Unexpected Injuries Research Articles

Enhancing Water Safety: Exploring Recent Technological Approaches for Drowning Detection.

Drowning poses a significant threat, resulting in unexpected injuries and fatalities. To promote water sports activities, it is crucial to develop surveillance systems that enhance safety around pools and waterways. This paper presents an overview of recent advancements in drowning detection, with a specific focus on image processing and sensor-based methods. Furthermore, the potential of artificial intelligence (AI), machine learning algorithms (MLAs), and robotics technology in this field is explored. The review examines the technological challenges, benefits, and drawbacks associated with these approaches. The findings reveal that image processing and sensor-based technologies are the most effective approaches for drowning detection systems. However, the image-processing approach requires substantial resources and sophisticated MLAs, making it costly and complex to implement. Conversely, sensor-based approaches offer practical, cost-effective, and widely applicable solutions for drowning detection. These approaches involve data transmission from the swimmer's condition to the processing unit through sensing technology, utilising both wired and wireless communication channels. This paper explores the recent developments in drowning detection systems while considering costs, complexity, and practicality in selecting and implementing such systems. The assessment of various technological approaches contributes to ongoing efforts aimed at improving water safety and reducing the risks associated with drowning incidents.

Freud’s Psychoanalysis and the Genealogy of Sport

ABSTRACT Freudian psychoanalysis offers us often neglected but unique and very fruitful possibilities for an original interpretation of sport. In this article we first look at some basic Freudian concepts, such as the role of sexuality, the unconscious and dreams. In doing so, it becomes clear that sport can and should be interpreted in a similar way to Freud’s interpretation of dreams. Just as dreams need to be decoded and interpreted, sport needs to be decoded and interpreted in order to understand it. On this basis, we then build a system for understanding sport that also incorporates the other important concepts of Freud’s psychoanalysis. The concepts of repression, symptom formation and the role of symbols prove to be particularly relevant for understanding sport. Decoding symbols in sport (e.g. scoring a goal) shows us that sport is a derivative of the libido and has an unconscious sexual structure. Unveiling the hidden unconscious sexuality of sport shows us that (male) sport was created for the sake of women, so that men (as winners) could gain a privileged status in female desire. Sport turns out to be a symbolic substitute for the satisfaction of human sexual needs. However, to better understand the competitive nature of sport, one must include the Oedipus and castration complex. It is castration anxiety that drives sporting competition. Victory is symbolically linked to the castration of the opponent. Next we turn to Freud’s concept of transference. It helps us to understand the complexity of the relationship between the athlete and the coach. This has a strong influence on athletic success. When things do not go as planned for an athlete and unexpected injuries occur, Freud’s concept of ‘advantage through illness’ can help us understand the athlete’s ‘escape into injury’.

Experience with Modified Makuuchi Incision in the Surgical Treatment of Huge Renal Tumor: A Single Institution’s Experience

Background: Surgical removal of huge renal and retroperitoneal tumors, such as adrenal cortical carcinoma or renal cell carcinoma with inferior vena cava (IVC) invasion, remains a challenge for urologists. Aim: Herein, we describe our experience with the modified Makuuchi incision for huge renal and retroperitoneal tumors. Methods: We applied the modified Makuuchi incision in 10 patients with a huge renal or retroperitoneal tumor. Another 11 patients with a huge renal or retroperitoneal tumor using different surgical incisions other than modified Makuuchi incision were collected for comparison. The modified Makuuchi incision of the abdomen is initiated in the cephalad to the xiphoid, extended 1 cm above the umbilicus, and then extended laterally to the lateral flank. Through the incision, we mobilized the colon, and when the renal space was seen, the tumor was removed. If an invasion of a nearby organ occurred, a general or cardiovascular surgery specialist was consulted for combined surgery. The patients’ age ranged from 43 to 82 years (three men and seven women). Results: The modified Makuuchi incision provided good and rapid exposure. No unexpected organ injuries occurred during surgery. There were no wound-related complications, such as dehiscence or incisional hernia, after 3 months of follow-up. Partial hepatectomy, splenectomy, distal pancreatectomy, and thrombectomy of the IVC thrombus were performed through the same incision. Conclusion: Our experience demonstrated that the modified Makuuchi incision is a good choice for patients with huge renal and retroperitoneal tumors, even those with nearby organ invasion.

