Patient Satisfaction and Surgeon Experience: A Follow-Up to the Reduction Mammaplasty Learning Curve Study

Background: While it is known that increasing surgeon experience is correlated with improved efficiency and safety in the reduction mammaplasty procedure, it is unclear whether these improvements lead to an erosion in patient satisfaction. Methods: The authors distributed the Breast-Q questionnaire to all patients who underwent bilateral reduction mammaplasty at their institution between 1995 and 2007. Univariate and multivariate analyses were performed to assess the relationship between postoperative patient satisfaction scores and surgeon experience, as well as to characterize those patients with particularly high or low satisfaction scores, in general. Results: A total of 279 (26.1%) completed surveys were analyzed. No statistically significant erosion in either Satisfaction with Breasts (SWB) or Satisfaction with Outcomes (SWO) scores were witnessed with increasing surgeon experience or efficiency. Patients older than 40 years demonstrated significantly higher SWB scores than younger patients (P = .004), while patients who suffered postoperative soft tissue necrosis demonstrated significantly lower SWB (P = .003) and SWO (P = .010) scores. Conclusions: Gains in operative efficiency with increasing surgeon experience do not appear to come at the expense of patient satisfaction in the reduction mammaplasty procedure. Younger patients and those who experience postoperative soft tissue necrosis appear to be at higher risk for reporting lower postoperative patient satisfaction scores

Electrodeless electro hydrodynamic printing of personalized drug dosages

There is compelling evidence that variability in drug efficacy in individuals depends on their genetic fingerprints. These observations have given rise to the concept of personalized therapy whose ultimate goal is to develop medicinal agents designed for each niche of the population and individual patients according to their genetic background. The drawback in current pharmaceutical technologies is that most processes are designed to target large population and are unable to meet the demand of small-scale manufacturing of tailored therapeutics with diverse range of physical properties. One of the major challenges lie in developing efficient and cost effective methods of manufacturing personalized treatments. Noncontact drop-on-demand (DOD) systems (i.e., drops are formed only as required) appear to be the most promising platform technology for small-scale manufacturing of personalized treatments. As a digital technology, DOD dosing is able to deposit precisely controlled amounts of material at exact locations without waste, rendering it especially attractive for use with expensive pharmaceutical products. It would provide the capability to form an individual dosage unit by printing a vast array of predefined amounts of therapeutics arranged in a specific pattern on a carrier substrate to achieve a desired drug release profile. However, current DOD methods developed for chemically and thermally stable, low-viscosity inks are of limited use for pharmaceuticals due to fundamentally different functional requirements. In this dissertation, a recently developed DOD method for gentle printing of personalized medicines is presented. To eliminate adverse effects of electrochemical reactions at the fluid-electrode interface, the fluid was infused into an electrically insulating nozzle to form a pendant drop that served as a floating electrode capacitively coupled to external electrodes. A short voltage pulse was applied to the electrodes to stretch the drop into a liquid bridge that broke up creating a sessile drop on the substrate which could be post-processed into a final dosage form. Versatility was proved in experiments on fluids spanning over three orders of magnitude in viscosity and electric conductivity. This method can be used for printing fluids of different physical properties in pharmaceutical, biomedical, and biotechnology applications. Model for pendant drop and scaling analysis which captured the essential physics of electrodless electrohyrodynamic drop dynamics is presented. This analysis describes the characteristics of the operating regimes and provides critical design guideline. To demonstrate the capability of electrodeless DOD for printing personalized dosages, assembled unit dosages were prepared by precisely loading porous hydroxy methylcellulose film matrix with controlled drops of model drugs dissolved in lowly volatile polyethylene glycol carrier. Dissolution tests were performed following United States Pharmacopeia (USP) protocol, and the drug release data was analyzed to identify the underlying drug release mechanisms from the assembled unit dosages. Data showed that the DOD method met the reproducibility requirement critical for content uniformity and that the porous film rapidly disintegrated resulting in instant release of drug which could be useful in fast orally dissolvable medicinal film dosage forms

