MANAGEMENT OF FIBULAR HEMIMELIA (CONGENITAL ABSENCE OF FIBULA) USING ILIZAROV METHOD IN SULAIMANI

Background: Fibular hemimelia is the most common congenital deficiency of long bones. Therefore, it is characterized by a wide spectrum of manifestations ranging from mild limb length inequality to sever shortening with foot and ankle deformities and associated anomalies. Objectives: To evaluate the results of ankle and foot reconstruction and limb length equalization in patients with Fibular Hemimelia. Patients and Methods: A prospective study was carried out on 40 limbs in 32 patients with fibular hemimelia during the periods of March 2010 to January 2014. Male to female ratio was 24:8. Their age ranged at an average between 2-16 years (9 years). The reconstruction of ankle and foot was done. Also, the equalization of the limb was done also using Ilizarov frame. Results: The result of this study was assessed using the Association for the Study of Applications of Methods of Ilizarov (ASAMI) scoring system. Therefore, the final results were: Failure rate with 2 limbs 5%, Poor with 2 limbs 5%, Fair with 2 limbs 5%, Good with 8 limbs 20%, and Excellent with 26 limbs 65%. Conclusion: In conclusion, the Ilizarov method is an attractive alternative method used for the management of selected fibular hemimelic patients having three or more toes who are refusing amputation

Predicting Students’ Course Performance Based on Learners’ Characteristics via Fuzzy Modelling Approach

Frequent assessment allows instructors to ensure students have met the course learning objectives. Due to lack of instructor-student interaction, most of the assessment feedbacks and early interventions are not carried out in the large class size. This study is to proposes a new way of assessing student course performance using a fuzzy modeling approach. The typical steps in designing a fuzzy expert system include specifying the problem, determining linguistic variables, defining fuzzy sets as well as obtaining and constructing fuzzy rules is deployed. An educational expert is interviewed to define the relationship between the factors and student course performance. These steps help to determine the range of fuzzy sets and fuzzy rules in fuzzy reasoning. After the fuzzy assessing system has been built, it is used to compute the course performances of the students. The subject expert is asked to validate and verify system performance. Findings show that the developed system provides a faster and more effective way for instructors to assess the course performances of students in large class sizes.  However, in this study, the system is developed based on 150 historical student data and only a total of six factors related to course performance are considered. It is expected that considering more historical student data and adding more factors as the variables help to increase the accuracy of the system

COMPARATIVE STUDY OF FLEXOR TENDON REPAIR BY MODIFIED KESSLER'S TECHNIQUE WITH OR WITHOUT USING VENOUS GRAFT AS A TENDON SHEATH SUBSTITUTE IN ZONE II

Background: Hands are frequently exposed to injuries during daily working hours which might affect its function. Flexor tendon injuries of the hand result in loss of function. The main goal of surgery is to restore function, and avoid the occurrence of postoperative adhesions. However, a better understanding of the process of tendon healing, and continuous evolution of operative technique helps in improving the result. The use of venous graft as a tendon sheath substitute following tendon repair, reduces the adhesion formation, improves tendon nourishment, decreases the need for intensive physiotherapy, restores the function, and improves the results. Despite this remarkable progress, flexor tendon lesions still continues to present difficulty. Objectives: To observe the effectiveness of using vein graft in tendon sheath reconstruction with the aim of decreasing adhesions and comparing it to the conventional method of tendon repair. Patients and Methods: Forty patients who were injured recently, had flexor tendon injuries of the hand involving zone II. They were divided into test and control groups (20 patients each). Modified Kessler technique for primary repair of acute flexor tendons injuries were used in both groups added by the cephalic vein as a tendon sheath substitute in the test group. Results: T h e evaluation of the results is based on TAM (Total Active Motion) score of the ASSH (American Society for Surgery of the Hand). The final results were 75% excellent, 25% good, with no fair or poor results concerning the test group, while in the control group, there was no excellent results; thus, 55% good, 45% fair, and the results obtained were not poor. Conclusion: Repair of the flexor tendon injuries using modified Kessler technique using a venous graft as a tendon sheath substitute and early active movement are recommended to provide effective results as a replacement for the conventional methods

A systematic review of factors associated with outcome of psychological treatments for post-traumatic stress disorder

