Polymath: to be or not to be?

Is it best to achieve excellence in one or multiple fields? Is it better to be a medical doctor reading only medical textbooks all your life or is it better to also tour around the world as a concert pianist and investigate the mysteries of the brain by conducting research projects? As a medical doctor, classical pianist, and neuroscientist, I discuss the advantages, disadvantages, opportunities, and challenges of pursuing multiple careers, drawing from my own experience and from polymaths of the past.

Basic Principles and Role of Endoscopic Ultrasound in Diagnosis and Differentiation of Pancreatic Cancer from Other Pancreatic Lesions: A Comprehensive Review of Endoscopic Ultrasound for Pancreatic Cancer

Pancreatic cancer is one of the leading causes of cancer-related deaths worldwide. Pancreatic lesions consist of both neoplastic and non-neoplastic lesions and often pose a diagnostic and therapeutic challenge due to similar clinical and radiological features. In recent years, pancreatic lesions have been discovered more frequently as incidental findings due to the increased utilization and widespread availability of abdominal cross-sectional imaging. Therefore, it becomes imperative to establish an early and appropriate diagnosis with meticulous differentiation in an attempt to balance unnecessary treatment of benign pancreatic lesions and missing the opportunity for early intervention in malignant lesions. Endoscopic ultrasound (EUS) has become an important diagnostic modality for the identification and risk stratification of pancreatic lesions due to its ability to provide detailed imaging and acquisition of tissue samples for analysis with the help of fine-needle aspiration/biopsy. The recent development of EUS-based technology, including contrast-enhanced endoscopic ultrasound, real-time elastography-endoscopic ultrasound, miniature probe ultrasound, confocal laser endomicroscopy, and the application of artificial intelligence has significantly augmented the diagnostic accuracy of EUS as it enables better evaluation of the number, location, dimension, wall thickness, and contents of these lesions. This article provides a comprehensive overview of the role of the different types of EUS available for the diagnosis and differentiation of pancreatic cancer from other pancreatic lesions while discussing their key strengths and important limitations.

Shade of Innovative Food Processing Techniques: Potential Inducing Factors of Lipid Oxidation

With increasing environmental awareness and consumer demand for high-quality food products, industries are strongly required for technical innovations. The use of various emerging techniques in food processing indeed brings many economic and environmental benefits compared to conventional processes. However, lipid oxidation induced by some "innovative" processes is often "an inconvenient truth", which is scarcely mentioned in most studies but should not be ignored for the further improvement and optimization of existing processes. Lipid oxidation poses a risk to consumer health, as a result of the possible ingestion of secondary oxidation products. From this point of view, this review summarizes the advance of lipid oxidation mechanism studies and mainly discloses the shade of innovative food processing concerning lipid degradation. Sections involving a revisit of classic three-stage chain reaction, the advances of polar paradox and cut-off theories, and potential lipid oxidation factors from emerging techniques are described, which might help in developing more robust guidelines to ensure a good practice of these innovative food processing techniques in future.

The current existence of ChatGPT in education: a double-edged sword?

The authors in this article would like to invite related parties to carry out updates in the world of education, that the existence of ChatGPT can provide new enthusiasm for all of us to improve in a better direction.

Desmopressin in nonsevere hemophilia A: patient perspectives on use and efficacy

Background

Desmopressin increases plasma factor VIII and von Willebrand factor levels in persons with nonsevere hemophilia A. Patients' perspectives on desmopressin are relevant to increase and optimize its suboptimal use. However, patients' views on desmopressin are not reported.

Objectives

To evaluate the perspectives of persons with nonsevere hemophilia A on desmopressin use, barriers for its use, side effects, and their knowledge about desmopressin's efficacy and side effects.

Methods

Persons with nonsevere hemophilia A were included in a cross-sectional, national, multicenter study. Questionnaires were filled out by adult patients and children aged ≥12 years themselves. Caretakers filled out questionnaires for children aged <12 years.

Results

In total, 706 persons with nonsevere hemophilia A were included (544 mild, 162 moderate, [age range, 0-88 years]). Of 508 patients, 234 (50%) patients reported previous desmopressin use. Desmopressin was considered as at least moderately effective in 171 of 187 (90%) patients. Intranasal administration was the modality of choice for 138 of 182 (76%) patients. Flushing was the most reported side effect in 54 of 206 (26%) adults and 7 of 22 (32%) children. The most frequently reported advantage and disadvantage were the convenience of intranasal, out-of-hospital administration by 56% (126/227) and side effects in 18% (41/227), respectively. Patients' self-perceived knowledge was unsatisfactory or unknown in 28% (63/225).

Conclusion

Overall, desmopressin was most often used intranasally and considered effective, with flushing as the most common side effect. The most mentioned advantage was the convenience of intranasal administration and disadvantage was side effects. More information and education on desmopressin could answer unmet needs in patients with current or future desmopressin treatment.

ChatGPT in Radiology: The Advantages and Limitations of Artificial Intelligence for Medical Imaging Diagnosis

This review article provides an overview of using artificial intelligence (AI) in radiology. It discusses the advantages and limitations of ChatGPT, a large language model, for medical imaging diagnosis. ChatGPT has shown great promise in improving the accuracy and efficiency of radiological diagnoses by reducing interpretation variability and errors and improving workflow efficiency. However, there are also limitations, including the need for high-quality training data, ethical considerations, and further research and development to improve its performance and usability. Despite these challenges, ChatGPT has the potential to significantly impact radiology and medical imaging diagnosis. The review article highlights the need for continued research and development, coupled with ethical and regulatory considerations, to ensure that ChatGPT is used to its full potential in improving radiological diagnoses and patient care.

Recent Advances in the Transition-Metal-Free Synthesis of Quinazolines

Quinazolines are a privileged class of nitrogen-containing heterocycles, widely present in a variety of natural products and synthetic chemicals with a broad spectrum of biological and medicinal activities. Owing to their pharmaceutical applications and promising biological value, a variety of synthetic methodologies have been reported for these scaffolds. From the perspective of green and sustainable chemistry, transition-metal-free synthesis provides an alternative method for accessing several biologically active heterocycles. In this review, we summarize the recent progress achieved in the transition-metal-free synthesis of quinazolines and we cover the literature from 2015 to 2022. This aspect is present alongside the advantages, limitations, mechanistic rationalization, and future perspectives associated with the synthetic methodologies.

