Lowering the Barrier of Surgical Endoscopy With a Novel Articulating Retractor

2017 ◽  
Vol 11 (3) ◽  
Author(s):  
Neil A. Ray ◽  
Dillon Kwiat ◽  
Stanley Rogers ◽  
Matthew Y. C. Lin
Keyword(s):  
Range Of Motion ◽  
Therapeutic Interventions ◽  
Surgical Endoscopy ◽  
P Value ◽  
Target Tissue ◽  
Viable Option ◽  
Novel Device ◽  
The Past ◽  
Significant Barrier ◽  
And Control

Surgical endoscopy has gained traction over the past several decades as a viable option for therapeutic interventions in the gastrointestinal tract. It utilizes natural orifice access which shortens hospital stay, minimizes patient discomfort, and decreases overall healthcare costs. However, the inability to effectively retract and position target tissue is a significant limitation for these procedures. Current instruments are unable to triangulate and can only be manually withdrawn or advanced through the channels. There is a need to provide better access and control of soft tissue to be able to perform more complex and complete endoscopic resections. We have developed a novel device to provide optimal tissue retraction for endoscopic procedures. Our device consists of an articulating tissue retractor and a specialized handle. Two articulating curves were created that can manipulate the position and direction of the retractor tip. Each curve is independently adjusted by locking thumb sliders, allowing for increased range of motion and retraction independent of endoscope position. With a diameter of 2.8 mm, the proposed device can be used in current endoscopic equipment. Preliminary testing showed that our retractor has comparable slip strength to a commercially available device (1.13 N ± 0.53 N versus 1.10 N ± 0.51 N, p-value: 0.416), but has much greater range of motion (maximum deflection of 72 deg compared to 0 deg). This increased range of motion allows the articulating grasper to better triangulate and preserve visualization of the dissection plane, allowing it to overcome the most significant barrier restricting endoscopic surgery.

Twentieth-Century Influences on the Development in Britain of Services for Child and Adolescent Psychiatry

1991 ◽  
Vol 159 (1) ◽  
pp. 53-68 ◽  
Author(s):  
Christopher J. Wardle
Keyword(s):  
Rapid Development ◽  
Child And Adolescent Psychiatry ◽  
Therapeutic Interventions ◽  
Teaching Hospitals ◽  
The Past ◽  
Child Guidance ◽  
Wide Range ◽  
The Media ◽  
Post War ◽  
And Control

Modern comprehensive multidisciplinary mental-health services for children and adolescents have four origins: psychology from 1890, psychoanalysis from 1906, the child-guidance movement from 1920, and the children's departments of psychiatric teaching hospitals from 1930. Post-war changes in society and reform, especially the NHS Act 1946, contributed to rapid development of services and an increasingly wide range of sophisticated therapeutic interventions; professional and interdisciplinary associations and trans-Atlantic exchange were also influential. In the last three decades a succession of official inquiries, reports, legislation and reorganisations have had a damaging effect. Children and their services have been prey tocauses célèbres,fashion and the exaggerated fads and foibles of the media and politicians; they have thrived best when society and their carers were tolerant, and loving, sought good qualities to augment, not evil to exorcise, and succeeded in balancing structure and control with flexibility and freedom to grow. Planners should review the past before acting.

scholarly journals Pengaruh latihan range of motion (ROM) ankle terhadap pencegahan terjadinya neuropati dan angiopati pada klien diabetes melitus

2019 ◽  
Vol 13 (3) ◽  
pp. 263-269
Author(s):  
Djunizar Djamaludin ◽  
Setiawati Setiawati ◽  
Rika Yulendasari
Keyword(s):  
Range Of Motion ◽  
Intervention Group ◽  
Exercise Program ◽  
Home Exercise ◽  
Control Group ◽  
P Value ◽  
Purposive Sampling ◽  
Foot Injury ◽  
Post Test ◽  
And Control

