyze the size of the rendered using mental ray? The development model in this study uses the Multimedia Development Life Cycle (MDLC) development which is the Luther version of the development method. Data collection by taking two finished or ready-to-rendering 3D films. The results show that the average length of time needed to render of The Little Human animation is 8.3 minutes, while the animated film Go Alex is 8.8 minutes. While the average size of the 12 rendered scenes of The Little Human animation is 17.3 mb and the animated film Go Alex is 17.8 Mb. Computer specifications will affect the performance of the rendering engine itself. This test only uses one type of computer, so to really test the performance of the rendering engine, a similar test is needed using several different types of computers and sepsis. When using the Autodesk Maya 2019 application, it is recommended to use incrementalSave to find out every step of the changes made, because it is to remember the steps to be taken if you forget and anticipate unexpected things such as blackouts.

Patterns of surgical complications after delayed fixation of peripartum pubic symphysis rupture: a report of 5 cases

BackgroundThe disruption of the pubic symphysis during the peripartum period is a rare injury to the pelvic ring. In most cases, conservative treatment is successful. Nonetheless, there are cases where surgical intervention is necessary. We analyzed five surgical cases treated in our department and performed a literature review.Case presentationsFive women, ranging in age from 25 to 38, who experienced peripartum symphysis rupture were primarily treated with a conservative approach. Patients who did not show improvement and met certain criteria, such as experiencing pain starting from childbirth, having a separation in the pubic bone of more than 10 mm, and/or having a vertical instability greater than 5 mm, were recommended to undergo surgery. The average length of time between childbirth and surgery was 5.6 months, ranging from 1 to 14 months. One patient was treated with an external fixator, another patient received a combination of an external fixator and an anterior plate, and three patients were treated with anterior plates. In four cases, we observed a failure in fixation and a partial or complete loss of reduction. The plate and screws were removed in one case, and in three cases, revision surgery was performed. One case involved using a larger plate, while the other used 90-90 plating, known as “box plate fixation.” The mean follow-up was 7.4 years. Two cases had good results, and two had excellent results on the Lindahl scale.ConclusionFor patients with peripartum pubic symphyseal dislocation, our case series and literature review demonstrated that early reduction and fixation correlate with improved clinical outcomes and lower implant failure. For patients with subacute/chronic injuries, there was a higher incidence of implant failure. Orthogonal plate fixation and/or pubic symphysiodesis was associated with improved clinical outcomes.

Karakteristik Peternak Sapi Peranakan Ongole Dan Keberhasilan Inseminasi Buatan Berdasarkan Service Per Conception Di Kabupaten Lampung Selatan

The success of artificial insemination is determined by three main factors namely; livestock, cement and humans. The human factor is one of the determining factors, especially the characteristics of farmers. The purpose of this study was to determine the characteristics of cattle farmers and the success of artificial insemination based on Service per Conception (S/C) in Palas Sub District, South Lampung District. This research was conducted in Palas Sub District, South Lampung District. The time of research was in July 2023. The material for this research was ongole cattle farmers in Palas Sub District, namely 150 cattle famers. The research sample is 60 cattle famers. The research method used is survey method. The data analysis technique uses descriptive analysis, namely analysis to explain the characteristics of cattle farmers and the success of insemination based on Service per Conception (S/C). The results of the research on the characteristics of onggole cattle farmers in Palas Sub District, South Lampung District, obtained an average age of famers cattle was 42.53, the level of education of cattle famers was mostly junior high school (SMP) and high school (SMA), the average length of time they raised cattle average 7.08 years, and there were no farmers who had ever been involved in animal husbandry training. The success rate of artificial insemination in ongole crossbreed cattle based on service per conception (S/C) obtained an average value of S/C = 1.54.

Older Age, Male Sex, and Early Start Time Lengthen the Recovery Room Stay Following Total Joint Arthroplasty in an Ambulatory Surgical Center.

Total joint arthroplasty (TJA) performed in the ambulatory surgical center (ASC) has been shown to be safe and cost-effective for an expanding cohort of patients. As criteria for TJA in the ASC become less restrictive, data guiding the efficient use of ASC resources are crucial. We sought to identify factors associated with length of stay in the recovery room after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) performed in the ASC. We conducted a retrospective review of 411 patients who underwent primary THA or TKA at our institution's ASC between November 2020 and March 2022. We collected patient demographics, perioperative factors, success of same-day discharge (SDD), and length of time in the recovery room. Of 411 patients, 100% had successful SDD. The average length of time spent in recovery was 207 minutes (SD: 73.9 minutes). Predictors of longer time in recovery were increased age, male sex, and operative start time before 9:59 am. Body mass index, preoperative opioid use, Charlson Comorbidity Index, type of surgery (THA vs TKA), urinary retention risk, and type of anesthesia (spinal vs general) were not significant predictors of length of time in the recovery room. In this retrospective study, factors associated with increased length of time in the recovery room included older age, male sex, and operative start time before 9:59 am. Such factors may guide surgeons in determining the optimal order of cases for each day at the ASC, but further prospective studies should seek to confirm these observations.