Rice Husk with PLA: 3D Filament Making and Additive Manufacturing of Samples for Potential Structural Applications.

Additive manufacturing has garnered significant attention as a versatile method for fabricating green and complex composite materials. This study delves into the fabrication of polymer composites by employing polylactic acid (PLA) in conjunction with rice husk as a reinforcing filler. The filaments were made by an extruded filament maker and then were used to make tensile and impact samples by another extrusion technology, fused deposition modeling (FDM). The structural and morphological characteristics of the composite materials were analyzed using scanning electron microscopy SEM. Results show that both the filament and samples are very reliable in producing polymer parts with this rice husk solid waste. This research contributes to increasing materials' circularity and potentially creating a local social economy around rice production, where this waste is not much used.

Satisfaction With Head and Neck Scar Appearance in Latin American Patients: A Cross-Sectional Study.

Background: Surgical scars have been related to poor quality of life, and this is important for head and neck scars. There is a paucity of data about the effect of scars on appearance in Latin American patients. The objective of this study was to describe the self-assessment of patient scars using the Patient Scar Assessment Questionnaire (PSAQ). Methods: This is a cross-sectional study. The validated Spanish version of the PSAQ was used. Adult patients who underwent elective head and neck surgery were included. Demographic and clinical data were obtained from clinical charts. Univariate and multivariate analysis using a forward logistic regression was planned to assess the weight of specific subscale items on the overall subscale score for appearance and satisfaction with appearance. Results: 180 patients were recruited. A total of 144 (80%) patients were female, and the most frequent type of surgery was thyroidectomy. The global appearance, the global scar consciousness and the global scar appearance satisfaction was classified as excellent/good in 72.2%, 93.9% and 87.8% of patients, respectively. The multivariate analysis showed that color (OR 5.9, 95% CI 1.7-20.8), width (OR 58.9, [4.3-807.6]), and flatness (OR 5.7, [1.3-23.6]) were the items statistically associated with a regular/bad result in the appearance subscale. Conclusions: There is a high level of satisfaction with head and neck scar appearance, and these data should be used to assess the impact of surgical interventions on cosmesis. The intrinsic characteristics of scars are the most relevant for defining scar satisfaction.

Evidence of beta amyloid independent small vessel disease in familial Alzheimer's disease.

We studied small vessel disease (SVD) pathology in Familial Alzheimer's disease (FAD) subjects carrying the presenilin 1 (PSEN1) p.Glu280Ala mutation in comparison to those with sporadic Alzheimer's disease (SAD) as a positive control for Alzheimer's pathology and Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) bearing different NOTCH3 mutations, as positive controls for SVD pathology. Upon magnetic resonance imaging (MRI) in life, some FAD showed mild white matter hyperintensities and no further radiologic evidence of SVD. In post-mortem studies, total SVD pathology in cortical areas and basal ganglia was similar in PSEN1 FAD and CADASIL subjects, except for the feature of arteriosclerosis which was higher in CADASIL subjects than in PSEN1 FAD subjects. Further only a few SAD subjects showed a similar degree of SVD pathology as observed in CADASIL. Furthermore, we found significantly enlarged perivascular spaces in vessels devoid of cerebral amyloid angiopathy in FAD compared with SAD and CADASIL subjects. As expected, there was greater fibrinogen-positive perivascular reactivity in CADASIL but similar reactivity in PSEN1 FAD and SAD groups. Fibrinogen immunoreactivity correlated with onset age in the PSEN1 FAD cases, suggesting increased vascular permeability may contribute to cognitive decline. Additionally, we found reduced perivascular expression of PDGFRß AQP4 in microvessels with enlarged PVS in PSEN1 FAD cases. We demonstrate that there is Aß-independent SVD pathology in PSEN1 FAD, that was marginally lower than that in CADASIL subjects although not evident by MRI. These observations suggest presence of covert SVD even in PSEN1, contributing to disease progression. As is the case in SAD, these consequences may be preventable by early recognition and actively controlling vascular disease risk, even in familial forms of dementia.

