Selfkaufman3849

Background Teleconsultation over the smartphone is now widely used in modern medicine in the management of burns, flap cover, upper extremity trauma, and in the assessment of the feasibility of reimplantation in amputated fingers. The development of the WhatsApp application has enhanced the smartphone's efficiency remarkably to transmit images in clinical and academic settings with its failsafe and encrypted technology. In hand surgery, a teleconsultation technology must communicate details of finger vascularity effectively. However, there is a paucity of evidence on the functionality of these modern teleconsultation technologies in Hand Surgery. Here, the authors have estimated the efficiency of the WhatsApp teleconsultation in the assessment of finger vascularity. Materials and Methods In two phases, the authors transmitted clinical photographs of vascular and avascular fingers to experienced hand surgeons over the WhatsApp and asked them to assess the finger vascularity. The efficiency of the WhatsApp teleconsultation in assessing the details of finger vascularity was estimated from their responses. Results Despite 81.06% of the hand surgeons rating the vascular fingers on the transmitted photographs correctly, only 44.95% detected the avascular digits accurately; that is, 55.05% of the surgeons failed to diagnose the avascularity of fingers. This suggests serious implications in a clinical setting. The intra- and the inter-rater reliability values were 0.232 and 0.6086 (with 95% confidence interval), respectively, which indicated poor reliability of the WhatsApp teleconsultation regarding the assessment of finger vascularity. Conclusion The authors, therefore, conclude that WhatsApp is inadequate in teleconsultation given the value of vascularity details of the fingers in making a diagnosis in hand surgery.With a lot of uncertainty, unclear, and frequently changing management protocols, COVID-19 has significantly impacted the orthopaedic surgical practice during this pandemic crisis. Surgeons around the world needed closed introspection, contemplation, and prospective consensual recommendations for safe surgical practice and prevention of viral contamination. One hundred orthopaedic surgeons from 50 countries were sent a Google online form with a questionnaire explicating protocols for admission, surgeries, discharge, follow-up, relevant information affecting their surgical practices, difficulties faced, and many more important issues that happened during and after the lockdown. Ten surgeons critically construed and interpreted the data to form rationale guidelines and recommendations. Of the total, hand and microsurgery surgeons (52%), trauma surgeons (32%), joint replacement surgeons (20%), and arthroscopy surgeons (14%) actively participated in the survey. Surgeons from national public health care/government COVID-19 pandemic has reached an unprecedented level where personal hygiene, hand washing, social distancing, and safe surgical practices are the viable antidotes, and they have all slowly integrated these practices into their lives. Strict adherence to local authority recommendations and guidelines, uniform and standardized norms for admission, inpatient, and discharge, mandatory RT-PCR tests before surgery and in selective cases with CT scan chest, optimizing and regularizing the surgeries, avoiding and delaying nonemergency surgeries and follow-up protocols, use of teleconsultations cautiously, and working in close association with the World Health Organization and national health care systems will provide a conducive and safe working environment for orthopaedic surgeons and their fraternity and also will prevent the resurgence of COVID-19.Mental ill health is a significant cause of suicide and disability worldwide. It has particularly affected the construction industry. The construction labor sectors in Australia and the United Kingdom have suicide rates 2 and 3.7 times higher, respectively, than their overall national averages, which has attracted the attention of researchers and the industry. However, few studies have examined the state of construction workers' mental health. This paper systematically reviews the existing body of knowledge on mental health in the construction industry. check details In total, 16 journal articles met inclusion criteria, and 32 risk factors (RFs) were deduced. The foremost RFs were related to job demand and job control. A conceptual framework and checklist to aid in better understanding these RFs were developed. In assessing mental health, the primary tool used was the Depression Anxiety Stress Scale. The findings of this study help to deepen the understanding of professional mental health assessment scales and relevant RFs and protective factors as used in the construction industry. The study concludes that stronger methodologies are needed for studies into RFs and protective factors in the construction industry.We describe and compare two methods for the group sequential design of two-arm experiments with Poisson distributed data, which are based on a normal approximation and exact calculations respectively. A framework to determine near-optimal stopping boundaries is also presented. Using this framework, for a considered example, we demonstrate that a group sequential design could reduce the expected sample size under the null hypothesis by as much as 44% compared to a fixed sample approach. We conclude with a discussion of the advantages and disadvantages of the two presented procedures.

Sexual coercion, in the form of forced copulations, is relatively frequently observed in orangutans and generally attributed to their semi-solitary lifestyle. High ecological costs of association for females may be responsible for this lifestyle and may have prevented the evolution of morphological fertility indicators (e.g., sexual swellings), which would attract (male) associates. Therefore, sexual conflict may arise not only about mating per se but also about associations, because males may benefit from associations with females to monitor their reproductive state and attempt to monopolize their sexual activities. Here, we evaluate association patterns and costs for females when associating with both males and females of two different orangutan species at two study sites Suaq, Sumatra (

), and Tuanan, Borneo (

). Female association frequency with both males and females was higher in the Sumatran population, living in more productive habitat. Accordingly, we found that the cost of association, in terms of reduced feeding to moving ratio and increased time being active, is higher in the less sociable Bornean population.