Rank Analysis Research Articles

The Prevalence and Association of Stress with Sleep Quality during the COVID-19 Pandemic among Medical Students at Airlangga University

The COVID-19 pandemic requires students to adapt to circumstances and cause various kinds of psychological problems during a pandemic outbreak. Some may experience stress, insomnia or hypersomnia. There are many factors causing poor sleep quality in students, including psychological problems such as stress which can worsen the quality of student’s sleep during the COVID-19 pandemic. This study aims to prove that there is a relationship between stress and the sleep quality of medical students at Airlangga University during the COVID-19 pandemic. This study is an observational analytic study using the cross-sectional design to assess the relationship between stress and sleep quality of respondents using the Pittsburgh Sleep Quality Index (PSQI) and Depression, Anxiety, Stress Scale - 42 (DASS-42) questionnaires. The research subjects were active pre-clinical students in the medical study program, Faculty of Medicine, Airlangga University, totaling 280 students who were divided into 3 batches, namely Class of 2019, Class of 2020, and Class of 2021. From the results of the study, it was found that 84.7% of students experienced poor sleep quality and a normal stress level of 55.5%. Sleep quality and stress levels are related to each other. This is proven by the Spearman rank analysis, which shows sleep quality is related to the stress level with a p-value = 0.000 and rho = 0.230. Based on these results, it was concluded that sleep quality and stress level have a positive correlation. The researcher expects that the institution will be able to use the study's findings as information about student stress levels and sleep quality in order to prevent stress and poor sleep or to implement health-related stress management programs for students.

Quality of life in parents of autistic children: A transcultural perspective.

The concepts of health, illness, and disability as well as the perceptions of autism and quality of life (QoL) vary greatly across cultures and across time. This study sought to explore the interplay of culture on QoL and impact on parents caring for autistic children. We used a transcultural dataset from seven countries (Australia, Hungary, Malaysia, Romania, Singapore, Spain, and the United Kingdom) with participating parents/carers reporting on the Quality of Life in Autism (QoLA) questionnaire. The QoLA questionnaire is a validated measure of QoL for parents of autistic children, with Part A subscale measuring parental QoL and part B subscale assessing the parental impact of the child's autism spectrum disorder (ASD) symptoms or features. We used the Quade's ranked analysis of covariance to determine significant differences between the countries in relation to QoLA Part A and Part B scores while adjusting for baseline differences using covariates such as parents' gender, child's age, and gender. Additionally, a post-hoc analysis with Bonferroni correction was also conducted to examine multiple pairwise comparisons. We found that while the effect of features of ASD (Part B subscale) stayed strongly comparable between cultures, the self-reported parental QoL was most likely determined by different aspects of culture in different countries. It is concluded that while the ASD symptoms or features appear to affect parents in the same way across different countries, the parental QoL may be a culturally informed construct.

Machine Learning Approach for Prediction of Lateral Confinement Coefficient of CFRP-Wrapped RC Columns

Materials have a significant role in creating structures that are durable, valuable and possess symmetry engineering properties. Premium quality materials establish an exemplary environment for every situation. Among the composite materials in constructions, carbon fiber reinforced polymer (CFRP) is one of best materials which provides symmetric superior strength and stiffness to reinforced concrete structures. For the structure to be confining, the region jeopardizes seismic loads and axial force, specifically on columns, with limited proportion of ties or stirrups implemented to loftier ductility and brittleness. The failure and buckling of columns with CFRP has been studied by many researchers and is ongoing to determine ways columns can be retrofitted. This article symmetrically integrates two disciplines, specifically materials (CFRP) and computer application (machine learning). Technically, predicting the lateral confinement coefficient (Ks) for reinforced concrete columns in designs plays a vital role. Therefore, machine learning models like genetic programming (GP), minimax probability machine regression (MPMR) and deep neural networks (DNN) were utilized to determine the Ks value of CFRP-wrapped RC columns. In order to compute Ks value, parameters such as column width, length, corner radius, thickness of CFRP, compressive strength of the unconfined concrete and elastic modulus of CFRP act as stimulants. The adopted machine learning models utilized 293 datasets of square and rectangular RC columns for the prediction of Ks. Among the developed models, GP and MPMR provide encouraging performances with higher R values of 0.943 and 0.941; however, the statistical indices proved that the GP model outperforms other models with better precision (R2 = 0.89) and less errors (RMSE = 0.056 and NMBE = 0.001). Based on the evaluation of statistical indices, rank analysis was carried out, in which GP model secured more points and ranked top.

Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage

Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of this work is thus to compare different surgical approaches, namely, lobectomy and segmentectomy (typical and atypical) to derive prognostic and predictive markers. Here we analyzed a cohort of 153 NSCLC patients in clinical stage TNM I who underwent pulmonary resection surgery with a mediastinal hilar lymphadenectomy from January 2017 to December 2021, with an average follow-up of 25.5 months. Partition analysis was also applied to the dataset to detect outcome predictors. The results of this work showed similar OS between lobectomy and typical and atypical segmentectomy for patients with stage I NSCLC. In contrast, lobectomy was associated with a significant improvement in DFS compared with typical segmentectomy in stage IA, while in stage IB and overall, the two treatments were similar. Atypical segmentectomy showed the worst performance, especially in 3-year DFS. Quite unexpectedly, outcome predictor ranking analysis suggests a prominent role of smoking habits and respiratory function, irrespective of the tumor histotype and the patient's gender. Although the limited follow-up interval cannot allow conclusive remarks about prognosis, the results of this study suggest that both lung volumes and the degree of emphysema-related parenchymal damage are the strongest predictors of poor survival in lung cancer patients. Overall, these data point out that greater attention should be addressed to the therapeutic intervention for co-existing respiratory diseases to obtain optimal control of early lung cancer.

The Influence of Gymnastics on Disminore Inadolescent Women

Dysmenorrhea is a condition that occurs when menstruation can interfere with activity and require treatment. Handling of dysmenorrhea is divided into two pharmacologically can be handled with analgesic therapy while non-pharmacologically can be treated with relaxation techniques such as gymnastics. Gymnastics is one of the non-pharmacological methods to reduce dysminorea. Method Quasi experimental research design with one group pre-test - post test design without control group. The number of samples 33 people. Data collection using observation sheets by examining the scale of dysmenorrhea before and after given the exercise intervention. Results In this study using the Wilcoxon signed rank analysis method. . Z value = -4.893 and p value 0.000 ≤ 0.05 Ho is rejected Ha is accepted, which means that there is an effect of gymnastics on decreasing the disminore pain scale between before Gymnastics and after Gymnastics.

Intelligent Emotion and Sensory Remote Prioritisation for Patients with Multiple Chronic Diseases.

An intelligent remote prioritization for patients with high-risk multiple chronic diseases is proposed in this research, based on emotion and sensory measurements and multi-criteria decision making. The methodology comprises two phases: (1) a case study is discussed through the adoption of a multi-criteria decision matrix for high-risk level patients; (2) the technique for reorganizing opinion order to interval levels (TROOIL) is modified by combining it with an extended fuzzy-weighted zero-inconsistency (FWZIC) method over fractional orthotriple fuzzy sets to address objective weighting issues associated with the original TROOIL. In the first hierarchy level, chronic heart disease is identified as the most important criterion, followed by emotion-based criteria in the second. The third hierarchy level shows that Peaks is identified as the most important sensor-based criterion and chest pain as the most important emotion criterion. Low blood pressure disease is identified as the most important criterion for patient prioritization, with the most severe cases being prioritized. The results are evaluated using systematic ranking and sensitivity analysis.

Harnessing Insights from Indicators-Based Resilience Assessment for Enhancing Sustainability in the Gurage Socio-Ecological Production Landscape of Ethiopia.