High-Performance Self-Healing Polymers

ConspectusSelf-healing ability is one of the most attractive features of biological tissues, as it helps living creatures to recover physiological functions and prolongs their lifespans after unexpected injuries. Inspired by this feature, self-healing artificial polymers have been developed based on extrinsic and intrinsic designs since the 1950s. In particular, the intrinsic self-healing polymers have received enormous attention since 2001 because of their unlimited self-healing times and easy preparation. Therefore, many excellent works are reported, and our understanding of the self-healing polymer goes deeper and deeper. Self-healing is the process of the rejoining of the dynamic bonds/interactions. Therefore, the healing process involves two critical factors. One is the dynamic nature of dynamic bonds/interactions. The other is the high mobility of the polymer chains. However, the dynamic bonds/interactions are vulnerable to external forces and environmental stimuli because their bond energy is lower than that of the covalent bonds, which leads to several innate drawbacks of intrinsic self-healing polymers, such as poor mechanical properties (low fracture strength, low fracture strain, low modulus, and low fracture toughness) and poor resistance against the external environment (vulnerable to acid, alkali, or moisture). Also, since high chain mobility is also a prerequisite for intrinsic self-healing, most polymers cannot be healed in the glassy state where the polymer chains are frozen. Therefore, it is challenging to develop high-performance self-healing polymers, which not only possess high mechanical strength, toughness, and stability under ambient conditions or severe environments but also manifest high self-healing efficiency in the rubbery state or even in the glassy state. Therefore, how to overcome this challenge has become a hot topic in the field of self-healing polymers.To address the above problem, many high-performance self-healing polymers with high mechanical properties, high self-healing ability, or high environmental stability are published by using different strategies. These strategies are effective at enhancing the mechanical properties or increasing its environmental stability and are worth learning about. Our group has carried out some work in this field. In this Account, we highlight our works toward fabricating high-performance self-healing polymers. We summarize the high-performance self-healing polymers from three aspects: self-healing polymers with high mechanical properties (such as high toughness, tensile strength, stretchability, and modulus), glassy polymers capable of self-healing in the glassy state, and environmentally stable self-healing polymers. In particular, strategies based on tailoring molecular-level structure, condensed structure, and filler reinforcement are discussed in detail to construct self-healing polymers with high mechanical properties. Finally, the future development of intrinsic self-healing polymers is examined from the perspective of practical application and fundamental research.

Accidental and Abusive Mandible Fractures in Infants and Toddlers.

Mandible fractures are uncommon injuries in infants and young children and may raise concern for nonaccidental trauma. Our study describes several children with mandible fractures to identify features that might differentiate abuse from accident. Records and imaging were reviewed for children aged 24 months and younger who were diagnosed with mandible fractures at 2 tertiary pediatric care centers. Twenty-one cases were included, 8 of whom had formal child abuse consultations. Cases were reviewed for mechanisms of injury, physical examination findings, and occult injuries identified, as well as the final abuse determination. Among children with child abuse consultations, 5 injuries (62.5%) were determined to be accidental, 1 (12.5%) was abusive, and 2 were indeterminate for abuse or accident (25%). In each accidentally injured child, the reported mechanism of injury was a short fall with evidence of facial impact. No accidentally injured child had unexpected occult injuries or noncraniofacial cutaneous injuries. Infants and young children can sometimes sustain mandible fractures accidentally after well-described short falls with evidence of facial impact. Abuse remains in the differential diagnosis, and children should be evaluated accordingly. We propose that accidental injury be considered when a well-evaluated child with an isolated mandible fracture has a history of a short fall.

Design and logistical considerations for the randomized adaptive non-inferiority storage-duration-ranging CHIlled Platelet Study.