Paper-Based Humidity Sensors as Promising Flexible Devices: State of the Art: Part 1. General Consideration

In the first part of the review article "General considerations" we give information about conventional flexible platforms and consider the advantages and disadvantages of paper when used in humidity sensors, both as a substrate and as a humidity-sensitive material. This consideration shows that paper, especially nanopaper, is a very promising material for the development of low-cost flexible humidity sensors suitable for a wide range of applications. Various humidity-sensitive materials suitable for use in paper-based sensors are analyzed and the humidity-sensitive characteristics of paper and other humidity-sensitive materials are compared. Various configurations of humidity sensors that can be developed on the basis of paper are considered, and a description of the mechanisms of their operation is given. Next, we discuss the manufacturing features of paper-based humidity sensors. The main attention is paid to the consideration of such problems as patterning and electrode formation. It is shown that printing technologies are the most suitable for mass production of paper-based flexible humidity sensors. At the same time, these technologies are effective both in the formation of a humidity-sensitive layer and in the manufacture of electrodes.

Early and Delayed Surgery for Isolated ACL and Multiligamentous Knee Injuries Have Equivalent Results: A Systematic Review and Meta-analysis

BACKGROUND

Early surgery for acute ligamentous injuries has recently shown good clinical and functional outcomes.

PURPOSE

To assess the advantages of early vs delayed surgery in patients undergoing isolated anterior cruciate ligament (ACL) or multiligament-injured knee (MLIK) surgery.

STUDY DESIGN

Meta-analyses of Level 1, 2, and 3 studies; Level of evidence, 4.

METHODS

A systematic search was performed via PubMed, EMBASE, and Cochrane for studies reporting outcomes of timing of surgery after isolated ACL injury or in the MLIK setting using accelerated rehabilitation protocols. Two analyses were conducted to differentiate early and delayed treatment (3- and 6-week cutoffs). Collected outcomes included meniscal or chondral lesions, failure and reoperation rates, range of motion (ROM) deficits, other complications, muscle strength, instrumented laxity, and functional outcomes. Outcomes were reported in risk ratios (RR) or mean differences with 95% CIs.

RESULTS

For timing of isolated ACL surgery, 16 studies were included with 2093 patients. High-grade evidence indicated that there were no differences in meniscal or chondral lesions, failure and reoperation rates, stiffness, ROM deficits, complications, muscle strength, instrumented laxity, and functional outcomes between patients treated early and late (all P > .05). When including only studies that set no preoperative criteria for early surgery, the findings were similar. Regarding MLIK surgery, 14 studies were included with 1172 patients. Low evidence was noted for the following: patients treated early had significantly fewer meniscal injuries (RR, 0.7; P = .04) and chondral injuries (RR, 0.5; P < .001), while no differences were found in reoperation rates, complications, stiffness, ROM deficits, muscle strength, instrumented laxity, and functional outcomes between the groups. Other than higher Lysholm scores in the early group for the 3-week analysis (mean difference, 6.8; P = .01), there were no differences between cutoff analyses.

CONCLUSION

This systematic review with meta-analysis found no differences in clinical and functional outcomes between early and delayed surgery for isolated ACL injuries. For MLIK injuries, there were also no differences in surgical outcomes between early and delayed surgery.

Gauging the Changing Landscape: Telehealth Perceptions among Hispanic Females with Breast Cancer

During the COVID-19 pandemic, telehealth use rapidly grew while its uptake steadily increased in cancer care. Prior research has reported existing racial and ethnic disparities in telehealth, with Hispanics reporting lower rates of use compared to other major racial/ethnic groups. Our study examined the perceived benefits and challenges/disadvantages faced by Hispanic females diagnosed with breast cancer in San Diego County, California. In-depth interviews were conducted with 27 participants, who were mostly Spanish speaking. The recordings of the interviews were transcribed and translated from Spanish to English. Reflexive thematic analyses revealed both potential benefits and challenges of telehealth. The perceived benefits included logistic and financial aspects (such as convenience and time/financial savings), faster access and longer duration spent with clinicians, the availability of family members, and the minimization of COVID-19 risk. The reported challenges/disadvantages of telehealth and the suggested strategies to address them focused on limitations in clinical care, diminished engagement with clinicians, difficulty accessing interpreter services, and technological access and challenges. The COVID-19 pandemic has greatly affected the landscape of how care is provided, with a greater shift to telehealth services. More research is needed to further examine the challenges of telehealth, particularly for groups that are disproportionately affected, to avoid the disruption of patients' cancer care and to promote a better patient healthcare experience.

[Tractography in functional neuronavigation]

The review addresses the combined use of tractography and neuronavigation. Fundamentals of diffusion tensor imaging are given, technical aspects of fiber tracking in general and in depicting separate subcortical tracts are described. Main advantages of the method and possible causes of errors are highlighted. Precision assessment of this technology is given by comparing with results of subcortical neurostimulation. Surgical tactics is described depending on distance between the tumor and subcortical pathways.

Advantages of growth and competitive ability of the invasive plant Solanum rostratum over two co-occurring natives and the effects of nitrogen levels and forms

Introduction

Atmospheric nitrogen (N) deposition has often been considered as a driver of exotic plant invasions. However, most related studies focused on the effects of soil N levels, and few on those of N forms, and few related studies were conducted in the fields.

Methods

In this study, we grew Solanum rostratum, a notorious invader in arid/semi-arid and barren habitats, and two coexisting native plants Leymus chinensis and Agropyron cristatum in mono- and mixed cultures in the fields in Baicheng, northeast China, and investigated the effects of N levels and forms on the invasiveness of S. rostratum.

Results

Compared with the two native plants, S. rostratum had higher aboveground and total biomass in both mono- and mixed monocultures under all N treatments, and higher competitive ability under almost all N treatments. N addition enhanced the growth and competitive advantage of the invader under most conditions, and facilitated invasion success of S. rostratum. The growth and competitive ability of the invader were higher under low nitrate relative to low ammonium treatment. The advantages of the invader were associated with its higher total leaf area and lower root to shoot ratio compared with the two native plants. The invader also had a higher light-saturated photosynthetic rate than the two native plants in mixed culture (not significant under high nitrate condition), but not in monoculture.

Discussion

Our results indicated that N (especially nitrate) deposition may also promote invasion of exotic plants in arid/semi-arid and barren habitats, and the effects of N forms and interspecific competition need to be taken into consideration when studying the effects of N deposition on invasion of exotic plants.

Pros and cons of remote medical education in Ukraine in terms of COVID-19 pandemics

Introduction

COVID-19 is an ongoing pandemic, which forced countries across the globe to adapt all daily activities to the new reality in order to stop the disease from spreading. The educational process was not an exception, it caused a sudden shift towards the exceptional introduction of online teaching and Kyiv Medical University was one of the first universities in Ukraine to assess the quality of education under the restrictive measures

Objectives

The aim was to analyze the advantages and disadvantages of online education during the COVID-19 pandemic in the learning of neurology at the Department of Neurology, Psychiatry and Physical Rehabilitation, Kyiv Medical University.

Methods

169 students were interviewed using an online questionnaire consisting of 18 items focused on different angles of educational process.

