Operating room black box:Scrutinizer of theatre practices

Objective:Adverse surgical events are a major cause of morbidity,mortality,and disability worldw ide.The cause of many such events can be attributed to interruptions in the operating room(OR),muli-tasking by surgeons,etc.The objective of this study was to observe the types and frequency of intra-operative wor kflow interruptions in our ORs.Method:This ccoss-sectional study was conducted from March Do April of 2023.An observational approach using an audio-video recording device was employed to record OR flow disr uptions.One elective OR and one emergency OR under the Department of General Surgery were selected for the study.All open and laparoscopic surger ies conducted in the selected ORs were included.An Internet Protocol camera'was installed in the selec ted ORS with a view of the entire room,including the anesthesia station.Audio-video recording was started after the first indsion and stopped after closure of the surgical site.Result:Of the 51 cases that were studied,45(88.2%)were elective,and 18(35.3%)were laparoscopic cases.They could be classified into 8 types of open procedures and 4 types of lapar oscopic procedures.The mean maximum headcount inside the OR was 15.5土3.6 and doors opened on average of 15.8土6.0 times during a procedure.Other interruptions were surgeons attending phone calls(24,47.1%),leaving the sterile area(21,41.2%),technical disturbances(32,62.7%),anesthetic interruptions(18,35.3%),and faulty instruments(29,56.9%)Elective procedures had a signifcandy higher average number of in-terruptions per operating hour than emergency procedures(175±8.6vs.7.1±2.9,p<0.01).Condusion:Preventable factors such as faulty instruments,anesthetic interruption,and attending phone calls by the surgeon are commonly observed in ORs.They need to be addressed by timely surgical audits or the adoption of continued sureillance methods that can help take measures to minimize their occurrence.

Novel operating theatre scheduling method based on estimation of distribution algorithm

In order to improve the efficiency of operating rooms,reduce the costs for hospitals and improve the level of service qualities, a scheduling method was developed based on an estimation of distribution algorithm（ EDA）. First, a scheduling problem domain is described. Based on assignment constraints and resource capacity constraints, the mathematical programming models are set up with an objective function to minimize the system makespan. On the basis of the descriptions mentioned above, a solution policy of generating feasible scheduling solutions is established. Combined with the specific constraints of operating theatres, the EDA-based algorithm is put forward to solve scheduling problems. Finally, simulation experiments are designed to evaluate the scheduling method. The orthogonal table is chosen to determine the parameters in the proposed method. Then the genetic algorithm and the particle swarm optimization algorithm are chosen for comparison with the EDA-based algorithm, and the results indicate that the proposed method can decrease the makespan of the surgical system regardless of the size of operations. Moreover, the computation time of the EDA-based algorithm is only approximately 5 s when solving the large scale problems, which means that the proposed algorithm is suitable for carrying out an on-line scheduling optimization of the patients.

Large carotid body tumor successfully resected in hybrid operating theatre: A case report

BACKGROUND Surgical treatment for large carotid body tumor (CBT),particularly the Shamblin III type,is challenging and rarely reported.CASE SUMMARY In July 2014,a 63-year-old woman presented to our hospital with a large CBT (130 mm × 60 mm × 70 mm).The lesion was hypervascular,spanned from the first to the seventh cervical vertebra,and adhered to the right common carotid artery (CCA),internal carotid artery (ICA) and external carotid artery (ECA).The resection was carried out in a hybrid operating theatre.First,we used Onyx gel to embolize the feeding artery.An ICA balloon was used to prevent gel entry into the ICA.After shrinkage and hardening of the CBT,we quickly resected the CBT as well as a part of the ECA that adhered to the CBT.A vascular shunt was inserted between CCA and ICA,and the part where the ICA was cut off from the CCA was directly sutured.A follow-up at four years later showed no neurological damage.CONCLUSION For large hypervascular CBT,embolization of the feeding artery prior to resection is helpful.The hybrid operating theatre is the ideal platform to carry out such operations.

Indoor Air Quality in a Real Operating Theatre under Effective Use Conditions

The aim of this study is to investigate the impact of surgical staff on the indoor air quality in a uni-directional ventilation Operating Theatre (OT). Experimental measurements of particles and microclimate were acquired at rest and in operational conditions. The real OT (operational) use was simulated by a sham hip arthroplasty. CFD simulations were carried out outlining the studied environment used for experimental measurement campaign. A standard k-ε closure scheme based on RANS equations was implemented to solve the velocity and pressure field using an eddy viscosity approach. Temperature and relative humidity distributions were also computed keeping into account sensible and latent heat sources inside the OT. An Euler-based approach was applied to solve the concentration fields of gaseous contaminant and small particles (up to 5 μm in diameter) in the indoor air. An innovative strategy is proposed to estimate, by an iterative comparison between experimental data and numerical results, the emission rate of particles (differentiated by diameters) released by the occupants to be considered as source terms in the numerical model. Compliance with literature evidence concerning thermal and velocity fields and CO2 concentration was confirmed. From our analyses, some IAQ indexes were deduced, allowing monitoring of the local and overall OT air quality level supplied by the ventilating system during real operational conditions. The highest values of microbial air contamination were recorded during surgical activity;nevertheless, results showed the suitability of the ventilation system in providing the expected air quality.

