Conventional Instruments Research Articles

Laparoscopic transabdominal preperitoneal herniorrhaphy performed using an articulating laparoscopic instrument is feasible and more efficient.

Ipsilateral left-sided-approach laparoscopic transabdominal preperitoneal herniorrhaphy (LA-TAPP) is a procedure used for inguinal hernia. However, conventional laparoscopic instruments may limit the operator's ability to approach certain areas during the procedure. This study aims to assess the feasibility of using an articulating bipolar grasper (ArtiSential®). Between January 2017 and May 2022, 184 patients with inguinal hernia underwent LA-TAPP and were divided into an articulating group (AG) and a conventional group (CG). The two groups were compared for clinical characteristics, surgical outcomes, and recurrence rates. Learning curve analysis was also performed using the CUSUM score. The AG and CG included 72 and 112 patients, respectively. Both groups had similar age, sex, BMI, hernia location, and hernia type. The AG had a significantly shorter operation time (59.2 ± 29.4 vs. 77.8 ± 22.4 min, p < 0.001) than the CG. The duration of hospitalization was slightly shorter in the AG (2.2 ± 0.5 vs. 2.5 ± 1.4 days, p = 0.056). Postoperative complications were lower in the AG (5.6%) than in the CG (9.8%). Scrotal neuralgic pain was observed in 1.4% of patients in the AG and 3.6% of patients in the CG. Learning curve analysis revealed that 24 cases were needed to overcome the learning curve for using an articulating device. IP-TAPP with an articulating instrument is a safe and efficient procedure. The operation time can be reduced by improving the surgeon's procedural autonomy and reducing collisions between the instruments and the patient's ribs.

A narrative review of current and future of Unilateral Biportal Endoscopic (UBE) transforaminal lumbar interbody fusion

With the ongoing development of Unilateral Biportal Endoscopic (UBE) spine surgery, it has become standard of care at many centers across the globe for lumbar decompressions and discectomies due to minimal muscle damage, minimal postoperative back pain and early recovery. In UBE, the separation of viewing portal and working portal allows greater freedom of movement for the surgical instruments as the camera and instruments move independently providing unrestricted vision. Moreover, the continuous irrigation fluid pressure decreases bleeding and helps to irrigate out the bone debris. Hence, UBE spine surgery has become quite popular and has expanded its indications to lumbar spinal fusion. The adoption of UBE for conventional spine surgeons into their routine practice is relatively easier than uniportal endoscopy because of use of standard arthroscopic lenses, familiar view of anatomy, and use of conventional open spinal instruments. In this article, we review the current literature and discuss the indications, contraindications, clinical outcomes, complications and compare it with existing minimally invasive transforaminal lumbar interbody fusion.

Safety and efficacy of the EndoRotor device for the treatment of walled-off pancreatic necrosis after EUS-guided cystenterostomy: A systematic review and meta-analysis.

Debridement of infected walled-off pancreatic necrosis is indicated to treat and prevent sepsis-related multiorgan failure. The aim of this study was to evaluate the efficacy and safety of the EndoRotor-powered endoscopic debridement system to remove solid debris under direct endoscopic visualization. Search strategies were developed for PubMed, EMBASE, and Cochrane Library databases from inception to June 2022, in accordance with Preferred Reporting items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Outcomes of interest included technical success defined as successful use of device for debridement, clinical success defined as complete debridement and cyst resolution, and procedure-related adverse events. A random-effects model was used for analysis, and results were expressed as odds ratio along with 95% confidence interval. A total of 7 studies (n = 79 patients) were included. The mean walled-off pancreatic necrosis size was 154.6 ± 34.0 mm, whereas the mean procedure time was 71.4 minutes. The mean number of necrosectomy sessions required was 2.2 (range, 1-7). The pooled rate of clinical success was 96% (95% confidence interval, 91%-100%; I 2 = 0%) with a pooled technical success rate of 96% (91%-100%; I 2 = 0%). The pooled procedure-related adverse event rate was 8% (2%-14%; I 2 = 6%), which included procedure-associated bleeding, pneumoperitoneum, peritonitis, pleural effusion, and dislodgement of lumen-apposing metal stents. Our study shows that the novel EndoRotor device seems to be safe and effective for treating pancreatic necrosis. Patients undergoing endoscopic necrosectomy with the EndoRotor seem to require less debridement sessions when compared with studies using conventional instruments.

