Interruption Method Research Articles

Evaluating the impact of the Public Health Wales Winter Respiratory Vaccines Communication Campaign 2022–23 on vaccination uptake in Wales: an investigation using controlled interrupted time series methods

BackgroundClinically vulnerable groups are at greater risk of serious illness when seasonal flu and increased COVID-19 infection rates coincide. Public Health Wales ran a national Winter Respiratory Vaccines Communications Campaign in 2022-23, jointly targeting flu and COVID-19 vaccination uptake, tailoring messages towards low uptake groups, and eligible groups with underlying health conditions. We evaluated whether the campaign increased vaccination uptake in the clinically vulnerable using a natural experiments approach. MethodsThe study used a total population of patients registered with NHS Wales during Sept 1 to Dec 31, 2022, who were eligible for both flu and COVID19 vaccination. Anonymised data from the National Vaccination Registry in the SAIL databank was analysed using a controlled interrupted time series (CITS) to investigate the impact of the campaign on vaccine uptake. Due to the availability of data before the beginning of the campaign, COVID-19 daily rates of vaccination were used. The campaign intervention group contained respiratory clinically vulnerable patients aged 16–49 years (n=49 749) and the control group was patients not clinically vulnerable but eligible because of age ≥50 years. The preintervention time series was 1 to 26 September 2022 and post campaign data was examined in the initial weeks after campaign introduction. Modelling will take account of COVID-19 infections, vaccination invitation letters and consider demographics. FindingsDescriptive trends in vaccination uptake show age is a dominating factor over clinical risk for people taking up the vaccine offer, particularly as age rises towards 65+ years. Early findings from the CITS suggest an increase in vaccination uptake from the campaign. InterpretationWe outline the practical application of using novel methods to evaluate the impact of a national communications campaign on vaccine uptake. Confidently attributing the effect of the campaign is challenging due to the complex vaccination delivery landscape, with results requiring careful interpretation. FundingNone.

A study to compare abdominal wall closure with interrupted vs. continuous sutures using polydioxanone in patients undergoing emergency exploratory laparotomy

Background: Wound closure in emergency surgeries can be done either by interrupted or by continuous sutures with each having its own advantages and disadvantages. In this paper we shall try to compare the advantages and adverse effects of both these methods of wound closure. Methods: A prospective comparative study involving 50 patients undergoing emergency laparotomies was conducted in Department of General Surgery, MMIMSR, Mullana from October 2022 to April 2024 (18 months). We compared two abdominal wall closure techniques using polydioxanone (PDS), patients, aged 18-75 years, were alternatively assigned to one of two groups: Group I received interrupted PDS sutures, while Group II received continuous PDS sutures. Postoperatively, pain and complications like infections were observed and analysed statistically. Results: In our study, we compared abdominal wall closure techniques in emergency exploratory laparotomy patients. The mean age was similar in the two groups, 43.68 years vs 43.08 years respectively in group I and II. Wound infection occurred in 44% of patients in the interrupted suture group and 60% in the continuous suture group, with a significant difference favouring the interrupted method. The mean wound closure time (33.24 vs 18.32 minutes) and post operative pain were more in the interrupted suture group as compared to the continuous suture group. Conclusions: The interrupted suturing method proved to be more effective in preventing complications, it did require more time to perform. However, after thoroughly reviewing the available data, no definitive evidence was found to support the superiority of either techniques.

The impact of recreational cannabis legalization on cannabis-related acute care events among adults with schizophrenia.

