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OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) mitigation measures in workplaces of employed US blood donors by industry and work arrangement. METHODS: During May-December 2021, blood donors responded to a survey; we describe the distribution of reported workplace mitigation measures by industry and work arrangement, organized using the hierarchy of controls. RESULTS: Of 53,433 respondents representing 21 industries, ventilation upgrades were reported by 4%-38% of respondents (overall: 20%); telework access ranged from 14%-80% (53% overall). Requiring masks (overall: 84%; range: 40%-94%), physical distancing (77%; 51%-86%), paid leave for illness (70%; 38%-87%), and encouraging vaccination (61%; 33%-80%) were common. Independent workers reported fewer mitigation measures than those in traditional employment settings. CONCLUSIONS: Mitigation measures varied by industry and work arrangement. Some mitigation measures may be challenging to implement or irrelevant in certain industries, supporting the idea that mitigation is not a one-size-fits-all strategy. POLICY IMPLICATIONS: Tailored strategies to mitigate workplace risks of disease transmission are vital. Strategies should rely on effective methods for identifying workplace controls (e.g., through the hierarchy of controls) and account for industry-specific characteristics and workplace environments.
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Donantes de Sangre , COVID-19 , SARS-CoV-2 , Lugar de Trabajo , Humanos , COVID-19/prevención & control , Donantes de Sangre/estadística & datos numéricos , Estados Unidos , Masculino , Adulto , Femenino , Encuestas y Cuestionarios , Teletrabajo , Persona de Mediana Edad , Industrias , Máscaras/estadística & datos numéricos , Distanciamiento Físico , Vacunación/estadística & datos numéricos , VentilaciónRESUMEN
In a supersymmetric theory, the IR contributions to the Higgs mass are calculable below the mediation scale Λ_{UV} in terms of the IR field content and parameters. However, logarithmic sensitivity to physics at Λ_{UV} remains. In this Letter, we present a first example of a framework, dictated by symmetries, to supersoften these logarithms from the matter sector. The result is a model with finite, IR-calculable corrections to the Higgs mass. This requires the introduction of new fields-the "lumberjacks"-whose role is to screen the UV-sensitive logs. These models have considerably reduced fine-tuning, by more than an order of magnitude for high-scale supersymmetry. This impacts interpretations of the natural parameter space, suggesting it may be premature to declare a naturalness crisis for high-scale supersymmetry.
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We examine the theoretical motivations for long-lived particle (LLP) signals at the LHC in a comprehensive survey of standard model (SM) extensions. LLPs are a common prediction of a wide range of theories that address unsolved fundamental mysteries such as naturalness, dark matter, baryogenesis and neutrino masses, and represent a natural and generic possibility for physics beyond the SM (BSM). In most cases the LLP lifetime can be treated as a free parameter from the [Formula: see text]m scale up to the Big Bang Nucleosynthesis limit of [Formula: see text] m. Neutral LLPs with lifetimes above [Formula: see text]100 m are particularly difficult to probe, as the sensitivity of the LHC main detectors is limited by challenging backgrounds, triggers, and small acceptances. MATHUSLA is a proposal for a minimally instrumented, large-volume surface detector near ATLAS or CMS. It would search for neutral LLPs produced in HL-LHC collisions by reconstructing displaced vertices (DVs) in a low-background environment, extending the sensitivity of the main detectors by orders of magnitude in the long-lifetime regime. We study the LLP physics opportunities afforded by a MATHUSLA-like detector at the HL-LHC, assuming backgrounds can be rejected as expected. We develop a model-independent approach to describe the sensitivity of MATHUSLA to BSM LLP signals, and compare it to DV and missing energy searches at ATLAS or CMS. We then explore the BSM motivations for LLPs in considerable detail, presenting a large number of new sensitivity studies. While our discussion is especially oriented towards the long-lifetime regime at MATHUSLA, this survey underlines the importance of a varied LLP search program at the LHC in general. By synthesizing these results into a general discussion of the top-down and bottom-up motivations for LLP searches, it is our aim to demonstrate the exceptional strength and breadth of the physics case for the construction of the MATHUSLA detector.
