Hook Method Research Articles

Lariat hooking method as an easy and quick preparation of clip-and-thread technique for endoscopic submucosal dissection.

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Numerical and experimental demonstrations of optical trapping and manipulation of a selective red blood cell using a photonic hook based on broken symmetry tapered fiber probe

Optical tweezers and trapping technologies have a crucial impact on scientific research by precisely manipulating mesoscale objects at wavelength scales. The development of simple fiber-based optical tweezers foreseeing sorting and manipulation of a single cell has been firstly encouraged by biomedical requirements. The ability to manipulate mesoscale objects with high flexibility and precision is essential for a wide class of different fields. The ability to precisely arrange cells into desired structures is important for numerous biomedical and physical applications. This study experimentally reports for the first time a simple and low-cost strategy to produce an optical fiber-based photonic hook for achieving new unprecedented functionalities to selective particle manipulation in a lab-on-tip platform. We show perspectives opened by combining the fields of structured light in the form of the photonic hook and optical manipulation method. This enables new applications for optical trapping setups based on structured fields in the form of the photonic hook produced by an optical fiber tip with broken symmetry, where it becomes possible to manipulate and sort cells selectively.

An investigation into the wound-healing mechanism in gill injuries of varying severity in the freshwater mussel Solenaia oleivora (Heude, 1877)

The Solenaia oleivora is an important freshwater economically farmed shellfish, and the traditional hooking method often causes different degrees of gill damage to the S. oleivora. Therefore, in this study, we investigated the mechanism of wound-healing in gill injuries in the freshwater mussel S. oleivora by simulating varying degrees of gill injury. It was found that the rates of oxygen consumption, ammonia excretion, and feeding did not change significantly in the mild-injury group at 2 and 12 h post-injury, while the rates were significantly lower in the severe-injury group compared with the control group, likely due to impairment of the respiratory metabolism. The rates of oxygen consumption, feeding, and ammonia excretion increased significantly in the mild-injury group at 24, 48, 72 h, compared with the control, as well as in the severe-injury group at 72 h post-injury, possibly due to increased energy requirements for tissue repair. Histological and transcriptomic analyses of tissues showed that in the mild-injury group at 2 and 12 h, blood cells migrated toward the wound, plugging it and triggering an inflammatory response associated with upregulation of TNF signaling, immune-related genes, and genes associated with the actin cytoskeleton, suggesting wound contraction and phagocytosis of blood cells. At 24 h post-injury, genes and pathways associated with antioxidant enzymes, chaperonins, autophagy, lysosomes, biochemical pathways, and energy metabolism were activated, suggesting a transition from an inflammatory response to an epithelialization process. At 48 h post-injury, Toll and Imd signaling were downregulated, together with upregulation of genes associated with the extracellular matrix, such as collagen, integrins, and glycoproteins, promoting epithelialization of the wound. After 72 h, proline and arginine metabolism were increased, as well as expression of mitochondrial genes. The severe-injury group showed reduced amino acid metabolism and activation of primary immunodeficiencies after 2 and 12 h, suggesting disturbances in metabolism and immunity, while after 2, 12, 24, and 48 h, genes related to the actin cytoskeleton, lipid metabolism, glycolysis, glycosyltransferases, chaperonins, guanylate-binding proteins, and NOD-like receptors were upregulated to promote wound contraction and inflammatory responses. At 72 h after injury, interleukin-4 and thymosin β-4 were activated and the NF-κB signaling pathway was inhibited to reduce inflammation, while epithelialization of the wounds was visible on tissue sections, possibly facilitated by the upregulation of ribosomal proteins, ATP. This study provides new insights into the mechanism of gill wound-healing in S oleivora.

Evaluation the quality of bag-mask ventilation by E/C, T/E and hook technique (a new proposed technique)