New approach for combined aortic valve and coronary procedures through the left anterior minithoracotomy.

We have developed a novel technique for accessing the aortic valve (AoV) through the left anterior minithoracotomy (LAmT). This approach has been used in patients requiring both AoV surgery and coronary artery bypass grafting (CABG). From April 2023 to July 2023, we performed 6 concomitant AoV procedures and CABG through the LAmT. The mean age was 71.5 [standard deviation (SD): 5.8; 64; 82] years, and the mean left ventricular ejection fraction was 53% (SD: 12.1; 30; 60). Surgical technique includes LAmT in the fourth intercostal space, peripheral cardiopulmonary bypass, aortic cross-clamping using transthoracic clamp, cold blood cardioplegia, conventional oblique aortotomy and special surgical exposure manoeuvres, aimed to position the ascending aorta and AoV close to the surgical incision. AoV was effectively visualized and the procedure was performed as planned in all 6 patients. No conversion to sternotomy was required. AoV replacement with biological prosthesis was performed in 6 (100%) patients. Conventional surgical instruments were used in all cases. The long-shafted instruments were not required. Knot-pusher was used in 4 (67%)cases. Concomitant complete revascularization was achieved in all cases. The mean number of distal anastomosis was 2.0 (SD: 0.6; 1; 3). Total operation time was 371 (SD: 43; 300; 420) min, cardiopulmonary bypass time was 253 (SD: 36; 193; 284) min and cross-clamp time was - 162 (SD: 29; 128; 214) min. intensive care unit stay was-1.5 (SD: 0.55; 1; 2) days, total hospital stay was-7.3 (SD: 1; 6; 9) days. There were no revisions for bleeding, no strokes or other major complications, and no hospital or 30-days mortality. The simultaneous performance of AoV replacement and multivessel CABG through a single left anterior thoracotomy is technically feasible and can be carried out by experienced surgeons. However, a larger number of cases are required to fully comprehend the potential limitations of this procedure.

Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study.

In the current odontological era, carious lesions are removed while tooth tissue is preserved. Most of these ideals are met by chemomechanical caries removal (CMCR) methods, which are easy and comfortable to use, differentiate and eliminate infected tissues, minimize pressure, vibration and heat, and are cost-effective. This study examines the efficacy of commercially available CMCR agents, namely Papacarie®, Carie-Care™ and BRIX3000™, and a conventional hand instrumentation method for caries removal in deciduous molars in terms of time consumption, ease of application, and pain perception. For this randomized clinical trial, 120 children aged 4 to 9 years were selected and randomly allocated to four groups of 30 patients each. Time consumption, ease of application, and pain perception were evaluated at three intervals: pre-, during- and post-caries removal, using Wong-Baker FACES (WBF) Pain Rating Scale and the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The results showed that among the compared materials and conventional hand instrumentation technique, Carie-Care™ was statistically found to be the least time-consuming with a p-value of 0.019, have the least pain perception with a p-value of 0.02, and was clinically the best with respect to manipulation and handling. While all three CMCR agents aid in the removal of carious tissue, Carie-Care™ was the most effective based on time consumption, pain perception and simplicity of administration.

A smartphone-based immunochromatographic strip platform for on-site quantitative detection of antigenic targets.

To report the testing signal of an immunochromatographic assay for on-site quantitative detection, a portable and user-friendly smartphone-based biosensing platform is developed in this study. This innovative system is composed of an ambient light sensor inherent smartphone reader and a 3D-printed handhold device, a quantitative tool capable of directly interpreting carbon nanoparticle (CNP)-conjugated immunochromatographic strips. To showcase the platform capability, the smartphone-based immunochromatography system (SPICS) reader and device were successfully used in CNP strips for rapid detection of the early pregnancy marker human chorionic gonadotropin in female urine (HCG; limit of detection [LOD]: 0.30 mIU mL-1), prostate-specific antigen in patient blood (PSA; LOD: 0.28 ng mL-1) and ampicillin residue in animal milk (AMP; LOD: 0.23 ng mL-1). The results were fully correlated with conventional commercial instruments (R2 = 0.99). The SPICS platform exhibits significant advantages, including portability, cost-effectiveness, easy operation, and rapid and quantitative detection, making it a valuable on-site diagnosis tool for use in home and community healthcare facilities.