Traditional communication media: a critique of the indigenous communication media of Ngwa people of Abia State

Every society has developed a communication system that meets its peculiar needs. These forms of communication are regarded as indigenous and have been part of the people's culture. Though these communication systems might undergo some adaptations and changes, they have not been completely eroded, irrespective of technological advancement and modernisation. One such is the indigenous communication system in Ngwa land of the Igbo linguistic group of South Eastern Nigeria. This study, therefore, is a critical evaluation of the indigenous communication media in Ngwa land. The theoretical framework was anchored on Cultural continuity and the Indigenous standpoint theories. The objectives of the study were to identify the various indigenous communication media in Ngwa land and what they communicate, establish the role of indigenous communication media in Ngwa culture, and examine the challenges of using Ngwa indigenous communication media. Findings indicated that Ngwa people have robust indigenous communication platforms that are still relevant and in use today. These media fulfill specific roles in meeting their existential needs for religion, education, politics, entertainment, morals, social life, community development, dispute resolution, etc. It was found that modernity and westernisation have impacted the use of some indigenous media. At the same time, the younger generation is not as enthusiastic as the older generation in embracing indigenous communication channels. It was recommended that the people should adopt a blend of exogenous and indigenous communication while the government incorporates indigenous communication in its development initiatives and policies

Towards online ageing detection in transformer oil: a review

Transformers play an essential role in power networks, ensuring that generated power gets to consumers at the safest voltage level. However, they are prone to insulation failure from ageing, which has fatal and economic consequences if left undetected or unattended. Traditional detection methods are based on scheduled maintenance practices that often involve taking samples from in situ transformers and analysing them in laboratories using several techniques. This conventional method exposes the engineer performing the test to hazards, requires specialised training, and does not guarantee reliable results because samples can be contaminated during collection and transportation. This paper reviews the transformer oil types and some traditional ageing detection methods, including breakdown voltage (BDV), spectroscopy, dissolved gas analysis, total acid number, interfacial tension, and corresponding regulating standards. In addition, a review of sensors, technologies to improve the reliability of online ageing detection, and related online transformer ageing systems is covered in this work. A non-destructive online ageing detection method for in situ transformer oil is a better alternative to the traditional offline detection method. Moreover, when combined with the Internet of Things (IoT) and artificial intelligence, a prescriptive maintenance solution emerges, offering more advantages and robustness than offline preventive maintenance approaches

Effect of organic amendments on soil nematode community composition, nematode infectivity and plant growth

Purpose: The effect of organic amendments on soil nematode community composition and pathogenicity on S.melongena L.was evaluated by comparing the nematode faunal composition in an amended soil with non-amended soil.Methodology: Prior to soil enrichment, the undisturbed plot was assessed to determine the endemic nematode community composition. Organic amendment was administered to the undisturbed plot and nematode population dynamics was determined. Planting was done 14 days after application of organic amendment after which soil samples were collected from the experimental plot at 30, 60 and 90 days intervals. Root samples of the S. melongena L. were also collected at the same interval. The modified Bearmann\u27s extraction technique was used to determine the soil and endophytic population of nematodes. Soil samples were collected from two different depths, 0-5cm and 6-10cm depths.Findings: There was variability in depth related occurrence of nematode genera and species, with abundance and species diversity declining as depth increased prior to amendment (p>0.05). This variability was replicated in the experimental plots after amendment (p<0.05). The study revealed that the soil enrichment strategies have a great influence on the spatial and temporal distribution of nematode community composition. In this study, the application of organic amendments stimulated trophic affiliation of nematodes such that the fungivores; Aphelenchoides spp., Aphelenchus spp., Tylenchusi spp. and Ditylenchus spp. were common at 0-5cm depth along with the specialist plant feeders (parasitic nematodes). The presence of K-strategists such as Xiphinema spp.indicated maturity and stability of the environmen