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1.
Cureus ; 16(5): e60358, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38883136

RESUMO

Foreign body-related complications are rare but possibly fatal events in clinical practice. Liver abscess as a result of gastrointestinal perforation caused by foreign bodies is even more rare. We report a case of a 63-year-old man who was admitted with fever and left epigastric pain. Further investigation revealed a liver abscess without resolution despite antibiotic therapy for several weeks. In the second admission, an enhanced computerized tomography scan revealed multiple abscesses in the left lobe of the liver, with a linear radio-dense foreign body within the collection. Open surgery was performed to extract the foreign body. The patient made a satisfactory postoperative recovery without complications and was discharged on the sixth postoperative day.

2.
Biosens Bioelectron ; 258: 116318, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-38701538

RESUMO

We report a massive field-of-view and high-speed videography platform for measuring the sub-cellular traction forces of more than 10,000 biological cells over 13 mm2 at 83 frames per second. Our Single-Pixel Optical Tracers (SPOT) tool uses 2-dimensional diffraction gratings embedded into a soft substrate to convert cells' mechanical traction force into optical colors detectable by a video camera. The platform measures the sub-cellular traction forces of diverse cell types, including tightly connected tissue sheets and near isolated cells. We used this platform to explore the mechanical wave propagation in a tightly connected sheet of Neonatal Rat Ventricular Myocytes (NRVMs) and discovered that the activation time of some tissue regions are heterogeneous from the overall spiral wave behavior of the cardiac wave.


Assuntos
Miócitos Cardíacos , Animais , Ratos , Miócitos Cardíacos/citologia , Técnicas Biossensoriais/métodos , Técnicas Biossensoriais/instrumentação , Desenho de Equipamento , Gravação em Vídeo , Células Cultivadas
3.
Nat Commun ; 15(1): 4081, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38744844

RESUMO

Combination of waning immunity and lower effectiveness against new SARS-CoV-2 variants of approved COVID-19 vaccines necessitates new vaccines. We evaluated two doses, 28 days apart, of ARCT-154, a self-amplifying mRNA COVID-19 vaccine, compared with saline placebo in an integrated phase 1/2/3a/3b controlled, observer-blind trial in Vietnamese adults (ClinicalTrial.gov identifier: NCT05012943). Primary safety and reactogenicity outcomes were unsolicited adverse events (AE) 28 days after each dose, solicited local and systemic AE 7 days after each dose, and serious AEs throughout the study. Primary immunogenicity outcome was the immune response as neutralizing antibodies 28 days after the second dose. Efficacy against COVID-19 was assessed as primary and secondary outcomes in phase 3b. ARCT-154 was well tolerated with generally mild-moderate transient AEs. Four weeks after the second dose 94.1% (95% CI: 92.1-95.8) of vaccinees seroconverted for neutralizing antibodies, with a geometric mean-fold rise from baseline of 14.5 (95% CI: 13.6-15.5). Of 640 cases of confirmed COVID-19 eligible for efficacy analysis most were due to the Delta (B.1.617.2) variant. Efficacy of ARCT-154 was 56.6% (95% CI: 48.7- 63.3) against any COVID-19, and 95.3% (80.5-98.9) against severe COVID-19. ARCT-154 vaccination is well tolerated, immunogenic and efficacious, particularly against severe COVID-19 disease.


Assuntos
Anticorpos Neutralizantes , Anticorpos Antivirais , Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , Humanos , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/efeitos adversos , Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , COVID-19/imunologia , Feminino , Masculino , SARS-CoV-2/imunologia , SARS-CoV-2/genética , Adulto , Anticorpos Neutralizantes/imunologia , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/imunologia , Pessoa de Meia-Idade , Imunogenicidade da Vacina , Adulto Jovem , Eficácia de Vacinas , Vietnã , Adolescente , Vacinas de mRNA , Vacinas Sintéticas/imunologia , Vacinas Sintéticas/efeitos adversos , Vacinas Sintéticas/administração & dosagem
4.
Foodborne Pathog Dis ; 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38700849