Excellent mid-term follow-up for a new 3D-printed cementless total knee arthroplasty.

AIMS: Cementless total knee arthroplasty (TKA) offers the potential for strong biological fixation compared with cemented TKA where fixation is achieved by the mechanical integration of the cement. Few mid-term results are available for newer cementless TKA designs, which have used additive manufacturing (3D printing). The aim of this study was to present mid-term clinical outcomes and implant survivorship of the cementless Stryker Triathlon Tritanium TKA. METHODS: This was a single institution registry review of prospectively gathered data from 341 cementless Triathlon Tritanium TKAs at four to 6.8 years follow-up. Outcomes were determined by comparing pre- and postoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) scores, and pre- and postoperative 12-item Veterans RAND/Short Form Health Survey (VR/SF-12) scores. Aseptic loosening and revision for any reason were the endpoints which were used to determine survivorship at five years. RESULTS: At mid-term follow-up, the mean KOOS JR score improved significantly from 33.14 (0 t0 85, standard deviation (SD) 21.88) preoperatively to 84.12 (15.94 to 100, SD 20.51) postoperatively (p < 0.001), the mean VR/SF-12 scores improved significantly from physical health (PH), 31.21 (SD 5.32; 23.99 to 56.77) preoperatively to 42.62 (SD 10.72; 19.38 to 56.82) postoperatively (p < 0.001) and the mental health (MH), 38.15 (SD 8.17; 19.06 to 60.75) preoperatively to 55.09 (SD 9.64; 19.06 to 66.98) postoperatively (p < 0.001). A total of 11 revisions were undertaken, with an overall revision rate of 2.94%, including five for periprosthetic joint infection (1.34%), three for loosening (0.80%), two for instability (0.53%), and one for pain (0.27%). The overall survivorship was 97.06% and survivorship for aseptic loosening as the endpoint was 98.40%, with a 99.5% survivorship of the 3D-printed tibial component. CONCLUSION: This 3D-printed cementless total knee system shows excellent survivorship at mid-term follow-up. This design and the ability to obtain cementless fixation offers promise for excellent long-term durability. Cite this article: Bone Joint J 2021;103-B(6 Supple A):32-37.

Survivorship, Clinical and Radiographic Outcomes of a Novel Cementless Metal-Backed Patella Design.

BACKGROUND: Enhanced implant longevity through biological fixation is achievable using cementless total knee arthroplasty but concerns about patellar component failure have lingered because of prior experiences with older component designs. A new metal-backed patella (MBP) design was released which features a 3-dimensional printed porous titanium metal backing to improve biologic fixation potential and a unique compression molding technique to create a stronger interlock layer between the polyethylene and metal backing. Our study purpose was to determine the clinical and radiographic outcomes and survivorship of this novel cementless MBP. METHODS: Our institutional registry identified 388 cementless MBP with minimum 2-year and 80 with minimum 5-year follow-up. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement and 12-item Veterans RAND/Short Form Health Survey (VR/SF-12) scores were used to evaluate clinical outcomes. Aseptic loosening noted on radiographs as well as revision for any reason were the end points used to determine survivorship. RESULTS: Improvement in the preoperative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, VR/SF-12 physical health and mental health scores were all statistically significant at 2-year follow-up and the VR/SF-12 mental health score at 5-year follow-up. By radiologic criteria, biologic fixation of the patellar component was present in all except 1 case at 2 years (99.6%) and at 5 years (97.7%). Radiolucent lines were present in 15 cases (6.2%) at 2 years and in 6 cases (14%) at 5 years, but progressive increase in radiolucent lines was seen in only 4 cases. No component was revised for loosening; aseptic survivorship was 100%. CONCLUSION: This 3-dimensional printed cementless patellar component shows excellent survivorship at 2-year and 5-year follow-up. We are hopeful about the long-term durability of this implant.