Craniomaxillofacial Surgery with Computer-generated Three-dimensional Solid Models.

Restoring complex craniofacial deformities presents numerous challenges. Recent years have seen the development of new surgical techniques aimed at improving operation quality and reducing difficulty. However, designing the reduction volume for the affected region and achieving precise contouring remain difficult tasks. The use of three-dimensional (3D) solid models can provide significant assistance at all stages of the operations. This study aimed to investigate the validity of prototype 3D solid models for complex craniofacial operations. Simulated 3D models of the patients were used. Conventional surgical instruments were employed for the planning of the operations. Patients had follow-up periods ranging from 6 to 18 months. Operations have been planned and performed using three-dimensional solid models. Intraoperative steps were executed as simulated during planning. No major complications were developed. All bone and soft-tissue reconstructions healed without major infection. Stereolithographic models provide: 1) a better understanding of anatomy, 2) presurgical simulation, 3) intraoperative accuracy in lesion localization, 4) accurate fabrication of implants, and 5) improved education for trainees. An accurate method for intraoperative navigation and preoperative planning is clearly useful. This technology offers a direct representation of the patient's anatomy through computer reconstruction, allowing for the efficient and precise transfer of information in complex facial restorative procedures.

Computer guided root tip extraction and implant placement: A clinical report

Extraction of a residual root tip and implant placement can be challenging because of the complexity and invasiveness of the procedure. Improvised application of a guided implant surgery may avoid such challenges. This clinical report presents an innovative technique combining a 3-dimensionally printed surgical guide with conventional instrumentation for a residual root tip extraction in a minimally invasive and predictable way.

Comparative Study Between Conventional Polypectomy With Microdebrider Assisted Endoscopic Sinus Surgery

Background: Nasal polyposis is a frequent presentation in ENT &amp; HNS OPD. When endoscope was introduced, surgical management of nasal polyposis took a turn. More recently microdebrider use is in frequent practice. The objective of this study is to compare the surgical outcome in patients undergoing microdebrider assisted endoscopic surgery and conventional methods using sinus endoscopes in the surgical management of nasal polyps.Methods: The study was a prospective randomized study carried out in department of ENT in college of medical sciences Bharatpur from January 2021 to December 2021. Forty patients undergoing nasal polypectomy were randomly allocated into two groups; Group C (n=20) underwent FESS using conventional instruments, Group M (n=20) underwent FESS assisted with microdebrider. Comparison was done based in intraoperative blood loss and surgical duration, and post operative outcome.Results: Blood loss was significantly less in Group M when compared with group C (P=0.000). Mean surgical time was also significantly less in group M (79.5 min), (P=0.000). No difference was found regarding postoperative scaring, crusting, nasal discharge, synechiae formation, polyp recurrence and hospital stay (P&gt;0.05) when two groups were compared. Significant symptomatic improvement was observed in both groups in 3 and 6 months follow up visits when compared with preoperative symptoms. Significantly low postoperative VAS score in Group M was observed when compared with group C at 3 months postoperative follow up. Conclusions:It was concluded that FESS using conventional instruments or assisted with micodebrider is acceptable for surgical management of nasal polyposis. When both techniques are available, microdebrider assisted FESS is superior regarding less intraoperative blood loss, shorter surgical duration and better postoperative outcomes.

A Study Literature of Interest Rates and Islamic Monetary Policy

This paper provides a comprehensive analysis of the existing literature about contemporary Islamic monetary policy and its implementation through interest rates in the context of monetary policy. Upon conducting a comprehensive examination of the pertinent literature, it becomes evident that numerous conventional monetary policy instruments can be suitably modified and employed within the framework of Islamic monetary policy. Using interest rates as a monetary policy tool has been observed to directly impact injustice, including social unfairness, widespread corruption, and manipulation by global financial institutions that governments and authorities support. The current global financial crisis exemplified this. This study aims to analyze the several alternatives to interest rates utilized in Islamic monetary policy tools while also conducting a literature analysis on Islamic monetary policy.