Platelet transfusion is a potentially life-saving therapy for actively bleeding patients, ranging from those undergoing planned surgical procedures to those suffering unexpected traumatic injuries. Platelets are currently stored at room temperature (20°C-24°C) with a maximum storage duration of 7 days after donation. The CHIlled Platelet Study trial will compare the efficacy and safety of standard room temperature-stored platelets with platelets that are cold-stored (1°C-6°C), that is, chilled, with a maximum of storage up to 21 days in adult and pediatric patients undergoing complex cardiac surgical procedures. CHIlled Platelet Study will use a Bayesian adaptive design to identify the range of cold storage durations for platelets that are non-inferior to standard room temperature-stored platelets. If cold-stored platelets are non-inferior at durations greater than 7 days, a gated superiority analysis will identify durations for which cold-stored platelets may be superior to standard platelets. We present example simulations of the CHIlled Platelet Study design and discuss unique challenges in trial implementation. The CHIlled Platelet Study trial has been funded and will be implemented in approximately 20 clinical centers. Early randomization to enable procurement of cold-stored platelets with different storage durations will be required, as well as a platelet tracking system to eliminate platelet wastage and maximize trial efficiency and economy. The CHIlled Platelet Study trial will determine whether cold-stored platelets are non-inferior to platelets stored at room temperature, and if so, will determine the maximum duration (up to 21 days) of storage that maintains non-inferiority. ClinicalTrials.gov, NCT04834414.

AN OVERVIEW OF FIRST AID BEHAVIOR IN TODDLER CHILDREN WHO FELL IN THE WORKING AREA OF THE BERAKIT PUBLIC HEALTH CENTER 2021

Children aged 1 to 3 years are the most critical period because 80% of brain growth occurs at that age or known as the Golden age (Nursalam, 2005). Based on the stages of growth and development of toddler-age children, it is necessary to get supervision from parents because in carrying out their activities children do not pay attention to the dangers that exist around them (Nursalam, 2005). According to dinkes Kepri (2014), the prevalence of injury events in toddler-aged children is injury (8.9%), drowning accidents (20.6%), bone fractures (2.6%), burns (5.3%), foreign body entry (9.7%), unexpected injuries (8.7%), and poisoning (10.26%). Toddler injuries can be prevented, one of which is with good supervision from parents (Arvin, 2000). This study aims to provide an overview of first aid behavior in toddler children who fall in the work area of the rafted health center. The total sample of this study was 30 people. The sampling technique uses a non-probability technique, namely a saturated sample or often called total sampling, where all members of the population are used as samples. In this study, it was known that respondents had alevel of good behavior (80%). This is influenced by several factors, namely education, sources of information, and experience. The results of this study are expected to add insight, contribute to science, especially those related to the problem of first aid in fallen toddler children and contribute thoughts for parents regarding first aid in fallen toddler children.

Development and Validation of a Subject-Specific Coupled Model for Foot and Sports Shoe Complex: A Pilot Computational Study.

Nowadays, footwear serves an essential role in improving athletic performance and decreasing the risk of unexpected injuries in sports games. Finite element (FE) modeling is a powerful tool to reveal the biomechanical interactions between foot and footwear, and establishing a coupled foot-shoe model is the prerequisite. The purpose of this pilot study was to develop and validate a 3D FE coupled model of the foot and sports shoe complex during balanced standing. All major foot and shoe structures were constructed based on the participant’s medical CT images, and 3D gait analysis was conducted to define the loading and boundary conditions. Sensitivity analysis was applied to determine the optimum material property for shoe sole. Both the plantar and shoe sole areas were further divided into four regions for model validation, and the Bland–Altman method was used for consistency analysis between methods. The simulated peak plantar and sole pressure distribution showed good consistency with experimental pressure data, and the prediction errors were all less than 10% during balanced standing with only two exceptions (medial and lateral forefoot regions). Meanwhile, the Bland–Altman analysis demonstrated a good agreement between the two approaches. The sensitivity analysis suggested that shoe sole with Young’s modulus of 2.739 MPa presented the greatest consistency with the measured data in our scenario. The established model could be used for investing the complex biomechanical interactions between the foot and sports shoe and optimizing footwear design, after it has been fully validated in the subsequent works under different conditions.

