Revision Rhinoplasty: With Introduction of a Novel Preoperative Assessment Classification System

2021 ◽  
Vol 35 (02) ◽  
pp. 078-087
Author(s):  
Austin Jiang ◽  
Edward S. Chamata ◽  
Fred J. Bressler
Keyword(s):  
Classification System ◽  
Surgical Planning ◽  
Revisional Surgery ◽  
Preoperative Assessment ◽  
Primary Surgery ◽  
Primary Rhinoplasty ◽  
Revision Rhinoplasty ◽  
Proper Patient Selection ◽  
Level Of Understanding ◽  
High Level

AbstractRevision rhinoplasty presents several complex surgical challenges. Proper patient selection for revision rhinoplasty, along with thorough preoperative examination and surgical planning, is key to achieving ideal outcomes. Along with achieving a high level of understanding of primary rhinoplasty techniques, surgeons performing revision rhinoplasty must understand and diagnose deformities created by the primary surgery. A systematic approach to diagnosing rhinoplasty deformities assists in forming a suitable surgical plan. A classification system based on nasal analysis, described here, may be used to differentiate the degree of difficulty of the surgery as well as assist in surgical planning. Surgeons have a multitude of options available in their armamentarium for addressing common nasal deformities encountered during revisional surgery, and a stepwise surgical approach may facilitate the creation of an optimal aesthetic and functional result.

Influence of Irrational Beliefs and Sensitivity to a Person on Future Psychology Students’ Propensity to Coercion or Nonviolence

2021 ◽  
pp. 143-165
Author(s):  
V.G. Maralov ◽  
◽  
V.A. Sitarov ◽  
Keyword(s):  
Irrational Beliefs ◽  
High Sensitivity ◽  
Daily Practice ◽  
Psychology Students ◽  
State Universities ◽  
Low Level ◽  
Level Of Understanding ◽  
Low Sensitivity ◽  
High Level ◽  
Dependent Type

The relevance of the problem is due to the importance of identifying factors that determine the propensity of students to coercion or nonviolence, creating psychological and pedagogical conditions for the formation of the socionomic sphere of nonviolent competencies for future specialists at universities. The theoretical basis of the study was the position of nonviolence as a daily practice of interaction, by which we understand the ability of a person to choose from a number of possible alternatives that carry the least charge of coercion. The aim of the work was to study the influence of irrational beliefs and sensitivity to a person (interest, empathy, understanding and assistance) on the students’ tendency to coercion, manipulation, non-violence and non-interference in the processes of interaction with people. The hypothesis was tested that the tendency of students to coercion, manipulation, and noninterference will be due to expressed irrational beliefs and low level of sensitivity to a person and the tendency to non-violence will be explained by the absence of irrational beliefs and a high level of sensitivity to a person. The study involved 125 students of pedagogical and psychological faculties of the Moscow Humanitarian and Cherepovets State universities. The authors used questionnaires to identify the positions of interaction among students and sensitivity to a person, as well as a list of irrational beliefs proposed by A. Beck and A. Freeman. It is established that the tendency to both coercion and manipulation are determined by the beliefs of anti-social type and low sensitivity to the person. The tendency to manipulate the narcissistic beliefs, high interest in people and understanding them, at the same time the tendency to non-violence and non-interference are determined by beliefs of avoidant and dependent types with a low level of understanding people. And a tendency to non-interference is determined by beliefs of dependent type with unexpressed orientation on helping. The tendency to nonviolence is determined by the high sensitivity to a person and the absence of irrational beliefs of antisocial, passive-aggressive and narcissistic types. As a result, the conclusion is made about the need to form purposefully the ability to nonviolent interaction among students, which should include the work on awareness and overcoming irrational beliefs and the development of sensitivity to a person. The obtained results can be used in practical work with students on the formation of their nonviolent competencies.

scholarly journals The program of communicative and personal development of primary schoolchildren within the framework of an innovative university-school partnership: Evaluation of the effectiveness

2021 ◽  
Vol 11 (4) ◽  
pp. 7-32
Author(s):  
Yulia Valerievna Batenova ◽  
◽  
Marina Yuryevna Buslaeva ◽  
Marina Nikolaevna Tereshchenko ◽  
Nadezhda Borisovna Novikova ◽  
...  
Keyword(s):  
Personal Development ◽  
Validity And Reliability ◽  
Communicative Development ◽  
Communication Program ◽  
Primary Schoolchildren ◽  
Research Findings ◽  
School Partnership ◽  
Methodological Principles ◽  
Level Of Understanding ◽  
High Level

