Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 29
Filter
Add more filters

Publication year range
1.
J Aerosol Sci ; 173: 106179, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37069899

ABSTRACT

Propagation of respiratory particles, potentially containing viable viruses, plays a significant role in the transmission of respiratory diseases (e.g., COVID-19) from infected people. Particles are produced in the upper respiratory system and exit the mouth during expiratory events such as sneezing, coughing, talking, and singing. The importance of considering speaking and singing as vectors of particle transmission has been recognized by researchers. Recently, in a companion paper, dynamics of expiratory flow during fricative utterances were explored, and significant variations of airflow jet trajectories were reported. This study focuses on respiratory particle propagation during fricative productions and the effect of airflow variations on particle transport and dispersion as a function of particle size. The commercial ANSYS-Fluent computational fluid dynamics (CFD) software was employed to quantify the fluid flow and particle dispersion from a two-dimensional mouth model of sustained fricative [f] utterance as well as a horizontal jet flow model. The fluid velocity field and particle distributions estimated from the mouth model were compared with those of the horizontal jet flow model. The significant effects of the airflow jet trajectory variations on the pattern of particle transport and dispersion during fricative utterances were studied. Distinct differences between the estimations of the horizontal jet model for particle propagation with those of the mouth model were observed. The importance of considering the vocal tract geometry and the failure of a horizontal jet model to properly estimate the expiratory airflow and respiratory particle propagation during the production of fricative utterances were emphasized.

2.
Indoor Air ; 31(6): 1896-1912, 2021 11.
Article in English | MEDLINE | ID: mdl-34297885

ABSTRACT

The COVID-19 pandemic has highlighted the need to improve understanding of droplet transport during expiratory emissions. While historical emphasis has been placed on violent events such as coughing and sneezing, the recognition of asymptomatic and presymptomatic spread has identified the need to consider other modalities, such as speaking. Accurate prediction of infection risk produced by speaking requires knowledge of both the droplet size distributions that are produced, as well as the expiratory flow fields that transport the droplets into the surroundings. This work demonstrates that the expiratory flow field produced by consonant productions is highly unsteady, exhibiting extremely broad inter- and intra-consonant variability, with mean ejection angles varying from ≈+30° to -30°. Furthermore, implementation of a physical mouth model to quantify the expiratory flow fields for fricative pronunciation of [f] and [θ] demonstrates that flow velocities at the lips are higher than previously predicted, reaching 20-30 m/s, and that the resultant trajectories are unstable. Because both large and small droplet transport are directly influenced by the magnitude and trajectory of the expirated air stream, these findings indicate that prior investigations of the flow dynamics during speech have largely underestimated the fluid penetration distances that can be achieved for particular consonant utterances.


Subject(s)
Aerosols , Air Pollution, Indoor , Mouth/physiology , Speech/physiology , COVID-19 , Humans , Research Subjects , SARS-CoV-2
3.
J Surg Oncol ; 121(4): 630-637, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31957034

ABSTRACT

BACKGROUND AND OBJECTIVES: Limb salvage surgery remains the standard treatment in bone and soft tissue tumors. Toronto Extremity Salvage Score (TESS) is the most used quality of life measure. Our objective was to perform cross-cultural adaptation and validation in Italian, testing test-retest reliability, construct validity, and responsiveness. METHODS: We interviewed patients already treated for content validity. A total of 124 patients completed TESS and other questionnaires presurgery, at 3 months, 3 months + 2 weeks, and 6 months follow-up. We calculated intraclass correlation coefficients (ICCs) for reliability, associations with Pearson's r, and change over time with paired T tests. RESULTS: A new item regarding touch-screen devices was added to the upper extremity (UE) questionnaire. ICC resulted of 0.99 for lower extremity (LE) and 0.98 for UE patients, Pearson's r between TESS and Musculoskeletal Tumor Society was .66 and .64, EuroQol-5D-5L r was .62 and .61, and r between TESS and short form-36 physical function subscale was .76 and .71 for LE and UE groups, respectively. Paired T test results were statistically significant to detect change over time (0.03, 0.04, and 0.04 for LE groups and 0.03, 0.01, and 0.04 for UE groups). CONCLUSION: The Italian version of TESS can be used for the bone and soft tissue sarcoma population in clinical trials in Italy and with Italian speaking patients abroad to ensure patients' perspectives for efficacy and efficiency of treatments.