RESUMO

The degree of contamination of retail meat with colistin-resistant bacteria and its potential contribution to dissemination within communities remains to be determined. Thus, we aimed to elucidate the contamination status of colistin-resistance genes, indicative of colistin-resistant bacteria, in retail meats in Vietnam. In total, 46 chicken and 49 pork meats from stores in Vietnam and Japan were examined. Multiplex real-time polymerase chain reaction with TaqMan probes was performed for detecting mcr-1, mcr-3, and Escherichia coli 16S rRNA. Colistin-resistant bacteria in meats were isolated using selective media. The minimum inhibitory concentrations of colistin were determined using the broth microdilution method. The results showed that 70.7% of chicken meats in Vietnam were contaminated with both mcr-1 and mcr-3. Meanwhile, mcr-1 and mcr-3 were detected in 15.9% and 40.9% of pork meat, respectively. Only mcr-3 was detected in 40% of chicken in Japan. In addition, mcr-1-harboring E. coli and mcr-3-harboring Aeromonas were isolated from chicken meats in Vietnam. Some of these isolates showed colistin resistance. These results showed that most retail meats were highly contaminated with colistin-resistance genes. Notably, our results suggest that mcr-3 is more prevalent in the contaminated samples compared with mcr-1.

5.
Nanoscale Adv ; 6(9): 2380-2389, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38694464

RESUMO

The treatment or conversion of air pollutants with a low generation of secondary toxic substances has become a hot topic in indoor air pollution abatement. Herein, we used triangle-shaped Ag nanoparticles coupled with SnO2 for efficient photocatalytic NO removal. Ag triangular nanoparticles (TNPs) were synthesized by the photoreduction method and SnO2 was coupled by a simple chemical impregnation process. The photocatalytic NO removal activity results show that the modification with Ag TNPs significantly boosted the removal performance up to 3.4 times higher than pristine SnO2. The underlying roles of Ag TNPs in NO removal activity improvement are due to some advantages of Ag TNPs. Moreover, the Ag TNPs contributed photogenerated holes as the main active species toward enhancing the NO oxidation reaction. In particular, the selectivity toward green products significantly improved from 52.78% (SnO2) to 86.99% (Ag TNPs/SnO2). The formation of reactive radicals under light irradiation was also verified by DMPO spin-trapping experiments. This work provides a potential candidate for visible-light photocatalytic NO removal with low toxic byproduct generation.

6.
Cerebrovasc Dis ; : 1-12, 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38684148

RESUMO

INTRODUCTION: Intracranial atherosclerotic disease (ICAD) has been identified as a major cause of acute basilar artery occlusion (BAO).This study compared the characteristics and treatment outcomes in acute BAO patients with and without ICAD. METHODS: A prospective cohort study was conducted at 115 People's Hospital, Ho Chi Minh city, Vietnam from August 2021 to June 2023. Patients with acute BAO who underwent endovascular treatment within 24 h from symptom onset were included (thrombectomy alone or bridging with intravenous alteplase). The baseline characteristics and outcomes were analyzed and compared between patients with and without ICAD. Good functional outcome was defined as mRS ≤3 at 90 days. RESULTS: Among the 208 patients enrolled, 112 (53.8%) patients were categorized in the ICAD group, and 96 (46.2%) in the non-ICAD group. Occlusion in the proximal segment of the basilar artery was more common in patients with ICAD (55.4% vs. 21.9%, p < 0.001), whereas the distal segment was the most common location in the non-ICAD group (58.3% vs. 10.7%, p < 0.001). Patients in the ICAD group were more likely to undergo treatment in the late window, with a higher mean onset-to-treatment time compared to the non-ICAD group (11.6 vs. 9.5 h, p = 0.01). In multivariable logistic regression analysis, distal segment BAO was negatively associated with ICAD (aOR 0.13, 95% CI: 0.05-0.32, p < 0.001), while dyslipidemia showed a positive association (aOR 2.44, 95% CI: 1.15-5.17, p = 0.02). There was a higher rate for rescue stenting in the ICAD compared to non-ICAD group (15.2% vs. 0%, p < 0.001). However, no significant differences were found between the two groups in terms of good outcome (45.5% vs. 44.8%, p = 0.91), symptomatic hemorrhage rates (4.5% vs. 8.3%, p = 0.25), and mortality (42% vs. 50%, p = 0.25). CONCLUSION: ICAD was a common etiology in patients with BAO. The location segment of BAO and dyslipidemia were associated with ICAD in patients with BAO. There was no difference in 90-day outcomes between BAO patients with and without ICAD undergoing endovascular therapy.

