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Abstract Introduction Traditionally, surgical procedures are explained through consultations between the surgeon and the patient to ensure informed consent. Patient education enhances engagement and knowledge, aiding informed decision-making. This study aimed to assess the effect of an educational video on preoperative patient knowledge and satisfaction in the context of total knee arthroplasty (TKA) as an adjunct to the consent process. Methods A prospective randomized controlled study involving 100 patients in dedicated elective orthopedic units in UK-based hospitals was conducted. After consultation with a dedicated knee surgeon and a preoperative education day for TKA run by dedicated orthopedic nurse specialists, patients were randomized into one of two limbs (video vs no video) at a 1:1 ratio. The treatment group (video group) was shown a video about the principles and steps of the procedure, including the recovery time. Following this, a 10-point knowledge test was completed, and patients rated their satisfaction with the preoperative education on a scale of 0–10. Results Patients in the video limb group had a significantly greater mean knowledge score and greater satisfaction with preoperative education than patients who did not view the video. The video group (n = 49) had a mean knowledge score of 8.73 +/− 0.159 compared to 7.68 +/− 0.281 for the nonvideo limb (n = 50) (p

Industrial processes are nonlinear and complicated in nature, requiring accurate fault detection to minimize the deterioration in performance and to respond quickly to emergencies. This work investigates industrial process defect identification and isolation, which is analytically difficult owing to their complexity. This paper carefully analyzes four design methods for flaw identification and isolation based on Principal Component Analysis (PCA), Fisher Discriminant Analysis (FDA), Kernel Fisher Discriminant Analysis (KFDA), and Sequential quadratic programming (SQP). Our study includes the Tennessee Eastman Process (TEP) and the Penicillin Fermentation Process (PFP), among other comparable methods. We assess the proposed fault detection and isolation methods through detailed analysis and comparison. The simulation findings from our extensive investigation provide remarkable insights. Simulation findings show that FDA and KFDA work well in fault identification and isolation, but PCA has certain limits. We also considered SQP as a TEP fault detection and isolation improvement tool. SQP is noted for its success in nonlinear and restricted optimization problems, making it ideal for fault identification and isolation in complicated industrial processes. Data-driven design approaches increase problem identification in complicated industrial processes with greater reliability and efficiency than PCA-based methods. This study also shows that advanced data-driven techniques can improve industrial fault diagnosis, improving operational safety and system performance by leveraging the FDA, KFDA, and SQP.

Introduction: Traditionally, surgical procedures are explained through consultations between the surgeon and the patient to ensure informed consent. Patient education enhances engagement and knowledge, aiding informed decision-making. This study aimed to assess the effect of an educational video on preoperative patient knowledge and satisfaction in the context of total knee arthroplasty (TKA) as an adjunct to the consent process. Methods: A prospective randomized controlled study involving 100 patients in dedicated elective orthopedic units in UK-based hospitals was conducted. After consultation with a dedicated knee surgeon and a preoperative education day for TKA run by dedicated orthopedic nurse specialists, patients were randomized into one of two limbs (video vs no video) at a 1:1 ratio. The treatment group (video group) was shown a video about the principles and steps of the procedure, including the recovery time. Following this, a 10-point knowledge test was completed, and patients rated their satisfaction with the preoperative education on a scale of 0–10. Results: Patients in the video limb group had a significantly greater mean knowledge score and greater satisfaction with preoperative education than patients who did not view the video. The video group (n = 49) had a mean knowledge score of 8.73 +/− 0.159 compared to 7.68 +/− 0.281 for the nonvideo limb (n = 50) (p < 0.05). The video group had a mean satisfaction score of 9.00 +/− 0.123 compared to 8.40 +/− 0.121 for the nonvideo limb group (p < 0.05). Conclusion: Video-assisted consent in total knee arthroplasty improves preoperative knowledge and patient satisfaction when used as an adjunct in the consent process. A simple, standardized video, either pre- or post-consultation could reinforce information that the patient receives in a simple effective manner, allowing for true informed consent. [ABSTRACT FROM AUTHOR]

Background: Opinion is divided as to optimum management of grade III acromioclavicular joint injuries that have failed conservative management. We objectively investigated the radiological and functional outcome of acromioclavicular joint reconstruction using the Ligament Augmentation Reconstruction System (LARS®). Methods: Retrospective review of patients with LARS reconstruction of acromioclavicular joint dislocations with minimum six-year follow-up. Functional assessment was performed using the constant score, Disability of Arm Shoulder and Hand score and simple satisfaction score. Radiological assessment was undertaken using plain radiographs. Results were compared with the uninjured limb. Results: Twenty-four of 25 patients were included. Mean constant score for the injured shoulder was 87.0, Disability of Arm Shoulder and Hand score was 11.6. All patients indicated that they would have the operation again. There were five complications including two patients that suffered small cracks in the clavicle. Coracoid erosion was frequently seen but was most often minor. In two cases, this resulted in a complete dissociation of the coracoid tip but without functional detriment. Discussion: LARS is a safe and effective method of acromioclavicular joint reconstruction producing good results, and we recommend its use for these injuries. We also caution clinicians who use cerclage methods to be aware of coracoid erosion when following up their patients. [ABSTRACT FROM AUTHOR]