Patients with schizophrenia have a higher risk of cannabis use disorder and may be uniquely affected by the legalization of recreational cannabis. This study examined whether cannabis legalization led to changes in acute care utilization among patients with schizophrenia. Using linked health administrative data, we included adult patients with schizophrenia in Ontario from October 2015 to May 2021 (n = 121,061). We examined the differences in cannabis, psychosis, and mental health-related emergency department (ED) visits over three periods: pre-legalization, legalization of flowers and herbs (phase 1), and legalization of edibles, extracts, and topicals (phase 2) using interrupted time-series methods. Our study found that phase 1 was associated with decreases in cannabis-related, mental health-related, and cannabis + psychosis-related ED visits among the patients with schizophrenia. Notably, an immediate 25.8% (95% CI 13.8-37.6%) decrease in cannabis-related ED visits was observed in men, and an immediate 18.5% decrease in mental health-related ED visits (95% CI 6.0-31.2%) in women. These decreases were also shown in the comparative ITS models, demonstrating that the changes observed were distinct from trends in the general population. However, phase 2 was not associated with any significant changes. Despite higher baseline rates of acute care utilization among patients with schizophrenia, cannabis legalization was associated with significant reductions, particularly during phase 1. Our findings suggest that regulatory measures accompanying legalization could enhance the quality and safety of cannabis products, potentially leading to fewer adverse health outcomes in vulnerable patient populations. Further research is needed to optimize healthcare responses for this vulnerable population.

Maternal Health During the COVID-19 Pandemic in the United States: An Interrupted Time-series Analysis.

The COVID-19 pandemic, and subsequent policy responses aimed at curbing disease spread and reducing economic fallout, had far-reaching consequences for maternal health. There has been little research to our knowledge on enduring disruptions to maternal health trends beyond the early pandemic and limited understanding of how these impacted pre-existing disparities in maternal health. We leveraged rigorous interrupted time-series methods and US National Center for Health Statistics Vital Statistics Birth Data Files of all live births for 2015-2021 (N = 24,653,848). We estimated whether changes in maternal health trends after the onset of the COVID-19 pandemic (March 2020) differed from predictions based on pre-existing temporal trends. Outcomes included gestational diabetes, hypertensive disorders of pregnancy, gestational weight gain, and adequacy of prenatal care. We found an increased incidence of gestational diabetes (December 2020 peak: 1.7 percentage points (pp); 95% confidence interval [CI]: 1.3, 2.1), hypertensive disorders of pregnancy (January 2021 peak: 1.3 pp; 95% CI: 0.4, 2.1), and gestational weight gain (March 2021 peak: 0.1 standard deviation; 95% CI: 0.03, 0.1) and declines in inadequate prenatal care (January 2021 nadir: -0.4 pp; 95% CI: -0.7, -0.1). Key differences by subgroups included greater and more sustained increases in gestational diabetes among Black, Hispanic, and less educated individuals. These patterns in maternal health likely reflect not only effects of COVID-19 infection but also changes in healthcare access, health behaviors, remote work, economic security, and maternal stress. Further research about causal pathways and longer-term trends will inform public health and clinical interventions to address maternal disease burden and disparities.

A novel dual-stage failure criterion based on forming limit curve for uncured GLARE

Forming limit curve (FLC) is an essential criterion for evaluating the formability of fiber metal laminates (FMLs) in mass fabrication. However, conventional methodologies are unable to predict inner fiber failure, very sensitive to wrinkling defects, resulting in low measurement accuracy and stability. Hence, a novel dual-stage failure criterion considering the progressive failure of fiber and metal layers has been developed and validated by utilizing a notch-pattern sample and forming of typical thin-walled structure, with four typical categories of glass laminate aluminum reinforced epoxy (GLARE). The Nakajima tests of a series of notch-pattern and conventional pattern specimens with different widths were conducted in this study, demonstrating the superiority of wrinkling and delamination prevention of the notch-pattern by enhancing 22.84 % stress triaxiality and reducing 39.51 % compress strain in the edge area. Notably, punch reaction force and strain field analyses unveiled a mutation phenomenon indicative of premature fiber failure while the aluminum remained intact, which was also verified by numerical and interrupted methods. Furthermore, the acoustic emission in-situ method was adopted to monitor the progressive damage evolution of uncured GLARE in the Nakajima test, providing solid support for the occurrence of fiber failure at the mutation site. Leveraging these mutations, a list of dual-stage forming limit curves was devised to quantify the progressive damage behavior of uncured GLARE under biaxial tensile conditions. Finally, the practical application of this novel dual-stage forming limit curve methodology was demonstrated in the manufacturing process of a box-shaped part, serving as a proof of concept for its effectiveness. This study offers a foundational guideline for characterizing the intrinsic failure mechanisms of fiber metal laminates, particularly internal fiber failure under various strain conditions, thereby enhancing predictive accuracy.