Aesthetic Processing for Theatre Translation

Theatre translation is one of the most neglected areas in the field of translation.Theatre is a special member of the literature family in that it doubles as a branch of the performing art.It follows that the aesthetic constitutions of a dramatic creation is a complex problem. It is the translator's duty to grasp the artistic features of the literary creation and reproduce them in the version since the most important thing in a piece of literature is its artistic features.

Patients' preferred mode of travel to the orthopaedic theatre

AIM: To determine the preferred mode of travel to the operating theatre for elective orthopaedic patients. METHODS: Data was collected prospectively over a 2-wk period at an elective Orthopaedic Treatment Centre. Patients were asked to complete a patient satisfaction questionnaire following their surgery on their experience and subsequent preferred mode of transport to theatre. The data was then recorded in a tabulated format and analysed with percentages. Fisher's exact test was used to determine if there was any statistical association between patients' preference to walk and various groups; in-patient or day case procedures, and whether patients were < 60 years or > 60 years of age.RESULTS: Seventy patients(40 females and 30 males) fully completed the questionnaire. In total there were 33 d-cases and 37 in-patients. The spectrum of orthopaedic sub-specialties included was knee(41%), hip(17%), foot and ankle(24%), spine(13%) and upper limb(4%). Patient satisfaction for overall experience of travelling to theatre was either excellent(77%) or good(23%). Following their experience of travelling to theatre, 87%(95%CI: 79%-95%) of the total cohort would have preferred to walk to the operating theatre. There was a statistically significant association(P = 0.003) between patients' preference to walk and whether they were daycase or in-patients. Similarly, there was a statistically significance association(P = 0.028) between patients' preference to walk and whether they were < 60 years or > 60 years of age.CONCLUSION: This study confirms the majority of Orthopaedic elective patients would prefer to walk to theatre, when given the choice and if practically possible.

New Perspective of Architectural Design Based on Immersive Theatre Thinking: A Case Study of Rural Living Room Design in Majia Marsh

The new urbanization provides opportunities for the ecological protection of traditional regional culture. In the context of the integrated development of agriculture, tourism, and cultural industries, this paper integrates the thinking of "immersive theatre" and adopts the design method of multithread dramatic narrative mode to create a number of interactive flow lines in the architecture and focus on the sensory experiences of environment, enabling the traditional regional culture to really touch the audience.

Numerical Investigation of Different Airflow Schemes in a Real Operating Theatre

A study on performances of different ventilation schemes provided by vertical and horizontal uni-directional air flow was carried out in a standard orthopaedic operating theatre (OT). Starting from our previous studies of a real OT under operating use conditions, in this research different air flow configurations, considering some air curtain solutions on the ceiling and at the sliding door always assumed to be open as a basic boundary condition, were investigated by numerical simulations. Indoor air quality (IAQ) indexes and thermal comfort parameters, deduced from simulation results were calculated and discussed referring to the best performance and efficacy between the air flow schemes to contrast the incorrect use conditions of the OT. Referring to the studied schemes, the reciprocal comparison emphasizes that a successful outcome in preventing surgical site infection can depend as much on resolving human factors (i.e. operational use conditions, door opening/closing), as on overcoming physical and technical obstacles.

Filtered-beam-search-based approach for operating theatre scheduling

To improve the efficiency of operating rooms, reduce the hospital＇ s costs and improve the level of service qualities, a scheduling method is presented based on a filtered-beam-search-based algo- rithm. Firstly, a scheduling problem domain is described. Mathematical programming models are al- so set up with an objective function of minimizing related costs of the system. On the basis of the de= scriptions mentioned above, a solving policy of generating feasible scheduling solutions is estab- lished. Combining with the speeific constraints of operation theatres, a filtered-beam-search-based algorithm is put forward to solve scheduling problems. Finally, simulation experiments are designed. The performance of the proposed algorithm is evaluated and compared with that of other approaches through simulations. Results indicate that the proposed algorithm can reduce costs, and are of prac- ticality and effectiveness.