Investment tokens as financial market tools

The rapid evolution of the digital financial asset market and its growing integration with traditional financial instruments, coupled with its global reach and unrestricted cross-border capital mobility, necessitate a thorough research of these market instruments. Specifically, it calls for an assessment of their potential as alternatives to conventional financial instruments. At the same time, there are many factors contributing to an increased risk of regulatory gaps in the financial market: structural vulnerability of the market of digital financial assets, high volatility of the value of crypto-assets, low transparency, the possibility of a spillover of risks from the market of digital financial assets to other financial markets, as well as the lack of regulatory consensus among financial regulators in the countries of the world. The research objective is to determine the role of investment tokens in today’s financial market, their utility in attracting investment resources on blockchain-based trading platforms, and the nuances of their classification as securities. The article delves into the core concepts and intricacies of regulating securities tokens and analyses quantitative metrics depicting the development of the investment token market and its relative share in the global financial market compared to other financial assets. Notably, the author outlines key criteria for securities regulators to consider when determining whether tokens should be classified as securities. The article reveals the main models of the initial offering of investment tokens, highlights their features, and shows their adaptability to changing conditions within the digital financial asset market and the evolving needs of market participants. It is evident that all current models for raising funds through investment tokens, including IEO, IDO, and STO sub-models, trace their roots back to the Initial Coin Offering (ICO) model and, fundamentally, do not differ significantly from traditional capital-raising models such as Initial Public Offering (IPO) and Secondary Public Offering (SPO) in traditional financial markets. This substantiates the need for global financial regulators to take actions aimed at officially classifying investment tokens as securities. Expanding securities legislation requirements to encompass issuers of investment tokens, particularly concerning information disclosure, promises to mitigate instances of fraud within the digital financial asset market. Such measures would fortify investor protection and reduce the vulnerability of financial markets as a whole.

Development of functional nougat without diabetic effects in vivo

Nougat is a confectionery foodstuff made of whipped egg white, sugar, honey, and nuts. In a traditional Italian nougat recipe, the mixture is flavoured with vanilla extract, and packed with toasted almonds. Traditional nougat is banned from the diets of diabetics due to high amount of sugar. In the present work, we aimed to develop innovative sugar-free nougat, and compare its textural and sensory properties with those of commercial nougat. Finally, we tested the residual hyperglycaemic effect in non-obese diabetic (NOD) mice, a model of type 1 diabetes. We developed a sugar-free nougat recipe by mixing xanthan gum, erythritol, and inulin with egg white and almonds using conventional industrial instruments. Technical analysis indicated that the structure, in terms of shear force, was comparable with that of traditional chewy nougat. Sensory analysis indicated that flavour and sweetness were preserved, whereas cohesiveness and fracturability changed significantly. Interestingly, the innovative food composition positively influenced two other texture parameters; solubility and adhesiveness. In vivo experiments showed that the number of mice in the group that was fed with experimental nougat that did not develop diabetes was significantly higher than that in the group fed with commercial nougat (66.6% vs. 33.0%; p &lt; 0.05), and not different from that in the group fed without nougat (72.7%; p = 0.37). In conclusion, we produced, on a pilot scale, innovative sugar-free nougat with improved texture and similar sensory properties, in comparison with the traditional product. In vivo, the experimental nougat did not increase the diabetes incidence significantly.

Design of a high bandwidth ECG signal low noise amplifier circuit for wearable devices

Nowadays, more than one million people die due to heart problems annually. Detecting the Electrocardiogram curve is an effective way to evaluate heart condition. Compared with large devices in the hospital, wearable devices are showing their advantage in detecting peoples Electrocardiogram whenever and wherever possible. However, in traditional amplifier circuit design, there is less attention to the bandwidth. The noise is negatively correlated with the current while the power consumption is positively correlated with the current, so it is challenging to balance the noise and power. Therefore, a design of a high bandwidth Electrocardiogram signal low noise amplifier circuit for wearable devices is proposed in this paper. The improved circuit is based on a conventional instrumentation amplifier and consists of two stages. The op-amps were replaced with Operational Transconductance Amplifier. The circuit also has a Driven-Right-Leg circuit part, which can tremendously reduce the effect of common-mode noise. The simulation result shows that the circuit has a high bandwidth and stable gain. Meanwhile, the circuit consumes less power and has a low integrated input-referred noise. This study is extremely helpful in expanding the application of wearable Electrocardiogram signal-detecting devices.