Synchrophasing control of multiple propellers based on hardware in the loop experimental platform

A hardware in the loop experimental platform is established to evaluate the optimal noise reduction prediction and maintenance capability of multiple propellers under high-precision synchrophasing control. This platform incorporates an online propeller noise model and a digital turboprop engine model into a novel integrated measurement system. Firstly, an improved propeller signature theory using CFD simulation's sound pressure signals is proposed to predict the online propeller noise efficiently. It achieves acceptable noise prediction accuracy using a subset of synchrophase angles to predict noise for all synchrophase angles at all receivers. Secondly, a high-priority interrupt method is proposed for the novel integrated measurement system to guarantee precise measurement and ultimate high-precision synchrophasing control. Thirdly, a turboprop engine model based on a component level model and propeller performance maps' CFD data is also established. To enhance the simulation confidence of the system, we compare the dynamic synchrophasing control effects between systems with and without the integration of a turboprop engine mode. The experimental results demonstrate that the high-priority interrupt method effectively reduces the synchrophase angle(θ) error. These approaches reduce noise by 3.62dB at SPL, exhibit a noise variation within ±0.13dB/°, and effectively manage thrust fluctuation within 4.14%. These results indicate that the method meets the control accuracy and noise reduction requirements in a twin-engined turboprop aircraft.

Not Right Now: Factors Affecting Interruption Decisions in a Healthcare Paradigm

Interruptions that occur during high-stakes tasks in healthcare increase the likelihood of adverse events. Research on interruption management strategies has addressed the outcomes of interruptions but not what influences the decision to accept or reject them. This study examined the effects of high and low levels of three moderators on the interruption decision-making process: priority, cost of the interruption, and method of interruption. Participants entered data in a simulated patient chart while monitoring simulated patient vital signs and were interrupted four times to perform other activities. Participants could either accept or reject each interruption. The results showed that high priority, low-cost, and face-to-face interruptions were more likely to be accepted. Thus, participants considered the nature of the interrupting task when deciding to suspend work on their current task. These results suggest that a better understanding of factors that affect interruption decisions can lay a foundation to help diminish their disruptiveness.

Rethinking treatment failures. Research on a group of Italian psychotherapists.

Psychotherapeutic failures involve situational, relational, and personal factors. Dropout refers to a patient's unilateral termination of treatment without the therapist's knowledge or approval. Premature termination occurs when therapy is discontinued before achieving a sufficient reduction in initial problems. This study explores the role of therapist's emotional response (countertransference), gender, psychotherapeutic orientation, and patient diagnosis in the context of psychotherapeutic failures. A mixed-method approach was used. Fifty-nine Italian psychotherapists, practicing mostly privately with at least 5 years of experience, were recruited through Italian professional internet websites. The Therapist Response Questionnaire and the Impasse Interview were administered to each psychotherapist. Each therapist was asked to reflect on their last dropout patient. Quantitative (MANOVA) and qualitative analyses (textual content analysis) were conducted with SPSS and T-LAB, respectively. The quantitative analyses revealed that the most frequent countertransference response was Helpless/Inadequate, with female therapists experiencing this more frequently than male therapists. The qualitative analyses identified two main factors explaining most of the variance in countertransference responses: Parental/Protective versus Hostile/Angry, and Positive/Satisfying versus Helpless/Inadequate, with Helpless/Inadequate central. Additionally, the qualitative analysis of treatment interruption methods revealed two factors explaining over 50% of the variance. Lack of communication was linked to negative themes, while mediated and direct communication were associated with positive terms. Direct communication was characterized as useful, while mediated communication was linked to dropout and attachment figures. Under pressure, psychotherapists' anxiety levels increase, often managed ambivalently or avoidantly. These results suggest that awareness of psychotherapist emotional responses is important to limit psychotherapeutic failures. These findings offer valuable insights for clinical practice.