Even though the mosaic of different land-use/land-cover types has long contributed to the resilience of socio-ecological production landscapes and seascapes in Ethiopia, recent data indicate that their sustainability is under threat. This study aims to evaluate landscape resilience by adopting a set of indicators for enhancing sustainability in the Gurage socio-ecological production landscape in Ethiopia. The authors employed a toolkit of indicators in the production landscape through a community-based scoring approach (1-5 Likert scale). The information from household surveys, land-use/land-cover analysis, and satellite-based drought incidents assessment was integrated with the ranking analysis to support the evaluations. The results revealed that landscape diversity, ecosystem protection, local governance, and social equity indicators had the highest landscape resilience ranks. In contrast, lower ranks are associated with knowledge, innovation, livelihoods, and well-being indicators. The overall resilience of the Gurage socio-ecological production landscape was estimated to be below average. Thus, strategies that enhance the resilience and sustainability of this socio-ecological landscape are essential. The findings could help draw the attention of policymakers and natural resource managers to building and strengthening the resilience of the landscape. This study demonstrates that indicators could aid in evaluating landscape resilience status along with other ancillary information, particularly in data-sparse regions. Methods of assessing resilience must be creative in such regions, and this paper may inform such efforts. In addition, the study recommends that landscape resilience indicators be improved by reducing subjective matter and including spatial-explicit dimensions for evaluating resilience.

Federated Learning for IoMT Applications: A Standardisation and Benchmarking Framework of Intrusion Detection Systems.

Efficient evaluation for machine learning (ML)-based intrusion detection systems (IDSs) for federated learning (FL) in the Internet of Medical Things (IoMTs) environment falls under the standardisation and multicriteria decision-making (MCDM) problems. Thus, this study is developing an MCDM framework for standardising and benchmarking the ML-based IDSs used in the FL architecture of IoMT applications. In the methodology, firstly, the evaluation criteria of ML-based IDSs are standardised using the fuzzy Delphi method (FDM). Secondly, the evaluation decision matrix (DM) is formulated based on the intersection of standardised evaluation criteria and a list of ML-based IDSs. Such formulation is achieved using a dataset with 125,973 records, and each record comprises 41 features. Thirdly, the integration of MCDM methods is formulated to determine the importance weights of the main and sub standardised security and performance criteria, followed by benchmarking and selecting the optimal ML-based IDSs. In this phase, the Borda voting method is used to unify the different ranks and perform a group benchmarking context. The following results are confirmed. (1) Using FDM, 17 out of 20 evaluation criteria (14 for security and 3 for performance) reach the consensus of experts. (2) The area under curve criterion has the lowest set of weights, whilst the CPU time criterion has the highest one. (3) VIKOR group ranking shows that the BayesNet is a best classifier, whilst SVM is the last choice. For evaluation, three assessments, namely, systematic ranking, computational cost and comparative analysis, are used.

Treatment selection and outcomes of locally advanced esophageal cancer in octo- and nonagenarians: Is a curative intent multimodal approach feasible?

333 Background: Neoadjuvant therapy followed by en bloc surgical resection affords the highest rates of survival from locally advanced esophageal cancer (LAEC) and represents the standard of care. However, patients of advanced age may not be offered this approach due to concerns over toxicity/tolerability. The outcomes of different treatment modalities for patients aged 80 and above with LAEC are not well described. Methods: A retrospective, single center, cohort analysis was performed on a prospectively maintained comprehensive esophageal cancer database. Between 2010-20, all patients ≥80yrs with locally advanced esophageal/GEJ cancer (cT2-4a, Nany, M0) were identified and outcomes stratified according to the following treatment categories: Neoadjuvant chemotherapy (nCT) or chemoradiotherapy (nCRT) followed by surgery; definitive CRT (dCRT); upfront surgery; palliative CT or RT; or best supportive care (BSC). Data presented as median(range). Univariate analysis used for clinicopathological data (*p<0.05). Survival was compared with log rank analysis (Mantel Cox). Results: 79 patients ≥80 yrs with LAEC were identified. Median age was 83yr (80-97) and Charlson comorbidity index=7 (6-10). Most were cT3 (73%), cN- (56%) and adenocarcinoma (62%). Treatment approaches included: neoadjuvant (nCT(n=11)/nCRT(N=5)) + surgery (16/79(20%)); surgery alone (19/79 (24%)); dCRT (12/29(15%)); palliative RT or CT (24 + 3/79(34%)); BSC (5/79(6%)). Neoadjuvant consisted of nCT (FLOT=4; carbo-taxol =4; FOLFOX=2; CP+pembro=1) and nCRT (CROSS=5) and most received the intended full treatment/cycles (10/16:63%). Surgery was performed in 35 (age=82(80-96)), with major complications (grade 3-5) in 13/35 (37%) and 90-day mortality in 3/35(8.5%). Overall Survival for the entire cohort was 58% (1yr) and 19% (3yr), but highest with nCT/nCRT+surgery (94%/46%)*, followed by surgery alone (68%/39%), dCRT (58%/8%), palliative treatment (40%/4%), and BSC (0%/0%). Curative intent treatment (nCT/nCRT/surgery/dCRT) had significantly increased 1 and 3-yr survival compare to palliative treatment (76%/31% vs 34%/3.3%)*. Conclusions: Multimodal standard of care treatment, including surgical resection, of locally advanced esophageal cancer in octo/nonagenarians is feasible and safe in a subset of this high-risk population and associated with improved outcomes compared to other approaches. Age alone should not bias against curative-intent treatment in elderly patients with esophageal cancer.