BackgroundBag-Mask Ventilation (BMV) is a crucial skill in managing emergency airway situations and induction of general anesthesia. Ensuring proficient BMV execution is imperative for healthcare providers. Various techniques exist for performing BMV. This study aims to compare the quality of ventilation achieved using the E/C technique, Thenar Eminence (T/E) technique and a novel approach referred to as the hook technique. The goal is to identify the most effective single-person BMV method.MethodWe conduct a pilot study on manikins involving 63 medical staff members who used the hook technique for ventilation. Subsequently, we obtained ethical approval and patient guardian consent to perform the study on 492 emergency department (ED) patients. These patients were randomly divided into three groups, with each group subjected to one three ventilation techniques. The study focused on patients requiring reliable airway management for rapid sequence intubation (RSI). Ventilation was administrated using bag-mask device connected to the capnograph. End-tidal CO2 (ETCO2) levels were recorded. Demographic data were collected and analyzed by SPSS software version 22. Success rates were reported as frequency (percentage) as well as mean ± standard deviation.ResultComparing partial pressure of CO2 (PCO2) results obtained via capnography between T/E, E/C and hook techniques, we found that the successful ventilation rate was 87.2% for T/E, 89.6% for E/C, and 93.3% for the hook methods. The hook method demonstrated significantly higher success rate compared to the other two techniques (P-value = 0.038). Furthermore, we observed statistically significant trends in PCO2 changes between measurements both within and between groups (P-value < 0/001).ConclusionOur study indicates that the hook method achieved notably higher success rate in ventilation compared to the T/E and E/C methods. This suggests that the hook method, which involves a chin lift maneuver while securely fitting the mask, could serve as a novel BMV technique, particularly for resuscitation with small hands for a prolonged use without fatigue and finger discomfort. Our finding contributes to the development of a new BMV method referred to as the hook technique.Trial registrationIRCT registration number: IRCT20121010011067N5. URL of trial registry record: https://www.irct.ir/trial/57420.

“Hooking method” for hepatic inflow control: a new approach for laparoscopic Pringle maneuver

BackgroundThe laparoscopic Pringle maneuver is crucial for controlling bleeding during laparoscopic hepatectomy. In this study, we introduce a new laparoscopic Pringle maneuver and preliminarily investigate its application in laparoscopic hepatectomy.MethodsWe collected and analyzed the clinical data of 17 consecutive patients who underwent laparoscopic hepatectomy at the Department of Hepatic Surgery, the First Affiliated Hospital of the University of Science and Technology of China, from January 2022 to January 2023. All patients underwent the hooking method for intermittent occlusion of hepatic inflow. Intraoperative and postoperative clinical indices were observed and recorded.ResultsAll 17 patients underwent laparoscopic hepatectomy with hepatic inflow control using the hooking method. Four patients with adhesions under the hepatoduodenal ligament successfully had occlusion loops placed using the hooking method combined with Zhang’s modified method during surgery. The median occlusion time for the 17 patients was 34 (12–60) min, and the mean operation time was 210 ± 70 min. The mean intraoperative blood loss was 145 ± 86 ml, and no patients required intraoperative blood transfusion. The patients’ postoperative peak AST was 336 ± 183 U/L, and the postoperative peak ALT was 289 ± 159 U/L. Postoperative complications occurred in 2 patients (11.8%), including 1 Clavien-Dindo grade I and 1 Clavien-Dindo grade II complication. No Clavien-Dindo grade IIIa or higher complications or deaths occurred in any patient. None of the patients developed portal vein thrombosis or hepatic artery aneurysm formation. The median postoperative hospital stay was 6 (4–14) days.ConclusionThe hooking method combines the advantages of both intracorporeal Pringle maneuver and extracorporeal Pringle maneuver. It is a simple, safe, and effective method for controlling hepatic inflow and represents a promising approach for performing totally intracorporeal laparoscopic Pringle maneuver.

Physico-chemical Parameters and Freshwater Fish Diversity of Sip River Madhya Pradesh, India

This study was carried out to analyze the variation in water quality and to investigate the current status of the fish fauna of the Sip river. Water samples and fish specimens were collected on monthly basis from six stations in the months of August 2017- July 2018. All the water quality attributes were found in the acceptable range that supports fish species, except stations IV and V, where pollution load was gradually increases. Seasonal changes in the physico-chemical parameters such as water temperature, pH, DO, free CO2 and total alkalinity revealed the effect on fish species diversity as well as health status of the river. The checklist of fish species recovered during the study was a total of 19 fish species belonging to 9 families, 13 genera and 4 orders. The family Cyprinidae dominant with 11 species, followed by Ambassidae 2 species, while as Bagridae, Channidae, Gobidae, Heteropneustidae, Nandidae and Siluridae each recorded 1 species, respectively. A total of 341 individuals of different fish species were caught from the different stations by using various fishing gears like cast net, gill net, hook and rod methods. Among all the stations studied, the maximum values of abundance 112 and 105 individuals was recorded from V and II stations, followed by I and VI stations having 57 and 51 individuals, while as minimum abundance 7 and 9 individuals was recorded from III and IV stations, respectively. Maximum values of Shannon-Weiner index (2.454) and Simpson’s index (0.906) were recorded from station-V (Pandagaon), while as minimum values of these indices (0.529 and 0.345) were recorded from stations-IV (Syampura). However, maximum values of Margalef’s index (2.793) and Pielou’s index (0.9898) were found from station-II (Ambhakadim) and station-III (Jiryna). The results of the study showed that the Sip river harbors rich ichthyofaunal diversity, but due to some anthropogenic pressure and illegal fishing practices adversely affected the fish diversity. The present study provide base line data initiative to update the current status of fish diversity and water quality parameters and will be useful to enhance the management and conservation strategies, for the fish species of Sip river. Therefore, important steps should be taken into consideration to increase the long-term sustainability of water health and fish activities in the river system

