Despite equivalent exposure to practical laparoscopic skills training, video-based coaching enhanced the quality of laparoscopic surgical performance on both VR and porcine LCs, although at the expense of increased time. Video-based coaching is a feasible method of maximizing performance enhancement from every clinical exposure.

No abstract

No abstract

Background: Delirium is a common complication after surgery in the elderly that leads to increased length of stay and other adverse outcomes. The aim of this study was to better understand the exact causes of post-operative delirium in patients undergoing surgery for neck of femur (NOF) fractures.Methods: We performed a prospective cohort study of 381 consecutive patients undergoing surgery for NOF fractures at a single institution. Baseline cognitive status and risk factors were recorded on admission. Post-operative cognitive status was assessed at regular intervals until discharge. Binary logistic regression was performed to identify independent predictors of delirium.Results: Patients who developed post-operative delirium (n = 70) were significantly older (average age 83 vs. 78, p = 0.019) and more likely to be female (79% vs. 67%, p = 0.062) than non-affected patients. The presence of delirium was associated with increased length of stay (13 vs. 10 days, p = 0.001) and 1-year mortality (25.7% vs. 15% p = 0.03). Independent predictors of delirium included age ≥65 years (Odds Ratio = 5.8), presence of anaemia (OR = 2.9), hypoxia (OR = 2.86), cardiac disease (OR = 2.8), Chronic Obstructive Pulmonary Disease (OR = 2.5), new onset electrolyte imbalance (OR = 2.2) and renal failure (OR = 1.9).Conclusion: Overall analysis demonstrated an increased incidence of delirium in older females with greater comorbid conditions. It was also found to be associated with increased morbidity and mortality. We recommend clinicians put greater effort into recognising risk factors of delirium and diagnosing it in a timely manner to mitigate its effects.

The purpose of the study is to investigate the utilisation of Napier fiber (Pennisetum purpureum) as a source for the fabrication of cellulose nanofibers (CNF). In this study, cellulose nanofibers (CNF) from Napier fiber were isolated via ball-milling assisted by acid hydrolysis. Acid hydrolysis with different molarities (1.0, 3.8 and 5.6 M) was performed efficiently facilitate cellulose fiber size reduction. The resulting CNFs were characterised through Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), thermogravimetric analysis (TGA), particle size analyser (PSA), field-emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), and transmission electron microscopy (TEM). The FTIR results demonstrated that there were no obvious changes observed between the spectra of the CNFs with different molarities of acid hydrolysis. With 5.6 M acid hydrolysis, the XRD analysis displayed the highest degree of CNF crystallinity at 70.67%. In a thermal analysis by TGA and DTG, cellulose nanofiber with 5.6 M acid hydrolysis tended to produce cellulose nanofibers with higher thermal stability. As evidenced by the structural morphologies, a fibrous network nanostructure was obtained under TEM and AFM analysis, while a compact structure was observed under FESEM analysis. In conclusion, the isolated CNFs from Napier-derived cellulose are expected to yield potential to be used as a suitable source for nanocomposite production in various applications, including pharmaceutical, food packaging and biomedical fields.

No abstract

BackgroundManagement of displaced mid-shaft clavicle fractures is controversial. Non-operative treatment can lead to shortening, a risk factor for non-union and poor functional outcomes. These inferior results have resulted in authors recommending surgical fixation for fractures with significant shortening. The aim of this systematic review is to analyse the effect of fracture shortening on shoulder function and non-union rate in non-operatively managed displaced mid-shaft clavicle fractures. MethodsA review of the online databases Medline and EMBASE was conducted in accordance with the PRISMA guidelines on the 16 th February 2018. The review was registered prospectively on the PROSPERO database. Clinical studies with mid-shaft clavicle fractures treated non-operatively reporting an evaluation of the degree of clavicle shortening, and either shoulder function and/or non-union were included. The studies were appraised using the Methodological index for non-randomised studies tool. ResultsThe search strategy identified 16 studies eligible for inclusion. Four studies were randomised controlled trials (RCTs) and twelve were non-randomised retrospective comparative studies. Eleven of the twelve case series failed to demonstrate any correlation between shortening and shoulder outcome scores. Of the four RCTs, three reported no significant association between fracture shortening and shoulder outcome *Manuscript Click here to view linked References Shortened, displaced mid-shaft clavicle fractures 2 scores. The studies also failed to demonstrate a significant association between nonunion and the presence of clavicle shortening. ConclusionThere is no significant association between fracture shortening and non-union rates or shoulder outcome scores in displaced mid-shaft clavicle fractures managed nonoperatively.

No abstract