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OBJECTIVES: To assess the prognostic significance of high vs. low grade coronary artery ectasia (CAE) and the impact of antithrombotic or anticoagulant therapy on adverse cardiac outcomes. BACKGROUND: There is paucity of knowledge on the impact of angiographic characteristics in CAE or that of antithrombotic or anticoagulant therapy on outcomes. METHODS AND RESULTS: In this retrospective study, we reviewed angiograms and medical records of all cases of confirmed CAE (2001-2011). Extent of CAE was categorized using the Markis classification. Types 1 and 2 were categorized as high-grade and types 3 and 4 as low-grade CAE. Angiographic flow was recorded as normal or sluggish (Asunto(s)
Síndrome Coronario Agudo/prevención & control
, Anticoagulantes/uso terapéutico
, Aneurisma Coronario/tratamiento farmacológico
, Angiografía Coronaria
, Vasos Coronarios/efectos de los fármacos
, Fibrinolíticos/uso terapéutico
, Síndrome Coronario Agudo/diagnóstico por imagen
, Síndrome Coronario Agudo/mortalidad
, Anciano
, Anciano de 80 o más Años
, Anticoagulantes/efectos adversos
, Velocidad del Flujo Sanguíneo
, Aneurisma Coronario/diagnóstico por imagen
, Aneurisma Coronario/mortalidad
, Aneurisma Coronario/fisiopatología
, Circulación Coronaria
, Vasos Coronarios/diagnóstico por imagen
, Vasos Coronarios/fisiopatología
, Dilatación Patológica
, Registros Electrónicos de Salud
, Femenino
, Fibrinolíticos/efectos adversos
, Humanos
, Incidencia
, Masculino
, Persona de Mediana Edad
, Valor Predictivo de las Pruebas
, Prevalencia
, Estudios Retrospectivos
, Factores de Riesgo
, Índice de Severidad de la Enfermedad
, Resultado del Tratamiento
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This paper describes the physics case for a new fixed target facility at CERN SPS. The SHiP (search for hidden particles) experiment is intended to hunt for new physics in the largely unexplored domain of very weakly interacting particles with masses below the Fermi scale, inaccessible to the LHC experiments, and to study tau neutrino physics. The same proton beam setup can be used later to look for decays of tau-leptons with lepton flavour number non-conservation, [Formula: see text] and to search for weakly-interacting sub-GeV dark matter candidates. We discuss the evidence for physics beyond the standard model and describe interactions between new particles and four different portals-scalars, vectors, fermions or axion-like particles. We discuss motivations for different models, manifesting themselves via these interactions, and how they can be probed with the SHiP experiment and present several case studies. The prospects to search for relatively light SUSY and composite particles at SHiP are also discussed. We demonstrate that the SHiP experiment has a unique potential to discover new physics and can directly probe a number of solutions of beyond the standard model puzzles, such as neutrino masses, baryon asymmetry of the Universe, dark matter, and inflation.
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Models of supersymmetry with Dirac gauginos provide an attractive scenario for physics beyond the standard model. The "supersoft" radiative corrections and suppressed supersymmetry production at colliders provide for more natural theories and an understanding of why no new states have been seen. Unfortunately, these models are handicapped by a tachyon which is naturally present in existing models of Dirac gauginos. We argue that this tachyon is absent, with the phenomenological successes of the model preserved, if the right-handed gaugino is a (pseudo-)Goldstone field of a spontaneously broken anomalous flavor symmetry.
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Ralstonia pickettii is a rare, emerging opportunistic pathogen that has been previously limited to nosocomial infections, often associated with contaminated sterile solutions. Here, we present the case of a neck abscess caused by R. pickettii, the first documented case of a deep neck space infection caused by this bacterium. The patient in this case had no risk factors for R. pickettii infection. By highlighting the atypical presentation and microbiology in this case, we aim to highlight the emergence of a wide spectrum of disease caused by R. pickettii.