Results

According to the obtained results, the biggest pros of online teaching included: flexibility of learning schedule, learning at your own pace; ability to develop deeper problem-solving and clinical thinking skills. Social distancing, family distractions, and internet connection issues negatively affected most students' feelings during online learning. One of the most prominent cons of online learning of neurology pointed out by the majority of medical students was a lack of practical component of training and contact with patients.

Conclusions

Online teaching, along with a number of advantages, has significant disadvantages, especially in medical education in case of studying clinical disciplines.

Molecular Mechanism of Anti-Colorectal Cancer Effect of Hedyotis diffusa Willd and Its Extracts

With the sharp change in our diet and lifestyle, the incidence of colorectal cancer (CRC) is increasing among young people and has become the second most common malignant tumor worldwide. Although the current treatment of CRC is getting updated rapidly, recurrence and metastasis are still inevitable. Therefore, new anticancer drugs are needed to break existing limitations. In recent years, Hedyotis diffusa Willd (HDW) extracts have been proved to demonstrate excellent anti-colorectal cancer effects and have been widely used in clinical practices. In this review, we aim to explore the advantages, potential signaling pathways, and representative active ingredients of HDW in the treatment of CRC from the perspective of molecular mechanism, in order to provide new ideas for the future treatment of CRC.

Are fructophilic lactic acid bacteria (FLAB) beneficial to humans?

Fructophilic lactic acid bacteria (FLAB) are heterofermentative and related to the genera Fructilactobacillus, Convivina, Leuconostoc, Oenococcus and Weissella. Although they generally prefer fructose above glucose, obligate heterofermentative species will ferment glucose in the presence of external electron acceptors such as pyruvate and fructose. Little is known about the presence of FLAB in the human gut, let alone probiotic properties. In this review we discuss the possible role FLAB may have in the human gastro-intestinal tract (GIT) and highlight the advantages and disadvantages these bacteria may have in individuals with a diet high in fructose.

Rationale and Advantages of Endoscopic Spine Surgery

The goal of a spine surgery is to achieve adequate neural tissue decompression, maintenance of spinal stability, and successful stabilization of an unstable spine. To achieve these surgical goals, damage to normal tissues, including the spinal column and surrounding soft tissues, is inevitable after the beginning of a spine surgery. Extensive damage to normal spinal column and paraspinal collateral tissues during operation can lead to unsuccessful outcomes due to persistent axial pain and additional surgeries due to occurrence of spinal instability. Numerous efforts, such as the usage of microscopy, tubular retractor systems, percutaneous instruments, and trials of new operative approaches have been attempted to reduce normal tissue damage and improve surgical outcomes. Endoscopic spine surgery (ESS) was introduced about 3 decades ago as a minimally invasive spine surgery and has been widely spread with the development of endoscopic surgical instruments and adoption of new endoscopic surgical approaches during the past 2 decades. Theoretically, ESS may be the gold standard method of spine surgery because of its minimal tissue damage and good visualization of the surgical field. However, surgeons hesitate to initiate an ESS due to its steep learning curve and the lack of high-level evidence of surgical outcomes. In this article, the rationale and advantages of performing ESS are discussed by reviewing published articles.

Avatar and distance simulation as a learning tool - virtual simulation technology as a facilitator or barrier? A questionnaire-based study on behalf of Netzwerk Kindersimulation e.V

BACKGROUND

Virtual simulation modalities have been implemented widely since the onset of the severe acute respiratory syndrome coronavirus 2 pandemic restrictions in March 2020, as educators face persistent restrictions to face-to-face education of medical students and healthcare professionals.There is paucity of published data regarding the benefits and barriers of distance and avatar simulation training modalities.

METHODS

Following a 2-day virtual pediatric simulation competition facilitated by Netzwerk Kindersimulation e.V., using remote human avatars and distance simulation, we conducted a multicenter survey to explore the advantages and challenges of avatar and distance simulation among participants. We used a modified Delphi approach to draft and develop the 32-item online questionnaire with 7-point Likert-like scales (7 being the highest rating).

RESULTS

Twenty participants answered our questionnaire. Respondents indicated both a high overall satisfaction (median of 5.0 [Q25-Q75: 4.0-6.0] ) for avatar and distance simulation 6.0 (5.0-6.0), respectively, as well as a high achieved psychological safety with both simulation types (5.0 [4.0-6.0] vs. 5.0 [4.0-6.0]). The most frequently reported profits of avatar and distance simulation included the elimination of travel distances, associated lower costs, less time spent attending the education activity, and effective communication and leadership training, especially with avatar simulation. Most often named challenges were technical problems, limited reception of non-verbal cues and a spatial distance from the team/educator.

DISCUSSION

Based on the results of this pilot study, avatar and distance simulation can be employed successfully and appear to be good supplements to face-to-face simulation. Other studies are warranted to further explore the effectiveness of various types of virtual simulation compared to conventional presential simulation. We suggest using avatar-based simulation for targeted communication and leadership skills training and the application of distance simulation to bring simulation experts virtually to remote places where educator resources are lacking.

Freehand Minimally Invasive Pedicle Screw Fixation and Minimally Invasive Decompression for a Thoracic or Lumbar Vertebral Metastatic Tumor From Hepatocellular Carcinoma

Objective: To compare freehand minimally invasive pedicle screw fixation (freehand MIPS) combined with percutaneous vertebroplasty (PVP), minimally invasive decompression, and partial tumor resection with open surgery for treatment of thoracic or lumbar vertebral metastasis of hepatocellular carcinoma (HCC) with symptoms of neurologic compression, and evaluate its feasibility, efficacy, and safety.

Methods: Forty-seven patients with 1-level HCC metastatic thoracolumbar tumor and neurologic symptoms were included between February 2015 and April 2017. Among them, 21 patients underwent freehand MIPS combined with PVP, minimally invasive decompression, and partial tumor resection (group 1), while 26 patients were treated with open surgery (group 2). Duration of operation, blood loss, times of fluoroscopy, incision length, and stay in hospital were compared between the two groups. Pre- and postoperative visual analog scale (VAS) pain score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) grade, ambulatory status, and urinary continence were also recorded. The Cobb angle and central and anterior vertebral body height were measured on lateral radiographs before surgery and during follow-ups.

Results: Patients in group 1 showed significantly less blood loss (195.5 ± 169.1 ml vs. 873.1 ± 317.9 ml, P = 0.000), shorter incision length (3.4 ± 0.3 vs. 13.6 ± 1.8 cm, P = 0.000), shorter median stay in hospital (4–8/6 vs. 8–17/12 days, P = 0.000), more median times of fluoroscopy (5–11/6 vs. 4–7/5 times, P = 0.000), and longer duration of operation (204.8 ± 12.1 vs. 171.0 ± 12.0 min, P = 0.000) than group 2. Though VAS significantly decreased after surgery in both groups, VAS of group 1 was significantly lower than that of group 2 immediately after surgery and during follow-ups (P < 0.05). Similar results were found in ODI. No differences in the neurological improvement and spinal stability were observed between the two groups.