Subject(s)
Bone Neoplasms/psychology , Bone Neoplasms/surgery , Limb Salvage/psychology , Osteosarcoma/psychology , Osteosarcoma/surgery , Sarcoma/psychology , Sarcoma/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Bone Neoplasms/pathology , Cross-Cultural Comparison , Extremities/pathology , Extremities/surgery , Female , Humans , Italy , Language , Limb Salvage/methods , Male , Middle Aged , Osteosarcoma/pathology , Quality of Life , Reproducibility of Results , Sarcoma/pathology , Severity of Illness Index , Surveys and Questionnaires , Translating , Young Adult
4.
BMC Nephrol ; 21(1): 71, 2020 02 28.
Article in English | MEDLINE | ID: mdl-32111173

ABSTRACT

BACKGROUND: Chronic kidney disease (CKD) is increasing worldwide, and the majority of the CKD burden is in low- and middle-income countries (LMICs). However, there is wide variability in global access to kidney care therapies such as dialysis and kidney transplantation. The challenges health professionals experience while providing kidney care in LMICs have not been well described. The goal of this study is to elicit health professionals' perceptions of providing kidney care in a resource-constrained environment, strategies for dealing with resource limitations, and suggestions for improving kidney care in Guatemala. METHODS: Semi-structured interviews were performed with 21 health professionals recruited through convenience sampling at the largest public nephrology center in Guatemala. Health professionals included administrators, physicians, nurses, technicians, nutritionists, psychologists, laboratory personnel, and social workers. Interviews were recorded and transcribed in Spanish. Qualitative data from interviews were analyzed in NVivo using an inductive approach, allowing dominant themes to emerge from interview transcriptions. RESULTS: Health professionals most frequently described challenges in providing high-quality care due to resource limitations. Reducing the frequency of hemodialysis, encouraging patients to opt for peritoneal dialysis rather than hemodialysis, and allocating resources based on clinical acuity were common strategies for reconciling high demand and limited resources. Providers experienced significant emotional challenges related to high patient volume and difficult decisions on resource allocation, leading to burnout and moral distress. To improve care, respondents suggested increased budgets for equipment and personnel, investments in preventative services, and decentralization of services. CONCLUSIONS: Health professionals at the largest public nephrology center in Guatemala described multiple strategies to meet the rising demand for renal replacement therapy. Due to systems-level limitations, health professionals faced difficult choices on the stewardship of resources that are linked to sentiments of burnout and moral distress. This study offers important lessons in Guatemala and other countries seeking to build capacity to scale-up kidney care.


Subject(s)
Attitude of Health Personnel , Health Care Rationing , Hospitals, Special/organization & administration , Outpatient Clinics, Hospital/organization & administration , Renal Insufficiency, Chronic/therapy , Burnout, Professional , Clinical Decision-Making , Guatemala , Hospitals, Special/standards , Humans , Outpatient Clinics, Hospital/standards , Peritoneal Dialysis , Personnel, Hospital/psychology , Qualitative Research , Quality of Health Care , Renal Dialysis , Stress, Psychological
5.
Build Environ ; 170: 1-16, 2019 Dec 18.
Article in English | MEDLINE | ID: mdl-32055099