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Louisiana experienced high morbidity and mortality from COVID-19. To assess possible explanatory factors, we conducted a cohort study (ClinSeqSer) of patients hospitalized with COVID-19 in New Orleans during August 2020-September 2021. Following enrollment, we reviewed medical charts, and performed SARS-CoV-2 RT-PCR testing on nasal and saliva specimens. We used multivariable logistic regression to assess associations between patient characteristics and severe illness, defined as ≥ 6 L/min oxygen or intubation. Among 456 patients, median age was 56 years, 277 (60.5%) were Black non-Hispanic, 436 (95.2%) had underlying health conditions, and 358 were unvaccinated (92.0% of 389 verified). Overall, 187 patients (40.1%) had severe illness; 60 (13.1%) died during admission. In multivariable models, severe illness was associated with age ≥ 65 years (OR 2.08, 95% CI 1.22-3.56), hospitalization > 5 days after illness onset (OR 1.49, 95% CI 1.01-2.21), and SARS CoV-2 cycle threshold (Ct) result of < 32 in saliva (OR 4.79, 95% CI 1.22-18.77). Among patients who were predominantly Black non-Hispanic, unvaccinated and with underlying health conditions, approximately 1 in 3 patients had severe COVID-19. Older age and delayed time to admission might have contributed to high case-severity. An association between case-severity and low Ct value in saliva warrants further investigation.
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COVID-19 , Humanos , Persona de Mediana Edad , Anciano , COVID-19/diagnóstico , COVID-19/epidemiología , SARS-CoV-2 , Estudios de Cohortes , Nueva Orleans , HospitalizaciónRESUMEN
Any new scalar fields that perturbatively solve the hierarchy problem by stabilizing the Higgs boson mass also generate new contributions to the Higgs boson field-strength renormalization, irrespective of their gauge representation. These new contributions are physical, and in explicit models their magnitude can be inferred from the requirement of quadratic divergence cancellation; hence, they are directly related to the resolution of the hierarchy problem. Upon canonically normalizing the Higgs field, these new contributions lead to modifications of Higgs couplings that are typically great enough that the hierarchy problem and the concept of electroweak naturalness can be probed thoroughly within a precision Higgs boson program. Specifically, at a lepton collider this can be achieved through precision measurements of the Higgs boson associated production cross section. This would lead to indirect constraints on perturbative solutions to the hierarchy problem in the broadest sense, even if the relevant new fields are gauge singlets.
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Diabetes is a leading cause for death in the United States, with African Americans (AA) being twice as likely to die from diabetes than White Americans (WA). AA are twice as likely to experience diabetes-related foot amputation due to foot ulcers, which are most often caused by high plantar pressure. While it is known that arch height, sex, family history of diabetes, Body Mass Index (BMI), age, and gait speed can impact plantar loading, there is a need to test the hypothesis that race in combination with the previously mentioned variables are significant predictors of plantar loading. To answer this question, plantar loading data was collected from 107 participants using an EMED pressure-measurement system (Novel Electronics, Inc, St Paul, MN, USA). Each participant walked barefoot at a self-selected walking pace ten times. Contact area, maximum force, and were force-time integral collected for each step on the pressure plate. A multiple linear regression was used to test if race, age, Arch Height Index (AHI), gait speed, sex assigned at birth, family history of diabetes, and BMI significantly predicted plantar loading. Race, age, AHI, gait speed, sex, and BMI were considered significant predictor variables for plantar loading. Most importantly, race was a significant predictor of maximum force in the hallux (ß = 6.46, p < 0.001), rearfoot (ß = -6.36, p < 0.001), and lateral midfoot (ß = -2.72, p < 0.001), and the force-time integral in the hallux (ß = 2.37, p < 0.001), rearfoot (ß = -2.14, p < 0.001), and lateral midfoot (ß = -0.65, p < 0.001). These findings could help with understanding why AA are more likely to develop diabetic foot ulcers than WA.
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Pie Diabético , Marcha , Recién Nacido , Humanos , Velocidad al Caminar , Presión , Pie , CaminataRESUMEN
Black individuals are underrepresented in science, technology, engineering, and mathematics (STEM) fields. In 2016, Black students earned 9% of science and 4% of engineering bachelor's degrees compared to a total of 56% of science and engineering bachelor's degrees earned by White students. Even with similar entering rates, Black students leave STEM majors at 1.4 times the rate of White students. These data reflect the manifestation of diversity, equity, and inclusion (DEI) barriers faced by Black students and scientists to successfully navigate higher education and pursue careers in STEM fields. There remains a critical need to develop better ways to recruit, retain, train, and graduate Black students in STEM, especially within predominantly White institutions. Biomechanics is a growing interdisciplinary and translational STEM field where DEI barriers persist. Thus, the Black Biomechanists Association (BBA) was founded in 2020 with intentions to reduce these barriers and give much needed support to Black students and biomechanists in STEM spaces. The organization's mission is to uplift and enrich Black biomechanists in their academic and professional careers. Our objectives to achieve this mission provide a supportive environment and resources to address the challenges, needs, and interests of Black biomechanists, as well as aid in the biomechanics community's efforts to achieve DEI. In two short years, BBA has developed a needs-based mentoring program, hosted professional development and culturally-competent mentoring workshops, and produced communications to educate the biomechanics community and broader audience on culturally-relevant topics that impact Black biomechanists. The purpose of this article is to share the work and impact of BBA to date.