The effect of range motion (ROM) ankle exercise on prevention of neuropathy and angiopathy in patient with diabetes mellitusBackground: Based on data from Basic Health Research (2013) conducted by the Indonesian Ministry of Health in a way to obtain the proportion of DM at the age of 15 years and over, confirmed / checked whether or not they suffer from DM or not.It was found that Lampung Province was ranked as the 8th largest DM person from 33 provinces throughout Indonesia, with DM patients with 38,923 lives and 5,560 people. One complication that needs attention is diabetes foot injury and it can cause amputation. The most common cause of diabetes foot injury is peripheral neuropathy which includes damage to sensory, autonomic and motor nerves.Purpose: The purpose of this study was to determine the effect of Range of Motion (ROM) ankle exercise on prevention of neuropathy and angiopathy on diabetes patients.Methods: A quasi experimental pre and post- test with control group study design was employed. The purposive sampling with 26 participants (13 respondents intervention group and 13 respondents control group) were recruited. The interventions groups performed ROM ankle exercise in their own respective training programs for 4 weeks, whereas no training was done in the control group. Both groups intervention and control, before and after the exercise program were measured with monofilament test for neuropathy and Venous Doppler for angiopathy. The data analysis was using t-test.Results: In the intervention group there were a significant improvements after ROM ankle exercise on prevention of neuropathy with p Value 0.000 and for angiopathy with p Value 0.000. There were significant different between intervention group and control group for neuropathy (p: .004) and angiopathy (p: .031).Conclusion: To prevent neuropathy and angiopathy on diabetes patients a home exercise program with Range of Motion (ROM) ankle could be implementedKeywords: Range of Motion; Neuropathy; Angiopathy; Diabetes MellitusPendahuluan: Berdasarkan Riskesdas tahun 2013 oleh Kemenkes RI dengan melakukan wawan cara untuk mendapatkan proporsi DM pada usia 15 tahun keatas yaitu proporsi penduduk yang terdiagnosis menderita DM dan penduduk yang belum pernah didiagnosis menderita DM. Provinsi Lampung menduduki peringkat ke – 8 penyandang DM terbesar dari 33 Provinsi diseluruh Indonesia, 38.923 jiwa dan 5.560 jiwa . Salah satu komplikasi yang harus mendapat perhatian yaitu luka kaki diabetes karena dapat mengakibarkan amputasi. Penyebab terbanyak dari luka kaki diabetes yaitu neuropati perifer yang meliputi kerusakan syaraf sensorik, otonom dan motorik.Tujuan: Diketahui pengaruh Range Of Motion (ROM) Ankle terhadap pencegahan terjadinya Neuropati dan Angiopati pada pasien Diabetes Melitus.Metode: Penelitian ini mengunakan desain quasi eksperimen pre post test dengan kelompok control dan intervensi..Sampel diambil dengan menggunakan tehnik Purposive Sampling dengan jumlah sampel yaitu 26 responden. Instrument penelitian ini  menggunakan 10 gr semmens weinstein monofilament untuk  mendeteksi  Neuropati dan  Venous Doppler  Ultrasound untuk  mendeteksi angiopati. Hasil: Menunjukkan adanya pengaruh latihan Range of Motion (ROM) Ankle terhadap pencegahan neuropati dengan p Value 0.000 dan angiopati dengan p Value 0.000. Terdapat perbedaan bermakna antara kelompok intervensi dan control untuk neuropati (p: .004) dan  angiopati  (p: .031).Simpulan: Untuk mencegah terjadinya neuropati dan angiopati pada penderita DM untuk dapat melakukan latihan Range of Motion (ROM) Ankle  dirumah

scholarly journals Prospects for Use of Biological Control of Insect and Mites for the Food Industry in North America

Agronomy ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1969
Author(s):  
Vincent A. D. Hervet ◽  
William R. Morrison
Keyword(s):  
Biological Control ◽  
North America ◽  
Insect Pests ◽  
Past Research ◽  
Stored Products ◽  
Viable Option ◽  
The Past ◽  
Insect Infestations ◽  
And Control ◽  
Control Insect

There are a number of strategies used to mitigate and control insect infestations in stored products and stored product facilities in North America and globally. Fumigation remains one of the main techniques used, particularly in bulk grain. Other techniques are also utilized effectively, such as the use of extreme temperatures and the use of biological control agents, but are mainly restricted to organic products and to Europe, respectively. Here, we review the past research conducted in the field of biological control for pests of stored products in North America and in Europe, its past and present successes in Europe, its challenges, and what we can learn from them to develop biological control as a viable option to problems of insect pests of stored products in North America.

The Estimation of prostate specific antigen (PSA) concentrations in patients with prostatitis by fully automated ELISA technique.