Introduction. The article addresses the problem of primary schoolchildren’s communicative and personal development within the frameworks of an innovative university-school partnership. The purpose of the article is to evaluate the effectiveness of the program aimed at communicative and personal development of primary schoolchildren and to identify psychological and educational factors contributing to its implementation. Materials and Methods. The research follows learner-centered, semiotic, and hermeneutic approaches. In order to assess communicative development of primary schoolchildren, the following empirical methods were used: G. A. Zuckerman’s ‘Mittens’ inventory, O. G. Mishanova’s ‘Polite words’ inventory, G. A. Zuckerman’s ‘Dictation Pattern’ inventory, the ‘Brothers and Sisters’ method (modified samples of Zh. Piaget). The study involved 50 primary schoolchildren and 4 primary school teachers. To analyze the empirical data and evaluate the dynamics, the Wilcoxon T-test was used, which ensures the validity and reliability of research findings. Results. The article analyzes and summarizes the experience of currently available programs aimed at social and communicative development of primary schoolchildren. The authors have developed a program enhancing primary schoolchildren’s communicative development, theoretically justified and implemented it. The explanatory and heuristic potential of methodological principles and approaches to solving this problem has been revealed. The authors describe an educational technology called ‘a hermeneutic circle’ and illustrate it by means of a text analyzes focusing on its expediency, relevance, and communicative significance for effective cognition of the language essence and training communicative skills. The research findings indicate the effectiveness of the program called ‘Culture of speech and ethics of communication’ in the communicative and personal development of primary schoolchildren in four areas: communication as cooperation; communication as management; communication as interiorization; communication as interaction. Relying on these directions, the authors have identified and described the following parameters of the integral communicative and personal development: the level of dialogic communication, the level of communication ethics, the level of communication productivity, the level of understanding of the other participants. Conclusions. The article concludes that the implementation of ‘Culture of speech and ethics of communication’ program and creating a psychologically beneficial learning environment have led to a high level of communicative and personal development of primary schoolchildren who consider language as a cultural, ethical, and aesthetic value.

Septal Deviation after Septorhinoplasty: Causes and Surgical Management

2020 ◽  
Vol 36 (01) ◽  
pp. 072-077
Author(s):  
Neil N. Luu ◽  
Oren Friedman
Keyword(s):  
Primary Source ◽  
New Techniques ◽  
Structural Support ◽  
Primary Rhinoplasty ◽  
Revision Rhinoplasty ◽  
Septal Surgery ◽  
Aesthetic Rhinoplasty ◽  
Surgically Induced ◽  
Improve Patient

AbstractRevision rhinoplasty exists because the perfect primary rhinoplasty technique does not. The benefit of revision surgery is that it offers us the opportunity to study and identify what did not work well during previous surgery. Thoughtful approaches to technique and outcomes allow us to recognize which maneuvers are dependable and worth repeating, and which are not reliable and therefore worth avoiding. As surgeons seek safer, more predictable results to improve patient outcomes, new techniques emerge which we then apply, study, and modify again, based on what works and what does not over the short term and the long term. There is no substitute for experience or for learning from trusted surgeons' experiences. Revision rhinoplasty presents many challenges including surgically induced anatomical changes, weakened structural support, a lack of available tissue for reconstruction, tissue remodeling responses, and other iatrogenic and wound healing complications. The septum, as the primary source of structural nasal integrity, forms the foundation for functional and aesthetic rhinoplasty. Herein, we describe strategies in septorhinoplasty for patients who have undergone prior nasal septal surgery.

scholarly journals The Critical Role of Biliary Candidiasis in Development of Surgical Site Infections after Pancreatoduodenectomy: Results of Prospective Study Using a Selective Culture Medium for Candida Species

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hiroyuki Kato ◽  
Yusuke Iizawa ◽  
Kei Nakamura ◽  
Kazuyuki Gyoten ◽  
Aoi Hayasaki ◽  
...  
Keyword(s):  
Risk Factor ◽  
Candida Species ◽  
Critical Role ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Preoperative Assessment ◽  
Significant Risk Factor ◽  
High Level ◽  
New Evidence