Computed tomography-based patient-specific cutting guides used for positioning of the femoral component of implants during unicompartmental knee arthroplasty: a cadaver study

BackgroundTo investigate whether patient-specific instrumentation (PSI) improves the femoral component positioning of implants during unicompartmental knee arthroplasty (UKA) using cadaver bone models.MethodsFifty adult cadaveric femoral bone specimens collected from February 2016–2018, were randomized to receive medial UKA with a PSI guide (n = 25) or conventional instrumentation (CI) (n = 25). Standard anteroposterior and lateral view radiographs were obtained postoperatively to assess the coronal and sagittal positioning of the femoral prostheses, respectively. The osteotomy time was recorded to assess the convenience of PSI in guiding osteotomy.ResultsOsteotomy time significantly shortened in the PSI group (3.12 ± 0.65 versus 4.33 ± 0.73 min, p < 0.001). There was a significant difference in the postoperative coronal alignment of the femoral component between the PSI and CI groups (varus/valgus angle: 1.43 ± 0.93° vs. 2.65 ± 1.50°, p = 0.001). The prevalence of outliers in coronal alignment was lower in the PSI than the CI group (2/25, 8% vs. 9/25, 36%). Sagittal posterior slope angle of the femoral component was significantly different between the two groups (8.80 ± 0.65° and 6.29 ± 1.88° in the CI and PSI groups, respectively, p < 0.001). The malalignment rate of the femoral component in the sagittal plane was 60% in the CI group, whereas no positioning deviation was observed in the PSI group.ConclusionThis study used a cadaver model to support the fact that CT-based PSI shows an advantage over CI in optimizing implant positioning for UKAs.

Ethiopia's Regulatory Regime on Advocates' Duty to Report Suspicious Transactions to Combat Money Laundering

Anti-Money Laundering measures have various objectives including detecting crime by following the money trail and protecting the integrity of the financial system against abuse by criminals. Suspicious Transactions Report (STR) is one of the vehicles to achieve these objectives. The Ethiopian Financial Intelligence Service has received reports of suspicious transactions involving 9 Billion Birr within five months of 2014 E.C. (Sept. 2021 to August 2022). On the other hand, some argue that the obligation contravenes legally protected rights, such as confidentiality, the relationship of trust between lawyers and client, professional freedom of the lawyers and fair trial. Based on international and national legal instruments and scholarly works, the practice in Ethiopia and views of experts, this author argues that advocates’ duty to report suspicious transaction is in line with legally protected rights due to the adverse impact of money laundering and the role of the professionals in combating money laundering through the bridge mechanism. The rights and privileges accorded to advocates and their clients are meant to protect legitimate interests of individuals, and cannot justify acts that conceal a crime, escape criminal liability or encourage impunity. The advocate’s duty to report suspicious transactions provided under Proclamation No. 780/2013 is thus in line with the state’s duty under the Palermo Convention and other international instruments.

Розвиток музичних здібностей молодших школярів засобами інструментального музикування