7.
Heliyon ; 10(7): e29339, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38633634

RESUMO

This study applies Jellyfish Search Algorithm and five other algorithms to minimize the electricity generation cost of two hybrid systems for one operating day. The first system comprises one pumped storage hydroelectric plant and two thermal power plants. The second system is expanded by integrating one wind and one solar photovoltaic power plant into the first system. For each system during one operating day, the pumped storage hydroelectric plant with only generation mode acts as a conventional hydroelectric plant in the first scenario. Still, it can run pumps to store water and produce electricity in the second scenario. As a result, JSA can reach smaller costs than all compared algorithms, from about 1 % to higher than 10 % for two scenarios in the two systems. The comparisons of generation cost indicate the second scenario with the pumped storage hydroelectric plant can reach a smaller cost than the first scenario with the conventional hydroelectric power plant by $53,359.7, corresponding to 7.4 % in the first system and $39,472.8, corresponding to 6.95 % in the second system. Therefore, the water storage function of the pumped storage hydroelectric plant is very effective in reducing the electricity generation costs for hybrid power systems.

8.
J Orthop Res ; 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38624253

RESUMO

Hip dislocation is one of the leading causes of failure and revision surgery for total hip arthroplasty. To reduce dislocation rates, lipped liners have been designed with an elevated portion of the rim, to increase jump distance and maintain greater contact area. While it has been documented that lipped liners help reduce dislocation, the objective of this study is to investigate whether lipped liners also help reduce smaller instances of hip micromotion, separation, and edge loading. This study uses an advanced three-dimensional preoperative planning tool to analyze 10 patients, each implanted with both a neutral and lipped liner. Patients within the simulation performed stance phase of gait, and each cup was implanted with the rotation center aligned with the preoperative acetabulum center as well as shifted medially by 2, 4, 6, 8, and 10 mm, yielding 120 total simulations. Specific postoperative outcomes-of-interest included specified component offset, resultant in vivo hip forces, hip separation, and contact area to evaluate edge loading. The planner predicted a reduction in hip separation and an increase in articulating contact area for when using a lipped liner compared to a neutral liner. Additionally, regardless of liner type, increases in hip separation corresponded to decreases in contact area, therefore resulting in edge loading of the liner. Together, this indicates that improper component alignment and offsets may lead to an increase in hip separation and edge loading, but the use of a lipped liner may provide improved stability and resistance to this micromotion.

9.
J Cardiovasc Thorac Res ; 16(1): 38-44, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38584663

RESUMO

Introduction: In Vietnam, the prevalence of hypertension is increasing rapidly. Patients need to be conscious of the disease for timely prevention and treatment. The Hypertension Knowledge Level Scale (HK-LS) is commonly used to assess knowledge about hypertension. Methods: Data collection was took place in a hospital in Binh Thuan province, Vietnam in February 2020 with a total of 184 paticipants. Translation and adaptation of the HK-LS, validate the questionnaire through in-person interviews with outpatients diagnosed with hypertension. The translation process followed WHO guidelines. The appraisal process evaluates through reliability (Cronbach's alpha coefficient) and validity (meaningful relationship between the response results of the scale and the patient's characteristics). Results: The Vietnamese version of the HK-LS was translated and proven to be reliable (Cronbach's alpha=0.72) and valid (statistically significant difference between age groups (P=0.021) and educational background (P=0.007). Conclusion: The HK-LS was translated from English into Vietnamese; the questions are clear, intelligible, and suitable for surveying patients in Vietnam.