Consumo de tabaco y condición de empleo en una región del eje cafetero colombiano / Smoking and employment conditions in a department of the coffee-triangle region of Colombia

RESUMEN Objetivos Estimar la prevalencia del consumo de tabaco en una región del eje cafetero y su asociación con la condición de empleo. Métodos Este estudio fue del tipo corte transversal. Los participantes fueron hombres y mujeres mayores de 15 años residentes de los municipios de Risaralda que aceptaron ser encuestados sobre las características del consumo de tabaco en 2017. Resultados Se evaluaron 4 157 registros de personas y se obtuvo una prevalencia de consumo de tabaco en Risaralda del 11,5%. En subempleados hubo una asociación significativa por fumar (p<0,05) (OR=1,51 IC95%: 1,18-1,94) cuando se ajustó el consumo de cigarrillo por edad y sexo, mientras que en desempleados el odds ratio reportado fue mayor (OR=3,10 IC95%: 2,03-4,73). Conclusiones Se encontró que el subempleo es un factor de riesgo para el consumo de tabaco que debe ser considerado en el desarrollo de políticas para el control de consumo de tabaco en la región en población vulnerable. La condición de empleo puede explicar las limitaciones de una política de control de consumo de tabaco en la población.

ABSTRACT Objective To estimate the links between smoking and employment conditions in a department of the coffee-triangle region. Methods This was a cross-sectional study. Participants were men and women older than 15 years residing in the municipalities of Risaralda. They agreed to complete a survey asking about the characteristics of tobacco consumption and socioeconomic status, in 2017. Results A total of 4 157 participants were surveyed. The smoking prevalence in Risaralda was 11,5%. Underemployment had a significant association with smoking (p<0,05 OR:1,51 CI95%: 1,18-1,94). Statistical significance was found when adjusting smoking by age and sex, whereas unemployment had over three times greater odds for smoking (OR:3,10, CI95%: 2,03-4,73). Conclusion This study finds that underemployment is a risk factor for smoking. This statement should be considered to the future assessment of the tobacco control policies in the region, particularly for vulnerable population. The employment conditions could explain the boundaries at the tobacco control policies in the population.

Patients With Modular-Neck Total Hip Arthroplasty: A Brief Five-Year Follow-Up Study.

BACKGROUND: We have previously reported the early clinical results of a modular-neck stem identifying an early 2-year revision rate of 13% due to neck-stem corrosion. This report updates our findings to a midterm mean follow-up of 5 years. METHODS: This is a consecutive retrospective review of 186 modular-neck hips in 175 patients with a mean follow-up period was 60.1 ± 22.9 months (range 24-100). We reviewed clinical findings, routine radiographs, detailed imaging (metal artifact reduction software-magnetic resonance imaging, ultrasound), and serum ion levels of cobalt and chromium. We performed a survival analysis with the endpoint defined as revision total hip arthroplasty due to neck-stem corrosion. RESULTS: We revised 41 hips (22.0%) for neck-stem corrosion. Clinical symptoms (groin pain ± local swelling) were consistently present in those that came for revision. Mean serum cobalt ion levels increased as time passed in all patients. Detailed image findings showed that larger fluid collections and local soft tissue masses were seen predominately in symptomatic patients. However, 14% of patients who underwent revision did not have positive magnetic resonance imaging or ultrasound findings. The survival rate was 87% (95% confidence interval 81-92) at 3 years postoperatively and 72% (95% confidence interval 64-80) at 7 years postoperatively. CONCLUSION: The revision rate for this modular-neck stem due to neck-stem corrosion at mid-term follow-up almost doubled in comparison to previous short-term results. It seems reasonable to consider clinical follow-up alone as symptoms, rather than blood testing for ion levels, seem to be the defining characteristic of failure.

A Maximum Likelihood Ensemble Filter Via A Modified Cholesky Decomposition For Non-Gaussian Data Assimilation.