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BACKGROUND: Thermal discomfort because of elevated residual limb skin temperatures and/or perspiration within the prosthetic socket is frequently reported among people with amputation. OBJECTIVE: To evaluate the impact of the thermal conductivity characteristics of prosthetic liners on transtibial prosthesis heat dissipation, following postactivity rest. STUDY DESIGN: Time-dependent heat transfer study in solids using finite element analysis. METHODS: A three-dimensional model of the transtibial residual limb was developed by simplifying the geometry to tapered, layered cylinders. Four prosthetic socket liners of varying thermal conductivities were then added to the exterior, and the final surface temperatures of the skin layer were analyzed. RESULTS: Warmer temperatures were observed near regions with greater muscle volume; cooler temperatures were observed at the distal end of the simplified model. The final residual limb skin temperatures for each prosthetic liner were found to be significantly different from one another. Overall, the average final surface temperatures of the skin layer at the end of postactivity rest was 3.85°C ± 0.12°C greater than the initial surface temperatures of skin layer. CONCLUSIONS: None of the prosthetic liners made a significant reduction in residual limb skin temperatures after activity. The results indicate that the focus should be on other material properties of the prosthetic liners or active cooling systems.
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Miembros Artificiales , Muñones de Amputación , Análisis de Elementos Finitos , Humanos , Diseño de Prótesis , Tibia/cirugíaRESUMEN
INTRODUCTION: Idiopathic inflammatory myopathies (IIMs, or myositis) represent a group of autoimmune diseases that result in decreased muscle strength and/or endurance. Non-invasive tools to assess muscle may improve our understanding of the clinical and functional consequences of myopathies and their response to treatment. In this study we examine magnetic resonance elastography (MRE), a non-invasive technique that assesses the shear modulus (stiffness) of muscle, in IIM subjects. METHODS: Nine subjects with active myositis completed the MRE protocol. Participants lay in a positioning device, and scans of the vastus medialis (VM) were taken in the relaxed state and at two contraction levels. Manual inversion was used to estimate the stiffness. RESULTS: A significant reduction in muscle stiffness was seen in myositis subjects compared with healthy controls during the "relaxed" condition. DISCUSSION: The use of non-invasive technologies such as MRE may provide greater understanding of the pathophysiology of IIM and improve assessment of treatment efficacy.
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Diagnóstico por Imagen de Elasticidad/métodos , Músculo Esquelético/fisiología , Miositis/diagnóstico , Miositis/fisiopatología , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: The moment, a force applied at a distance, is responsible for movement and balance. A key component of the moment is the moment arm. The moment arms of nine muscles surrounding the ankle complex during motion in three planes, were studied. MATERIALS AND METHODS: Five cadaveric feet were mounted in a testing device that created moments in the sagittal, coronal and transverse planes. Axial and tendon loads were applied as the foot was passively moved in these planes. Tendon excursions and bone kinematics were monitored. The moment arm was calculated using the tendon excursion method and averaged across all specimens. RESULTS: The largest average moment arm during plantarflexion/dorsiflexion, was the Achilles (mean, 53.1; SD, 5.1 mm). During internal/external rotation the largest moment arm was the peroneus brevis (mean, 20.5; SD, 6.4 mm). During inversion/eversion, the largest moment arm was the peroneus longus (31 mm; SD, 2.3 mm). CONCLUSION: This study quantified the functional moment arms of nine tendons of the ankle/foot. The involvement of multiple tendons in multiple planes of motion should be considered in computational models and when deciding treatments. CLINICAL RELEVANCE: The correlation between moment arms and muscle function has significant effects on treatment efficacy. Information on the balance of moments around the ankle will assist in achieving optimal biomechanical behavior following operative treatments.