Pediatric Oronasopharyngeal Stricture– A Rare Surgical Complication of Adeno-Tonsillectomy Abstract

Introduction: Oronasopharyngeal stricture is a rare sequel of oropharyngeal surgical procedure which can cause swallowing difficulty, dyspnea, sleep related breathing disorders, incompetence at the velopharynx due to soft palatal adherence. Case: Here we present a case of nine-year-old girl who presented to us with complains of nasal obstruction since 3 months and symptoms of sleep disordered breathing. She underwent adenotonsillectomy 5 years ago and coblator assisted palatoplasty and stricture release 4 months ago. On examination adenoid facies was noted, postpalatoplasty and tonsillectomy status with stricture between the anterior and posterior tonsillar pillars. Soft palate was stuck to posterior pharyngeal wall. Computed tomography scan was done which depicted homogenously enhancing soft tissue density causing complete nasopharyngeal airway obstruction. Oronasopharyngeal stricture release was performed under general anesthesia. Infant feeding tube was inserted through the nasal cavity and introduced through the oropharynx into exterior and was tied externally which was removed on postoperative day 5. Child is on regular follow up since 5 months and asymptomatic. Discussion: Oropharyngeal stricture is reported as a rare sequela of adenotonsillectomy. Many surgical techniques have been reported for release of similar oropharyngeal and nasopharyngeal stricture patterns such as triamcinolone injection, manual dilation method, plasma hook method, division and skin grafting, local flaps like pharyngeal or palatal mucosal flaps, and free flap techniques. Conclusion: Utmost care must be taken during the surgical procedure of oropharynx to prevent collateral damage to mucosal surfaces which can result in such devastating complications.

Building Community Through Queer Learning Disability Amateur Filmmaking: Oska Bright Film Festival and Queer Freedom

Much has been written on the intersection of disability and sexuality since the publication of &lt;i&gt;The Sexual Politics of Disability&lt;/i&gt; (Shakespeare et al., 1996), however scant literature refers to these issues as represented on the screen, where it can be argued representations have the most power to shape perceptions. Disabled characters in media narratives are invariably represented as lacking in any sexuality or negation of heteronormative gender and sexual expressions.&lt;br /&gt; In 2017, Brighton-based learning disability film festival Oska Bright (OBFF) launched their Queer Freedom (QF) strand as an intervention in this lack of queer representation within learning disability narratives. In 2017 and 2019, QF featured films made by or featuring queer people with learning disabilities and autism, including Glasgow-based queer femme filmmaker Mattie Kennedy. Devised by OBFF Lead Programmer and queer filmmaker Matthew Hellett after meeting Kennedy at a previous OBFF, Hellett believed he had a responsibility to create a space for these unheard voices.&lt;br /&gt; This article mobilises Bonnie Honig’s feminist refusal method of inclination and bell hooks’ theory of talking back to explore how OBFF and QF have enabled Kennedy and Hellett to create space and claim their visibility as queer learning-disabled filmmakers through a process of mutual affirmation. Learning-disabled people have historically been segregated from society, so in the spirit of Foucault’s heterotopia, by coming together to form a community of people who affirm and encourage other queer learning-disabled people to make their voices heard, they are refusing their assigned societal segregation.

Safety and Effectiveness of Diode Laser Used in Stapes Surgery.