In accordance with previous reports, the incidence of biliary candidiasis (BC) after pancreaticoduodenectomy (PD) was reported to be 0 to 5%, and the clinical significance of BC still has been elusive. In this study, we prospectively evaluated the precise incidence of BC after PD using the CHROMagar Candida plate in an attempt to elucidate whether BC has a significant impact on the clinical outcomes after PD.Patients and Method. From November 2014 to March 2016, the consecutive 51 patients who underwent PD were enrolled for this study. The bile juice was prospectively collected through the biliary stent tube on postoperative days (POD) 3, 7, and 14 and directly incubated onto the CHROMagar Candida plate for the cultivation of various Candida species. In the presence or absence of BC, we compared the incidence of SSIs.Results. The incidence of postoperative BC was 15% on POD 3, 24% on POD 7, and 39% on POD 14, respectively. Taken together, 22 patients out of 51 (43.1%) developed BC after PD. Moreover, the incidence of SSIs was significantly higher in patients with BC than in those without it (71% versus 7%, p=0.005). BC was selected as the only significant risk factor of SSIs after PD among the various risk factors. Even though a cause of BC is unknown, high level of alkaline phosphatase (cut-off line >300 IU/L) was selected as the only preoperative risk factor of the development of BC.Conclusion. We elucidated new evidence in which BC could be the independent cause of SSIs after PD and should not be recognized as just contamination artifacts. Preoperative assessment for identifying carriers of Candida species might be essential for reducing the incidence of SSIs after PD.

The Application of Rapid Prototyping and Manufacturing for Anatomical Modelling in Medicine

2010 ◽  
Vol 6 ◽  
pp. 57-65 ◽  
Author(s):  
S. Singare ◽  
W. Ping ◽  
X. Guanghui
Keyword(s):  
Tissue Engineering ◽  
Rapid Prototyping ◽  
Computer Aided Design ◽  
Surgical Planning ◽  
Three Dimensional ◽  
Advanced Technology ◽  
Tissue Scaffold ◽  
Custom Implant ◽  
Rapid Prototyping And Manufacturing ◽  
High Level

This paper reviews the applications of advanced technology such as CT, reverse engineering (RE), computer aided design (CAD) and rapid prototyping (RP) in medicine. We described: 1) the use of RP and medical imaging in surgical planning; 2) the design process for the production of customized medical implants by rapid prototyping; and 3) the fabrication of three-dimensional scaffolds for tissue engineering of human liver. In order to examine the applicability and efficiency of the rapid prototyping technology, some case studies are presented, involving visualization and surgical planning; the design of custom implant for cranial reconstruction; and the use of RP in the production of tissue scaffold. From the results, it has been shown that RP can be applied with high level of accuracy in surgical planning, custom implant and tissue engineering.

scholarly journals Tahap Kefahaman dan Kemahiran Pengajaran Matapelajaran Jawi dalam Kalangan Guru Pendidikan Islam

2021 ◽  
Vol 5 (1) ◽  
pp. 39-45
Author(s):  
Mohamad Radhi Mohamad Yusof ◽  
Hafizhah Zulkifli
Keyword(s):  
Work Experience ◽  
Survey Study ◽  
Kuala Lumpur ◽  
National Education ◽  
National Education System ◽  
Major Subject ◽  
Significant Difference ◽  
Level Of Understanding ◽  
High Level ◽  
The Relationship

Islamic education is a major subject in the National Education system and it is an important subject contained in the education curriculum system. Therefore, this study is conducted to unravel the level of understanding and skills of Religious teachers on teaching Jawi subjects, identify significant differences between the understanding and skills of Religious teachers based on gender, age, level of education and work experience and the relationship between understanding and skills among teachers Religion. This study was conducted with a survey study method based on a questionnaire of 140 respondents consisting of all religious teachers in one area zone 6 Kuala Lumpur. The results of the descriptive study show that the mean of understanding and skills of Religious teachers are at a high level. The results of the inference analysis show that there is no significant difference between the understanding and skills of Religious teachers on the teaching of Jawi subjects based on gender, age, and work experience. While there is a positive relationship between understanding and skills among Religious teachers. Therefore, the results of this study prove that Religious teachers have a good understanding and skills in teaching Jawi subjects and at the same time become a catalyst for a quality educator. Keywords: Teaching, Jawi Subjects, Understanding, Skills, Religious Teachers AbstrakPendidikan Islam adalah satu subjek yang utama dalam sistem Pendidikan Kebangsaan dan ia adalah satu matapelajaran penting yang terkandung dalam sistem kurikulum pendidikan. Justeru kajian ini dilaksanakan bertujuan bagi merungkai tahap kefahaman dan kemahiran guru Agama terhadap pengajaran matapelajaran Jawi, mengenal pasti perbezaan yang signifikan di antara kefahaman dan kemahiran guru Agama berdasarkan jantina, umur, tahap pendidikan dan pengalaman kerja serta hubungan antara kefahaman dan kemahiran di kalangan guru Agama. Kajian ini telah di jalankan dengan kaedah kajian tinjauan berdasarkan borang soal selidik sebanyak 140 respondan yang terdiri semuanya daripada para guru Agama di satu kawasan zon 6 Kuala Lumpur. Hasil dapatan kajian deskriptif menunjukkan bahawa min kefahaman dan kemahiran guru Agama berada pada tahap yang  tinggi. Hasil analisis inferensi menunujukkan tidak terdapat perbezaan  yang signifikan di antara kefahaman dan kemahiran guru Agama terhadap pengajaran matapelajaran Jawi berdasarkan jantina, umur, dan pengalaman kerja. Manakala terdapat hubungan positif di antara kefahaman dan kemahiran di kalangan guru Agama. Oleh yang demikian, hasil daripada dapatan kajian ini membuktikan bahawa guru-guru Agama mempunyai kefahaman dan kemahiran yang baik dalam pengajaran matapelajaran Jawi dan sekaligus menjadi pemangkin seorang pendidik yang berkualiti. Kata kunci: Pengajaran, Matapelajaran Jawi, Kefahaman, Kemahiran, Guru Agama