ABSTRACT

Carpet and rugs currently represent about half of the United States flooring market and offer many benefits as a flooring type. How carpets influence our exposure to both microorganisms and chemicals in indoor environments has important health implications but is not well understood. The goal of this manuscript is to consolidate what is known about how carpet impacts indoor chemistry and microbiology, as well as to identify the important research gaps that remain. After describing the current use of carpet indoors, questions focus on five specific areas: 1) indoor chemistry, 2) indoor microbiology, 3) resuspension and exposure, 4) current practices and future needs, and 5) sustainability. Overall, it is clear that carpet can influence our exposures to particles and volatile compounds in the indoor environment by acting as a direct source, as a reservoir of environmental contaminants, and as a surface supporting chemical and biological transformations. However, the health implications of these processes are not well known, nor how cleaning practices could be optimized to minimize potential negative impacts. Current standards and recommendations focus largely on carpets as a primary source of chemicals and on limiting moisture that would support microbial growth. Future research should consider enhancing knowledge related to the impact of carpet in the indoor environment and how we might improve the design and maintenance of this common material to reduce our exposure to harmful contaminants while retaining the benefits to consumers.

6.
Environ Res ; 167: 7-14, 2018 11.
Article in English | MEDLINE | ID: mdl-30005199

ABSTRACT

Land-use regression (LUR) models provide location and time specific estimates of exposure to air pollution and thereby improve the sensitivity of health effects models. However, they require pollutant concentrations at multiple locations along with land-use variables. Often, monitoring is performed over short durations using mobile monitoring with research-grade instruments. Low-cost PM monitors provide an alternative approach that increases the spatial and temporal resolution of the air quality data. LUR models were developed to predict hourly PM concentrations across a metropolitan area using PM concentrations measured simultaneously at multiple locations with low-cost monitors. Monitors were placed at 23 sites during the 2015/16 heating season. Monitors were externally calibrated using co-located measurements including a reference instrument (GRIMM particle spectrometer). LUR models for each hour of the day and weekdays/weekend days were developed using the deletion/substitution/addition algorithm. Coefficients of determination for hourly PM predictions ranged from 0.66 and 0.76 (average 0.7). The hourly-resolved LUR model results will be used in epidemiological studies to examine if and how quickly, increases in ambient PM concentrations trigger adverse health events by reducing the exposure misclassification that arises from using less time resolved exposure estimates.


Subject(s)
Air Pollutants , Air Pollution , Environmental Monitoring , Environmental Monitoring/instrumentation , Environmental Monitoring/methods , Models, Theoretical , Particulate Matter , Seasons
7.
Sensors (Basel) ; 17(8)2017 Aug 21.
Article in English | MEDLINE | ID: mdl-28825680

ABSTRACT

There is concern regarding the heterogeneity of exposure to airborne particulate matter (PM) across urban areas leading to negatively biased health effects models. New, low-cost sensors now permit continuous and simultaneous measurements to be made in multiple locations. Measurements of ambient PM were made from October to April 2015-2016 and 2016-2017 to assess the spatial and temporal variability in PM and the relative importance of traffic and wood smoke to outdoor PM concentrations in Rochester, NY, USA. In general, there was moderate spatial inhomogeneity, as indicated by multiple pairwise measures including coefficient of divergence and signed rank tests of the value distributions. Pearson correlation coefficients were often moderate (~50% of units showed correlations >0.5 during the first season), indicating that there was some coherent variation across the area, likely driven by a combination of meteorological conditions (wind speed, direction, and mixed layer heights) and the concentration of PM2.5 being transported into the region. Although the accuracy of these PM sensors is limited, they are sufficiently precise relative to one another and to research grade instruments that they can be useful is assessing the spatial and temporal variations across an area and provide concentration estimates based on higher-quality central site monitoring data.