The optimal regional irradiation volume for breast cancer patients: A comprehensive systematic review and network meta-analysis of published studies.

Currently, the optimal adjuvant regional nodal irradiation (RNI) volume for breast cancer (BC) remained controversial. We aimed to define the optimal RNI treatment volume for BC by using a comprehensive network meta-analysis (NMA) of published studies. PubMed, Embase, Medline, and Cochrane Central Register of Controlled Trials were searched from database inception to 30 May 2022. Studies assessing different adjuvant RNI volumes for BC were eligible for inclusion. The primary outcome was overall survival (OS), and secondary outcome was disease-free survival (DFS) and distant-metastasis-free survival (DMFS). A total of 29,640 BC patients from twenty studies were included. The pooled hazard ratio demonstrated that internal mammary node irradiation (IMNI) in BC patients significantly improved OS giving HR (hazard ratio) of 0.87 (95%CI: 0.83-0.91, p<0.001), DFS with HR of 0.78 (95%CI: 0.68-0.90, p<0.01), and DMFS with HR of 0.87 (95%CI: 0.79-0.97, p<0.01) when compared to controls. Sub-group analysis indicated that RNI with IMNI significantly improved OS (HR 0.87, 95%CI: 0.81-0.93, p<0.01), DFS (HR 0.65, 95%CI: 0.56-0.77, p<0.01), and DMFS (HR 0.90, 95%CI: 0.82-0.98, p=0.02) when compared to RNI without IMNI. NMA showed that CW/WB (chest wall/whole breast) + RNI with IMNI significantly improved DFS (HR 0.93, 95%CI: 0.86-1.00) and DMFS (HR 0.90, 95%CI: 0.81-0.99), but not for OS (HR 0.93, 95%CI: 0.84-1.03) when compared to CW/WB alone. Based on the analysis of the treatment ranking, CW/WB+RNI with IMNI appeared as the best treatment approach for BC patients. Our pooled results demonstrated that RNI with IMNI yielded a significant survival advantage for BC patients. NMA showed that CW/WB+RNI with IMNI was the optimal radiation volume for BC patients.

An Examination of Employee Attitudes toward Work Satisfaction

Abstract: The current study examined the work satisfaction level of employees in Commercial Synbag, Pithampur-India. The sample size 60 employees from Commercial Synbag, Pithampur was considered for invetigation. In this research paper, an effort has been made to comprehend how employees' attitudes toward work satisfaction, organisational climate, work-life balance-oriented HR policies, satisfaction with HR policies, maintaining mutual responsibility between employees and employers, and work-life balance contribute to organisational success and effectiveness. Employee attitudes have been examined for this purpose based on employment position. The annova test was used to determine the relationship between the aforementioned variables and the demographic factor (job status) among the Commercial Synbag employees. The qualitative research includes target population sampling procedures, sampling techniques, sample size determination, and so on. Reliability, one way Anova and Rank analysis test were applied in SPSS to analyse the data

Ranking and sensitivity analysis of stainless-steel pipe in sugar industry by MATLAB

Ranking and sensitivity analysis of stainless-steel pipe in sugar industry by MATLAB

Ranking and sensitivity analysis of stainless-steel pipe in sugar industry by MATLAB

Selection of best material considering technical and economic aspects is an important key issue of pipe material design. Basically, it is a multiple attribute decision making problem. Through entropy method, it gives us unbiased and optimized weight factor for each alternative and MATLAB approaches accurate calculation. Pipe is manufactured by various stainless steel. Selection the best material among various steel is one of the difficult and subtle tasks. In this paper, the methodology of Multi-Objective Optimization on the basis of Ratio Analysis (MOORA) and Simple Additive Weighting (SAW) are implemented first time and comparatively Analysis is to find out best material for better product development.

