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A static correction: Cesium as well as iodine release through fluoride-based molten sea reactor fuel.
On the other hand, VM had a significant positive association with abnormality in BCV oVEMPs compared with PVM. CONCLUSION VM is associated with dysfunction of the utriculo-ocular pathway more frequently than PVM, suggesting that the pathophysiology of VM involves the utriculo-ocular pathway.BACKGROUND Obstructive sleep apnea (OSA) has been linked to increased perioperative complications. The National Surgical Quality Improvement Project (NSQIP), which is the leading outcomes-based patient database, does not report OSA as a comorbidity. Therefore, we started recording the patient's OSA status as part of Lahey Hospital and Medical Center's (LHMC) NSQIP database in an effort to study the effect of OSA on perioperative complications. METHODS Starting July 2013 we have been including patients' OSA status in our hospital's NSQIP database. We conducted chart review of all patients who underwent any surgical intervention at LHMC between 2013 and 2016 and identified those who had OSA as part of their medical history. We then compared their perioperative mortality and complications to a matched sample. RESULTS A total of 7872 patients were examined. In total, 739 patients had OSA bringing our prevalence to 9.4%. In total, 631 were matched to patients without OSA after adjusting for age, gender, BMI and multiple other comorbidities. We found no statistically significant difference in 30-day mortality (0.1 vs 0%), unplanned intubation (2.6 vs 1.1%), pulmonary embolism (0.5 vs 0.2%), respiratory failure requiring mechanical ventilation (2.3 vs 1.4%), cardiac arrest (0.5 vs 0.3%), myocardial infarction (0.4 vs 0.5%), surgical site infections (4.6 vs 4.3%), sepsis (2.4 vs 1.9%) and average length of stay (3.8 vs 4.2). CONCLUSION Patients with OSA did not have any statistically significant difference in post-op complications or mortality when compared to patients without OSA. This is the first study that tracked OSA status as part of the NSQIP database and studied its effect on perioperative complications. Randomized controlled studies are needed to conclude whether OSA status affects perioperative outcomes.BACKGROUND Five billion people lack access to surgery. Accurate and complete data have been identified as essential to the global scale-up of perioperative care. This study retrospectively validates the Mbarara Surgical Services Quality Assurance Database (SQUAD), an electronic outcomes database at a Ugandan secondary referral hospital. METHODS SQUAD data were compared to paper records from August 2013 to January 2017. To assess data entry accuracy, two researchers independently extracted 24 patient variables from 170 charts. To assess completeness of patient capture, SQUAD entries were compared to a sample of charts returned to the Medical Records Department, and to a sample of entries in ward and operating room logbooks. Two-tailed binomial proportions with 95% CI were calculated from the comparative results of patient observations, against a predefined accuracy of 0.85-0.95. RESULTS Agreement between completed validation observations from charts and SQUAD data was 91.5% (n = 3734/4080 data points). Binomial tests indicated that 15 variables had higher than 95% accuracy. A total 19 of 24 variables had ≥ 85% accuracy. The completeness of SQUAD patient capture was 98.2% (n = 167/170) of charts returned to the Medical Records Department, 97.5% (n = 198/203) of operating logbook entries, and 100% (n = 111/111) of ward logbook entries, respectively. CONCLUSION SQUAD closely reflects the primary surgical and anaesthetic data at a Ugandan secondary hospital. Data accuracy of key variables and completeness of population capture were comparable to those of databases in high-income countries and outperformed those of other low- and middle-income countries.INTRODUCTION Music can have a positive effect on stress and general task performance. This randomized crossover study assessed the effects of preferred music on laparoscopic surgical performance in a simulated setting. METHODS Sixty medical students, inexperienced in laparoscopy, were included between June 2018 and November 2018. A randomized, 4-period, 4-sequence, 2-treatment crossover study design was used, with each participant acting as its own control. Participants performed four periods, consisting of five peg transfer tasks each period, on a laparoscopic box trainer two periods while wearing active noise-cancelling headphones and two periods during music exposure. STINGinhibitorC178 Participants were randomly allocated to a sequence determining the order of the four periods. The parameters time to task completion, path length and normalized jerk were assessed. Mental workload was assessed using the Surgical Task Load Index questionnaire. Also, heart rate and blood pressure were assessed. RESULTS Participants performed the peg transfer task significantly faster [median difference - 0.81 s (interquartile range, - 3.44-0.69) p = 0.037] and handled their instruments significantly more efficient as path length was reduced [median difference, - 52.24 mm (interquartile range, - 196.97-89.81) p = 0.019] when exposed to music. Also, mental workload was significantly reduced during music [median difference, - 2.41 (interquartile range, - 7.17-1.83) p = 0.021)]. No statistically significant effect was observed on heart rate and blood pressure. CONCLUSION Listening to preferred music improves laparoscopic surgical performance and reduces mental workload in a simulated setting. TRIAL REGISTRATION Trial registration number NCT04111679.BACKGROUND There is no consensus regarding the gold standard technique for rectal cancer as Total Mesorectal Excision (TME) may be safely performed either by open or minimally invasive surgery. The laparoscopic approach, however, may carry technical difficulties. For this reason, a novel technique has emerged in the last decade combining a dual laparoscopic dissection (abdominal and transanal) to perform the TME technique (TaTME). When focusing on oncological outcomes, there is a lack of literature regarding mid-long term results. The aim of this study is to evaluate the mid-term oncological impact of TaTME for treating rectal cancer. METHODS A prospective multicentre study was performed in four tertiary centres including consecutive patients who underwent TaTME for mid-low rectal cancer by the same group of experienced surgeons. The analysed data included pathological results on the quality of TME and mid-term oncological outcomes. RESULTS In total, 173 patients were included throughout a study period of 6 years.
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