This paper proposes an efficient and practical implementation of the Maximum Likelihood Ensemble Filter via a Modified Cholesky decomposition (MLEF-MC). The method works as follows: via an ensemble of model realizations, a well-conditioned and full-rank square-root approximation of the background error covariance matrix is obtained. This square-root approximation serves as a control space onto which analysis increments can be computed. These are calculated via Line-Search (LS) optimization. We theoretically prove the convergence of the MLEF-MC. Experimental simulations were performed using an Atmospheric General Circulation Model (AT-GCM) and a highly nonlinear observation operator. The results reveal that the proposed method can obtain posterior error estimates within reasonable accuracies in terms of ℓ - 2 error norms. Furthermore, our analysis estimates are similar to those of the MLEF with large ensemble sizes and full observational networks.

Cross-cultural adaptation and psychometric validation of the Patient Scar Assessment Questionnaire to the Spanish language in head and neck surgery.

External appearance is the main aesthetic outcome in patients who undergo surgical procedures. Scars located in exposed areas, such as the neck and face, are important for patients. There are at least eight instruments that are used to evaluate postoperative scars, but few fulfil standard methodological conditions. The Patient Scar Assessment Questionnaire (PSAQ) was designed and validated using psychometric methodology. However, this scale has not been translated or validated in the Spanish language. The aim of this study was to undergo a cross-cultural adaptation and psychometric validation of the PSAQ scale to the Spanish language in patients who underwent head and neck surgery. We followed The Professional Society for Health Economics and Outcomes Research (ISPOR) guidelines for the translation and validation of health-related scales. Forward and back translations were made by independent translators. We included adult patients who underwent thyroidectomy, parathyroidectomy, parotidectomy, and neck dissection. For the psychometric validation, we used a principal axis exploratory factor analysis with oblimin rotation. A reliability test involving Cronbachs alpha and the item-total correlation was performed and for the convergent/concurrent validity, we selected the Spanish version of the Vancouver Scar Scale. A total of 180 patients were recruited. Factor analysis showed a five-factor solution. Cronbachs alpha for the subscales was >0.7. The comparison between the PSAQ appearance subscale and the VSS demonstrated a high correlation (rho = - 0.89). In a sample of 62 patients, the test-retest evaluation showed high correlation (0.74-0.99). Our study supports the Spanish version of the PSAQ as a valid, reliable, and reproducible tool to assess the perception and impact of neck scars in Spanish-speaking patients who undergo head and neck surgery.

Depresión, ansiedad y calidad de vida relacionada con la salud en estudiantes universitarios de educación física y deportes / Depression, anxiety, and health-related quality of life in college students of physical education and sports / Depressão, ansiedade e qualidade de vida relacionada à saúde em estudantes universitários de educação física e esportes

Introducción: la educación universitaria puede afectar la salud mental de los estudiantes universitarios. Objetivo: identificar el estado de depresión, ansiedad y calidad de vida relacionada con la salud en estudiantes universitarios de educación física y deportes. Métodos: estudio transversal realizado en 100 estudiantes universitarios. Se indagó sobre depresión, ansiedad, calidad de vida relacionada con la salud, VO2máx, perímetro de cintura y variables sociodemográficas. Resultados: se identificaron prevalencias de depresión del 22% y ansiedad del 10%. Las puntuaciones de calidad de vida relacionada con la salud oscilaron entre 70 y 100 en diferentes dominios. Se encontraron asociaciones inversas de depresión y ansiedad con la edad y el VO2máx. Algunos dominios de calidad de vida relacionada con la salud se asociaron con perímetro de cintura, depresión, ansiedad, y VO2máx. Conclusiones: en la muestra se detectaron síntomas de depresión y ansiedad, y puntajes adecuados de calidad de vida relacionada con la salud.

Introduction: University education may affect the mental health of university students. Objective: To identify the state of depression, anxiety and health-related quality of life in university students of physical education and sports. Methods: Cross-sectional study conducted in 100 university students. Depression, anxiety, health-related quality of life, VO2máx, waist circumference, and sociodemographic variables were investigated. Results: Prevalences of depression and anxiety of 22 and 10%, respectively, were identified. Scores of health-related quality of life ranged from 70 to 100 in different domains. Inverse associations of depression and anxiety were found with age and VO2máx. Some health-related quality of life domains were associated with waist circumference, depression, anxiety, and VO2máx. Conclusions: In the sample, symptoms of depression and anxiety, and adequate scores of health-related quality of life were detected.