Analysis of the Concept and the Drama Psychology of Immersive Theatre

Immersive theatre means put audience into the space where the story take place.Actors and actresses perform in the authentic environment and audience also in this environment,watching the peoceeding of the story closely.With the success of Sleep No More,more and more people pay attention to immersive theatre.Some Chinese theatre directors also launch out into doing similar things.It is no doubt that immersive theatre is popular now at home and abroad.However,as a new form of theatre,immersive theatre theoretical study is really inadequate.This text aims explain the connotation and concepts of immersive theatre or what is immersive theatre,the feature of immersive theatre in addition to its present situation in China,though Sleep No More,one of the most famous immersive theatres.I hope to offer reference for Chinese theatre people,make contributions for their study and creations,then again filling in gaps in immersive theatre theory.Only in this way,can immersive theatre develop healthily and can its ecology be constructed well.

Headaches Associated with N95 Mask Usage amongst Healthcare Workers in Operating Theatres during COVID-19 Pandemic: A Cross-Sectional Study

Introduction: N95 respirator masks are a cornerstone in the fight against the ongoing COVID-19 pandemic. However, its use has side effects such as headaches. The primary aim of this study is to identify factors that may contribute to higher occurrences of headaches with wearing N95 masks. Methods: A cross-sectional study was conducted across healthcare providers in operating theatres of a tertiary hospital based in Singapore involved in the care of COVID-19 patients. The study involved a self-administered online questionnaire completed by all participants. Results: 176 participants were included into the study, of which 65 (36.9%) reported headaches associated with wearing N95 masks. Out of the 65 participants who experienced headaches, 28 (43.1%) reported experiencing “mild” headache, 30 (46.2%) reported experiencing “moderate” headache, and 7 (10.7%) reported experiencing “severe” headache. 44 participants (67.7%) reported that the headache has affected their work, and 20 participants (30.8%) required analgesia to relieve the headaches. Other symptoms associated with N95 mask usage include skin damage (12.3%), breathlessness (15.4%), giddiness (6.2%), nausea (6.2%) and ear pain (3.1%). Multivariate logistic regression analysis showed that participants younger than 32 years old (p = 0.001) and history of pre-existing headache disorders (p = 0.001) were associated with higher occurrences of headaches with wearing N95 masks. Conclusion: Our study showed that younger age and history of pre-existing headache disorders contribute to higher occurrences of headaches with N95 mask usage. These associations could be useful in identifying at-risk individuals so that precautions may be taken to reduce the occurrence of headaches when wearing N95 masks.

The Redemptive Power of Theatre and the Pursuit of Justice in Our Country’s Good

This paper aims to understand Timberlake Wertenbaker’s Our Country’s Good in the context of theatre in crisis in the 1980s Britain and attempts to find the contemporary resonance of this history play. Through exploring the adaptation and workshop of the play, discussing the transformative influence of rehearsals on the convicts in the Australian penal colony, and expounding on theatre as an important venue for rehabilitation and justice in contemporary society, the paper intends to disclose the playwright’s commitment to theatre, her reassertion of the social role of theatre in contemporary Britain and her critique of Mrs. Thatcher’s philistinism which impaired art, particularly theatre, to a great degree.

Humour in Surrealist Theatre

Surrealist playwrights of the twentieth century use black humour in order to express their discontent towards the society in which they live.Parody of everyday life is a way of reaction against the extensive lifestyle.The actions,the choices and the situations,in which the characters of the surrealist dramas are involved,are comic and grotesque.Surrealist dramas reject the rules of the Western theatre;the lack of plot,the absurd,the misunderstanding,the use of poetic symbols,the parody of bourgeois life,the unexpected reactions and the unreasonable behaviour of the characters are some of the factors that cause laughter and surprise the audience.In this paper we will try to reveal the humour that emerges through the surrealist plays of AndréBreton,Philippe Soupault,Louis Aragon and Roger Vitrac.We will also attempt to highlight the key points through which surrealism in theatre uses black humour in an effort to cover the deep melancholy and pessimistic mood of surrealist dramatists.The questions arising are;in which ways is humour a way of revolution?How can humour include dreams,ingenuity and fantasy?

Vision and Imagination in the Renaissance Theatre

To see what lacks representation on stage is a fully creative act that the spectator performs thanks to his or her imagination, as （s）he is called to retrieve via memory what is objectively absent from the scene. The Renaissance audience accomplished such a creative act by making use of rhetoric and figurative arts. However, it is pre-eminently words that trigger and support the imagination, as Shakespeare＇s drama best exemplifies. Both in the Elizabethan drama and in the Italian Renaissance theatre, with its perspectival vision, the spectator＇s creative act takes place in an ideal space where the stage space turns into the locus of stereoscopic vision. Consequently, the creation and consumption of the vision originates first and foremost in drama （comedy and tragedy）. The psychological, aesthetic, and anthropological mechanisms at the heart of vision, and the fruition of the images deriving from words, can be found as operating within the dramatic text, from the point of view of both the playwright and of the spectator/listener, in a direct relationship of cause and effect. Religious and especially Jesuitical drama, whose theatrical experience aims at discovering a correspondence between words and images, testifies to the visual power of the theatre.