scholarly journals Student-Designed Cross-Sectional Pandemic Knowledge Survey of 8th−12th Grade Students, Milwaukee, WI, April 2020

2021 ◽  
Vol 9 ◽  
Author(s):  
Krish Vasudev ◽  
Hersh Singh ◽  
August A. Neumann ◽  
William M Zhao ◽  
Lyle Dominic Pelayo Mondano
Keyword(s):  
The Novel ◽  
Cross Sectional ◽  
Safety Measures ◽  
Web Based ◽  
12Th Grade ◽  
Twelfth Grade ◽  
Level Of Understanding ◽  
Novel Coronavirus ◽  
High Level ◽  
Knowledge Survey

Background: The novel coronavirus and its effect on our society are unprecedented. Given the recent pandemic, numerous measures have been taken to protect our communities. We sought to understand our school community's knowledge and the measures that were taken by our school for our safety.Objective: Our objective was to describe the overall understanding and attitudes of 8–12th grade students from a single institution during the initial phase of the Wisconsin's Governor's stay-at-home order.Methods: A voluntary web-based survey was communicated to 8–12th grade students through their online school portal. Data were collected and analyzed using SurveyMonkey.Results: There was a 20.2% response rate. Answers regarding the coronavirus, spread, and response to the coronavirus pandemic showed a high level of understanding of the virus and the actions necessary to prevent its spread.Conclusion: Eight-twelfth grade students have a high level of understanding of the virus, its effects, and the safety measures implemented to protect society.

scholarly journals Pengembangan buku ajar digital Geografi SMA berplatform aplikasi 3D Page Flip dengan pendekatan STEAM (Science, Technology, Engineering, Art, Mathematic) materi keragaman budaya di Indonesia

2021 ◽  
Vol 26 (2) ◽  
pp. 92-98
Author(s):  
Yuli Yana ◽  
Budi Handoyo ◽  
Alfyananda Kurnia Putra
Keyword(s):  
Cultural Diversity ◽  
Test Scores ◽  
Development Research ◽  
Digital Textbook ◽  
Product Trial ◽  
Digital Era ◽  
Science Technology ◽  
Addie Model ◽  
Level Of Understanding ◽  
High Level

Today students live in a digital era. Such conditions affect the changing needs of textbooks as a source of learning for students. The purpose of this development research is to produce a digital textbook on cultural diversity in Indonesia with a 3D page flip application platform with a STEAM approach (Science, technology, engineering, art, mathematics). The design of this study uses the ADDIE model. Product trial results show that the percentage of the feasibility of textbooks is as much as 87 percent, which means it is very feasible to use. While the results of students' understanding test scores in the range of 76-85 with a percentage of 53 percent. These results indicate that students have a high level of understanding criteria.

scholarly journals Analytical Quality by Design

2021 ◽  
Vol 8 (32) ◽  
pp. 1-5
Author(s):  
Márcia Breitkreitz
Keyword(s):  
Manufacturing Process ◽  
Quality By Design ◽  
Pharmaceutical Products ◽  
Quality Parameters ◽  
Regulatory Agencies ◽  
Regulatory Requirements ◽  
Significant Step ◽  
Level Of Understanding ◽  
High Level