8.
Knee Surg Sports Traumatol Arthrosc ; 23(9): 2484-93, 2015 Sep.
Article in English | MEDLINE | ID: mdl-24714975

ABSTRACT

PURPOSE: In the last two decades, many surgical techniques have been described for articular cartilage repair. Reliable histological scoring systems are fundamental tools to evaluate new procedures. Several histological scoring systems have been described, and these can be divided in elementary and comprehensive scores, according to the number of sub-items. The aim of this study was to test the inter- and intra-observer reliability of ten main scores used for the histological evaluation of in vivo cartilage repair. The authors tested the starting hypothesis that elementary scores would show superior intra- and inter-observer reliability compared with comprehensive scores. METHODS: Fifty histological sections obtained from the trochlea of New Zealand Rabbit and stained with Safranin-O fast green were used. The histological sections were analysed by 4 observers: 2 experienced in cartilage histology and 2 inexperienced. Histological evaluations were performed at time 1 and time 2, separated by a 30-day interval. The following scores were used: Mankin, O'Driscoll, Pineda, Wakitani, Fortier, Selleres, ICRS, ICRSII, Oswestry (OsScore) and modified O'Driscoll. Intra- and inter-observer reliability were evaluated for each score. In addition, the pavement-ceiling effect and the Bland-Altman Coefficient of Repeatability were then evaluated for each sub-item of every score. RESULTS: Intra-observer reliability was high for all observers in every score, even though the reliability was significantly lower for non-expert observers compared with expert counterparts. In terms of Coefficient of Repeatability, some scores performed better (O'Driscoll, Modified O'Driscoll and ICRSII) than others (Fortier, Seller). Inter-observer reliability was high for all observers in every score, but significantly lower for non-expert compared with expert observers. CONCLUSIONS: In expert hands, all the scores showed high intra- and inter-observer reliability, independently of the complexity. Although every score has advantages and disadvantages, ICRSII, O'Driscoll and Modified O'Driscoll scores should be preferred for the evaluation of in vivo cartilage repair in animal models.


Subject(s)
Cartilage, Articular/surgery , Histological Techniques , Animals , Cartilage, Articular/pathology , Observer Variation , Rabbits , Random Allocation , Reproducibility of Results , Wound Healing
9.
J Hazard Mater ; 470: 134278, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38631247

ABSTRACT

Resuspension caused by human walking activities is an important source of indoor bioaerosols and has been associated with health effects such as allergies and asthma. However, it is unknown whether inhalation of resuspended bioaerosols is an important exposure pathway for airborne infection. Also, crucial factors influencing the resuspension of settled microbes have not been quantified. In this study, we experimentally investigated the resuspension of culturable bacteria from human-stepping on polyvinyl chloride (PVC) flooring under different conditions. We determined the bacterial resuspension emission factor (ER), a normalized resuspension parameter for the ratio of resuspended mass in the air to the mass of settled particles, for two common bacteria, Escherichia coli and Salmonella enterica. The investigation involved varying factors such as microbial surface-attached durations (0, 1, 2, and 3 days), the absence or presence of nutrients on flooring surfaces, and changes in relative humidity (RH) (35%, 65%, and 85%). The results showed that, in the absence of nutrients, the highest ER values for E. coli and S. enterica were 3.8 × 10-5 ± 5.2 × 10-6 and 5.3 × 10-5 ± 6.0 × 10-6, respectively, associated with surface-attached duration of 0 days. As the surface-attached duration increased from 0 to 3 days, ER values decreased by 92% and 84% for E. coli and S. enterica, respectively. In addition, we observed that ER values decreased with the increasing RH, which is consistent with particle adhesion theory. This research offers valuable insights into microbial resuspension during human walking activities and holds the potential for assisting in the assessment and estimation of risks related to human exposure to bioaerosols.


Subject(s)
Escherichia coli , Humidity , Walking , Humans , Floors and Floorcoverings , Salmonella enterica , Aerosols , Air Pollution, Indoor , Air Microbiology , Polyvinyl Chloride/chemistry , Nutrients
10.
Sci Rep ; 13(1): 18294, 2023 10 25.
Article in English | MEDLINE | ID: mdl-37880507