Conclusion: Freehand MIPS combined with PVP, minimally invasive decompression, and partial tumor resection is a safe, effective, and minimally invasive method for treating thoracolumbar metastatic tumors of HCC, with less blood loss, better pain relief, and shorter length of midline incision and stay in hospital.

Perceptions of Physicians Regarding Implementation of Hospital Management Information Systems in a Tertiary Setting Hospital of a Developing Country

Background Health Management Information Systems (HMIS) are being adopted increasingly in tertiary hospitals in developing countries like Pakistan, with the aim of improving physician and patient convenience. However, the perception of healthcare professionals regarding HMIS should be thoroughly assessed in order to achieve effective utilization and implementation of this system. Objective To assess the perception of physicians regarding the newly implemented HMIS in a tertiary setting hospital in Pakistan. Materials and methods A cross-sectional study was conducted in all the departments of Ghurki Trust Teaching Hospital (GTTH), Lahore. Total 145 physicians of varying specialty units, fulfilling the inclusion and exclusion criteria, were included and data were collected over a span of six months between July 2020 and December 2020. Data was collected by using a structured questionnaire. The SPSS software version 22 was used for data analysis. Results are presented in the form of frequencies and tables. Results The sample population consisted of 80 males (55.2%) and 65 females (44.8%), with the majority of the respondents having 1-5 years of clinical experience. Of the total, 61.4% (n = 89) knew about the term HMIS, while 71.7% (n = 104) of participants responded that no formal training was provided to them before the implementation of HMIS. Overall, 77.9% of respondents agreed that formal training should have been conducted before the implementation of this system. In total, 77.2% of respondents considered the ease to review patients' history (ERPH) as the biggest advantage of HMIS, while 54.5% considered being paper-free (PF), and 53.1% considered facilitation of data analysis (FDA) as the next two major advantages. As for the disadvantages, 75.9% of respondents considered HMIS to be more time-consuming (TC) and 57.2% considered it to be a hindrance to smooth running (HSR) of clinical work in case of overloading of patients. Conclusions While implementation of HMIS was found to have significant advantages in the opinion of physicians, such as ease in reviewing patients' medical records, data analysis, and providing paperless patient care, it should nevertheless be preceded by formal training of all physicians regarding its use. Many physicians consider HMIS to be more TC, especially in circumstances where the patient load is overwhelming.

Zebrafish as a Model System to Study the Mechanism of Cutaneous Wound Healing and Drug Discovery: Advantages and Challenges

In humans, cutaneous wounds may heal without scars during embryogenesis. However, in the adult phase, the similar wound may undergo a few events such as homeostasis, blood clotting, inflammation, vascularization, and the formation of granulation tissue, which may leave a scar at the injury site. In consideration of this, research evolves daily to improve the healing mechanism in which the wound may heal without scarring. In regard to this, zebrafish (Danio rerio) serves as an ideal model to study the underlying signaling mechanism of wound healing. This is an important factor in determining a relevant drug formulation for wound healing. This review scrutinizes the biology of zebrafish and how this favors the cutaneous wound healing relevant to the in vivo evidence. This review aimed to provide the current insights on drug discovery for cutaneous wound healing based on the zebrafish model. The advantages and challenges in utilizing the zebrafish model for cutaneous wound healing are discussed in this review. This review is expected to provide an idea to formulate an appropriate drug for cutaneous wound healing relevant to the underlying signaling mechanism. Therefore, this narrative review recapitulates current evidence from in vivo studies on the cutaneous wound healing mechanism, which favours the discovery of new drugs. This article concludes with the need for zebrafish as an investigation model for biomedical research in the future to ensure that drug repositions are well suited for human skin.

Textile-Based Mechanical Sensors: A Review

Innovations related to textiles-based sensors have drawn great interest due to their outstanding merits of flexibility, comfort, low cost, and wearability. Textile-based sensors are often tied to certain parts of the human body to collect mechanical, physical, and chemical stimuli to identify and record human health and exercise. Until now, much research and review work has been carried out to summarize and promote the development of textile-based sensors. As a feature, we focus on textile-based mechanical sensors (TMSs), especially on their advantages and the way they achieve performance optimizations in this review. We first adopt a novel approach to introduce different kinds of TMSs by combining sensing mechanisms, textile structure, and novel fabricating strategies for implementing TMSs and focusing on critical performance criteria such as sensitivity, response range, response time, and stability. Next, we summarize their great advantages over other flexible sensors, and their potential applications in health monitoring, motion recognition, and human-machine interaction. Finally, we present the challenges and prospects to provide meaningful guidelines and directions for future research. The TMSs play an important role in promoting the development of the emerging Internet of Things, which can make health monitoring and everyday objects connect more smartly, conveniently, and comfortably efficiently in a wearable way in the coming years.

Non-Rodent Genetic Animal Models for Studying Tauopathy: Review of Drosophila, Zebrafish, and C. elegans Models

Tauopathy refers to a group of progressive neurodegenerative diseases, including frontotemporal lobar degeneration and Alzheimer's disease, which correlate with the malfunction of microtubule-associated protein Tau (MAPT) due to abnormal hyperphosphorylation, leading to the formation of intracellular aggregates in the brain. Despite extensive efforts to understand tauopathy and develop an efficient therapy, our knowledge is still far from complete. To find a solution for this group of devastating diseases, several animal models that mimic diverse disease phenotypes of tauopathy have been developed. Rodents are the dominating tauopathy models because of their similarity to humans and established disease lines, as well as experimental approaches. However, powerful genetic animal models using Drosophila, zebrafish, and C. elegans have also been developed for modeling tauopathy and have contributed to understanding the pathophysiology of tauopathy. The success of these models stems from the short lifespans, versatile genetic tools, real-time in-vivo imaging, low maintenance costs, and the capability for high-throughput screening. In this review, we summarize the main findings on mechanisms of tauopathy and discuss the current tauopathy models of these non-rodent genetic animals, highlighting their key advantages and limitations in tauopathy research.

Electrospun Metal Oxide Nanofibers and Their Conductometric Gas Sensor Application. Part 2: Gas Sensors and Their Advantages and Limitations

Electrospun metal oxide nanofibers, due to their unique structural and electrical properties, are now being considered as materials with great potential for gas sensor applications. This critical review attempts to assess the feasibility of these perspectives. This article discusses approaches to the manufacture of nanofiber-based gas sensors, as well as the results of analysis of the performances of these sensors. A detailed analysis of the disadvantages that can limit the use of electrospinning technology in the development of gas sensors is also presented in this article. It also proposes some approaches to solving problems that limit the use of nanofiber-based gas sensors. Finally, the summary provides an insight into the future prospects of electrospinning technology for the development of gas sensors aimed for the gas sensor market.