Throughout the 20th century, the notion of ‘quality’ underwent major changes. The concept of ‘Quality by Testing’, i.e. evaluating the quality of a product by testing it for some pre-defined parameters after completing the manufacturing process, started to be replaced by the enhanced approach of Quality by Design (QbD). In this concept, idealized by Joseph Juran [1], quality is initially conceived for the product, and then the product is manufactured and evaluated to reach that quality. Driven by the need to reduce costs and to encourage companies to improve their understanding of their products and manufacturing processes, pharmaceutical regulatory agencies, through the ICH (International Council on Harmonization), published the ICH Q8 guideline, highlighting the QbD strategy for pharmaceutical development [2]. This represented a significant step in replacing the existing quality paradigms in the conventional manufacturing of pharmaceutical products and paved the way to support development and production activities within a scientific, flexible environment, with a high level of quality, without the need for extensive regulatory surveillance. The higher level of understanding gained during development allows out-of-specification batches to be foreseen and ensures that the desired quality will be obtained at the end of the manufacturing process. The two pillars of the QbD concept are quality risk management and multivariate study of the outcomes (quality parameters) as functions of the inputs (materials, formulation and process inputs). At this point, Chemometrics emerged officially as a strategy to support the pharma regulatory requirements- the beginning of a joyful and long-life union.

scholarly journals Is combined MDCT and echocardiography needed to guarantee accuracy in diagnosis and surgical planning of DORV and associated anomalies?

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Samira Saraya ◽  
Yousra Mahmoud Ahmad ◽  
Ragab Hani Donkol ◽  
Hazem Hamed Soliman ◽  
Reem Ibrahim Ismail ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Diagnostic Accuracy ◽  
Surgical Planning ◽  
Septal Defect ◽  
Preoperative Assessment ◽  
Double Outlet Right Ventricle ◽  
Great Vessels ◽  
Associated Malformations

Abstract Background The term of Double-outlet right ventricle (DORV) is used to describe a spectrum of complex congenital cardiac malformations where anomalies of the ventriculo-arterial alignment are noted where both great arteries (pulmonary artery and aorta) originate completely or predominantly from the right ventricle. The purpose of this study is to evaluate the diagnostic accuracy of electrocardiography (ECG) gated multidetector computed tomography (MDCT) in preoperative assessment of DORV and its associated malformations, providing key anatomic parameters that affect surgical planning. Results A total of 50 patients diagnosed by echocardiography with DORV referred from our institute between September 2018 and August 2020 were enrolled. The location of the ventricular septal defect (VSD) to the great vessels and the alignment of the great vessels to each other as well as other associated malformations that affect the surgical planning were assessed by MDCT. The patients were retrospectively classified into subgroups according to the relative positions of the great arteries, the relationship between the great arteries and the VSD, and the presence of associated malformations according to the classification of Society of Thoracic Surgeons database. The diagnostic value of MDCT and transthoracic echocardiography (TTE) in evaluation of associated cardiac malformations apart from double outlet right ventricle was compared in 20 patients, whom surgeries were performed and surgical results were obtained. Fallot type of DORV was the most common clinical type which represented 48% of the patients in which the VSD is committed to the aorta. The second most common clinical type was Taussig–Bing anomaly which represented 30% of the patients and the VSD was seen committed to the pulmonary artery. The atrio-ventricular septal defect (AVSD)/uni-ventricular type represented 16% of the patients in the current study, with pulmonary and systemic venous anomalies, heterotaxy syndrome and situs anomalies were commonly associated. A total of 53 malformations apart from DORV were found in 20 patients whom performed surgical interventions. MDCT detected different vascular and situs anomalies in those patients with 100% sensitivity and 100% positive predictive value compared to 71.4% and 94% respectively in TTE. On the other hand, in our study TTE was superior to MDCT for detection of intracardiac anomalies with 100% sensitivity and 100% accuracy compared to 87.5% and 95% respectively in MDCT. Conclusions Our study suggested that ECG gated MDCT serves as a rapid, noninvasive imaging modality with good spatial resolution and provides excellent diagnostic image quality and has satisfactory diagnostic accuracy in the preoperative assessment of DORV. It is superior to echocardiography in providing a comprehensive mapping of the anatomy of complex anomalies especially that of extra-cardiac structures such as aorta, systemic veins, pulmonary veins, and pulmonary arteries. However, it can miss tiny intracardiac malformations. So combining the results of MDCT and echocardiography would be beneficial to guarantee the accuracy of diagnosis of DORV.

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