Changing the Narratives of Physics-Learning in Secondary Schools: The Role of Culture, Technology, and Locational Context

This study is concerned with the persistent underperformance of secondary school students in Nigeria in physics. The study was conducted in two phases. Phase one was a survey of difficult concepts in physics, while phase two explored the potency of culturo-techno-contextual approach (CTCA) in breaking the barriers to meaningful learning of refractive indices, which ranked the most difficult concept in phase one of the study. A total of 1621 SS3 students from Nigeria and Ghana participated in the survey phase. The second phase employed a mixed-methods approach (quasi-experimental and interviews) with a total of 205 SS1 students. The control group was taught with the lecture method and had 96 students (54 males; 42 females), while the experimental group, taught with CTCA, had 109 students (65 females; 44 males). Both groups had a pretest and posttest using the achievement test in refractive indices; treatment lasted four weeks. Data gathered in the survey were analyzed using mean rank analysis, and refractive indices was perceived as the most difficult to learn. Phase two data were analyzed using one-way ANCOVA since intact classes were used. The result obtained showed that the experimental group performed better (mean for experimental = 15.49; control 11.97; F (1, 202) = 64.48; p &lt; 0.01)) than the control group. Implications of the study are highlighted and the need for further studies is recommended.

Delay Factor Analysis and Dynamic System Modeling on the EPC Project of Liquid Petreleum Gas Tank in Kupang

Project delays are an event that often occurs in every project, especially projects with the scope of Engineering Procurement &amp; Construction (EPC) in Indonesia. Many factors affect the slowness of the project so that the performance of a project will not run well if supervision and control are not carried out. The purpose of this study is to find out what are the factors that cause delays, make modeling using dynamic systems and how to make effective managerial suggestions to accelerate project performance. This research method uses mixed methods. The results of this study there are 3 factors that cause delays in the project, starting from the largest factor based on the results of the mean rank analysis is the Construction factor, followed by Procurement, and finally Engineering. In the Construction Factor, five main indicators were taken to cause the delay in the Petreleum Gas Liquid Tank EPC project in Kupang which occurred because the material did not meet specifications, work was stopped due to design changes, delays in project manager decision making, differences of opinion between contractors and consultants, and poor construction quality. Managerial advice in this study is to improve the quality of Human Resources and improve communication networks, tighten the control function and evaluate periodically.

Delay Factor Analysis and Dynamic System Modeling on the EPC Project of Liquid Petreleum Gas Tank in Kupang

Project delays are an event that often occurs in every project, especially projects with the scope of Engineering Procurement &amp; Construction (EPC) in Indonesia. Many factors affect the slowness of the project so that the performance of a project will not run well if supervision and control are not carried out. The purpose of this study is to find out what are the factors that cause delays, make modeling using dynamic systems and how to make effective managerial suggestions to accelerate project performance. This research method uses mixed methods. The results of this study there are 3 factors that cause delays in the project, starting from the largest factor based on the results of the mean rank analysis is the Construction factor, followed by Procurement, and finally Engineering. In the Construction Factor, five main indicators were taken to cause the delay in the Petreleum Gas Liquid Tank EPC project in Kupang which occurred because the material did not meet specifications, work was stopped due to design changes, delays in project manager decision making, differences of opinion between contractors and consultants, and poor construction quality. Managerial advice in this study is to improve the quality of Human Resources and improve communication networks, tighten the control function and evaluate periodically.