Use of interrupted time series methods in the evaluation of the Jordanian National Strategy for Women Empowerment (JNSWE) from 2013 to 2017 and its gender action plan for STEM field

AbstractEven though we have varied backgrounds, experiences, roles, and privileges in the community research field, we are all committed to studying equity theory and associated literature in educational contexts. The purpose of this evaluation is to assess the Jordanian national strategy for women's empowerment from 2013 to 2017 and its gender equality program in its efforts to increase Jordanian women's representation in scientific studies, achieve gender equality, and empower all women and girls, in addition to the goals related to other objectives. This analysis considers interrupted time series methods (randomized controlled trials) to measure the impacts of Jordanian National Strategy for Women Empowerment (JNSWE). Pre‐ and post‐policy periods were compared. Trend, regression analysis, r and r2, and the Mann–Whitney U test were utilized. The impact of this strategy delivers impressive results. This evaluation indicates that between 2013 and 2017, the JNSWE was effective in increasing Jordanian women's presence in STEM studies due to addressing gender inequality, the gender pay gap, and training deficiencies in the field. The first hypothesis was accepted (Z = −2.812, P > .005, df = 11), and the JNSWE's implementation from 2013 to 2017 increased the number of Jordanian women in science. The execution of the JNSWE (2013–2017) supported the representation of Jordanian women in telecommunications more than before, and Hypothesis H2 was accepted (Z = −2.892, P > .004, df = 11). Ultimately, Hypothesis H3 was approved (Z = −2.254, P > .024, df = 11), and the JNSWE's implementation from 2013 to 2017 increased the number of Jordanian women pursuing careers in engineering and mathematics. In this sense, this evaluation is innovative and responsive to the rising calls and concerns of feminists to empirically address the low presence of Jordanian women in scientific studies science, technology, engineering, and mathematics, known by the acronym STEM, and seeks to eliminate all forms of gender bias against women in the public spheres, including pay inequality. Included are the study's recommendations for further research.

Multilocus genetic analysis of Trypanosoma cruzi supports non-domestic intrusion into domestic transmission in an endemic region of Colombia

Trypanosoma cruzi, the causative agent of Chagas disease, is primarily transmitted to humans by hematophagous bugs of the Triatominae subfamily. In the Colombian Caribbean region, particularly on Margarita Island, T. cruzi transmission is highly endemic and associated with vectors such as Triatoma maculata and Rhodnius pallescens. Additionally, T. cruzi-infected Didelphis marsupialis are commonly found in close proximity to human dwellings. Given the complex transmission dynamics involving various domestic and non-domestic hosts, this study aimed to analyze 145 T. cruzi clones from twelve strains isolated from T. maculata, R. pallescens, and D. marsupialis using spliced leader intergenic region (SL-IR) sequences and nine polymorphic microsatellite loci. The results indicate the presence of a single polymorphic T. cruzi population, suggesting sustained local transmission dynamics between triatomines adapted to A. butyracea forests and peridomestic areas inhabited by synanthropic mammal reservoir such as D. marsupialis. Notably, this population appears to lack substructure, highlighting the importance of adopting an alternative eco-health approach to complement traditional chemical vector control methods for more effective and sustainable interruption of transmission.

Queen ringing vs. queen caging for summer brood interruption

In many temperate regions, increasing temperatures in the autumn and winter result in shorter or even non-existent brood breaks in honey bee (Apis mellifera L.) colonies. This facilitates a year-round reproduction of Varroa destructor and corresponding pathogen pressure. To address this problem, introducing an artificial brood break during winter might be essential. On the other hand, queen caging in summer, as one of the most prominent brood interruption methods, has already been accepted as an effective way for Varroa control in honey bee colonies. In this study, we compared queen caging vs. queen ringing as a novel technique for inducing summer brood interruption.