10.
J Vet Sci ; 25(2): e20, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38568822

RESUMO

BACKGROUND: Avian influenza (AI) is a contagious disease that causes illness and death in poultry and humans. High pathogenicity AI (HPAI) H5N6 outbreaks commonly occur in Quang Ninh province bordering China. In June 2021, the first HPAI H5N8 outbreak occurred at a Quang Ninh chicken farm. OBJECTIVES: This study examined the risk factors associated with HPAI H5N6 and H5N8 outbreaks in Quang Ninh. METHODS: A retrospective case-control study was conducted in Quang Ninh from Nov 2021 to Jan 2022. The cases were households with susceptible poultry with two or more clinical signs and tested positive by real-time reverse transcription polymerase chain reaction. The controls were households in the same village as the cases but did not show clinical symptoms of the disease. Logistic regression models were constructed to assess the risk factors associated with HPAI outbreaks at the household level. RESULTS: There were 38 cases with H5N6 clade 2.3.4.4h viruses (n = 35) and H5N8 clade 2.3.4.4b viruses (n = 3). Compared to the 112 controls, raising poultry in uncovered or partially covered ponds (odds ratio [OR], 7.52; 95% confidence interval [CI], 1.44-39.27), poultry traders visiting the farm (OR, 8.66; 95% CI, 2.7-27.69), farms with 50-2,000 birds (OR, 3.00; 95% CI, 1.06-8-51), and farms with ≥ 2,000 birds (OR, 11.35; 95% CI, 3.07-41.94) were significantly associated with HPAI outbreaks. CONCLUSIONS: Combining biosecurity measures, such as restricting visitor entry and vaccination in farms with more than 50 birds, can enhance the control and prevention of HPAI in Quang Ninh and its spread across borders.


Assuntos
Vírus da Influenza A Subtipo H5N8 , Influenza Aviária , Doenças das Aves Domésticas , Animais , Humanos , Influenza Aviária/epidemiologia , Estudos Retrospectivos , Estudos de Casos e Controles , Vietnã/epidemiologia , Surtos de Doenças/veterinária , Surtos de Doenças/prevenção & controle , Aves Domésticas , Galinhas
11.
Heliyon ; 10(8): e28657, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38628730

RESUMO

This study revisits the feedback effect from foreign direct investments (FDI) on environmental regulations under the presence of the host country's political structure. Such a relationship may encounter the endogeneity problem due to the omitted variable bias and reverse causality. As such, the two-step system generalized method of moments is employed. Using data from 21 OECD countries from 1990 to 2019, we confirm that FDI flows influence environmental regulations, but such an effect is conditional on the host country's political constraints. Specifically, FDI increases (decreases) the stringency of environmental regulations if domestic political constraints are sufficiently high (low). Understanding the mechanisms of how FDI flows can affect environmental regulations allows countries to revise their policies to attract more FDI flows to support economic growth while simultaneously minimising their negative effects on the environment.

12.
Wound Repair Regen ; 32(3): 229-233, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38534045

RESUMO

The capability to produce suture material using three-dimensional (3D) printing technology may have applications in remote health facilities where rapid restocking of supplies is not an option. This is a feasibility study evaluating the usability of 3D-printed sutures in the repair of a laceration wound when compared with standard suture material. The 3D-printed suture material was manufactured using a fused deposition modelling 3D printer and nylon 3D printing filament. Study participants were tasked with performing laceration repairs on the pigs' feet, first with 3-0 WeGo nylon suture material, followed by the 3D-printed nylon suture material. Twenty-six participants were enrolled in the study. Survey data demonstrated statistical significance with how well the 3D suture material performed with knot tying, 8.9 versus 7.5 (p = 0.0018). Statistical significance was observed in the 3D-printed suture's ultimate tensile strength when compared to the 3-0 Novafil suture (274.8 vs. 199.8 MPa, p = 0.0096). The 3D-printed suture also demonstrated statistical significance in ultimate extension when compared to commercial 3-0 WeGo nylon suture (49% vs. 37%, p = 0.0215). This study was successful in using 3D printing technology to manufacture suture material and provided insight into its usability when compared to standard suture material.