ABSTRACT

The number of respiratory particles emitted during different respiratory activities is one of the main parameters affecting the airborne transmission of respiratory pathogens. Information on respiratory particle emission rates is mostly available for adults (few studies have investigated adolescents and children) and generally involves a limited number of subjects. In the present paper we attempted to reduce this knowledge gap by conducting an extensive experimental campaign to measure the emission of respiratory particles of more than 400 children aged 6 to 12 years while they pronounced a phonetically balanced word list at two different voice intensity levels ("speaking" and "loudly speaking"). Respiratory particle concentrations, particle distributions, and exhaled air flow rates were measured to estimate the respiratory particle emission rate. Sound pressure levels were also simultaneously measured. We found out that median respiratory particle emission rates for speaking and loudly speaking were 26 particles s-1 (range 7.1-93 particles s-1) and 41 particles s-1 (range 10-146 particles s-1), respectively. Children sex was significant for emission rates, with higher emission rates for males during both speaking and loudly speaking. No effect of age on the emission rates was identified. Concerning particle size distributions, for both respiratory activities, a main mode at approximately 0.6 µm and a second minor mode at < 2 µm were observed, and no differences were found between males and females. This information provides important input parameters in predictive models adopted to estimate the transmission risk of airborne pathogens in indoor spaces.


Subject(s)
Air Pollution, Indoor , Exhalation , Male , Adult , Female , Adolescent , Humans , Child , Particle Size
11.
Front Bioeng Biotechnol ; 11: 1114711, 2023.
Article in English | MEDLINE | ID: mdl-36937770

ABSTRACT

Introduction: Spinal stability plays a crucial role in the success of the surgical treatment of lumbar vertebral metastasis and, in current practice, less invasive approaches such as short constructs have been considered. Concurrently, carbon fiber-reinforced (CFR) poly-ether-ether-ketone (PEEK) fixation devices are expanding in oncologic spinal surgery thanks to their radiotransparency and valid mechanical properties. This study attempts to provide an exhaustive biomechanical comparison of different CFR-PEEK surgical stabilizations through a highly reproducible experimental setup. Methods: A Sawbones biomimetic phantom (T12-S1) was tested in flexion, extension, lateral bending, and axial rotation. An hemisome lesion on L3 vertebral body was mimicked and different pedicle screw posterior fixations were realized with implants from CarboFix Orthopedics Ltd: a long construct involving two spinal levels above and below the lesion, and a short construct involving only the levels adjacent to L3, with and without the addition of a transverse rod-rod cross-link; to provide additional insights on its long-term applicability, the event of a pedicle screw loosening was also accounted. Results: Short construct reduced the overloading onset caused by long stabilization. Particularly, the segmental motion contribution less deviated from the physiologic pattern and also the long-chain stiffness was reduced with respect to the prevalent long construct. The use of the cross-link enhanced the short stabilization by making it significantly stiffer in lateral bending and axial rotation, and by limiting mobiliza-tion in case of pedicle screw loosening. Discussion: The present study proved in vitro the biomechanical benefits of cross-link augmentation in short CFR-PEEK fixation, demonstrating it to be a potential alternative to standard long fixation in the surgical management of lumbar metastasis.

12.
Article in English | MEDLINE | ID: mdl-37337048

ABSTRACT

BACKGROUND: The COVID-19 pandemic was caused by the SARS-CoV-2 coronaviruses transmitted mainly through exposure to airborne respiratory droplets and aerosols carrying the virus. OBJECTIVE: To assess the transport and dispersion of respiratory aerosols containing the SARS-CoV-2 virus and other viruses in a small office space using a diffusion-based computational modeling approach. METHODS: A 3-D computational model was used to simulate the airflow inside the 70.2 m3 ventilated office. A novel diffusion model accounting for turbulence dispersion and gravitational sedimentation was utilized to predict droplet concentration transport and deposition. The numerical model was validated and used to investigate the influences of partition height and different ventilation rates on the concentration of respiratory aerosols of various sizes (1, 10, 20, and 50 µm) emitted by continuous speaking. RESULTS: An increase in the hourly air change rate (ACH) from 2.0 to 5.6 decreased the 1 µm droplet concentration inside the office by a factor of 2.8 and in the breathing zone of the receptor occupant by a factor of 3.2. The concentration at the receptor breathing zone is estimated by the area-weighted average of a 1 m diameter circular disk, with its centroid at the center of the receptor mannequin mouth. While all aerosols were dispersed by airflow turbulence, the gravitational sedimentation significantly influenced the transport of larger aerosols in the room. The 1 and 10 µm aerosols remained suspended in the air and dispersed throughout the room. In contrast, the larger 20 and 50 µm aerosols deposited on the floor quickly due to the gravitational sedimentation. Increasing the partition between cubicles by 0.254 m (10") has little effect on the smaller aerosols and overall exposure. IMPACT: This paper provides an efficient computational model for analyzing the concentration of different respiratory droplets and aerosols in an indoor environment. Thus, the approach could be used for assessing the influence of the spatial concentration variations on exposure for which the fully mixed model cannot be used.