Objective: We comprehensively assessed the safety and effectiveness of a 980-nm diode laser with fiberoptic delivery in stapes surgery by laser energy use, complications, and audiometric outcomes. Materials and methods: We retrospectively reviewed 116 primary stapes surgery cases. A high-power (30-40 W), short-pulse (60 msec), 980-nm diode laser was used for superstructure removal and footplate fenestration in the diode laser group (DLG) and, the hook and drill method in the conventional technique group (CTG). Data on complications and surgical diode laser use were collected; audiometric results within 6 months postoperatively were included in the analysis. Results: In DLG, the median fenestration and superstructure resection energy were 4.80 and 18.23 J, respectively. Footplate floating occurred in two ears (2/128, 1.56%) with manual fenestration, although none in the DLG (p = 0.07). Six CTG patients (6/26, 23.08%) underwent inevitable stapedectomy owing to footplate dislocation, which was higher than that in the DLG (2.11%, p < 0.01). No patients in the DLG experienced sensorineural hearing loss, and bone conduction (BC) improved at 1 (preoperative and postoperative means: 23.69 and 20.93 dB, respectively; p = 0.003) and 2 kHz (preoperative and postoperative means: 35.28 and 31.40 dB, respectively; p < 0.001), whereas changes in BC at 0.5 and 3 kHz were stable (p > 0.05). Four DLG patients (4/107, 3.74%) experienced transient facial nerve palsy postoperatively. Laser energy analysis showed shorter superstructure vaporization intervals in patients with transient facial nerve palsy (mean, 11.65 sec; median of control, 24.57 sec; p = 0.037). Conclusions: High-power, short-pulse, 980-nm diode laser is safe and effective in stapes surgery.

Accompanying Grave Goods from the Kyrgyz Warrior Burial from the Vicinity of the Novoselovo Village (Krasnoyarsk Region)

Purpose. An analysis of the collection of iron weapons of the Kyrgyz warrior and the equipment of his riding horse showed that they come from a burial made according to the cremation rite. Items of horse equipment are: a bit with a hook method of connecting links and cheek-pieces in the form of large rings; two arched stirrups with holes in the upper part of the shackle and 10 lamellar overlays for a wooden saddle.Results. The weapons consist of 13 flat arrowheads and a saber, which was bend during the funeral rite. Saber length is 0.85 m, blade width is 3.2 cm, and weight is 568 grams. The guard is in the form of a rook; on one side of it, cruciform figures are applied. At the guard on the blade there is a figured clip. The bend of the blade is 1.7 cm, which makes it possible to attribute the saber to slightly curved samples. At the end of the shank, there is a hole for attaching the handle. Probably, the handle was made of solid wood, with a through hole and a prominent head at the end. The saber’s feature is the offset of the handle to the back of the blade, which is found on Caucasian (Circassian) checkers.Conclusion. The whole complex of objects has numerous analogies and dates back to the Mongolian period (13th – 14th centuries). During this period, there were several migrations of the Yenisei Kyrgyz to the territory of Mongolia and Manchuria.

The dangers of reused personal protective equipment: healthcare workers and workstation contamination

BackgroundPersonal protective equipment (PPE) is essential to protect healthcare workers (HCWs). The practice of reusing PPE poses high levels of risk for accidental contamination by HCWs. Scarce medical literature compares practical means or methods for safe reuse of PPE while actively caring for patients.MethodsIn this study, observations were made of 28 experienced clinical participants performing five donning and doffing encounters while performing simulated full evaluations of patients with coronavirus disease 2019. Participants' N95 respirators were coated with a fluorescent dye to evaluate any accidental fomite transfer that occurred during PPE donning and doffing. Participants were evaluated using blacklight after each doffing encounter to evaluate new contamination sites, and were assessed for the cumulative surface area that occurred due to PPE doffing. Additionally, participants' workstations were evaluated for contamination.ResultsAll participants experienced some contamination on their upper extremities, neck and face. The highest cumulative area of fomite transfer risk was associated with the hook and paper bag storage methods, and the least contamination occurred with the tabletop storage method. Storing a reused N95 respirator on a tabletop was found to be a safer alternative than the current recommendation of the US Centers for Disease Control and Prevention to use a paper bag for storage. All participants donning and doffing PPE were contaminated.ConclusionPPE reusage practices pose an unacceptably high level of risk of accidental cross-infection contamination to healthcare workers. The current design of PPE requires complete redesign with improved engineering and usability to protect healthcare workers.