2020 ◽  
Vol 3 (11) ◽  
pp. 1100-1104
Author(s):  
Hussein Naeem Aldhaheri ◽  
Ihsan Edan AlSaimary ◽  
Murtadha Mohammed ALMusafer
Keyword(s):  
Personal Information ◽  
Receptor Gene ◽  
Specific Antigen ◽  
Gene Clusters ◽  
Control Group ◽  
P Value ◽  
Group Data ◽  
Elisa Technique ◽  
And Control

      The Aim of this study was to determine Immunogenetic expression of  Toll-like receptor gene clusters related to prostatitis, to give acknowledge about Role of TLR in prostatitis immunity in men from Basrah and Maysan provinces. A case–control study included 135 confirmed prostatitis patients And 50 persons as a control group. Data about age, marital status, working, infertility, family history and personal information like (Infection, Allergy, Steroid therapy, Residency, Smoking, Alcohol Drinking, Blood group, Body max index (BMI) and the clinical finding for all patients of Prostatitis were collected. This study shows the effect of PSA level in patients with prostatitis and control group, with P-value <0.0001 therefore the study shows a positive significant between elevated PSA levels and Prostatitis.

PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

2019 ◽  
Vol 1 (2) ◽  
pp. 47-55
Author(s):  
Syahredi Syaiful Adnani ◽  
Hafni Bachtiar
Keyword(s):  
Wound Healing ◽  
Caesarean Section ◽  
Amniotic Membrane ◽  
Healing Time ◽  
Cost Of Care ◽  
Control Group ◽  
P Value ◽  
Control Groups ◽  
And Control ◽  
Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

On-Surface Radical Oligomerisation: A New Approach to STM Tip-Induced Reactions

2018 ◽  
Author(s):  
Gaolei Zhan ◽  
Younes Makoudi ◽  
Judicael Jeannoutot ◽  
Simon Lamare ◽  
Michel Féron ◽  
...  
Keyword(s):  
Sample Surface ◽  
Scanning Tunnelling Microscope ◽  
Transfer Event ◽  
New Approach ◽  
The Past ◽  
Organic Nanostructures ◽  
Scanning Tunnelling ◽  
New Strategy ◽  
Surface Fabrication ◽  
And Control

Over the past decade, on-surface fabrication of organic nanostructures has been widely investigated for the development of molecular electronic devices, nanomachines, and new materials. Here, we introduce a new strategy to obtain alkyl oligomers in a controlled manner using on-surface radical oligomerisations that are triggered by the electrons/holes between the sample surface and the tip of a scanning tunnelling microscope. The resulting radical-mediated mechanism is substantiated by a detailed theoretical study. This electron transfer event only occurs when <i>V</i><sub>s</sub> < -3 V or <i>V</i><sub>s</sub> > + 3 V and allows access to reactive radical species under exceptionally mild conditions. This transfer can effectively ‘switch on’ a sequence leading to formation of oligomers of defined size distribution due to the on-surface confinement of reactive species. Our approach enables new ways to initiate and control radical oligomerisations with tunnelling electrons, leading to molecularly precise nanofabrication.

Truth Matters: Cognitive Integrity as an Intervention for Self-Deception

2017 ◽  
Author(s):  
Eugenia Isabel Gorlin ◽  
Michael W. Otto
Keyword(s):  
Decision Making ◽  
Problem Solving ◽  
Autonomous Agents ◽  
Therapeutic Interventions ◽  
Empirical Validation ◽  
The Past ◽  
Adaptive Problem

To live well in the present, we take direction from the past. Yet, individuals may engage in a variety of behaviors that distort their past and current circumstances, reducing the likelihood of adaptive problem solving and decision making. In this article, we attend to self-deception as one such class of behaviors. Drawing upon research showing both the maladaptive consequences and self-perpetuating nature of self-deception, we propose that self-deception is an understudied risk and maintaining factor for psychopathology, and we introduce a “cognitive-integrity”-based approach that may hold promise for increasing the reach and effectiveness of our existing therapeutic interventions. Pending empirical validation of this theoretically-informed approach, we posit that patients may become more informed and autonomous agents in their own therapeutic growth by becoming more honest with themselves.

scholarly journals Ten-year trends of hypertension treatment and control rate in Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kwang-il Kim ◽  
Eunjeong Ji ◽  
Jung-yeon Choi ◽  
Sun-wook Kim ◽  
Soyeon Ahn ◽  
...  
Keyword(s):  
Age Groups ◽  
Favorable Effect ◽  
Age Group ◽  
Hypertension Treatment ◽  
Treatment Rate ◽  
Cross Sectional ◽  
The Past ◽  
Nationally Representative ◽  
Multistage Sampling ◽  
And Control