13.
Curr Allergy Asthma Rep ; 12(5): 465-77, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22833251

ABSTRACT

Asthma is a common disease in which environmental exposures and lifestyle factors play critical roles in expression and symptoms. Recommended methods for reducing exposure to domestic allergens as a component of asthma and rhinitis management have changed little over the last 30 years. The data that implementation of these provides clinical benefit are inconsistent. We contend that current methods are ineffective at reducing chronic personal exposure. More effective strategies can be developed based on understanding when people are exposed, the sources of this exposure and the activities associated with this exposure. Developing new methods should be founded on understanding the aerodynamic behavior of particles, their aerosolization, removal from surfaces, and the complex relationships between exposures and clinical outcomes. It will also require developing better proxy measures of chronic exposure, identifying markers for the sub-set of people who benefit, and integrating this with strategies addressing other domestic exposures and lifestyle factors.


Subject(s)
Allergens/immunology , Asthma/etiology , Environmental Exposure/adverse effects , Environmental Monitoring/methods , Immunity, Innate , Pyroglyphidae/immunology , Allergens/adverse effects , Animals , Asthma/epidemiology , Asthma/immunology , Dust/immunology , Humans , Hygiene , Mites/immunology , Rhinitis/immunology
14.
Surg Oncol ; 45: 101883, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36371906

ABSTRACT

BACKGROUND: Soft tissue sarcomas of the buttock (BSTS) are historically associated with a poor prognosis. The literature includes retrospective studies with small sample size. It is difficult to estimate the rate of local recurrence (LR), distant metastasis (DM) and overall survival (OS). A systematic review and meta-analysis was deployed to summarize the available information on BSTS patients that underwent surgical treatment. METHODS: The PubMed, EMBASE, Scopus and Google Scholar databases were reviewed for eligible studies following PRISMA guidelines. INCLUSION CRITERIA: (1) primary BSTS confirmed by pathological biopsy (2) indication for surgical treatment (3) reporting either the rate of LR, DM, or OS at 5-year (4) articles published up to December 2021 (5) english language. The Methodological Index for Non-Randomized Studies (MINORS) was applied for the quality appraisal. RESULTS: Six eligible studies with 216 BSTS patients were identified. Most patients underwent surgical resection, associated with radiation therapy. The most represented histological types were liposarcoma (n = 43, 19,9%), rhabdomyosarcoma (n = 27, 12.5%), and undifferentiated pleomorphic sarcoma (n = 23, 10.6%). High-grade tumor rates ranged from 37% to 88.2%, marginal resection rates from 20.3% to 50%, LR rates from 0% to 62.5%, DM rates from 37.5% to 62.5%. The pooled 5-year OS from 1941 to 2002 was 41% (IC95%: 33%-49%). The average MINORS score was 9.3 (range: 6 to 11). CONCLUSIONS: Surgical resection of BSTS had on average dissatisfactory outcomes, and the 5-year overall survival was poor, with high rates of local recurrence and distant metastasis. An effort to collect new data with a higher level of evidence is warranted.