Assuntos
Estudos de Viabilidade , Impressão Tridimensional , Técnicas de Sutura , Suturas , Resistência à Tração , Animais , Suínos , Lacerações/cirurgia , Teste de Materiais , Nylons , Cicatrização , Humanos , Modelos Animais de Doenças
13.
Clin Med Insights Oncol ; 18: 11795549241233692, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38482163

RESUMO

Background: The reported complication rates of neck dissection are not specific patients with papillary thyroid cancer` with metastatic lymph nodes. This study aimed to describe the complication profile of neck dissection and the effect of concurrent lateral neck dissection on complication rates. Methods: This single-center prospective cohort study analyzed the data of 52 patients who underwent a total thyroidectomy and therapeutic lymph node dissection between March 2021 and March 2023. The clinicopathologic characteristics of patients and surgical complications were analyzed. Results: The transient recurrent laryngeal nerve palsy (RLNP) and hypoparathyroidism rates were 55.8% and 51.9%, respectively. The chyle leakage rate was 5.8%. Tracheostomy was performed on 1 patient (1.9%). Patients with transient RLNP had more retrieved lymph nodes than patients without RLNP (5.5 ± 2.7 vs 3.9 ± 1.5, P = .013). The rates of transient RLNP and hypoparathyroidism were higher in the total thyroidectomy with central and lateral neck dissection group than the total thyroidectomy with central neck dissection group (62.2% vs 14.3%, P = .035 and 57.8% vs 14.3%, P = .046). Multivariate analysis showed that the increased number of retrieved lymph nodes in the central compartment and the addition of lateral neck dissection were independent risk factors for transient RLNP, with odds ratio (OR) (95% confidence interval) of 0.72 (0.53-0.98) and 9.42 (1.02-87.34). Conclusion: The rates of transient RLNP and hypoparathyroidism after lymph node dissection in patients with papillary thyroid cancer with metastatic lymph nodes were high, and a greater number of retrieved lymph nodes in the central neck and the addition of lateral neck dissection were predictors for transient RLNP. These data may be used to discuss preoperatively with patients and make surgeons more cautious and meticulous during surgery to minimize complications.

14.
Heliyon ; 10(5): e26845, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38455559

RESUMO

The paper optimizes the placement of soft open points (SOPs) devices, shunt capacitor banks (SCBs), and distributed generators (DGs) in the IEEE 69-node distribution power grid for reducing the power loss of a single hour and total energy losses of one year. EO is proven to be more effective than previous methods and three other applied algorithms, including the Coot optimization algorithm (COOT), Modified weight inertia factor and modified acceleration coefficients-based particle swarm optimization (CFPSO), and Tunicate swarm algorithm (TSA). So, EO is applied for the last case considering one SOPs, one wind turbine (WT), two solar photovoltaic systems (PVs), and two SCBs over one year with twelve months and 24 h each month. The study reaches the smallest power loss compared to previous studies in the first case with one SOPs device. The results from the second to the fourth cases indicate that the power grid needs the placement of SCBs and DGs first and SOPs devices to reach the lowest power loss. Case 5 indicates that the hybrid system with one WT and two PVs suffers higher power losses than the base system at hours with high generation from renewable sources; however, integrating the SOPs and SCBs into the hybrid system can reach smaller losses than the base system at these hours. Thus, using SOPs and SCBs in integrated distribution power grids with renewable energies can greatly benefit energy loss reduction.

15.
J Orthop Res ; 42(7): 1557-1565, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38348693

RESUMO

Advancements in three-dimensional (3D) preoperative planning tools can offer surgeons and design engineers detailed feedback and additional opportunities for clinical advancements. The objective of this study is to use a 3D total hip arthroplasty preoperative planning tool to compare femoral component alignment for three different stem systems. The planning tool in this study used morphology data of femoral bones gathered from a CT database, seven from postoperative patients and 63 from statistical shape models (SSMs), to suggest specific implant sizes and optimal placements in 3D to match each specific bone model. Retrospective validations of predicted stem size and femoral version were first performed by comparing planner-chosen and surgeon-implanted stem sizes and version angles for the seven postoperative patients. Next, the alignment of three different stem systems was evaluated using bone models generated from SSMs, with a quantitative focus on component head positioning. In the validation study, the planner accurately selected stem size and orientation compared to the surgeon for all assessed subjects. In the stem evaluation, the three stem systems yielded different accuracies in component placement, with the newest stem system demonstrating the closest restoration of anatomical head center location. It is evident that new stem designs may have the potential for increased accuracy over their predecessors, demonstrating that new stem designs can offer improved intraoperative and postoperative alignment potential. The 3D preoperative planning tools can provide novel and reliable data to both surgeons and design engineers, which can ultimately improve clinical outcomes and future implant designs.


