Study to assess proper timing of laryngoscopy in post-thyroid surgery patients to detect recurrent laryngeal nerve injury

Background: Thyroid surgeries are commonly done nowadays for benign and malignant conditions. Recurrent laryngeal nerve palsy (RLNP) is an important and potentially catastrophic complication of thyroid surgery. The purpose of the study was to determine the impact of rigid endoscopy (Hopkins rod-lens telescope) performed at different time intervals on the diagnosis of RLNP in post-thyroid surgery patients. Aims and Objectives: To assess Proper Timing of Laryngoscopy in Post-thyroid Surgery patients to Detect RLN Injury. Materials and Methods: Rigid endoscopy was performed postoperatively at day 0 (T0), at 2nd day post-op (T1), and day 14 (T2). For patients with RLNP, repeated examinations were performed at 2 months (T3), 6 months (T4), and 12 months (T5). Results: The study included 50 patients of thyroid swelling with different diagnoses. Overall, 35 patients appeared for postoperative laryngoscopic examination of the vocal folds at our center, providing 61 nerves at risk. RLNP rate was 8.1% at T0, 11.5% at T1, 9.8% at T2, 8.1% at T3, 4.9% at T4, and 3.3% at T5. T1 was significantly superior to all other time intervals in terms of diagnosis of RLNP but statistically not significant. Conclusion: Rigid endoscopy is essential for the detection of vocal cord paralysis after thyroidectomy. We report different time evaluation criteria of vocal cord morbidity with great and significant variability of results. Second day post-op inspection of the larynx (T1) is suggested.

Cranioplasty

Calvarial defects are commonly encountered after neurosurgical procedures, trauma, and ablative procedures of advanced head neck cancers. The goals of cranioplasty are to provide a protective barrier for the intracranial contents, to restore form, and prevent syndrome of the trephined. Autologous and alloplastic techniques are available, each with their advantages and drawbacks. A multitude of materials are available for cranioplasty, and proper timing of reconstruction with attention to the overlying skin envelope is important in minimizing complications.

COVID-19 in South Korea: Proper timing for Easing Mask mandates after COVID-19 Vaccination

As of 25 July 2021, the Korea Disease Control and Prevention Agency reported 1,422 new COVID-19 cases, 188,848 total cases, and 2.073 total deaths (1.10% fatality rates). Since the first SARS-CoV-2 case was reported, efforts to find a treatment and vaccine against COVID-19 have been widespread. Four vaccines are on the WHO’s emergency use listing and are approved of their usage; BNT162b2, mRNA-1273, AZD1222, and Ad26.COV2.S. Vaccines against SARS-CoV-2 need at least 14 days to achieve effectiveness. Thus, people should abide by prevention and control measures, including wearing masks, washing hands, and social distancing. However, a lot of new cases were reported after vaccinations, as many people did not follow the prevention control measures before the end of the 14 days period. There is no doubt we need to break free from mask mandates. But let us not decide the timing in haste. Even if the mask mandates are eased, they should be changed depending on the number of reported cases, vaccinations, as well as prevention and control measures on how circumstances are changing under the influence of mutant coronavirus.

An integer mathematical model for the problem of timetabling university exams

This research is an attempt to create optimized planning in educational units. The problem of university courses timetabling is one of the problems that is very important for educational units; establishing optimal distances to comply with students' study status as well as balancing other constraints of the timetabling problem is one of the challenges in a timetabling problem. Therefore, sometimes an educational unit may not be able to strike a good balance between all the constraints it faces and fail to achieve a proper timing table. In this paper, in order to achieve optimal exam timetabling with an integer scheduling approach, a model for exam timetabling is presented. The purpose of the proposed mathematical model is to maximize the appropriate time intervals that should be established between students' exams. In this mathematical model, according to the number of allowed exam days and the number of possible exam sessions per day, a number of positions have been considered and it is tried to assign these positions to the courses according to the courses related to the students of each entrance. The most important advantage of the proposed model is its simplicity while sufficient accuracy. Therefore, complex methods are not needed to solve this model.

A simple system for improving the accuracy of IZC bone screw placement

An operator often finds it hard to assess the ideal timing to start angulating the driver while placing infrazygomatic crest screws. Thus, we have designed a simple system to guide the operator to know exactly when the angulation of the driver should be started for the ideal placement of the IZC screw. The components of the system include the calculation of the amount of tissue that needs to be pierced perpendicularly and the fabrication of an indicator device over the implant driver with a stainless steel wire. Hence, using this system, the proper timing for angulation can be obtained, thus improving the accuracy of placement.

Effectiveness of Indaziflam and Glyphosate Tank Mix to Control Weed in Mature Oil Palm

Tank mixing of pre and post emergence herbicides with proper timing application is one potential way to reduce the rotation of herbicide application per year. An experiment was conducted in the field of 10 years old mature oil palm using the mixture of indaziflam 50 - 150 g a.i./ha and glyphosate 135 g a.i./ha. The standard herbicide used in the estate (mixture of methyl-metsulfuron 10 g a.i/ha and glyphosate 135 g a.i./ha) was used as a comparison. The experiment was designed by randomized block of 6 treatments and 4 repetitions. Herbicides were applied in rotation based on the designed timetable following field condition and certain policy in the estate. Indaziflam had shown its ability to suppress the growth of weed up to 9 months after application, just by the lowest dosage of 50 g b.a./ha. Indaziflam is safe to be used in the plantation as it showed no toxic nor negative effects to the oil palm. The mixture of indaziflam and standard herbicide have also reduced the rotation of herbicide application to twice a year.

Changes in Serum Markers Failed to Predict Persistent Infection after Two-stage Exchange Arthroplasty

Background The proper timing of reimplantation is importation to treatment success in two-stage exchange revision. The 2018 International Consensus Meeting suggested that a variation trend toward normalization in serum markers was useful for determining the proper timing of reimplantation. However, the opposite results were found that by previous studies, and the normalization of serum markers was reported to fail to predict infection control. We investigated whether value changes and percent changes in four common serum markers (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen) can predict persistent infection?Methods A retrospective review of 141 patients treated with two-stage revision from 2014 to 2018 was conducted. The variation trend in serum indicators was evaluated by the percent changes (using values of serum markers prereimplantation divided by values preresection) and value changes (using values of serum markers preresection minus values prereimplantation). Treatment success was defined according to the Delphi-based consensus criteria with a minimum follow-up of 1 year, and the receiver operator characteristic (ROC) was used to examine the usefulness of changes in serum markers.Results 22 patients (15.60%) were persistently infected. No significant difference was found in either the value change or percent change in serum markers between reinfection and non-reinfection patients. When predicting persistent infection, the area under the curves (AUC) demonstrated that both percent changes and value changes in serum markers were poor indicators. The AUC of value changes was 0.533 for the CRP, 0.504 for the IL-6, 0.508 for the ESR and 0.586 for fibrinogen when predicted persistent PJI. In addition, the AUC indicated that percent changes in the CRP (0.464), the IL-6 (0.534), the ESR (0.527) and fibrinogen (0.586) were all poor markers.Conclusions We have shown that both value changes and percent changes in serum markers were not sufficiently rigorous to aid in persistent infection diagnosis. The proper timing of reimplantation must therefore take into account various clinical tests rather than the downward trend of serum markers only.