Introduction: Mucinous Carcinoma (MC) is a special type of breast cancer. It comprises 4% (1-7%) of all invasive breast cancer. MC is also called colloid breast cancer characterised by nests of cells floating in lakes of mucin. It is divided into two subtypes Pure Mucinous Carcinoma (PMC) and Mixed Mucinous Carcinoma (MMC). PMC classified into two main types according to its structural and cytological features type A (paucicellular) the classical variant with a large amount of extracellular mucin, and type B (hypercellular) a hypercellular variant with less mucin and often with neuroendocrine differentiation. Hormone receptors, Human Epidermal growth factor Receptor-2 (HER2) and MUC2 status play an important role in prognosis and management. Aim: To study histopathological features of MC breast and Immunohistochemical (IHC) status. Materials and Methods: A retrospective study of patients who presented with breast cancer were studied at Department of Pathology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India. The study was analysed in June 2002 and authors included data from January 2021 to June 2022. The data included the age at diagnosis, Tumour (T), Lymph Nodes (N), and Metastases (M) (TNM) stage, presence and number of Lymph Node (LN) metastases, Oestrogen Receptor (ER), Progesterone Receptor (PR), HER2 and MUC2 status. The patients in whom the diagnosis of MC of breast was given on histopathology were only included in the study. Patients of breast cancer of other pathological types were excluded from the detailed study. Descriptive statistics like mean, tables, and charts were used with the help of Microsoft office 2007 to interpret the results. Results: A total of 245 patients reported as invasive breast cancer during 18 months of study period, out of which 12 cases diagnosed as MC were taken in study. Amongst 12 cases, eight cases were PMC and four cases were MMC. The mean age at presentation was 63.37±16.38 years (eight PMC) and 60.0±19.30 years (four MMC). A total of 11 out of 12 cases were females and only one was male case (PMC). Majority of PMC 04 (50.0%) and MMC 03 (75.0%) were observed to be in TNM Stage 2, and four of 12 cases of MC had LN metastasis with no distant metastasis. MC showed higher expression of hormone receptors and lower expression of HER2/neu and MUC2 positivity, which corroborates with other studies and concluded that, MC with such an immunohistochemistry profile was prognostically better. Conclusion: Mucinous Breast Carcinoma (MBC) is a rare type of breast cancer accounting for about 4% of all diagnosed breast cancers. These are associated with a better long-term prognosis than other breast cancers. Hormone receptors and HER2 status play an important role in prognosis and management. MUC2 also plays a major role in mediating the proliferation, apoptosis, metastases of breast cancer cells and determining the use of chemotherapy drugs.

Background Recent studies have shown a decline in theatre efficiency and productivity coinciding with the coronavirus disease 2019 (COVID-19) pandemic. In this study, we evaluate trauma theatre task efficiency in three different time periods (April 2019, April 2020, and November 2020), and analyse if productivity has altered since the start of the pandemic. Methods The records of a total of 320 patients who underwent orthopaedic trauma surgery at a large district general hospital in April 2019, April 2020 (during the first wave of the pandemic) and November 2020 (during the second wave of the pandemic) were analysed. Primary outcomes measured include time to get to the theatre, anaesthetic preparation time, the sum of time of anaesthesia and surgical preparation time, duration of surgery and time to transfer to recovery. Patient demographics as well as the type of surgery were also analysed. Results The time to get to the theatre and anaesthetic preparation time significantly increased in April 2020 (p<0.05) but fell in November 2020 with no significant difference in comparison to before the pandemic in April 2019 (p>0.05). The duration of surgery and time to transfer to recovery significantly increased in April 2020 (p<0.05) and though reduced in November 2020, was still significantly greater in comparison to April 2019 (p<0.05). In April 2020, the proportion of patients aged 18-65 was just 26% as compared to 35% in April 2019. This figure rose again to 45% in November 2020. The number of hip fracture procedures remained similar during the three time periods, with 32, 32 and 36 hip fracture operations in April 2019, April 2020 and November 2020, respectively. Conclusion While operating theatres' efficiency decreased during the first wave of the COVID-19 pandemic, it increased again in the second wave, coming close to the 'normal' levels before the pandemic struck., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Arshad et al.)