Effect of the Method of Response Interruption and Redirection in Verbal Stereotypical Behaviors

Bu araştırmanın amacı tepkiyi yarıda kesme ve yeniden yönlendirme (TYKY) yönteminin Otizm Spektrum Bozukluğu (OSB) tanısı olan bireylerde görülen sözel basmakalıp davranışların ortaya çıkma sıklığını azaltma üzerindeki etkisini incelemektir. Araştırmada tek denekli araştırma modellerinden ABAB deseni kullanılmıştır. Araştırmanın bağımlı değişkeni OSB tanısı olan öğrencilerde görülen sözel basmakalıp davranışlar, bağımsız değişkeni ise uygulanan tepkiyi yarıda kesme ve yeniden yönlendirme yöntemidir. Bulgulara bakıldığında TYKY yönteminin OSB tanısı olan bireylerde görülen sözel basmakalıp davranışların ortaya çıkma sıklığını azalttığı, bu nedenle olumlu etkisinin olduğu, bu olumlu etkinin kalıcı olduğu görülmüştür. Ek olarak annelerin yöntem ile ilgili görüşlerinin olumlu olduğu bilgisine ulaşılmıştır. Geçmiş araştırma bulguları da yöntemin OSB tanısı olan bireylerde görülen sözel basmakalıp davranışların ortaya çıkma sıklığını önemli ölçüde azalttığını, bu olumlu etkinin kalıcı olduğunu göstermekte ve yöntemin ebeveynler tarafından tercih edildiği görülmektedir. OSB tanısı olan bireylerde yoğun görülebilen sözel basmakalıp davranışının ortaya çıkma sıklığını azaltmak için, TYKY yönteminin etkili, kalıcı ve uygulanabilir bir yöntem olduğu sonucuna ulaşılmıştır.

Developmental or Procedural Vena Cava Interruption and Venous Thromboembolism: A Review.

The inferior vena cava (IVC) and superior vena cava are the main conduits of the systemic venous circulation into the right atrium. Developmental or procedural interruptions of vena cava might predispose to stasis and deep vein thrombosis (DVT) distal to the anomaly and may impact the subsequent rate of pulmonary embolism (PE). This study aimed to review the various etiologies of developmental or procedural vena cava interruption and their impact on venous thromboembolism. A systematic search was performed in PubMed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines per each clinical question. For management questions with no high-quality evidence and no mutual agreements between authors, Delphi methods were used. IVC agenesis is the most common form of congenital vena cava interruption, is associated with an increased risk of DVT, and should be suspected in young patients with unexpected extensive bilateral DVT. Surgical techniques for vena cava interruption (ligation, clipping, and plication) to prevent PE have been largely abandoned due to short-term procedural risks and long-term complications, although survivors of prior procedures are occasionally encountered. Vena cava filters are now the most commonly used method of procedural interruption, frequently placed in the infrarenal IVC. The most agreed-upon indication for vena cava filters is for patients with acute venous thromboembolism and coexisting contraindications to anticoagulation. Familiarity with different forms of vena cava interruption and their local and systemic adverse effects is important to minimize complications and thrombotic events.

The influence of shot peening on gear teeth micropitting and contact fatigue failure

Case-hardened gears present a high contact fatigue load capacity in a compact and light mechanical transmission systems but sometimes, micropitting appears. This damage can lead to early contact fatigue failure called macropitting (NF ISO 10825-1). A previous study has demonstrated that an appropriate shot peening treatment could reduce the micropitting phenomenon via tests on a twin disc machine.The aim of this paper is to study the influence of shot peening on the micropitting of case-hardened gears tooth flank and its development to macropitting. Experimental tests are carried out using a back-to-back gear test rig, an interrupted test method is defined in order to monitor the micropitting initiation and its propagation on the tooth flank. Two variants of carburized spur gear specimens are tested. The reference specimen has a case-hardened ground tooth flanks which is a typical gear application. The other specimen has a case-hardened ground tooth flanks with a shot peened finishing process. The fatigue tests are run until the appearance of macropitting. The performed inspections of specimens indicate that shot peening modifies the surface roughness, the surface topography and increases the compressive residual stress. The experimental results show that micropitting occurs on both shot-peened and non-shot-peened gears after approximately the same running time. However, a difference is observed in the propagation of micropitting on the tooth flanks. In comparison to reference gears, shot peening has postponed the apparition of macropitting by more than 60%. An analytical study is also conducted to validate the prediction of micropitting using the ISO/TR 6336-22 by comparing the results with the occurrence of micropitting on the tested gears.