Evaluation of Nursing Home Residents Applying to The Emergency Service

Background: Emergency deparment (ED) has an important role at the care of nursing home residents and acts facilitator role at the acute care, admission to the hospital, unexpected injuries and hospitals. Our research is aiming the evaluation of the demographic and clinical features of the nursing home patients applying to ED. 
 Materials and methods: The nursing home residents who are aged 18 and over 18 applying to ED at the date between 15.04.2014-15.05.2015 are included to this respective study. In the study, demographic information of the patients and diagnosis and treatment information in the emergency room were evaluated. 
 Results: 51 (52%) of the patients are male. The average age of them is 73. The most frequent disease observed in their medical history is Alzheimer’s disease. The physical examinations of the patients resulted that they have cachexia and dehydration. The oftenest diagnosises detected are lung disease (23.5%), infection (22.4%) and malnutrition (22.4%). It has been also detected that 45% of them admitted to hospital and 3.1% of them are to die. The rate of intensive care admission is 64% while the service admission rate is 36%. 
 Conclusion: The rate of the admission of the nursing home residents to ER and especially to intensive care units is quite high. To ameliorate this condition, training and supervision of the nursing home workers should be made more carefully and often. Since we do not have sociodemographic and clinical data about the nursing home residents applying to ED, more study must be made about this area.

A Study to Assess the Effectiveness of Video Assisted Teaching Programme on Knowledge and Beginning Skills Regarding the First Aid Management of Selected Minor Injuries in Children Among the School Teachers Working in the Selected Primary Schools of Narma

Background: School age children are active youngster, have more interest in playing, attempt to get mastery overnew motor skills and these age group children can be naughty, deficient and impulsive from time to time whichis perfectly normal. So, occurrences of unexpected injuries are more common especially among primary schoolchildren. It is important for the school teachers to have knowledge and equipped with relevant skills of first aidmanagement to deal with any emergency situation occur in school premises.Aim: To assess the effectiveness of Video assisted teaching programme on knowledge and beginning skillsregarding FAM of selected common conditions in children among school teachers.Methods: Pre-experimental one group pre-test post-test design was used for the study. Population of the study wasschool teachers of two selected schools. Sample comprises of 40 school teachers convenient sampling techniquewas used to select the sample. Structured knowledge questionnaire, observation checklist and lesson plan wereused an instruments.Results: In the pre-test regarding knowledge score out of 40 primary school teachers 35(87.5%) had inadequateknowledge, 5(12.5%) of them had moderate knowledge and none of them had adequate knowledge on the otherhand for the beginning skills 33(87.5%) of school teachers had poor beginning skills, 5(12.5%) had moderatebeginning skills and none of them had good beginning skills. In the post-test majority 33(82.5%) of school teachershad adequate knowledge, 7(17.5%) had moderate knowledge and none of them had inadequate knowledge. Withregards to beginning skills 33(82.5%) of the school teachers had good beginning skills and 7 (17.5%) had moderatebeginning skills and none of them had poor beginning skills after the administration of video assisted teachingprogramme.
 Conclusion: VATP was found to be an effective teaching strategy in improving knowledge and beginning skills ofschool teachers regarding first aid management of selected minor injuries in children.