Assuntos
Artroplastia de Quadril , Imageamento Tridimensional , Humanos , Artroplastia de Quadril/métodos , Estudos Retrospectivos , Fêmur/cirurgia , Fêmur/diagnóstico por imagem , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Prótese de Quadril , Cuidados Pré-Operatórios/métodos
16.
PLoS One ; 19(2): e0297293, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38324541

RESUMO

Improving cruise ports of call is essential for enhancing the overall cruise experience for passengers, promoting tourism, and supporting the economic development of the regions served by these ports. Therefore, this article aims to assess selection factors (SFs) for the cruise port of call from the perspective of cruise operators (COs) and port operators (POs). In doing so, this paper first identifies SFs for the cruise port of call and establishes their hierarchical structure thanks to the extensive literature and expert brainstorming. Afterwards, The Modified Fuzzy Analytic Hierarchy Process (MFAHP) is developed to gauge the discrepancy in SFs between COs and POs. Empirical results from MFAHP pinpoint two significant SFs for POs to improve and attract their customers: customs, immigration control and quarantine (CIQ), and incentive measures. Besides, theoretical and managerial implications, and potential limitations for the next research are discussed.


Assuntos
Processo de Hierarquia Analítica , Surtos de Doenças , Navios , Quarentena/métodos , Turismo
17.
Cureus ; 16(2): e53668, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38327720

RESUMO

Background Intrasphincteric injection of botulinum toxin is an alternative treatment for anal fissures, which may present less risk of fecal incontinence than more invasive procedures, such as lateral internal sphincterotomy. The aim is to compare cure and complication rates between these two treatments. Methods We conducted a retrospective audit of patients who underwent treatment of anal fissures with intrasphincteric botulinum toxin or lateral internal sphincterotomy from 2016 to 2020 at the Colorectal Surgery Unit of Monash Health, Melbourne, Australia, excluding those who had previously had either procedure. Results Fifty-one patients received intrasphincteric botulinum toxin, and 40 patients underwent lateral internal sphincterotomy. Most patients in the botulinum group had a total dose of either 80 (53%; n=27) or 100 units (37%; n=19) and had the dose administered bilaterally at the 3 o'clock and 9 o'clock positions (n=41; 80%). Thirty-one patients in the botulinum group (61%) had complete resolution of symptoms, with a mean time to cure of two months, compared to 36 patients (90%) in the sphincterotomy group with a mean time to cure of 1.5 months. In most cases, postoperative incontinence was transient, although one patient in the botulinum group had persistent incontinence of flatus, and two patients in the sphincterotomy group had persistent fecal incontinence. Conclusion Intrasphincteric botulinum injection is an effective, less-invasive alternative to sphincterotomy for the treatment of anal fissures, with incontinence usually temporary when it occurs. Further research is needed to optimize the dose and location of injection and guide future recommendations.

18.
J Biomech ; 163: 111950, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38237494

RESUMO

Three-dimensional (3D) preoperative planning tools can be used to help plan and compare component alignment scenarios for different total hip arthroplasty systems to ultimately improve postoperative outcomes and patient satisfaction. The objective of this study is to use 3D preoperative planning tools based on patient-specific bone models to compare two different stem designs, specifically a compaction broach stem and a proximal press fit stem. The planner uses patient-specific proximal femoral bone morphology to suggest a specific implant size and placement. The planner then allows for preoperative predictions of component head positioning, stem fit within the canal, and potential cortical bone reaming that must be done, as well as postoperative predictions of stability and mechanics. The stems were evaluated to determine the accuracy of stem placement, the theoretical volumetric bone removal/reaming required to achieve a desired fit, and the associated postoperative mechanics. This study demonstrated that there was a difference in component alignment and predicted postoperative mechanics between a compaction broach stem and a press fit stem, with the compaction broach stem allowing for more accurate alignment with less required bone removal, resulting in improved postoperative stability and mechanics. This study also demonstrated that much of the stem misalignment for both systems occurred in the anterior/posterior direction. Overall, 3D preoperative planning offers significant benefits and novel intraoperative insight, and the industry should continue to enhance their THA preoperative planning tools.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Humanos , Desenho de Prótese , Artroplastia de Quadril/métodos , Fêmur/cirurgia , Tomografia Computadorizada por Raios X , Estudos Retrospectivos
19.
EBioMedicine ; 98: 104879, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38042747