Identification and analysis of Nonlinear behaviors of vocal fold biomechanics during phonation to assess efficacy of surgery for benign laryngeal Diseases

BackgroundCurrent voice assessments focus on perceptive evaluation and acoustic analysis. The interaction of vocal tract pressure (PVT) and vocal fold (VF) vibrations are important for volume and pitch control. However, there are currently little non-invasive ways to measure PVT. Limited information has been provided by previous human trials, and interactions between PVT and VF vibrations and the potential clinical application remain unclear. Here, we propose a non-invasive method for monitoring the nonlinear characteristics of PVT and VF vibrations, analyze voices from pathological and healthy individuals, and evaluate treatment efficacy. MethodHealthy volunteers and patients with benign laryngeal lesions were recruited for this study. PVT was estimated using an airflow interruption method, VF vibrational frequency was calculated from accelerometer signals, and nonlinear relationships between PVT and VF vibrations were analyzed. Results from healthy volunteers and patients, as well as pre- and post-operation for the patients, were compared. ResultsFor healthy volunteers, nonlinearity was exhibited as an initial increase and then prompt decrease in vibrational frequency at the end of phonation, coinciding with PVT equilibrating with the subglottal pressure upon airflow interruption. For patients, nonlinearity was present throughout the phonation period pre-operatively, but showed a similar trend to healthy volunteers post-operatively. ConclusionThis novel method simultaneously monitors PVT and VF vibration and helps clarify the role of PVT. The results demonstrate differences in nonlinear characteristics between healthy volunteers and patients, and pre-/post-operation in patients. The method may serve as an analysis tool for clinicians to assess pathological phonation and treatment efficacy.

State of health estimation for lithium-ion batteries based on current interrupt method and genetic algorithm optimized back propagation neural network

Accurate state-of-health (SOH) estimation is an essential prerequisite for a battery management system (BMS) to improve battery utilization efficiency. The impedance information can be utilized to reflect the SOH. However, the traditional electrochemical impedance spectroscopy (EIS) method suffers from time-consuming measurements and specialized equipment. This study aims to establish a connection between EIS and the current interrupt method, which reduces the difficulty of obtaining impedance information through its utilization. This method can be applied in real time during charging, enabling it to be incorporated into a BMS. A genetic algorithm optimized back propagation neural network (GA-BPNN) is developed to estimate the SOH based on the impedance information obtained in the current interrupt method as inputs. The genetic algorithm improves the weights and thresholds of the neural network, which solves the parameter calibration problem. In this study, besides utilizing measurement data from different aging conditions as training set data, hybrid tests comparable to the actual usage environment are employed as validation set data. The experimental results show that a combination of the proposed current interrupt method and GA-BPNN can estimate SOH accurately with the root mean square error (RMSE) as low as 0.77 % in a complex hybrid test environment.

Emergency department visits and hospital admissions for suicidal ideation, self-poisoning and self-harm among adolescents in Canada during the COVID-19 pandemic.