POS-548 GLOMERULAR FILTRATION STATE OF CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS ACCORDING TO Cys-C INDICATORS

According to modern literature reveiw, it is believed that about 8% of children with juvenile idiopathic arthritis (JIA) have chronic kidney disease. Subclinical kidney damage in JIA remains undiagnosed in real clinical practice. Kidney damage can manifest itself as a complication of the underlying disease or, as a consequence, its long-term treatment.The structure of renal pathology in JIA is represented by secondary amyloidosis, glomerulonephritis, tubulo-interstitial nephritis. We investigated the level of cystatin C (Cys-C) in the blood of 80 children with JIA. The age of the subjects was from 3 to 17 years. The calculation of the glomerular filtration rate (GFR) was carried out twice (the first and third months of the study) on the basis of the concentration of Cys-C and creatinine in serum according to the methods: Hoek F.J. et al. (2003), Equation based on cystatin C (2012), Schwartz and Counahan-Barratt (2012). Cys-C averaged 0.886 ± 0.1495 (0.84; 0.79-0.98) μg / ml. The average GFR according to the 2012 equation based on cystatin C was 81.04 ± 12.129 (82.92; 71.74-88.53) ml / min / 1.73 m2, which is significantly lower than with the same GFR calculated using the method Hook - 88.81 ± 14.948 (91.05; 77.32- 98) ml / min / 1.73 m2, p <0.01. The percentage below normal GFR calculated using the 2012 equation based on cystatin C was twice that calculated using Hook's formula: 65 (81.3%) versus 33 (41.3%) cases (p <0.001 according to McNemar's test ). Analysis of the frequency of GFR decline, calculated on the basis of creatinine and Cys-C, also revealed a number of significant differences. Thus, the cystatin C-based equation technique compared with Schwartz and Counahan-Barratt 2012 methods overestimated the incidence of GFR abnormalities by 81.3% (p <0.001) and 47.5% (p <0.001), respectively, in the first month of the study and 81 respectively 3% (p <0.001) and 55.0% (p <0.001) in the third month. A similar comparison with Hook's method showed that according to the Schwartz formula, GFR decreased by 41.3% less often (p <0.001) both in the first and in the third month. The Counahan-Barratt formula did not show significant differences in the first study of creatinine (difference 7.5%, p <0.05), and the second study showed that the decrease in GFR according to the Counahan-Barratt was recorded 15.0% less frequently than according to the data on Hook's method - a deviation close to the level of significance, p <0.09. A more subtle method for detecting subclinical kidney damage in children with JIA is to determine the level of cystatin C followed by calculating the glomerular filtration rate, according to Hook's formula. The concentration of Cys-C was directly related to the duration of the use of non-steroidal drugs (ρ = 0.44, p <0.04), thus, the lengthening of their use had a negative effect on GFR (ρ = -0.44, p <0.04) . And, conversely, with an increase in the duration of immunobiological therapy, the level of cystatin C in the blood decreased (ρ = -0.48, p <0.02) and GFR increased (ρ = 0.48, p <0.02). When detecting a decrease in GFR in children with JIA, it is necessary to limit the intake of non-steroidal anti-inflammatory drugs and increase the basic therapy.

Play-Based Learning With Cantol Method for Developing Early Children's Linguistic Intelligence at Roudhoh Course Depok

This study describes the implementation of playing while learning children with the hook method and its implications for language development for early childhood at Roudhoh Depok tutoring. This research is descriptive research with a qualitative approach. The subjects of this study were PAUD students and educators at the Roudhoh Learning Guidance, Depok. Methods of data collection with interviews and documentation. Data analysis uses data analysis techniques from the Miles and Huberman model, consisting of data reduction, data presentation, and concluding. The results showed that the implementation of playing while learning with the hook method is a learning method that is given to introduce letters and how to read without coercion but with games that use visual aids and systems. Not spell, but hooks, which combine two letters (consonants and vowels) read together. The implication for the development of linguistic intelligence in early childhood is that it can produce students who can develop linguistic intelligence according to standards.