Usefulness and outcome of whole-body computed tomography (pan-scan) in trauma patients: A prospective study

BackgroundSevere trauma can cause multi-organ injuries, and the mortality rate may increase if significant organ injuries are missed. This study was performed to determine whether whole-body computed tomography scan (pan-scan) can detect significant injury and leads to proper management, including alteration the priority of management. MethodsThis prospective study was conducted from January 2019 to March 2021 and involved trauma patients level 1, level 2, and dangerous mechanism of trauma. Additionally, the data of trauma patients who had selective computed tomography scan were retrospectively reviewed to compared the clinical benefits. ResultsTwenty-two patients were enrolled in the prospective study. The pan-scan detected significant organ injury in 86% of the patients. Prioritization of organ injury management changed after performance of the pan-scan in 64% (major change in 64.29% and minor change in 35.71%). Skull base fracture, small bowel injury, retroperitoneal injury, kidney and bladder injury, and occult pneumothorax were the majority of injuries which was not consider before underwent pan-scan (p < 0.05). The door-to-scan time tended to be shorter in the pan-scan group than in the selective scan group without a significant difference [mean (SD), 59.5 (34) and 72.0 (86) min, respectively; p = 0.13]. Pan-scan contribute 100% confidence for trauma surgeon in diagnosis of specific organ injuries in severe injured patients. ConclusionsThe pan-scan facilitates timely detection of significant unexpected organ injuries such as the skull base, occult pneumothorax, small bowel, and retroperitoneum. It also helps to prioritize management and increases the diagnostic confidence of trauma surgeons, leading to better outcomes without delay.

Appropriate supplementation of testosterone alleviates post-stroke damage via decreasing inflammation and oxidative stress in aged male C57BL/6 mice

Stroke injury is closely related to testosterone levels. Testosterone supplementation in elderly men is seen to protect the cardiovascular system and reduce the risk of stroke. But this medication method is controversial. This study aims to investigate the effect of long-term testosterone supplementation on brain injury after stroke in aged mice. 60 male C57BL/6 mice,12-months of age were divided into 3 groups: low-dose group, high-dose group, and control group, each group was injected subcutaneously with 100 μL of sesame oil or 5 mg/kg or 50 mg/kg of testosterone (in 100 μL of sesame oil) twice per week, respectively. One week after the injection, stroke was induced by light. After the stroke, the injection continued for 6 weeks. The motion ability was measured by rotating rod and tail suspension. The brain injury was observed by naked eyes and TTC staining. In addition, we measured the inflammation ( Tnf-α, Il-6, and Mcp-1) and oxidative stress (Malondialdehyde (MDA) and T-AOC) in the injured tissue 72 h post-stroke. Low-dose testosterone supplementation improved the motion ability and decreased brain injury. It also decreased the inflammatory factors ( Tnf-α, Il-6, and Mcp-1), decreased MDA product, and increased T-AOC. High-dose testosterone supplementation not only reduced the motion ability and aggravated stroke injury, but also increased the inflammation, MDA level and decreased T-AOC level. In summary, supplementation of testosterone at normal levels in elderly mice can alleviate post-stroke injury by reducing inflammation and oxidative stress; however, excessive supplementation may cause unexpected injuries. This study has important implications for the application of testosterone replacement therapy.

Book Review: Waiting to Happen: The Sociology of Unexpected Injuries

Book Review: <i>Waiting to Happen: The Sociology of Unexpected Injuries</i>

The Reasons for National Athletes with Undergraduate Education to Leave Sports

Background: There are studies in the literature scrutinising the reasons for dropping out of sports in terms of physiological, psychosocial, and surrounding factors. In addition to these, it is a fact that there are athletes who end their sports life immediately after beginning their undergraduate education. At this point, the reasons for students to leave sports during their undergraduate education remains a matter to be discovered. Aim: To this end, this study aims to reveal the factors that cause these persons to leave sports. Methods: This research was conducted through the qualitative research method, utilising the phenomenology design. The participants of the study were eleven former national athletes who left sports after beginning their undergraduate education. The participants were selected by criterion sampling method from purposive sampling methods. The data were obtained through face-to-face interviews composed of semi-structured questions. The data acquired were analyzed by the content analysis method. Results: Five main themes were composed in the study: training, social life, health, psychology, and school. It was observed that the participants failed to balance their school and sports life due to heavy and intense training, socialisation needs, unexpected injuries, nutritional problems, psychological fear of failure, and inability to achieve the success they desire. Conclusion: The study results revealed that the participants decided to leave sports not for a single reason, but as a result of a process during which multiple reasons accumulated. In this context, measures can be taken to facilitate their academic and sports life in order to prevent national athletes from leaving sports. These measures may include enabling them to continue to school where they do sports, providing them with distance education and exam opportunities, and enabling them to better integrate into campus life. In order to prevent early specialisation, long-term athlete development models may also be implemented. Keywords: National athlete, undergraduate students, dropping out of sports