The COVID-19 pandemic had profound effects on the mental wellbeing of adolescents. We sought to evaluate pandemic-related changes in health care use for suicidal ideation, self-poisoning and self-harm. We obtained data from the Canadian Institute for Health Information on emergency department visits and hospital admissions from April 2015 to March 2022 among adolescents aged 10-18 years in Canada. We calculated the quarterly percentage of emergency department visits and hospital admissions for a composite outcome comprising suicidal ideation, self-poisoning and self-harm relative to all-cause emergency department visits and hospital admissions. We used interrupted time-series methods to compare changes in levels and trends of these outcomes between the prepandemic (Apr. 1, 2015-Mar. 1, 2020) and pandemic (Apr. 1, 2020-Mar. 31, 2022) periods. The average quarterly percentage of emergency department visits for suicidal ideation, self-poisoning and self-harm relative to all-cause emergency department visits was 2.30% during the prepandemic period and 3.52% during the pandemic period. The level (0.08%, 95% confidence interval [CI] -0.79% to 0.95%) or trend (0.07% per quarter, 95% CI -0.14% to 0.28%) of this percentage did not change significantly between periods. The average quarterly percentage of hospital admissions for the composite outcome relative to all-cause admissions was 7.18% during the prepandemic period and 8.96% during the pandemic period. This percentage showed no significant change in level (-0.70%, 95% CI -1.90% to 0.50%), but did show a significantly increasing trend (0.36% per quarter; 95% 0.07% to 0.65%) during the pandemic versus prepandemic periods, specifically among females aged 10-14 years (0.76% per quarter, 95% CI 0.22% to 1.30%) and females aged 15-18 years (0.56% per quarter, 95% CI 0.31% to 0.81%). The quarterly change in the percentage of hospital admissions for suicidal ideation, self-poisoning and self-harm increased among adolescent females in Canada during the first 2 years of the COVID-19 pandemic. This underscores the need to promote public health policies that mitigate the impact of the pandemic on adolescent mental health.

Experimental study on the effect of scanning path on skin tissue properties of femtosecond laser welding.

To study the influence pattern of femtosecond laser scanning path on the welding effect of skin tissue, this experiment analyzed the influence of scanning path on the surface morphology, degree of thermal damage, tensile strength, and microstructure of skin samples after skin attachment by designing nine scanning paths to weld skin tissue. The results showed that the skin samples connected by interrupted parallel mattress eversion sewing method with d = 0.2 mm showed no obvious color changes in morphology, the skin samples were connected on both front and back sides, the tensile strength was the highest, reaching 12.80 N/cm2 , the thermal damage parameter was low at 1.08 × 10-2 , the microstructure had obvious directionality, and the texture was clear and uniformly distributed.

Observational study on the timing and method of interruption by hospital consultants during the opening statement in outpatient consultations

ObjectiveTo analyse verbal interruptions by Dutch hospital consultants during the patient’s opening statement in medical encounters.DesignCross-sectional descriptive study.SettingIsala teaching hospital in Zwolle, the Netherlands.Participants94 consultations by 27 consultants, video recorded...

Correction of Asymmetry of Palpebral Folds by Adopting Interrupted and Continuous Buried Suture Techniques Respectively on Different Eyelid.

People with an obvious palpebral fold on 1 eye and a narrow or no palpebral fold on the other eye are usually more satisfied with the shape of the obvious palpebral fold and want to acquire symmetry by minimally invasive surgical methods that preserve the shape of the original folds they are more satisfied with. This study introduced a minimally invasive approach using 2 different buried suture techniques on different eyelids to acquire symmetry. The continuous suture method aimed to build palpebral folds, whereas the 3-point interrupted suture method aimed to enhance naturally formed palpebral folds. The 3-point interrupted buried suture method was used on the eye with an obvious palpebral fold, and the continuous buried suture method was performed on the eye with a narrow or no palpebral fold. Twenty patients underwent this procedure to correct the asymmetry between June 2010 and July 2022. The mean follow-up period was 18.12 months. The average swelling period was 7 days on the side using the interrupted buried suture technique and 10 days on the side using the continuous suture method. It took ~3 weeks to recover a relatively natural appearance. According to postoperative follow-up data, all patients were satisfied with the results. Our surgical approach of adopting 2 different buried suture techniques on different eyelids allowed the building of the palpebral fold on one eyelid while enhancing the original fold on the other eyelid, leading to satisfactory results of palpebral fold symmetry.