Electrospun Metal Oxide Nanofibers and Their Conductometric Gas Sensor Application. Part 1: Nanofibers and Features of Their Forming

Electrospun metal oxide nanofibers, due to their unique structural and electrical properties, are now being considered as materials with great potential for gas sensor applications. This critical review attempts to assess the feasibility of these perspectives. The article in Part 1 discusses the basic principles of electrospinning and the features of the formation of metal oxide nanofibers using this method. Approaches to optimization of nanofibers’ parameters important for gas sensor application are also considered.

Surgical treatment of sternum comminuted fracture with memory alloy embracing fixator

Background

Sternal fracture can result from multiple types of severe chest trauma and carries significant risk. Surgical fixation is an effective method for sternal fracture.

Methods

The clinical data of patients with sternal fractures who presented to our hospital between August 2016 and July 2019 were collected. The 42 patients were divided into three groups, with 15 patients treated by internal fixation with NI-TI memory alloy embracing fixator, 10 patients receiving steel wire fixation, and 17 who received non-surgical treatment and who was designated as a control (conservative) group. Differences in clinical indices included the duration of surgery, blood loss, hospitalization, wound healing, hospitalization expenses, VAS scores, and patient satisfaction scores between the three groups was compared. The analysis of variance and t-test were used for quantitative variables, which were approximately normally distributed. Dichotomous data were compared used Pearson χ² or Fisher’s exact test, and a P value less than 0.05 was considered as statistically significant.

Results

All patients were cured, and there were no significant differences in general clinical features between the three groups (P>0.05). Thoracic deformity in the surgical groups was corrected anatomically and received better pain scores, while patients in the NI-TI memory alloy embracing fixator group showed advantages of bleeding and patient satisfaction (P<0.05).

Conclusions

Operative treatment for a sternal fracture is safe, effective and can quickly restore the stability of the thorax. Memory alloy embracing fixator is markedly superior to other fixator materials.

Six Key Advantages and Disadvantages of Working from Home in Europe during COVID-19

The number of people working from home (WFH) increased radically during the coronavirus (COVID-19) pandemic. The purpose of this study was therefore to investigate people's experiences of WFH during the pandemic and to identify the main factors of advantages and disadvantages of WFH. Data from 29 European countries on the experiences of knowledge workers (N = 5748) WFH during the early stages of lockdown (11 March to 8 May 2020) were collected. A factor analysis showed the overall distribution of people's experiences and how the advantages and disadvantages of WFH during the early weeks of the pandemic can be grouped into six key factors. The results indicated that most people had a more positive rather than negative experience of WFH during lockdown. Three factors represent the main advantages of WFH: (i) work-life balance, (ii) improved work efficiency and (iii) greater work control. The main disadvantages were (iv) home office constraints, (v) work uncertainties and (vi) inadequate tools. Comparing gender, number of children at home, age and managers versus employees in relation to these factors provided insights into the differential impact of WFH on people's lives. The factors help organisations understand where action is most needed to safeguard both performance and well-being. As the data were collected amidst the COVID-19 pandemic, we recommend further studies to validate the six factors and investigate their importance for well-being and performance in knowledge work.

Reports on the Perceived Advantages and Disadvantages of Suicidal Behavior by Patients With Depression

Background: Studies suggest there may be perceived secondary advantages to engaging in suicidal behavior that impact the help-seeking behavior of at-risk individuals. Aims: The aim of this study was to assess the views of patients with depression regarding the advantages and disadvantages of engaging in suicidal behavior using a decisional balance worksheet (DBW) to inform prevention and intervention efforts. Method: Participants were adults with depression between the ages of 18 and 75 presenting to the emergency department with suicidal ideation (N = 42) who participated in a larger pilot study of a brief intervention aimed focused on treatment engagement. Using a content analysis approach, common themes were extracted. Results: Escaping from problems and negative thoughts, ending pain and suffering, and eliciting support and help were the most commonly cited advantages of engaging in suicidal behavior. Negatively impacting family, violating one's values, and missing out on the future were the most commonly reported disadvantages of suicidal behavior. Limitations: Results may not be generalizable to patients without depression who are experiencing suicidality. Conclusion: Results suggest intervention efforts focused on addressing decision-making and problem-solving skills and reinforcing the important role patients play in the lives of their significant others may help patients to resist the urge to act on suicidal thoughts.

Ocular Toxocariasis: Beyond Typical Patterns through the New Imaging Technologies

PURPOSE

To report five cases of ocular Toxocariasis (OT) in which ultrawide-field (UWF) imaging was helpful in diagnosis and assessment. OT is an underdiagnosed condition triggered by the ocular invasion of Toxocara larvae. Typical features are peripheral granuloma or endophthalmitis.Methods: A retrospective case series of 10 outpatients were studied by complete ophthalmologic examination and complementary tests. UWF retinal imaging, fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SDOCT) were retrospectively analyzed. Five patients with suspected OT were included.Results: UWF imaging and FAF was able to detect all retinal lesions in a single rapid capture. Two patients showed positive serology for Toxocara. An image suggesting the larva in the vitreous cavity was shown in one patient. Antihelmintic 15 treatment along with steroids was prescribed in two patients.Conclusion: UWF imaging and SDOCT provide a more efficient approach and follow-up in OT, raising final standards of care.

Potential of Nanoparticles as Permeation Enhancers and Targeted Delivery Options for Skin: Advantages and Disadvantages

The topical route of administration has many advantages for the treatment of various skin disorders as well as cosmeceutical purposes. This route bypasses hepatic first-pass effect and systemic availability of many pharmaceuticals is limited to skin organelles such as hair follicles and so could avoid unwanted adverse reactions and increase the localized therapeutic effect. Despite such attributed advantages of the topical route, the most important challenge is skin barrier characteristics that should be overcome to obtain dermal or trans-dermal drug delivery. Different approaches have been recruited to overcome this barrier. In this review, different types of nanoparticles for skin permeation enhancement and targeted delivery to skin organelles are discussed. The potential mechanisms of each nanocarrier in permeation enhancement and dermal delivery are considered and finally, the most important advantages and disadvantages of each group are summarized.