Introdução: O ensino universitário pode afetar a saúde mental dos estudantes universitários. Objetivo: identificar o estado de depressão, ansiedade e qualidade de vida relacionada à saúde em estudantes universitários de educação física e esportes. Método: estudo transversal realizado em 100 estudantes universitários; com eles se pesquisou sobre depressão, ansiedade, qualidade de vida relacionada com a saúde, VO2máx, circunferência da cintura (CP) e variáveis sociodemográficas. Resultados: as prevalências de depressão e ansiedade que foram de 22% e 10%, respectivamente. Os escores da qualidade de vida relacionada com a saúde oscilaram de 70 a 100 em diferentes domínios. Além disso, evidenciaram-se associações inversas de depressão e ansiedade com a idade e o VO2máx. Alguns domínios da qualidade de vida relacionada com a saúde foram associados à circunferência da cintura , depressão, ansiedade e VO2máx. Conclusões: na amostra de estudantes universitários foram detectados sintomas de depressão e ansiedade, porém foram encontrados escores adequados de qualidade de vida relacionada à saúde.

Pelvic Incidence in Patients with Hip Osteoarthritis.

BACKGROUND: Hip osteoarthritis (OA) is a major cause of pain and disability that results in considerable social and medical costs. Mechanics such as posture, alignment and orientation of the hips and the spinal column and the relationship between these factors have been implicated in the development of both hip and spine pathologies. This study aims to test the hypothesis if pelvic incidence varies in patients with and without osteoarthritis. We assessed the relationship between spinopelvic alignment as measured by pelvic incidence (PI) and the presence of hip OA. METHODS: We collected supine pelvis CT scans of 1,012 consecutive patients not known to have hip OA. Our first group consisted of 95 patients with moderate to severe hip OA as per radiology reports. The second group included 87 patients with no evidence of hip OA. Power analysis revealed the need for 77 patients per group to find a mean difference in PI of 5° or less between both groups. Two trained physicians independently measured the PI to account for inter-observer reliability. RESULTS: Patients with moderate to severe hip OA had a mean PI of 56.5°±12.8°. The mean PI for patients without hip OA was 57.2°±7.5°. An independent samples t-test revealed no significant difference between the PI values of the two groups. Spearman's correlation coefficient of 0.754 demonstrated a high inter-observer reliability. CONCLUSION: There was no difference in PI angle of hip OA patients and "healthy" patients. Our measurements of patients without OA were almost identical to the reported normal PI values in the literature. It appears that hip OA is not associated with PI angle, refuting the hypothesis made in previous studies, stating that elevated PI contributes to the future development of hip arthritis. CT scan seems to be a reliable and accurate way of assessing pelvic incidence.

Adverse clinical outcomes in a primary modular neck/stem system.

We report our experience with 215 recalled neck modular stems due to corrosion. Among the 195 hips with 2 years follow-up, 56% had no clinical symptoms, 26% had groin pain (typical of corrosion), and 17% had other symptoms. Cobalt levels were comparable between asymptomatic (3.4 µg/L, range 0.7-7.3 µg/L) and symptomatic patients (4.0 µg/L range 0-13.2 µg/L). Abnormal imaging findings were seen in 46% of symptomatic and 11% of asymptomatic hips (P=0.001). Twenty-six hips (13%) have either undergone revision surgery or have been scheduled. Evidence of corrosion was seen at revision surgery in all patients. Despite modest elevations in serum cobalt levels, abnormal imaging studies were seen in 36%, clinical symptoms were seen in 44%, and revision for corrosion was undertaken or scheduled in 13% of the hips.

Bilateral adventitial cystic disease of the popliteal artery: a case report.

Adventitial cystic disease (ACD) of the popliteal artery is an uncommon vascular condition of unknown etiology. In the present case report, we describe a case of bilateral ACD of the popliteal artery in a 58-year-old male. To the best of our knowledge, this is the first case of bilateral ACD of the popliteal artery reported in the literature.