Diagnosis of premalignant and malignant cervix diseases in HPV-positive females: Digene test performance evaluation

Background. Cervical cancer is one of the most preventable malignancies in females. However, there is an increasing trend of disease incidence mainly due to the low specificity of routine screening tests.&#x0D; Aim. To assess the diagnostic value of standard tests for the diagnosis of cervix disorders based on the Digene test.&#x0D; Materials and methods. The obtained data were processed using the Statistica software package. Due to the unique features of specimens obtained, non-parametric methods were used for small samples with extreme data variability and possible artifacts. These methods do not require an assumption of "normality" of distribution. KruskalWallis rank analysis of variance and MannWhitney test for comparison of individual samples were used to estimate the relationship between the studied parameter and controlled factors. Median (Me) and quartiles (Q1 and Q3) were used in describing the results.&#x0D; Results. The study found a low performance of colposcopy and cytology and a higher performance of status assessment for human papillomavirus.&#x0D; Conclusion. Our findings indicate that viral load measurement is only sometimes informative. This test can be used as a stage 2 screening; additional data are needed for further patient management. Digene test helps to determine the risk group for a follow-up study.

Combining in vivo proton exchange rate (k ex) MRI with quantitative susceptibility mapping to further stratify the gadolinium-negative multiple sclerosis lesions.

Conventional gadolinium (Gd)-enhanced MRI is currently used for stratifying the lesion activity of multiple sclerosis (MS) despite limited correlation with disability and disease activity. The stratification of MS lesion activity needs further improvement to better support clinics. To investigate if the novel proton exchange rate (k ex ) MRI combined with quantitative susceptibility mapping (QSM) may help to further stratify non-enhanced (Gd-negative) MS lesions. From December 2017 to December 2020, clinically diagnosed relapsing-remitting MS patients who underwent MRI were consecutively enrolled in this IRB-approved retrospective study. The customized MRI protocol covered conventional T2-weighted, T2-fluid-attenuated-inversion-recovery, pre- and post-contrast T1-weighted imaging, and quantitative sequences, including k ex MRI based on direct-saturation removed omega plots and QSM. Each MS lesion was evaluated based on its Gd-enhancement as well as its susceptibility and k ex elevation compared to the normal appearing white matter. The difference and correlation concerning lesion characteristics and imaging contrasts were analyzed using the Mann-Whitney U test or Kruskal-Wallis test, and Spearman rank analysis with p < 0.05 considered significant. A total of 322 MS lesions from 30 patients were identified with 153 Gd-enhanced and 169 non-enhanced lesions. We found that the k ex elevation of all lesions significantly correlated with their susceptibility elevation (r = 0.30, p < 0.001). Within the 153 MS lesions with Gd-enhancement, ring-enhanced lesions showed higher k ex elevation than the nodular-enhanced ones' (p < 0.001). Similarly, lesions with ring-hyperintensity in QSM also had higher k ex elevation than the lesions with nodular-QSM-hyperintensity (p < 0.001). Of the 169 Gd-negative lesions, three radiological patterns were recognized according to lesion manifestations on the k ex map and QSM images: Pattern I (k ex + and QSM+, n = 114, 67.5%), Pattern II (only k ex + or QSM+, n = 47, 27.8%) and Pattern III (k ex - and QSM-, n = 8, 4.7%). Compared to Pattern II and III, Pattern I had higher k ex (p < 0.001) and susceptibility (p < 0.05) elevation. The percentage of Pattern I of each subject was negatively correlated with the disease duration (r = -0.45, p = 0.015). As a potential imaging biomarker for inflammation due to oxidative stress, in vivo k ex MRI combined with QSM is promising in extending the clinical classification of MS lesions beyond conventional Gd-enhanced MRI.

Treatment of orbital vascular malformations with intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization

Objective: To evaluate the clinical efficacy of bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization and resection in the treatment of orbital vascular malformations. Methods: It was a retrospective case series study. Patients with orbital vascular malformations diagnosed at the Ophthalmology Division of Chinese PLA General Hospital from January 2018 to October 2021 were included and divided into exophthalmos group and non-exophthalmos group based on whether the patients had postural exophthalmos. Intralesional bleomycin injection and N-butyl-2-cyanoacrylate glue embolization were performed. The preoperative and postoperative visual acuity, the dosages of bleomycin and isobutyl cyanoacrylate glue, pathological results, imaging findings and remission rate were recorded and analyzed. The Chi-square test, Wilcoxon signed rank analysis and Mann-Whitney U test were used for statistical analysis. Results: A total of 58 patients (58 eyes)were included, and there were 22 males (37.9%) and 36 females (62.1%). Nineteen (32.8%) patients had postural exophthalmos, and 39 (67.2%) patients did not suffer postural exophthalmos. The patient's age of the two groups was 39.0 (28.0, 54.5) years vs. 14.0 (5.7, 26.5) years, with a statistically significant difference (Z=-3.96, P<0.001). There was no significant difference in gender, eye laterality, follow-up time and the disease course between the two groups (all P>0.05). During the operation, the dosage of bleomycin was 15 000 (13 500, 15 000) U in the exophthalmos group, and 15 000 (9 000, 16 500) U in the non-exophthalmos group (Z=-0.70, P=0.944). The dosages of N-butyl-2-cyanoacrylate glue were 2.8 (1.0, 3.0) ml and 1.7 (1.0, 2.2) ml, respectively, in the two groups, with no significant difference (Z=-1.11, P=0.268). There was no visual impairment in both groups, while the visual acuity in 5 patients without postural exophthalmos was improved postoperatively. The imaging examination results showed no difference in the malformed vascular area before and after the treatment in the exophthalmos group [384.0 (329.0, 458.0) mm2 vs. 330.5 (271.6, 356.7) mm2; Z=-1.26, P=0.208], but a significantly decreased area after the treatment in the non-exophthalmos group [960.8 (822.1, 1058.3) mm2 vs. 311.6 (164.6, 361.6) mm2; Z=-2.67, P=0.008]. All patients had no obvious local or systemic adverse reactions during the follow-up. The pathology reports showed vascular malformations in all 15 specimens obtained from the exophthalmos group, as well as vascular malformations in 41.0% (16/39) of specimens and venous lymphatic malformations in 59.0% (23/39) of specimens from the non-exophthalmos group. Thirty-nine patients had complete remission (67.2%), 19 patients had partial remission (32.8%), and the effective treatment rate was 100%. Conclusion: Bleomycin lavage combined with N-butyl-2-cyanoacrylate glue embolization can achieve good therapeutic effects on orbital vascular malformations.

Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study

BackgroundComputer Assisted Design and Computer Assisted Manufacturing (CAD/CAM) have revolutionized oncologic surgery of the head and neck. A multitude of benefits of this technique has been described, but there are only few reports of donor site comorbidity following CAD/CAM surgery.MethodsThis study investigated comorbidity of the hip following deep circumflex iliac artery (DCIA) graft raising using CAD/CAM techniques. A cross-sectional examination was performed to determine range of motion, muscle strength and nerve disturbances. Furthermore, correlations between graft volume and skin incision length with postoperative donor site morbidity were assessed using Spearman's rank correlation, linear regression and analysis of variance (ANOVA).ResultsFifteen patients with a mean graft volume of 21.2 ± 5.7 cm3 and a mean incision length of 228.0 ± 30.0 mm were included. Patients reported of noticeable physical limitations in daily life activities (12.3 ± 11.9 weeks) and athletic activities (38.4 ± 40.0 weeks in mean) following surgery. Graft volume significantly correlated with the duration of the use of walking aids (R = 0.57; p = 0.033) and impairment in daily life activities (R = 0.65; p = 0.012). The length of the scar of the donor-site showed a statistically significant association with postoperative iliohypogastric nerve deficits (F = 4.4, p = 0.037). Patients with anaesthaesia of a peripheral cutaneous nerve had a larger mean scar length (280 ± 30.0 mm) than subjects with hypaesthesia (245 ± 10.1 mm) or no complaints (216 ± 27.7 mm).ConclusionsDespite sophisticated planning options in modern CAD/CAM surgery, comorbidity of the donor site following iliac graft harvesting is still a problem. This study is the first to investigate comorbidity after DCIA graft raising in a patient group treated exclusively with CAD/CAM techniques. The results indicate that a minimal invasive approach in terms of small graft volumes and small skin incisions could help to reduce postoperative symptomatology.Trial registration Retrospectively registered at the German Clinical Trials Register (DRKS-ID: DRKS00029066); registration date: 23/05/2022