Advances in exogenous docosahexaenoic acid-containing phospholipids: Sources, positional isomerism, biological activities, and advantages

In recent years, docosahexaenoic acid-containing phospholipids (DHA-PLs) have attracted much attention because of theirs unique health benefits. Compared with other forms of docosahexaenoic acid (DHA), DHA-PLs possess superior biological effects (e.g., anticancer, lipid metabolism regulation, visual development, and brain and nervous system biochemical reactions), more intricate metabolism mechanisms, and a stronger attraction to consumer. The production of DHA-PLs is hampered by several challenges associated with the limited content of DHA-PLs in natural sources, incomplete utilization of by-products, few microorganisms for DHA-PLs production, high cost, and complex process of artificial preparation of DHA-PLs. In this article, the sources, biological activities, and commercial applications of DHA-PLs were summarized, with intensive discussions on advantages of DHA-PLs over DHA, isomerism of DHA in phospholipids (PLs), and brain health. The excellent biological characteristics of DHA-PLs are primarily concerned with DHA and PLs. The metabolic fate of different DHA-PLs varies from the position of DHA in PLs to polar groups in DHA-PLs. Overall, well understanding of DHA-PLs about their sources and characteristics is critical to accelerate the production of DHA-PLs, economically enhance the value of DHA-PLs, and improve the applicability of DHA-PLs and the acceptance of consumers.

The H-index in Life and Health Sciences: Advantages, Drawbacks and Challenging Opportunities

In recent years, there has been a significant increase in the number of scientific publications. The h-index offers a consistent estimation method about a researcher's overall scientific achievements since it combines the total number of publications (i.e., productivity) and the number of citations (i.e., quality of those publications). In other words, the h-index is intended to measure simultaneously the quality and quantity of scientific output in a cumulative approach and does not provide data regarding the recent productivity. This editorial presents advantages and limitations of h-index that all researchers in health sciences need to be aware of, especially if this metric is used for professional progression, and discusses the simple modification indexed to "academic/scientific age". It is obvious that no single metric is perfect, and the use of two or more metrics is more prone to success.

Critical review on conventional spectroscopic α-amylase activity detection methods: merits, demerits, and future prospects

α-Amylase is an endoenzyme that catalyses the hydrolysis of internal α-l,4 glycosidic linkages in polysaccharides to produce maltose, maltotriose, and α-limit dextrins. It is widely used in the laboratorial and industrial workflow for several applications. There are several methods utilizing different techniques and substrates to assess α-amylase activity, among which the spectroscopic methods have found widespread applicability due to their ease of use and cost-effectiveness. Depending upon the reaction principle, these assays are classified into four groups: reducing sugar, enzymatic, chromogenic, and amyloclastic methods. Despite the presence of numerous methods, there is no general reliable method to assess α-amylase activity. Each method is shown to have its own merits and demerits. Many improvements have been made to make the available methods more accurate, reliable, and easy. This communication briefly discusses the basic reaction mechanisms and critically reviews the advantages and shortcomings associated with each method. Further recommendations are made for future development. © 2020 Society of Chemical Industry.

Benefits and Disadvantages of Electronic Patient-reported Outcome Measures: Systematic Review

Background

Patient-reported outcome measures (PROMs) are important in clinical practice and research. The growth of electronic health technologies provides unprecedented opportunities to systematically collect information via PROMs.

Objective

The aim of this study was to provide an objective and comprehensive overview of the benefits, barriers, and disadvantages of the digital collection of qualitative electronic patient-reported outcome measures (ePROMs).

Methods

We performed a systematic review of articles retrieved from PubMED and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during all stages. The search strategy yielded a total of 2333 records, from which 32 met the predefined inclusion and exclusion criteria. The relevant ePROM-related information was extracted from each study.

Results

Results were clustered as benefits and disadvantages. Reported benefits of ePROMs were greater patient preference and acceptability, lower costs, similar or faster completion time, higher data quality and response rates, and facilitated symptom management and patient-clinician communication. Tablets were the most used ePROM modality (14/32, 44%), and, as a platform, Web-based systems were used the most (26/32, 81%). Potential disadvantages of ePROMs include privacy protection, a possible large initial financial investment, and exclusion of certain populations or the “digital divide.”

Conclusions

In conclusion, ePROMs offer many advantages over paper-based collection of patient-reported outcomes. Overall, ePROMs are preferred over paper-based methods, improve data quality, result in similar or faster completion time, decrease costs, and facilitate clinical decision making and symptom management. Disadvantages regarding ePROMs have been outlined, and suggestions are provided to overcome the barriers. We provide a path forward for researchers and clinicians interested in implementing ePROMs.

Trial Registration

PROSPERO CRD42018094795; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94795

Historical Perspective: Models of Parkinson's Disease

Parkinson’s disease (PD) is the most common movement disorder with motor and nonmotor signs. The current therapeutic regimen for PD is mainly symptomatic as the etio-pathophysiology has not been fully elucidated. A variety of animal models has been generated to study different aspects of the disease for understanding the pathogenesis and therapeutic development. The disease model can be generated through neurotoxin-based or genetic-based approaches in a wide range of animals such as non-human primates (NHP), rodents, zebrafish, Caenorhabditis (C.) elegans, and drosophila. Cellular-based disease model is frequently used because of the ease of manipulation and suitability for large-screen assays. In neurotoxin-induced models, chemicals such as 6-hydroxydopamine (6-OHDA), 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), rotenone, and paraquat are used to recapitulate the disease. Genetic manipulation of PD-related genes, such as α-Synuclein(SNCA), Leucine-rich repeat kinase 2 (LRRK2), Pten-Induced Kinase 1 (PINK1), Parkin(PRKN), and Protein deglycase (DJ-1) Are used in the transgenic models. An emerging model that combines both genetic- and neurotoxin-based methods has been generated to study the role of the immune system in the pathogenesis of PD. Here, we discuss the advantages and limitations of the different PD models and their utility for different research purposes.

Current approaches to the diagnosis of vascular erectile dysfunction

Vascular erectile dysfunction (ED) is closely related to cardiovascular events, and early diagnosis of vascular ED may be helpful to predict the occurrence of cardiovascular events and improve prognosis. At present, there are many approaches to diagnose ED, but each method has its advantages and limitations. This study retrospectively reviewed all available literature focusing on the diagnosis of vascular ED through a systematic PubMed and EMBASE search. According to the different application scenarios, the main methods for the diagnosis of vascular ED are divided into four categories. Intra-cavernous injection of vasoactive drugs is the earliest method used in the diagnosis of vascular ED and is a basic test. For the diagnosis of arterial ED, color duplex Doppler ultrasound, selective penile angiography, magnetic resonance imaging, and computed tomography are more commonly used. While for the diagnosis of venous ED, shear wave elastography, dynamic infusion cavernosometry and cavernosography are more accurate. Endo-peripheral arterial tonometry (PAT) has also been used to detect vascular endothelial function. Although various existing examinations are widely used for the evaluation of vascular ED, they still have some shortcomings, such as invasiveness, contingency, high false positive (negative) rate. New methods of long-term dynamic detection are needed.

Robotic Management of Endometriosis: Discussion of Use, Criteria and Advantages: a Review of the Literature

Endometriosis is a very common benign condition affecting fertility and quality of life. Different methods, either definitive or fertility sparing are used for its management by using open, laparoscopic, and robotic techniques. This is a literature review presenting the role and the advantages of robotic surgery in endometriosis. Such a management is effective, safe, and feasible in hands of well-trained multidisciplinary teams even for severe cases of endometriosis.