Musculoskeletal infection imaging: past, present, and future.

Imaging plays a key role in the evaluation of patients with known or suspected musculoskeletal infection. Although conventional radiograph still remains as the initial imaging approach, it has low sensitivity and specificity in the setting of acute infection. Magnetic resonance is highly sensitive for the detection of acute osteomyelitis and septic arthritis. Computed tomography is usually reserved for guided interventional procedures (eg, aspiration or drainage) and for evaluation of sinus tracts in chronic infections. Ultrasound is useful for fluid detection in joints and soft tissues but limited in bone assessment. Nuclear medicine, with the different radiotracers currently available, is highly sensitive for the diagnosis of acute osteomyelitis. Newer radiotracers are being developed that promise high sensitivity and specificity for the detection of these pathologies.

Sinonasal hemangiopericytomas: clinicopathologic and imaging findings.

Hemangiopericytomas are rare soft-tissue neoplastic lesions that can arise in any part of the body. They are mesenchymal tumors that account for 3 to 5% of all soft-tissue sarcomas and 1% of all vascular tumors. They originate in extravascular cells (pericytes). Some 15 to 30% of all hemangiopericytomas occur in the head and neck; of these, approximately 5% occur in the sinonasal area. We describe our brief retrospective review of 7 histologically proven cases of sinonasal hemangiopericytoma, and we discuss the imaging characteristics and clinical and pathologic findings in these patients.

Renal cell carcinoma with peri-renal fat necrosis radiographically mimicking extra-capsular tumor extension.

Peri-renal fat necrosis is rarely encountered, especially in the absence of previous surgery, trauma, or pancreatic disease. We report a patient being followed for chronic renal insufficiency by renal ultrasound in whom a renal mass was detected. Imaging studies were suggestive of renal cell carcinoma with extra-capsular extension. Histologic study confirmed renal cell carcinoma but the radiographic impression of tumor extension into surrounding adipose tissue was explained by peri-renal fat necrosis and fibrosis. To the best of our knowledge, this is the second reported case of peri-renal fat necrosis associated with renal cell carcinoma. We propose a possible mechanism for the association.

Mediastinitis fibrosante: Fisiopatología y hallazgos en imágenes diagnósticas / Fibrosing mediastinitis

La mediastinitis fibrosante (MF) es un trastorno poco común que se caracteriza por una proliferación excesiva de colágeno acelular y tejido fibroso en el mediastino, que puede comprimirlas estructuras mediastínicas.Una infección por Histoplasma capsulatum (HQ es considerada su etiología más frecuente. Se ha descrito asociación con otras enfermedades granulomatosas (tuberculosis, blastomicosis,criptococosis,mucormicosis y aspergilosis), así como con patologías no infecciosas (enfermedades autoinmunes,tiroiditis de Riedel, fibrosis retroperitoneal y seudotumor orbitario). Existen dos patrones de afectación del mediastino: primero, una masa generalmente localizada en la región paratraqueal, subcarinal e hiliar con calcificación punteada o densa. Este patrón está asociado casi siempre con una infección previa por HC y se encuentra en la mayoría de pacientes. Segundo, una masa infiltrante no calcificada que afecta múltiples compartimentos mediastínicos. Otros hallazgos, además de las masas de tejido fibroso anormal, son aquéllos secundarios a la distorsión de la vía aérea y la compresión de las estructuras vasculares

Tracheobronchopathia osteochondroplastica: helical CT findings in 4 cases.

Tracheopathia osteochondroplastica is an uncommon abnormality of the cartilaginous tracheal wall, characterized by the presence of osteocartilaginous calcified nodules within the submucosa, with variable degree of diffuse tracheal narrowing. Imaging findings in CT are characterized by the presence of calcified nodular densities protruding into the tracheal lumen, with an abnormally irregular tracheal morphology and often decreased lateral diameter. This can extend to the proximal main stem bronchi. CT is the imaging modality of choice in this entity. The clinical manifestations, as well as the imaging findings, in 4 cases are reviewed.