The article is devoted to the problem of developing musical abilities of younger schoolchildren in the process of instrumental music making. Today, reforms are actively taking place in the field of education, the purpose of which is the formation of a competitive, creative personality capable of self-determination, self-realization and self-improvement; promote his comprehensive development, talents, abilities, competences, creativity and curiosity. Therefore, a modern school should ensure the formation of such a personality, and an important role in the implementation of these tasks should be assigned to the art of music. The influence of instrumental music-making on the development of abilities, the formation and improvement of musical hearing and skills, emotional and conscious perception, expressiveness, improvisational development, a deep sense of music, aesthetic, patriotic and musical education of younger schoolchildren in modern education is considered. Attention is focused on finding ways to activate the development of musical abilities and constantly improving the methodology of musical education of younger schoolchildren in the process of various musical activities, and especially in the process of instrumental performance on elementary musical instruments. A certain number of elementary musical instruments are considered, both conventional (instruments without a certain pitch: sticks, bars, box, drum, tambourine, triangle, plates, brushes, spoons), and electronic (keyboard-electronic, instruments with non-fixed tuning). Methods of organizing training using such tools and their impact on the development of younger schoolchildren. The need and expediency of teaching younger schoolchildren to play musical instruments is determined. The focus is especially acute on modern musical instruments, such as: electric guitar, synthesizer, drums, etc. The effectiveness, efficiency, usefulness and perspective of using musical instruments in the process of education, training and activation of musical abilities of younger schoolchildren are revealed. Ways and methods of promoting the development of various musical abilities of younger schoolchildren through instrumental performance, such as: musical ear, technical skills, emotional perception, musical creativity, joint musical interaction, self-discipline, responsibility.

Lower Perioperative Complication Rates and Shorter Lengths of Hospital Stay Associated With Technology-Assisted Total Knee Arthroplasty Versus Conventional Instrumentation in Primary Total Knee Arthroplasty

BackgroundThe use of technology allows increased precision in component positioning in total knee arthroplasty (TKA). The objectives of this study were to compare (1) perioperative complications and (2) resource utilization between robotic-assisted (RA) and computer-navigated (CN) versus conventional (CI) TKA. MethodsA retrospective cohort study was performed using a national database to identify patients undergoing unilateral, primary elective TKA from January 2016 to December 2019. A total of 2,174,685 patients were identified and included RA (69,445), CN (112,225), or CI (1,993,015) TKA. Demographics, complications, lengths of stay, dispositions, and costs were compared between the cohorts. Binary logistic regression analysis was performed. ResultsThe RA TKA cohort had lower rates of intraoperative fracture (0.05 versus 0.08%, P < .05), respiratory complications (0.6 versus 1.1%, P < .05), renal failure (1.3 versus 1.7%, P < .05), delirium (0.1 versus 0.2%, P < .05), gastrointestinal complications (0.04 versus 0.09%, P < .05), postoperative anemia (8.9 versus 13.9%, P < .05), blood transfusion (0.4 versus 0.9%, P < .05), pulmonary embolism, and deep vein thrombosis (0.1 versus 0.2%, P < .05), and mortality (0.01 versus 0.02%, P < .05) compared to conventional TKA, though the cohort did have higher rates of myocardial infarction (0.09 versus 0.07%, P < .05). The CN cohort had lower rates of myocardial infarction (0.02 versus 0.07%, P < .05), respiratory complications (0.8 versus 1.1%, P < .05), renal failure (1.5 versus 1.7%, P < .05), blood transfusion (0.8 versus 0.9%, P < .05), pulmonary embolism (0.08 versus 0.2%, P < .05), and deep vein thrombosis (0.2 versus 0.2%, P < .05) over CI TKA. Total cost was increased in RA (16,190 versus $15,133, P < .05) and CN (17,448 versus $15,133, P < .05). However, the length of hospital stay was decreased in both RA (1.8 versus 2.2 days, P < .05) and CN (2.1 versus 2.2 days, P < .05). ConclusionsTechnology-assisted TKA was associated with lower perioperative complication rates and faster recovery.

Varying Complication Rates and Increased Costs in Technology-Assisted Total Hip Arthroplasty Versus Conventional Instrumentation in 1,372,300 Primary Total Hips