Principles of digital PCR and its applications in current obstetrical and gynecological diseases

Digital PCR (dPCR) is a revolutionary technique to precisely quantify nucleic acids. For its high sensitivity and specificity, this technique has been widely replicated worldwide. To verify its applicability, we reviewed all the related articles in PubMed database published before May 10, 2019. Original articles and reviews on the topics were selected. Entered key words included "digital PCR/dPCR", "advantage", "combined use", "microfluidic chip", "gynecological cancer/tumor". We found that dPCR has shown great potential in clinical operations, like tumor liquid biopsy, non-invasive prenatal diagnosis, microorganism detection, and next-generation sequencing library quality-control.

The concept of welfare technology in Swedish municipal eldercare

PURPOSE

An ageing population presents a challenge for municipal eldercare in Sweden due to difficulties recruiting staff and there being a strained economy. A strategy involving welfare technology is presented as one such solution. An important group to carry out this strategy involves those who work with welfare technology in municipal eldercare. In this paper we describe their perception of welfare technology, and the challenges and opportunities they perceive in utilizing it.

METHODS

A self-administered online questionnaire was distributed to all Swedish municipalities and answered by 393 respondents. Analyses show that the respondents were representative of the different professions who work with welfare technology within municipal eldercare.

RESULTS

Welfare technology was perceived as being more reliable and safer than humans with regards to supervisions and reminders. The respondents acknowledged factors that slowed down the implementation of welfare technology in municipal eldercare organizations, such as resistance to change, lack of finances, lack of supporting evidence, lack of infrastructure, high staff turnover, difficulties with procurement and uncertainties about responsibility and laws.

CONCLUSIONS

We found that the people who work with and make decisions about welfare technology in municipal eldercare organizations were generally very positive about the deployment and use of such technology, but there appear to be problems within municipal eldercare organizations to realize this vision. The lack of structured implementation processes and coherent evaluation models indicates inequality of the access to welfare technology and, as a result, even though Swedish eldercare is publicly funded, the availability of welfare technologies and their usage differ between municipalities.IMPLICATIONS FOR REHABILITATIONThe research findings show that implementing welfare technologies in municipal eldercare must include transformed working processes and long-term strategies or they may lead to conflicts of priorities or unstructured implementation processes.Structured implementation processes and coherent evaluation models are needed for equality of access and availability of welfare technologies in municipal eldercare.High staff turnover negatively affects the deployment of welfare technology and the root cause of high staff turnover needs to be addressed.

Tannins: Prospectives and Actual Industrial Applications

The origin of tannins, their historical evolution, their different types, and their applications are described. Old and established applications are described, as well as the future applications which are being developed at present and that promise to have an industrial impact in the future. The chemistry of some of these applications is discussed where it is essential to understand the tannins and their derivates role. The essential points of each application, their drawbacks, and their chance of industrial application are briefly discussed. The article presents historical applications of tannins, such as leather, or traditional medicine, and more recent applications.

The optimal choices of animal models of white matter injury

White matter injury, the most common neurological injury in preterm infants, is a major cause of chronic neurological morbidity, including cerebral palsy. Although there has been great progress in the study of the mechanism of white matter injury in newborn infants, its pathogenesis is not entirely clear, and further treatment approaches are required. Animal models are the basis of study in pathogenesis, treatment, and prognosis of white matter injury in preterm infants. Various species have been used to establish white matter injury models, including rodents, rabbits, sheep, and non-human primates. Small animal models allow cost-effective investigation of molecular and cellular mechanisms, while large animal models are particularly attractive for pathophysiological and clinical-translational studies. This review focuses on the features of commonly used white matter injury animal models, including their modelling methods, advantages, and limitations, and addresses some clinically relevant animal models that allow reproduction of the insults associated with clinical conditions that contribute to white matter injury in human infants.

Black Phosphorus-New Nanostructured Material for Humidity Sensors: Achievements and Limitations

The prospects of using nanostructured black phosphorus for the development of humidity sensors are considered. It was shown that black phosphorus has a set of parameters that distinguish it from other two-dimensional (2D) materials such as graphene, silicone, and dichalcogenides. At the same time, an analysis of shortcomings, limiting the use of black phosphorus as a humidity sensitive material in devices aimed for market of humidity sensors, was also conducted.

Recent Advancements in Intestinal Microbiota Analyses: A Review for Non-Microbiologists

Microbial constituents naturally inhabiting the gastrointestinal tract may influence the homeostasis of the gut environment. The presence or overabundance of some bacterial taxa has been reported to be associated with complex diseases, and the metabolites of certain bacteria may contribute to diverse disorders by influencing signaling pathways. Therefore, the study of gut microbial population has emerged as a crucial field and a new potential area of clinical significance. Advances in the methods of microbiota analysis have shed light upon the details including species diversity, microfloral activities as well as the entire gut microbiota. Nevertheless, comprehensive reviews on this subject are still limited. For elucidating the appropriate selection strategy of the methods to address a particular research question, we comprehensively reviewed the continuously improving technologies, classical to newly developed, and dissected their relative advantages and drawbacks. In addition, aiming at the rapidly advancing next-generation sequencing, we enumerated the improvements in mainstream platforms and made the horizontal and vertical comparison among them. Additionally, we demonstrated the four main -omics methods, which may provide further mechanistic insights into the role of microbiota, to propel phylotyping analysis to functional analysis.

Advantages and Limitations of Current Techniques for Analyzing the Biodistribution of Nanoparticles

Nanomedicines are typically submicrometer-sized carrier materials (nanoparticles) encapsulating therapeutic and/or imaging compounds that are used for the prevention, diagnosis and treatment of diseases. They are increasingly being used to overcome biological barriers in the body to improve the way we deliver compounds to specific tissues and organs. Nanomedicine technology aims to improve the balance between the efficacy and the toxicity of therapeutic compounds. Nanoparticles, one of the key technologies of nanomedicine, can exhibit a combination of physical, chemical and biological characteristics that determine their in vivo behavior. A key component in the translational assessment of nanomedicines is determining the biodistribution of the nanoparticles following in vivo administration in animals and humans. There are a range of techniques available for evaluating nanoparticle biodistribution, including histology, electron microscopy, liquid scintillation counting (LSC), indirectly measuring drug concentrations, in vivo optical imaging, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine imaging. Each technique has its own advantages and limitations, as well as capabilities for assessing real-time, whole-organ and cellular accumulation. This review will address the principles and methodology of each technique and their advantages and limitations for evaluating in vivo biodistribution of nanoparticles.