Reduction of Zygomatic Bone Fracture by Two Different Treatment Protocols

Background: Zygomatic bone, a malar bone or cheekbone usually works as eye socket. All over the world, around 15 to 20 million people are traumatized with road accidents. Over 50% of these statistics are diagnosed with zygomatic fractured bone. There are different approaches of therapy to treat zygomatic fractured bone. In this research, two approaches have been studied. The Percutaneous Hook approach is extraoral while Keen’s approach is intraoral. The objective of this study was to evaluate outcomes of two different treatment protocols (percutaneous bone hook method and Keen’s method) for reduction of zygomatic bone fracture. Methods: This comparative analytical study conducted at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Liaquat University Hospital, Hyderabad, Pakistan. Subjects with displaced isolated zygomatic bone fracture were divided in two groups, Group A (Percutaneous Hook Method) and Group B (Keen’s Method). The data was analyzed through SPSS and p&lt;0.05 was considered as statistically significant. Results: Males were predominantly affected in both groups as compared to females i.e., Group A male patients were 22(73.52%) while in Group B male patients were 23(79.41%). Road traffic accidents were the most common etiological factor in both groups. There was a significant difference between the groups in diplopia, cheek flattening and mean mouth opening at postoperative 2nd, 4th and 6th week. The obtained p-value=0.01 was less than 0.05; therefore, the results were statistically significant. Conclusion: It was observed that percutaneous hook method had better outcomes compared to Keen’s method in reducing isolated zygomatic bone fracture. Keywords: Bone Fracture; Treatment Protocols; Zygoma.

Application of the Cantol Roudhoh Method to Improve Student's Reading Ability in RA Siti Fatimah

The application of learning to read cantol roudhoh is one of the learning techniques that can improve children's language skills. This technique is very suitable for early childhood learning. The results of research conducted at RA Siti Fatimah, Harjamukti Village, Cirebon City, showed that the objective conditions of language learning were studied from the teacher's perspective, positive responses of children, teaching and learning processes, and supporting facilities, using the cantol roudhoh method which was applied in developing aspects of language, and skills children's language that can develop as expected. The implementation of this raudhoh hook method in its application process at RA Siti Fatimah is to practice in class A, which is to introduce hooks from her friends in clothes to her friends, Zahra, after reaching the target of her friends, Zahra continues on package B, which is entering the introduction of vocal groups (a, i, u, e, o), after that they enter the ng (cat) group, then enter the Koran group (nga, ngi, ngu, nge, ngo) and mosquitoes (nya, nyi, nyu, nye, nyo ). The last stage is the introduction of hooks with consonants.

Passage of electromagnetic wave through a rectangular wave guide with an active rectangular film

The proposed work examines the passage of the electromagnetic wave through a rectangular wave guide with active film and magnetized ferritic layers. Ferrimagnetic layers are located between metal planes with perfect conductivity. A dispersion equation has been obtained to calculate the constant spread in the structure in question. The dispersion equation was solved by the Jeeves–Hook method. The graphs obtained at different parameters of the film and at different values of the magnetizing field are presented.

Increasing the Interferogram Sensitivity by Digital Holography

This paper presents the results of experimental studies and digital methods for recording of holograms using spatial light modulators. The use of holographic interference methods for measuring nanoscale irregularities is described for the case of a nanostep (70 nm in height and 30 $$\mu$$ m in width). Examples are given of the method of increased sensitivity for nanostep measurements and the method of hooks using a digital technique. Correction of internal system distortions in the interferometer has been shown to be a workable method. The holographic interference methods with digital processing of holograms allows the sensitivity of interferograms to be increased without loss of basic information about the object and without increasing the measurement accuracy.

Outcomes of laparoscopic incarcerated inguinal hernia repair in children.

Aim:Laparoscopic inguinal hernia repair (LIHR) is gaining widespread acceptance, but its role in the management of incarcerated cases is not well outlined. This review analyses the outcomes of laparoscopic repair of incarcerated inguinal hernia in children.Patients and Methods:Literature was searched on PubMed® using terms 'laparoscopic', 'incarcerated', 'inguinal', 'hernia' and 'children'. Age, sex, side, sac content, operative technique, follow-up period, complication and recurrence rate were analysed.Results:Fifteen articles with 689 paediatric incarcerated inguinal hernias were identified between 1998 and 2018. Median age of patients was 22.4 months (2 weeks–16 years; M:F = 2.2:1). Side was mentioned in n = 576: n = 398 (69.1%) right and n = 178 (30.9%) left. In n = 355 (51.5%) manual reduction and delayed surgery (MRDS), in n = 34 (4.9%) manual reduction in general anaesthesia (MRGA) followed by emergency LHR and in n = 300 (43.5%) intraoperative reduction (IOR) was necessary. Incarcerated contents were documented in n = 68: intestine n = 36 (52.9%), ovary n = 14 (20.6%), omentum n = 11 (16.2%), appendix n = 5 (7.4%) and Meckel's diverticulum n = 2 (2.9%). Among the n = 18 girls in IOR group, n = 14 (77.8%) had ovaries incarcerated. For LHR, the hook method was used in 376 (54.6%) and purse-string suture in 313 (45.4%), with two conversions in IOR group. Mean followup was 15 months (3–80 months), with one (0.15%) testicular atrophy, and 4 (0.58%) recurrences in MRDS and 1 (0.15%) in IOR. All five cases were closed with pursestring technique. Total recurrence rate was 0.73%; significantly higher (P = 0.014) with pursestring (n = 5, 1.6%) than with the hook (none).Conclusion:Hook and purse-string methods are equally popular in LHR for paediatric incarcerated hernias, with 50% hernia reductions possible at the time of surgery. Recurrence rate is low and comparable with non-incarcerated hernias; however, it is significantly higher in purse-string method than hook technique.