Objective: Psychological interventions for post-traumatic stress disorder (PTSD) are not always effective and can leave some individuals with enduring symptoms. Little is known about factors that are associated with better or worse treatment outcome. Our objective was to address this gap. Method: We undertook a systematic review following Cochrane Collaboration Guidelines. We included 126 randomized controlled trials (RCTs) of psychological interventions for PTSD and examined factors that were associated with treatment outcome, in terms of severity of PTSD symptoms post-treatment, and recovery or remission. Results: Associations were neither consistent nor strong. Two factors were associated with smaller reductions in severity of PTSD symptoms post-treatment: comorbid diagnosis of depression, and higher PTSD symptom severity at baseline assessment. Higher education, adherence to homework and experience of a more recent trauma were associated with better treatment outcome. Conclusion: Identifying and understanding why certain factors are associated with treatment outcome is vital to determine which individuals are most likely to benefit from particular treatments and to develop more effective treatments in the future. There is an urgent need for consistent and standardized reporting of factors associated with treatment outcome in all clinical trials

Identifying factors associated with 3MDR treatment outcome; A Phase II randomised controlled trial of virtual reality and exposure therapy for military veterans with PTSD

Trauma-focused (TF) psychological therapy has been shown to be the most effective treatment for Post Traumatic Stress Disorder (PTSD). However, a growing number of military veterans have been shown to either not respond or engage with existing treatment, which has resulted in a diagnosis of Treatment-Resistant (TR) PTSD. There is an urgent need to develop more effective and personalised treatments for military veterans with TR-PTSD. As with existing treatment, not all individuals will respond or engage with novel treatments, therefore identifying factors associated with treatment outcome is essential for improving its effectiveness. The aim of this thesis is to explore factors associated with treatment outcome. A systematic review of factors associated with psychological treatment outcome for PTSD was conducted to identify the most commonly reported factors. The factors identified in the systematic review were applied to explore factors associated with outcome in a Randomised Controlled Trial (RCT) of Multi-Modular Motion assisted Memory Desensitization and Reconsolidation (3MDR). 3MDR is a novel intervention that combines virtual reality, movement, personalised music and photographs to expose the participant to their trauma. The RCT included 40 military veterans with TR-PTSD to identify whether 3MDR was more effective than waiting list control. A quantitative analysis involved multiple regression analysis to examine whether any of the factors identified in the systematic review were associated with the 3MDR treatment outcome, as measured by a reduction in Clinician-Administered Post Traumatic Stress Disorder Scale for Diagnostic and Statistical Manual of Mental Disorders 5th edition scores. Qualitative thematic analysis was conducted on semi-structured interviews with 11 military veterans from the 3MDR sample to explore any novel factors associated with treatment outcome. No clear picture with respect to factors associated with outcome emerged and the results indicate that further research is required to examine factors associated with treatment outcome in a larger sample of routinely collected data before any clinical recommendation can be made

COMPARATIVE STUDY OF FLEXOR TENDON REPAIR BY MODIFIED KESSLER'S TECHNIQUE WITH OR WITHOUT USING VENOUS GRAFT AS A TENDON SHEATH SUBSTITUTE IN ZONE II

Background: Hands are frequently exposed to injuries during daily working hours which might affect its function. Flexor tendon injuries of the hand result in loss of function. The main goal of surgery is to restore function, and avoid the occurrence of postoperative adhesions. However, a better understanding of the process of tendon healing, and continuous evolution of operative technique helps in improving the result. The use of venous graft as a tendon sheath substitute following tendon repair, reduces the adhesion formation, improves tendon nourishment, decreases the need for intensive physiotherapy, restores the function, and improves the results. Despite this remarkable progress, flexor tendon lesions still continues to present difficulty. Objectives: To observe the effectiveness of using vein graft in tendon sheath reconstruction with the aim of decreasing adhesions and comparing it to the conventional method of tendon repair. Patients and Methods: Forty patients who were injured recently, had flexor tendon injuries of the hand involving zone II. They were divided into test and control groups (20 patients each). Modified Kessler technique for primary repair of acute flexor tendons injuries were used in both groups added by the cephalic vein as a tendon sheath substitute in the test group. Results: T h e evaluation of the results is based on TAM (Total Active Motion) score of the ASSH (American Society for Surgery of the Hand). The final results were 75% excellent, 25% good, with no fair or poor results concerning the test group, while in the control group, there was no excellent results; thus, 55% good, 45% fair, and the results obtained were not poor. Conclusion: Repair of the flexor tendon injuries using modified Kessler technique using a venous graft as a tendon sheath substitute and early active movement are recommended to provide effective results as a replacement for the conventional methods

Sulfuros metálicos para la conversión de energía: Síntesis, caracterización y uso en celdas fotoelectroquímicas para la generación de hidrógeno

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Ciencias, Departamento de Física de Materiales. Fecha de lectura: 12-06-201

Evaluation of resource creations accuracy by using sentiment analysis

Opinionated texts in various social media can be further processed using sentiment analysis to generate a sentiment polarity reading. This reading shows the general public view toward a product for both developer and user. However, the task is difficult due to the dynamic changes in these texts. The purpose of this paper is to evaluate the capability of existing dictionaries (resource creations) to analyse the opinionated comments from an online learning video