Capabilities and Advantages of Cloud Computing in the Implementation of Electronic Health Record

Background:

With regard to the high cost of the Electronic Health Record (EHR), in recent years the use of new technologies, in particular cloud computing, has increased. The purpose of this study was to review systematically the studies conducted in the field of cloud computing.

Methods:

The present study was a systematic review conducted in 2017. Search was performed in the Scopus, Web of Sciences, IEEE, Pub Med and Google Scholar databases by combination keywords. From the 431 article that selected at the first, after applying the inclusion and exclusion criteria, 27 articles were selected for surveyed. Data gathering was done by a self-made check list and was analyzed by content analysis method.

Results:

The finding of this study showed that cloud computing is a very widespread technology. It includes domains such as cost, security and privacy, scalability, mutual performance and interoperability, implementation platform and independence of Cloud Computing, ability to search and exploration, reducing errors and improving the quality, structure, flexibility and sharing ability. It will be effective for electronic health record.

Conclusion:

According to the findings of the present study, higher capabilities of cloud computing are useful in implementing EHR in a variety of contexts. It also provides wide opportunities for managers, analysts and providers of health information systems. Considering the advantages and domains of cloud computing in the establishment of HER, it is recommended to use this technology.

[Review on advantages and evidence of treating and preventing urinary tract infection in traditional Chinese medicine]

Urinary tract infection (UTI) in traditional Chinese medicine (TCM) belongs to the category of stranguria. This article describes the unsatisfactory situations in clinical practice such as antibiotics abuse, increasing of drug-resistant bacteria, high recurrence rate, etc. According to evidence-based medicine, literatures as evidence are collected for summarizing and analyzing and the result shows the advantages of TCM of relieving symptoms, reducing the dosage of antibiotics, less side effects, lower recurrence rate, etc. In the field of fundamental research, literatures associated with UTI are also summarized and analysed from several perspectives, such as causes, pathogenesis, syndrome differentiation, pharmacological effects of Chinese herbal medicine, working mechanism of non-drug therapy, etc and the result presents that integrated treatment of TCM in UTI has significant advangtages and its own characteristic.

A review on current nanomaterials and their drug conjugate for targeted breast cancer treatment

Breast cancer is the most common malignancy worldwide, especially among women, with substantial after-treatment effects. The survival rates of breast cancer have decreased over the years even with the existence of various therapeutic strategies, specifically, chemotherapy. Clinical drugs administered for breast cancer appear to be non-targeting to specific cancer sites leading to severe side effects and potentially harming healthy cells instead of just killing cancer cells. This leads to the need for designing a targeted drug delivery system. Nanomaterials, both organic and inorganic, are potential drug nanocarriers with the ability of targeting, imaging and tracking. Various types of nanomaterials have been actively researched together with their drug conjugate. In this review, we focus on selected nanomaterials, namely solid-lipid, liposomal, polymeric, magnetic nanoparticles, quantum dots, and carbon nanotubes and their drug conjugates, for breast cancer studies. Their advantages, disadvantages and previously conducted studies were highlighted.

The demands and benefits of ergonomics in Sri Lankan apparel industry: A case study at MAS holdings

BACKGROUND

Apparel exports bring in sizeable foreign income to Sri Lanka. To protect and promote this industry is a paramount need. This can be carried out by applying Human Factors/Ergonomics (HFE) which has proved to control negative effects at work places.

OBJECTIVES

This paper reports a case study which describes the demands and benefits of HFE in MAS Holdings which owns a large share of the apparel industry in Sri Lanka.

METHODS

The study consisted of walk through observation survey, a questionnaire survey and ergonomic work place analysis followed by a training programme to selected employees in three companies.

RESULTS

Positive responses to questionnaires revealed good ergonomic practices in the work places surveyed. Ergonomically unfit chairs and potential hazards e.g. exposure to noise and hot environment were detected. It is seen that MAS have introduced strategies originated by Toyota Production System viz. 5S, Kaizen, six sigma etc., which are in fact ergonomic methods. A progressive project MAS boast of viz. 'MAS Operating System' (MOS) empowers training and development to employees.

CONCLUSIONS

MAS Holdings has adequately realized the benefits of applying HFE as evident by the number of awards received. Relevant companies were advised to take appropriate corrective measures to control the potential hazards.

Modified Miccoli's thyroid surgery for thyroid diseases

Minimally invasive video-assisted thyroidectomy (MIVAT), originally described by Miccoli, is considered to be the most widely practiced and easily reproducible procedure for selected patients with benign and/or malignant thyroid nodules. Modified techniques based on MIVAT, namely modified Miccoli's thyroid surgery (MMTS), were developed based on MIVAT. This study aimed to evaluate the preliminary results of MMTS compared with those of MIVAT. The enrolling criteria included a benign nodule <3.5 cm in diameter, a malignant tumor <2 cm, no previous neck surgery and no evidence of any suspected lymph node metastasis or local invasion. Unilateral lobectomy was considered for benign lesions and the additional dissection of central compartment (level VI) lymph nodes was applied for malignant disease. The modified techniques included carefully selecting the operative incision, expanding the operative space, embedding a drainage tube in situ and delicately suturing every layer inwards and crosswise, as well as measuring cervical motion. In addition to the comparison of surgical outcomes between MMTS and MIVAT, other surgical parameters, including operative time, blood loss, postoperative drainage, cosmetic satisfaction, peak angle of cervical rotation, length of hospitalization and complications, were retrospectively analyzed. A consecutive series of 70 patients, including 54 cases of benign and 16 cases of malignant disease, initially underwent MIVAT between April, 2008 and May, 2012, while 127 patients, including 98 benign and 29 malignant cases, subsequently underwent MMTS between September, 2011 and October, 2014. Patients who received MMTS exhibited significantly less blood loss (20.3±11.3 vs. 32.3±12.6 ml, P<0.01), lower volume of postoperative drainage (42.77±15.2 vs. 50.48±23.2 ml, P<0.01) and higher cosmetic satisfaction (94.6±3.5 vs. 88.9±2.7%, P<0.01), but a longer operative time (102±36 vs. 50.48±23.2 min, P<0.01) when compared with MIVAT. In addition, a better peak angle of cervical rotation (38.6±4.1° vs. 35.3±3.8°, P=0.25) and shorter length of hospitalization (4.25±1.08 vs. 4.51±1.30 days, P=0.52) was observed in the MMTS group, although the differences with the MIVAT group were not statistically significant. No complications were observed, apart from 2 cases of recurrent laryngeal nerve palsy and 1 case of transient hypocalcemia at the beginning of MIVAT. In conclusion, both MMST and MIVAT are safe and feasible methods of thyroidectomy; however, MMST is associated with less trauma and higher cosmetic satisfaction compared with MIVAT. Therefore, MMST may be used as a standard operative method and prospectively applicable for thyroidectomy, even for early-stage malignancies.