Size structure and gear selectivity of target species in the multispecies multigear fishery of the Kenyan South Coast

Multispecies fisheries commonly target those species and sizes that provide highest revenues (due to both their high abundances and market values) using multiple gears. Yet most tropical countries still apply single species management approaches, which ignore species - species and species - gear interactions in these complex fisheries. The objective of the here presented study was to evaluate the role and importance of the different fishing gears for the exploitation of the different species and sizes of the artisanal reef fishery catch from the Kenyan South Coast. Like in most tropical multi-species fisheries, the artisanal catch was characterized by a very large number of species (138 species representing 38 families). Of these, 17 species dominated the catch making up 91% of the overall abundance and 70% by weight of the total catch from all gears. Species belonging to the families Siganidae, Scaridae and Lethrinidae dominated the catch of most gears. Species selectivity by gear was determined by a classification analysis (hierarchical agglomerative clustering) based on a similarity matrix from transformed abundance data of the fish species by gear. At a similarity of 50%, five groups were differentiated by the cluster dendrogram. Considerable species and size overlap was observed between gears with the basket trap and beach seine showing very similar selectivity with the composition of their catches to a large extent being complementary. Overall the beach seine landed the smallest individuals in the catch with the key species captured being smaller than the size at first maturity but only contributed 10% of the total biomass landed compared to the basket traps which also targeted similar size ranges but at higher relative abundance and biomass. The hook and line method and the ring net targeted the largest individuals in the catch but the hook and line contributed more in terms of the total biomass landed (31%). Our findings indicate that the current fishing practices exploit fish species of small sizes but also small to medium sized specimens relative to the species potential maximum size. Therefore, fishers by diversifying their gears and strategies, have been able to target a significant part of the entire fish assemblage (species and sizes) with each gear imposing different fishing mortalities on the target species. This fishery strategy is a major challenge to decision-makers, and it is evident that the current regulations focusing on gear restrictions are not adequate to manage this complex and highly effective fishery. Thus, our proposal is that in addition to the current measures, an attempt should be made towards an integrated approach that incorporates the fishing dynamics and distribution of effort across different gears while complementing these with market based regulatory measures. Therefore, an important next step in the analysis of the fishery of Kenya’s coast should be the determination of the present exploitation rate of the target species along the resource size spectrum both temporally and spatially to provide a proper assessment of the fisheries and provide a more succinct management advice towards reallocation of fishing effort among alternative target species in this multispecies fisheries.

The Optimal Placement of Sutures in All-inside Repair of Meniscocapsular Separation.

Background:The aim of this study was to show the effects on the meniscus of repair applied from the femoral, the femoral-tibial and the tibial surfaces. Methods:In the treatment of meniscocapsular separation, although the accepted gold standard technique in the past was the inside-out suture technique, the current treatment method is all-inside repair methods. The all-inside techniques include the hook method and applications with a meniscus suture device. The hook method is difficult with a steep learning curve. In meniscus repair applied with the all-inside meniscus devices, the application of the suture can change the anatomic structure and position of the meniscus. Results:The suturing method applied from the tibial section of the meniscus does not disrupt the anatomic position of the meniscus in meniscocapsular separation. Thus, the optimum conditions are provided for restoration of the functions of the meniscus. Conclusion:The optimal repair in meniscocapsular separations can be considered to be that made with sutures from the tibial section of the meniscus. This technique may be helpful in obtaining better clinical results.