The Politicisation of Arab Theatre： Sa＇d Allah Wannus

The political theatre in the Arab world emerged from rough seas of opposition and state monitoring schemes. Some critics may claim that political tendencies in Arab theatre can be traced to the early contributors to Arab theatre Others attribute the emergence of this theatre to the revolution of Egypt＇s Nasir. However, the Syrian playwright Sa＇d Allah Wannus may be viewed as the true representative of this kind of theatre in the Arab world. Shocked by the defeat of the Arabs by Israel in 1967, he began what he coined ＂theatre of politicization＂, aiming to attack Arab governments and blaming them for the defeat, and at the same time, insighting his audience to revolt against existing political ideas. In this kind of theatre, the audience assumed ever-increasing importance. Wannus wrote several plays, the aim of which was to develop a mentality and strengthen a collective consciousness in an Arab historical context. This article aims to exploring the concept of theatre of politicization and the impact of that on Arab political theatre

English Christmas Pantomime： Theatre or Community Activism

How is English Christmas panto community activism？ The structure of pantomime has not changed in a hundred years, but allows for local creativity to work within its framework to be both family entertainment and social satire This basic structure is founded on a children＇s story like Puss ＇n ＇boots or Cinderella. The story and character types remain the same; but the community can add their own jokes and commentary to make the play relevant to themselves and their community. What is added by the community says a lot about who they are and what they care about. The company Price-Waterhouse-Coopers produces their pantomime as management training and team building while engaging the community. The Basel Swiss panto raises money for African Charities. The Maplewood, NJ panto raises money for the homeless and the Jaguar Charity panto in Birmingham performs to disadvantaged children and adults. The productions can be extravagant or threadbare, but share the same goal of raising cheer and goodwill to the benefit of the community. What is it, then, about panto that brings a community together in such civic mindedness？

When Pupils Go to Theatre:The Activation of Memory and the Mnemonic Depiction

Going to theatre,may be a unique experience for schoolchildren,which is indelibly etched in their memory.The Primary School pupil-spectator comes in touch with the theatre principles and is initiated in its world.S/he experiences its ritual and cohesively structured character within the frame of the collectivity that is required and with the particularity of the formation of the psychic mechanism and social conscience in this specific phase of the development of his/her personality,as well as the influence of a number of some other differentiating factors,thus leading to the establishment of a very special relation and interaction between the stage and the audience.S/he also focuses on the elements of the performance that attract his/her interest,are closer to his/her mentality,and challenge his/her attention and emotional stimulation.In this way,the mnemonic recording is activated.The theatre performance consists of a very rich environment for mnemonic traces because of its wealth of codes,their multiple combinations,and variety of functions.The actors’speech,the intense content of ideas and principles in combination with the challenging audio-visual stimuli of the secondary codes of the performance,the plot dynamics,and the director’s techniques and practices,are elements that may initiate mnemonic recording.It is important on the other hand that the school invests in cultural activities such as the attendance of a theatre performance and includes them in the school curriculum.The teacher,as the best advocate of cultural education,the active mediator and coordinator of this visit,undertakes a large part of the responsibility for its successful and indelible mnemonic recording—from the difficult part of the selection of a performance to the care of the suitable conditions for the reception of the spectacle—thus creating the appropriate frame for the pupils to experience the acting event as a means of interaction,play,learning,communication and above all of the activation of the old and the creation of new memories.Therefore,the research interest of the present study focuses on the analysis of all the elements mentioned above,with the aim to examine and analyze the specific factors that influence the mnemonic recordings of the school audience.

Theatrical Traces of the Past in the Contemporary Theatre： The Case of Simos Kakalas

This paper examines the contemporary theatre of Simos Kakalas, the director of Horos Theatre Company, and his troupe. The object of this study is the performances of the troupe during the period 2004-2016, which include： （1） the eight different versions of the dramatic idyll Golfo, written in 1894 by Spyridon Peresiadis; （2） the three different versions of the tragedy Erofili, written in Crete in 1595 by Georgios Hortatzis, and （3） the three different versions of the ancient Greek tragedy Euripides＇ Orestes written in 408 B.C. The research shows how these performances bring the young audience closer to the Greek theatre, tradition and identity, and at the same time they lead the audience＇s thought to current issues. It also explores how Kakalas brings the past closer to us to the present time, combining the poetic fifteen-syllable verse, the theatrical codes of the Greek ＂bouloukia＂ （the wandering troupes who used to play at squares in the nineteenth century）, the technique of narration, parody and shadow theatre with postmodern style, manga masks, video projections and anime.

Beijing Liyuan Theatre

On October 8,1990,theBeijing Liyuan Theatrewas formed at the QianmenHotel in Beijing.In the past fiveyears,nearly one millionChinese and foreign peoplehave been there to watch 2,000performances of Beijing opera.