RESUMO

BACKGROUND: Local fistula injection of mesenchymal stromal/stem cells (MSC) is effective for complex perianal Crohn's fistulas but is also expensive and requires specialised facilities for cell revival before administration. Human amnion epithelial cells (hAEC) are non-MSC cells with therapeutic properties. The primary aim of this study was safety of hAEC therapy. Secondary aims included hAEC efficacy, feasibility of the protocol and impact on quality of life. METHODS: A phase I open label study of ten adults with active complex Crohn's perianal fistulas refractory to conventional treatment, including anti-tumour necrosis factor alpha therapy, was undertaken. A single dose of hAEC was injected into the fistula tract(s) after surgical closure of the internal opening(s). Study outcomes were assessed at week 24 with follow up for at least 52 weeks. FINDINGS: Local injection of hAEC was safe, well tolerated and the injection procedure was feasible. Complete response occurred in 4 patients, and a partial response in an additional 4 patients. There was a mean reduction in the Perianal Disease Activity Index of 6.5 points (95% CI -9.0 to -4.0, p = 0.0002, paired t-test), modified Van Assche MRI Index of 2.3 points (95% CI -3.9 to -0.6, p = 0.012, paired t-test) and a mean improvement of 15.8 points (95% CI 4.9 to 26.8, p = 0.010, paired t-test) in quality of life using the Short IBD-Questionnaire in complete responders. INTERPRETATION: Local injection of hAEC therapy for refractory complex perianal fistulising Crohn's disease appears safe, well-tolerated, feasible and demonstrated improvement. Quality of life is improved in those who achieve complete fistula healing. FUNDING: This study was funded by competitive research grant funding from the Gastroenterological Society of Australia Seed Grant 2018.


Assuntos
Doença de Crohn , Transplante de Células-Tronco Hematopoéticas , Transplante de Células-Tronco Mesenquimais , Fístula Retal , Adulto , Humanos , Âmnio , Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Doença de Crohn/terapia , Células Epiteliais , Seguimentos , Transplante de Células-Tronco Mesenquimais/efeitos adversos , Transplante de Células-Tronco Mesenquimais/métodos , Qualidade de Vida , Fístula Retal/terapia , Fístula Retal/tratamento farmacológico , Resultado do Tratamento
20.
Work ; 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-38108369

RESUMO

BACKGROUND: In 2022, many universities transitioned from virtual learning back to in-person teaching. Significant changes in working conditions, along with COVID-19-related anxiety during the pandemic, might impact the well-being of lecturers. OBJECTIVE: This study aims to assess the perceived stress, self-rated physical and occupational health of Vietnamese lecturers in 2022 compared to the pre-pandemic levels, and to identify their associating factors. METHOD: This is a cross-sectional study conducted in May-June 2022 through an online survey questionnaire. A sample of 425 university lecturers were included. Participants' stress levels were assessed using the Perceived Stress Scale. Participants were asked to compare their current physical and occupational health with before the pandemic. Explanatory variables included (1) COVID-19 exposure; and (2) perceptions of changes in working environment due to the pandemic. Multivariable ordinal least squared regression analyses were used to estimate the coefficient and 95% confidence intervals for the associations between COVID-19 exposure variables, work conditions, and each outcome. RESULTS: Our findings indicated that over 60% of participants experienced moderate stress, while nearly half reported worsened physical and occupational health during the pandemic. Gender, age, perceptions of workload, workplace safety, COVID-19 infection, and incentive programs were significant factors associated with higher stress levels and worse self-rated health. CONCLUSION: To ensure occupational safety and support lecturers as they return to in-person classes, it is crucial to provide appropriate psychological and health support services.

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