BackgroundThe use of technology allows surgeons increased precision in component positioning in total hip arthroplasty (THA). The objective of this study was to compare (1) perioperative complications and (2) resource utilizations between robotic-assisted (RA) and computer-navigated (CN) versus conventional instrumenttaion (CI) THA. MethodsA retrospective cohort study was performed using a large national database to identify patients undergoing unilateral, primary elective THA from January 1, 2016 to December 31, 2019 using RA, CN, or CI. There were 1,372,300 total patients identified and included RA (29,735), CN (28,480), and CI (1,314,085) THA. Demographics, complications, lengths of stay, dispositions, and costs were compared between the cohorts. Binary logistic regression analyses were performed. ResultsThe use of RA THA led to lower rates of intraoperative fracture (0.22% versus 0.39%), delirium (0.1% versus 0.2%), postoperative anemia (14.4% versus 16.7%), higher myocardial infarction (0.13% versus 0.08%), renal failure (1.7% versus 1.6%), blood transfusion (2.0% versus 1.9%), and wound dehiscence (0.02% versus 0.01%) compared to CI THA. The use of CN led to lower rates of respiratory complication (0.5% versus 0.8%), renal failure (1.1% versus 1.6%), blood transfusion (1.3% versus 1.9%), and pulmonary embolism (0.02% versus 0.1%) compared to CI THA. Total costs were increased in RA ($17,729 versus $15,977) and CN ($22,529 versus $15,977). Lengths of hospital stay were decreased in RA (1.8 versus 1.9 days) and CN (1.7 versus 1.9 days). ConclusionsPerioperative complication rates vary in technology-assisted THA, with higher rates in RA THA and lower rates in CN THA, relative to CI THA. Both RA THA and CN THA were associated with more costs, shorter postoperative hospital stays, and higher rates of discharge home compared to CI THA.

Securitization of Migration: Sociocultural Ontology of Contemporaneity

The study takes as its starting point the incorporation of the socio-cultural factor into the cognitive schemes of politics as a key trend in changing the interpretive logic of political ontology. The depletion of conventional epistemological instruments for interpreting modern world socio-political constructions prompts inquiry into new cognitive perspectives. Migration is one factor that concentrates the spectrum of ongoing transformations within the conceptual and discursive spaces built around it. The article examines the contradictions between the generalisation of Western experience and forms of collective identity, the evolving understanding of the border, and the diversifi cation of political actors that have arisen due to migration fl ows. The reimagining of migration in the context of security is a theoretical, political, and instrumental force in shaping contemporary society. It alters the customary fi elds of politics, value hierarchies, dominant cognitive frameworks, and global order. The reimagining of migration in the context of security is a theoretical, political, and instrumental force in shaping contemporary society. The reimagining of migration in the context of security is a theoretical, political, and instrumental force in shaping contemporary society. Drawing on various narratives, this article shows that the securitization of migration in public consciousness and political practice perpetuates a fear of a total security vacuum and perceived threats.

A randomized controlled trial comparing conventional and piezosurgery methods in mandibular bone block harvesting from the retromolar region

BackgroundAlthough piezosurgery is now commonly used for various applications in maxillofacial surgery, its advantages over conventional rotary instruments in terms of postoperative edema, ecchymosis, postoperative morbidity, and prolonged osteotomy time have been questioned.Materials and methodsThis study aimed to compare the efficiency, postoperative morbidity, and complication rates of piezosurgery and conventional methods in harvesting autogenous ramus grafts. In this randomized controlled trial, 21 patients (32 sides) underwent autogenous graft harvesting from the ramus area, with 16 sites treated using piezosurgery and 16 using the conventional method. The primary outcomes measured were osteotomy time, total operation time, and postoperative morbidity. Complication rates were also evaluated.ResultsThe final analysis encompassed 19 patients, accounting for a total of 30 donor sites, following the exclusion of two patients who were unable to attend the scheduled follow-up visits. A total of 19 patients (30 donor sites) were included in the final analysis. No statistically significant difference was found in the mean osteotomy time between the piezosurgery group (mean: 10.35, SD: 2.74 min) and the conventional group (mean: 8.74, SD: 2.74 min) (95% CI: -3.67 to 0.442, p = 0.119). The total operation time, postoperative pain, and swelling were not significantly different between the two groups (p > 0.05). The complication rates, including wound dehiscence and inferior alveolar nerve exposure, were similar in both groups.ConclusionsPiezosurgery can be safely used for harvesting autogenous ramus grafts and does not increase osteotomy or total operation time compared to the conventional method. The postoperative morbidity and complication rates were also similar, indicating that both techniques can be effectively employed in clinical practice.Clinical Trial RegistrationThe protocol was registered on clinicaltrials.gov (ID: NCT05548049, First registration date: 21/09/2022).