AbstractWe analyzed the Korean National Health and Nutrition Examination Survey (KNHANES) database to determine the trends of hypertension treatment and control rate in Korea over the past 10 years. In addition, we tried to investigate the effect of chronic medical conditions on hypertension management. We investigated the hypertension prevalence, awareness, treatment, and control rate from 2008 to 2017. KNHANES, which uses a stratified multistage sampling design, is a cross-sectional, nationally representative survey conducted by the Korean government. A total of 59,282 adults (≥ 20 years) were included, which was representative of the total population of around 40 million Koreans per year. The mean age was 50.7 ± 16.4 years and 42.6% were male. The prevalence of hypertension, hypercholesterolemia, diabetes mellitus, and obesity significantly increased over the 10 years. During this period, the hypertension treatment and control rate significantly improved. Hypertension treatment rate was significantly lower in the younger age group compared to the older age group, but the control rate among the treated patients was not significantly different between age groups. The treatment and control rates of hypertension were higher in patients with multimorbidity, which implies that it has a favorable effect on the treatment and control of hypertension. Hypertension treatment and control rate have improved over the past 10 years. The higher treatment and control rate in patients with multimorbidity suggest that the more aggressive surveillance might be associated with the improvement of hypertension treatment and control rate in Korea.

scholarly journals Inflammation, epigenetics, and metabolism converge to cell senescence and ageing: the regulation and intervention

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Xudong Zhu ◽  
Zhiyang Chen ◽  
Weiyan Shen ◽  
Gang Huang ◽  
John M. Sedivy ◽  
...  
Keyword(s):  
Cell Fate ◽  
Cellular Response ◽  
State Of The Art ◽  
Cell Senescence ◽  
Therapeutic Interventions ◽  
Cell Fate Decision ◽  
The Past ◽  
Fate Decision ◽  
The Individual ◽  
Remarkable Progress

AbstractRemarkable progress in ageing research has been achieved over the past decades. General perceptions and experimental evidence pinpoint that the decline of physical function often initiates by cell senescence and organ ageing. Epigenetic dynamics and immunometabolic reprogramming link to the alterations of cellular response to intrinsic and extrinsic stimuli, representing current hotspots as they not only (re-)shape the individual cell identity, but also involve in cell fate decision. This review focuses on the present findings and emerging concepts in epigenetic, inflammatory, and metabolic regulations and the consequences of the ageing process. Potential therapeutic interventions targeting cell senescence and regulatory mechanisms, using state-of-the-art techniques are also discussed.

Contracture Severity at Hospital Discharge in Children: A Burn Model System Database Study

2020 ◽  
Author(s):  
Miranda Yelvington ◽  
Matthew Godleski ◽  
Austin F Lee ◽  
Jeremy Goverman ◽  
Ingrid Parry ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Range Of Motion ◽  
Hospital Discharge ◽  
Injury Severity ◽  
Model System ◽  
Future Research ◽  
P Value ◽  
Local Practices ◽  
Improvement Measures ◽  
Joint Motions

Abstract Contractures can complicate burn recovery. There are limited studies examining the prevalence of contractures following burns in pediatrics. This study investigates contracture outcomes by location, injury, severity, length of stay, and developmental stage. Data were obtained from the Burn Model System between 1994 and 2003. All patients younger than the age of 18 with at least one joint contracture at hospital discharge were included. Sixteen areas of impaired movement from the shoulder, elbow, wrist, hand, hip, knee, and ankle joints were examined. Analysis of variance was used to assess the association between contracture severity, burn size, and length of stay. Age groupings were evaluated for developmental patterns. A P value of less than .05 was considered statistically significant. Data from 225 patients yielded 1597 contractures (758 in the hand) with a mean of 7.1 contractures (median 4) per patient. Mean contracture severity ranged from 17% (elbow extension) to 41% (ankle plantarflexion) loss of movement. Statistically significant associations were found between active range of motion loss and burn size, length of stay, and age groupings. The data illustrate quantitative assessment of burn contractures in pediatric patients at discharge in a multicenter database. Size of injury correlates with range of motion loss for many joint motions, reflecting the anticipated morbidity of contracture for pediatric burn survivors. These results serve as a potential reference for range of motion outcomes in the pediatric burn population, which could serve as a comparison for local practices, quality improvement measures, and future research.

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