A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly:does skin grafting influence satisfaction?

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

On subgroups in division rings of type 22

Let $D$ be a division ring with center $F$. We say that $D$ is a {\em division ring of type $2$} if for every two elements $x, y\in D,$ the division subring $F(x, y)$ is a finite dimensional vector space over $F$. In this paper we investigate multiplicative subgroups in such a ring.Comment: 10 pages, 0 figure

Pengembangan Buku Ajar Kalkulus Integral Berbasis Maple untuk Meningkatkan Pemahaman Konsep Mahasiswa

Penelitian ini bertujuan untuk menganalisis: (1) kevalidan buku ajar kalkulus integral berbasis maple; (2) keefektifan buku ajar yang telah dirancang terhadap peningkatan pemahaman konsep matematis mahasiswa; (3) kepraktisan buku ajar yang telah dirancang terhadap peningkatan pemahaman konsep matematis mahasiswa.  Metode yang digunakan adalah penelitian dan pengembangan dengan desain pengembangan model Plomp yang terdiri dari lima tahapan berupa (1) investigasi awal, (2) desain, (3) realisasi/konstruksi, (4) tes, evaluasi dan revisi, (5) implementasi. Subjek penelitian adalah mahasiswa pendidikan matematika STKIP Soe semester genap tahun ajaran 2017/2018 yang mengambil mata kuliah kalkulus integral yang terdiri dari 2 (dua) kelas yakni kelas eksperimen terdiri dari 14 orang dan kelas kontrol yang terdiri dari 15 orang. Instrumen dan teknik pengumpulan data yang digunakan berupa observasi, tes dan angket. Analisis data menggunakan uji t sampel independen dan skor gain normalisasi. Hasil penelitian menunjukkan bahwa buku ajar kalkulus integral berbasis maple valid, efektif dan praktis untuk meningkatkan pemahaman konsep mahasiswa

Assessment of the Effectiveness of Ich Tam Khang as a Supportive Therapy for Chronic Heart Failure

Background: Heart failure is a chronic disease needing lifelong management. Despite the advances that have been made in the treatment of the disease, both the longevity and quality of life for those with chronic heart failure remain impaired. A more effective therapeutic approach with less negative side effects is still needed. In this study, we evaluate Ich Tam Khang (ITK), the poly-ingredient herbal and nutritional preparation with multiple physiological actions, as a supportive therapy for patients with chronic heart failure.Aims of Study: To evaluate the effectiveness and safety of Ich Tam Khang as an adjunctive treatment of chronic heart failure.Methods: A total of 60 patients with chronic congestive heart failure were enrolled in this open label, cross-sectional and prospective study. All patients were treated with a conventional regimen (digoxin, diuretics, angiotensin-converting-enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), beta blockers) for at least 4 weeks before being divided into two equal groups. In the treated patients with ITK, patients received conventional therapy plus 4 tablets ITK per day added in two divided doses. In the control patients, all patients kept the same conventional regimen without ITK. All patients were followed up for 3 months for clinical and para-clinical outcomes.Result: The symptoms of heart failure (dyspnea, palpitation, peripheral edema, neck vein distention, heptojugular reflex) decreased. Heart rate and blood pressure stabilized during treatment in the treated patients with ITK. Additionally, total cholesterol and HDL-cholesterol normalized in the patients treated with ITK. Most of echocardiography parameters in the ITK treated patients were superior to the control patients. ITK is safe and it has no side effects.Conclusion: ITK as a combination of herbal and nutritional preparation is effective in reducing heart failure symptoms, improving patient's quality of life for the patients with decompensated heart failure and reducing total cholesterol and LDL-C

RSNA International Trends: A Global Perspective on the COVID-19 Pandemic and Radiology in Late 2020

The COVID-19 pandemic has challenged and changed our healthcare systems around the world. There has been a heterogeneity of disease burden, healthcare resources, and non-imaging testing availability, both geographically and over time. In parallel, there has been a continued increase in understanding of how the disease affects patients, effectiveness of therapeutic options, and factors that modulate transmission risk. Here we detail experiences from radiology experts in representative countries from around the world, to share insights gained from local experience. These insights provide a guidepost to help address management challenges as cases continue to rise in many parts of the world and suggest modifications in workflow that are likely to continue after this pandemic subsides

Screening and brief interventions for hazardous and harmful alcohol use in primary care: a cluster randomised controlled trial protocol

A large number of randomised controlled trials in health settings have consistently reported positive effects of brief intervention in terms of reductions in alcohol use. However,although alcohol misuse is common amongst offenders, there is limited evidence of alcohol brief interventions in the criminal justice field. This factorial pragmatic cluster randomised controlledtrial with Offender Managers (OMs) as the unit of randomisation will evaluate the effectiveness and cost-effectiveness of different models of screening to identify hazardous and harmful drinkers in probation and different intensities of brief intervention to reduce excessive drinking in probation clients. Ninety-six OMs from 9 probation areas across 3 English regions (the NorthEast Region (n = 4) and London and the South East Regions (n = 5)) will be recruited. OMs will berandomly allocated to one of three intervention conditions: a client information leaflet control condition (n = 32 OMs); 5-minute simple structured advice (n = 32 OMs) and 20-minute brieflifestyle counselling delivered by an Alcohol Health Worker (n = 32 OMs). Randomisation will be stratified by probation area. To test the relative effectiveness of different screening methods all OMs will be randomised to either the Modified Single Item Screening Questionnaire (M-SASQ) orthe Fast Alcohol Screening Test (FAST). There will be a minimum of 480 clients recruited into the trial. There will be an intention to treat analysis of study outcomes at 6 and 12 months postintervention. Analysis will include client measures (screening result, weekly alcohol consumption,alcohol-related problems, re-offending, public service use and quality of life) and implementation measures from OMs (the extent of screening and brief intervention beyond the minimum recruitment threshold will provide data on acceptability and feasibility of different models of brief intervention). We will also examine the practitioner and organisational factors associated with successful implementation.The trial will evaluate the impact of screening and brief alcohol intervention in routine probation work and therefore its findings will be highly relevant to probation teams and thus the criminal justice system in the UK

Comparison of lens- and fiber-coupled CCD detectors for X-ray computed tomography

Lens- and fiber-coupled X-ray detectors with identical CCD chips were compared in their performance in high-resolution computed tomography experiments