Subject(s)
Liposarcoma , Sarcoma , Soft Tissue Neoplasms , Humans , Buttocks/pathology , Retrospective Studies , Soft Tissue Neoplasms/surgery , Soft Tissue Neoplasms/pathology , Sarcoma/surgery , Sarcoma/pathology , Neoplasm Recurrence, Local/pathology
15.
J Expo Sci Environ Epidemiol ; 32(5): 689-696, 2022 09.
Article in English | MEDLINE | ID: mdl-35351959

ABSTRACT

OBJECTIVE: To elucidate the role of phonation frequency (i.e., pitch) and intensity of speech on respiratory aerosol emissions during sustained phonations. METHODS: Respiratory aerosol emissions are measured in 40 (24 males and 16 females) healthy, non-trained singers phonating the phoneme /a/ at seven specific frequencies at varying vocal intensity levels. RESULTS: Increasing frequency of phonation was positively correlated with particle production (r = 0.28, p < 0.001). Particle production rate was also positively correlated (r = 0.37, p < 0.001) with the vocal intensity of phonation, confirming previously reported findings. The primary mode (particle diameter ~0.6 µm) and width of the particle number size distribution were independent of frequency and vocal intensity. Regression models of the particle production rate using frequency, vocal intensity, and the individual subject as predictor variables only produced goodness of fit of adjusted R2 = 40% (p < 0.001). Finally, it is proposed that superemitters be defined as statistical outliers, which resulted in the identification of one superemitter in the sample of 40 participants. SIGNIFICANCE: The results suggest there remain unexplored effects (e.g., biomechanical, environmental, behavioral, etc.) that contribute to the high variability in respiratory particle production rates, which ranged from 0.2 particles/s to 142 particles/s across all trials. This is evidenced as well by changes in the distribution of participant particle production that transitions to a more bimodal distribution (second mode at particle diameter ~2 µm) at higher frequencies and vocal intensity levels.


Subject(s)
Phonation , Respiratory Aerosols and Droplets , Female , Humans , Male , Speech
16.
Knee Surg Sports Traumatol Arthrosc ; 18(10): 1360-5, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20535448

ABSTRACT

Controversy still exists regarding which cementation technique of the tibial component is preferable. Full cementation showed excellent long-term outcomes, and surface cementation with fixed-bearing designs provided excellent mid-term results. Concerns have been expressed about possible rotary forces to the tibial rotating platform, when the tibial stem remains cementless, with the risk of early loosening. The purpose of this study was to evaluate the rate of early loosening and radiolucency lines in 70 consecutive unidirectional rotating platform, posterior stabilized, total knee arthroplasties, using surface cementation. Multivariate analysis was performed to identify any correlations between early loosening or radiolucency lines and clinically relevant covariates: age, sex, BMI, follow-up time, cement penetration, radiolucencies, tibial slope, femoral flexion, frontal alignment, pre-operative and post-operative Knee Scores. The tibial plateau was divided into four zones in antero-posterior view and into two zones in lateral view, and the cement penetration was evaluated in each zone. The mean follow-up was 43 months (SD 14), and the average patients' age was 73 (SD 7). The Knee Score averaged 91 (SD 8) and the Function score 86 (SD 17) at last follow-up visit. The cement penetration was >2 mm in all zones. No early loosening was detected, but in five asymptomatic patients (7%) radiolucency was noted around the tibial stem. The presence of radiolucent lines was not correlated with any of the covariates. The rate of early loosening and radiolucency lines with mobile tibial tray and surface cementation is comparable to other studies using different cementation techniques or surface cementation combined with fixed platform total knee arthroplasties.


Subject(s)
Arthroplasty, Replacement, Knee/adverse effects , Bone Cements/adverse effects , Joint Instability/etiology , Knee Prosthesis , Osteoarthritis, Knee/surgery , Prosthesis Failure , Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee/methods , Chi-Square Distribution , Cohort Studies , Female , Follow-Up Studies , Humans , Incidence , Joint Instability/epidemiology , Male , Middle Aged , Multivariate Analysis , Observer Variation , Osteoarthritis, Knee/diagnostic imaging , Prosthesis Design , Radiography , Range of Motion, Articular/physiology , Retrospective Studies , Risk Assessment , Severity of Illness Index , Statistics, Nonparametric , Time Factors , Treatment Outcome , Weight-Bearing
17.
Knee Surg Sports Traumatol Arthrosc ; 17(8): 990-5, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19444429

ABSTRACT

Accessory soleus is a rare congenital anatomical variant, which may manifest in the second/third decade of life as an exertional ankle pain and swelling or as an asymptomatic postero-medial mass. The incidence of this condition ranges from 0.7 to 5.5%. Many treatment options have been described in literature, including conservative treatment, excision, fasciotomy, release and closure of blood supply. We report a symptomatic massive accessory soleus (17 x 5 x 4 cm) in an 18-year-old male semi-professional soccer player. Excision of the accessory soleus was performed. The patient went back to the game 3 months after surgery. The literature review stated that either fasciotomy or excision of the muscle produce good results in the athletes.