Morphometric evaluation of nasolacrimal duct

Objectives: Obstructions are very commonly seen in nasolacrimal duct before it opens into the inferior nasal meatus. Detailed anatomical knowledge of the nasolacrimal duct is crucial for physicians to understand the etiology of the obstructions, to plan ideal management option and to reduce unexpected iatrogenic injuries during surgeries. The aim of this study was to investigate morphometric properties of the nasolacrimal duct on computed tomography images. Methods: Three-dimensional computed tomography (3D-CT) of 142 adults (65 females, 77 males) were retrospectively evaluated. Antero-posterior cranial diameter, antero-posterior and transverse diameters and vertical angle of the nasolacrimal duct, distance between distal end of the nasolacrimal duct to anterior surface of the maxilla were measured and the differences evaluated statistically between right and left sides and among females and males and among different ages. All measurements were done using Osirix-Lite version 9 software. Results: None of the morphometric parameters of the nasolacrimal duct showed significant differences between right and left sides. Antero-posterior cranium and transverse diameter of the nasolacrimal duct were longer in men than women. Conclusion: Determining to morphometric properties of the nasolacrimal canal has advantages for understanding the etiology of the NLD obstructions, deciding the ideal surgical technique and reducing to unexpected injuries during surgeries related with this region.

Lobectomy for lung cancer with a displaced left B1 + 2 and an anomalous pulmonary vein: a case report

BackgroundA displaced left B1 + 2 accompanied by an anomalous pulmonary vein is a rare condition involving complex structures. There is a risk of unexpected injuries to bronchi and blood vessels when patients with such anomalies undergo surgery for lung cancer.Case presentationA 59-year-old male with suspected lung cancer in the left lower lobe was scheduled to undergo surgery. Chest computed tomography revealed a displaced B1 + 2 and hyperlobulation between S1 + 2 and S3, while the interlobar fissure between S1 + 2 and S6 was completely fused. Three-dimensional computed tomography (3D-CT) revealed an anomalous V1 + 2 joining the left inferior pulmonary vein and a branch of the V1 + 2 running between S1 + 2 and S6. We performed left lower lobectomy via video-assisted thoracic surgery, while taking care with the abovementioned anatomical structures. The strategy employed in this operation was to preserve V1 + 2 and confirm the locations of B1 + 2 and B6 when dividing the fissure.ConclusionThe aim of the surgical procedure performed in this case was to divide the fissure between S1 + 2 and the inferior lobe to reduce the risk of an unexpected bronchial injury. 3D-CT helps surgeons to understand the stereoscopic positional relationships among anatomical structures.

Surgical Tips for STA-MCA Bypass from Misato Central General Hospital

Superficial temporal artery to middle cerebral artery (STA-MCA) bypass is an essential technique, not just for treating cerebral ischemia but also for assisting aneurysm clipping and compensating for unexpected vascular injuries during surgery.Although it is becoming a more fundamental surgery technique because of the provision of off-the-job training, there are several points that should be considered to achieve successful anastomosis. In this article, we describe important points and tips to consider during STA-MCA bypass.To perform a successful anastomosis, it is important to ensure the following: (1) creation of an operative view without blood and cerebrospinal fluid, (2) selection of a suitable recipient artery, and (3) prevention of anastomosis occlusion.A recipient artery that runs downward from right to left (when the operator is right-handed) is considered suitable because of easier needle handling while suturing. Suturing the backside and inversion of the anastomosis should be avoided to prevent anastomosis occlusion. To avoid suturing the backside, we perform an oval arteriotomy on the recipient artery instead of a linear incision. Furthermore, difficult anastomosis is prioritized, and stay sutures and bilateral sutures are performed by the marked pin method and T-junction bypass when anastomosing in part with a large-diameter branch. To avoid inversion, we require the stitch interval of the donor and recipient arteries to be at a ratio of 6:4. We also tie a knot by pulling the thread from the donor side, which ensures that the inner membranes are attached together.Anastomosis is the most important procedure because the ultimate goal of this operation is to prevent cerebral ischemia by achieving long-term patency. The technique should be unified and simplified so that it is available for even young neurosurgeons.The techniques we have introduced are not difficult or complicated, although they can only be put into practice after acquiring the basic skills. Therefore, young neurosurgeons must continue training and preparing for surgeries.