Subject(s)
Muscle, Skeletal/abnormalities , Muscle, Skeletal/surgery , Adolescent , Ankle Joint/physiopathology , Ankle Joint/surgery , Arthralgia/physiopathology , Arthralgia/surgery , Humans , Magnetic Resonance Imaging , Male , Soccer
18.
J Air Waste Manag Assoc ; 58(4): 502-16, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18422037

ABSTRACT

Resuspension experiments were performed in a single-family residence. Resuspension by human activity was found to elevate the mass concentration of indoor particulate matter with an aerodynamic diameter less than 10 microm (PM10) an average of 2.5 times as high as the background level. As summarized from 14 experiments, the average estimated PM10 resuspension rate by a person walking on a carpeted floor was (1.4 +/- 0.6) x 10(-4) hr(-1). The estimated residence time for PM in the indoor air following resuspension was less than 2 hr for PM10 and less than 3 hr for 2-microm tracer particles. However, experimental results show that the 2-microm tracer particles stayed in the combined indoor air and surface compartments much longer (>>19 days). Using a two-compartment model to simulate a regular deposition and resuspension cycle by normal human activity (e.g., walking and sitting on furniture), we estimated residence time for 2-microm conservative particulate pollutants to be more than 7 decades without vacuum cleaning, and months if vacuum cleaning was done once per week. This finding supports the observed long residence time of persistent organic pollutants in indoor environments. This study introduces a method to evaluate the particle resuspension rate from semicontinuous concentration data of particulate matter (PM). It reveals that resuspension and subsequent exfiltration does not strongly affect the overall residence time of PM pollutants when compared with surface cleaning. However, resuspension substantially increases PM concentration, and thus increases short-term inhalation exposure to indoor PM pollutants.


Subject(s)
Air Pollution, Indoor/analysis , Particulate Matter/analysis , Climate , Housing , Particulate Matter/chemistry , Time Factors , Ventilation
19.
J Air Waste Manag Assoc ; 57(2): 190-203, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17355080

ABSTRACT

A factor analytic model has been applied to resolve and apportion particles based on submicron particle size distributions downwind of a United States-Canada bridge in Buffalo, NY. The sites chosen for this study were located at gradually increasing distances downwind of the bridge complex. Seven independent factors were resolved, including four factors that were common to all of the five sites considered. The common factors were generally characterized by the existence of two or more number and surface area modes. The seven factors resolved were identified as follows: fresh tail-pipe diesel exhaust, local/street diesel traffic, aged/evolved diesel particles, spark-ignition gasoline emissions, background urban emissions, heavy-duty diesel agglomerates, and secondary/transported material. Submicron (<0.5 microm) and ultrafine (<0.1 microm) particle emissions downwind of the bridge were dominated by commercial diesel truck emissions. Thus, this study obtained size distinction between fresh versus aged vehicle exhaust and spark-ignition versus diesel emissions based on the measured high time-resolution particle number concentrations. Because this study mainly used particles <300 nm in diameter, some sources that would usually exhibit number modes >100 nm were not resolved. Also, the resolved profiles suggested that the major number mode for fresh tailpipe diesel exhaust might exist below the detection limit of the spectrometer used. The average particle number contributions from the resolved factors were highest closest to the bridge.


Subject(s)
Air Pollutants/analysis , Air Pollutants, Occupational/analysis , Canada , Factor Analysis, Statistical , Models, Statistical , Particle Size , United States , Vehicle Emissions
SELECTION OF CITATIONS
SEARCH DETAIL