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults.

Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of “tension-free repair” is generally accepted, and surgical repairs with mesh are categorized as “hernioplasties”. Surgeons should have good knowledge of the relevant anatomy. Physicians generally focus on the preperitoneal space, myopectineal orifice, topographic nerves, and regional vessels. Currently, laparoscopic surgery has therapeutic potential in the surgical setting for hernioplasty, with laparoscopic transabdominal preperitoneal (TAPP) repair appearing to be a powerful tool for use in adult hernia patients. TAPP offers the advantages of accurate diagnoses, repair of bilateral and recurrent hernias, less postoperative pain, early recovery allowing work and activities, tension-free repair of the preperitoneal (posterior) space, ability to cover obturator hernias, and avoidance of potential injury to the spermatic cord. The disadvantages of TAPP are the need for general anesthesia, adhering to a learning curve, higher cost, unexpected complications related to abdominal organs, adhesion to the mesh, unexpected injuries to vessels, prolonged operative time, and as-yet-unknown long-term outcomes. Both technical skill and anatomical familiarity are important for safe, reliable surgery. With increasing awareness of the importance of anatomy during TAPP repair, we address the skills and pitfalls during laparoscopic TAPP repair in adult patients using illustrations and schemas. We also address debatable points on this subject.

On Future Occupational Safety and Health Challenges

Occupational safety and health (OSH) have constantly changed and evolved throughout the industrial revolutions and in recent years. The aim of this systematic literature review was to give an overview of future OSH challenges in industrialized countries. A search within the Scopus database returned 31 peer-reviewed journal articles published since 2014 on new and emerging OSH risks and challenges in the future. A review of articles identified future overall OSH challenges, OSH challenges caused by climate change, and OSH challenges related to sustainable development and responsibility. In addition, branch-specific challenges in industries and health care were determined. Individual employees can experience a wide range of OSH challenges from heat stress to poison absorption, musculoskeletal disorders, increased psychosocial load, ergonomic issues, and unexpected accidents and injuries. OSH management is discussed and future studies proposed.

Facial nerve neurorrhaphy due to unexpected facial nerve injury during parotid gland tumor surgery.

Unexpected facial nerve damage can occur during parotid gland tumor surgery. We sought to determine the incidence and treatment outcomes of unexpected facial nerve injuries in patients with parotid gland tumor surgery. We retrospectively enrolled in this study five patients, who underwent facial nerve neurorrhaphy due to unexpected facial nerve injury during parotid gland tumor surgery January 2012-August 2019. There were five patients (0.008%) with unexpected facial nerve injuries during the parotid gland tumor surgery of 577 patients in our hospital for approximately 8 years. The most common injury site of facial nerve was the marginal mandibular branch (n = 3), followed by the buccal branch (n = 1), and the cervicofacial division (n = 1). In the case of unexpected facial nerve damage, our treatment is immediate primary neurorrhaphy and steroid treatment. Three patients of five recovered and two did not worsen immediately after surgery. Unexpected facial nerve injury during parotid gland tumor surgery is extremely unfortunate. In this case, immediate primary neurorrhaphy and systemic steroids are recommended to restore facial function and reduce cosmetic deficits.