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Articulación del Tobillo/fisiología , Músculo Esquelético/fisiología , Rango del Movimiento Articular/fisiología , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Cadáver , Humanos , Masculino , Movimiento/fisiología , Rotación , Tendones/fisiologíaRESUMEN
Hyperglycemia, which is associated with diabetes, increases the production of advanced glycation end products. Advanced glycation end products lead to the structural degradation of soft tissues. The structural degradation of diabetic soft tissues has been investigated in humans, rodents, and canines. Therefore, the objective of this review is to unify the various contributions to diabetes research through the mechanical properties and geometric characteristics of soft tissues. A systematic review was performed and identified the effects of diabetes on mechanical and geometric properties of soft tissues via experimental testing or in vivo - driven finite element analysis. The literature concludes that diabetes contributes to major structural changes in soft tissues but does not cause the same structural changes in all soft tissues (e.g., diabetic tendons are weaker and diabetic plantar tissues are tougher). Diabetes stiffens and toughens soft tissues, thus altering viscoelastic behavior (e.g., poor strain and stress response). However, diabetes management routines can prevent or minimize the effects of diabetes on the mechanical and geometric properties of soft tissues. Unification of the structural effects of diabetes on soft tissues will contribute to the pathophysiology of diabetes.
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Type 1 Diabetes (T1D) poses an increasing threat to public health, as incidence rates continue to rise globally. However, the etiology of T1D is still poorly understood, especially from the perspective of geography. The objective of this research is to examine the incidence of T1D among youth and to identify high-risk clusters and their association with socio-demographic and geographic variables. The study area was the entire state of Utah and included youth with T1D from birth to 19 years of age from 1998 to 2015 (n = 4161). Spatial clustering was measured both globally and locally using the Moran's I statistic and spatial scan statistic. Ordinary least squares (OLS) regression was used to measure the association of high-risk clusters with certain risk factors at the Census Block Group (CBG) level. The mean age at diagnosis was 9.3 years old. The mean incidence rate was 25.67 per 100,000 person-years (95% CI, 24.57-26.75). The incidence rate increased by 14%, from 23.94 per100,000 person-years in 1998 to 27.98 per 100,000 person-years in 2015, with an annual increase of 0.80%. The results of the spatial scan statistic found 42 high-risk clusters throughout the state. OLS regression analysis found a significant association with median household income, population density, and latitude. This study provides evidence that incidence rates of T1D are increasing annually in the state of Utah and that significant geographic high-risk clusters are associated with socio-demographic and geographic factors.
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Diabetes Mellitus Tipo 1 , Adolescente , Niño , Análisis por Conglomerados , Diabetes Mellitus Tipo 1/epidemiología , Geografía , Humanos , Incidencia , Análisis Espacial , Utah/epidemiologíaRESUMEN
PURPOSE: To quantify the articular surface area ratio of the radial head to the coronoid process to gain a better understanding of the stress distribution across these articulations and possibly to explain the patterns of osteoarthritis that are commonly seen in the elbow. METHODS: Thirty cadaveric elbows were harvested and dissected to allow measurement of the radial head and coronoid process articular surfaces. The articular surface areas were measured using the Image J program (National Institutes of Health, Chicago, IL). Twelve men were recruited for this study, and all received a computed tomography (CT) scan of the elbow. A 3-dimensional image of the proximal radioulnar articular surface was created using volume rendering. All specimens were measured 3 times by 2 observers. RESULTS: In the cadaveric measurements, the mean area of the radial head articular fossa was 247.3 +/- 52.6 mm(2) (mean +/- SD). The mean area of the medial facet of the coronoid process was 232.29 +/- 36.5 mm(2), and the mean area of the lateral facet was 141.9 +/- 33.3 mm(2). The articular surface area ratio of radial head to coronoid process was 1:1.5. In the CT measurement, the mean area of the radial head articular fossa was 258.9 +/- 26.3 mm(2). The mean area of the coronoid process articular surface was 376.9 +/- 37.0 mm(2). The articular surface area ratio of radial head to coronoid process was 1:1.46. CONCLUSIONS: The ratio of articular surface area of radial head to coronoid process is 1:1.51 in cadavers and 1:1.46 using a CT in vivo, which is the reverse of the reported force transmission ratio across the elbow joint.
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Articulación del Codo/diagnóstico por imagen , Imagenología Tridimensional/métodos , Radio (Anatomía)/anatomía & histología , Cúbito/diagnóstico por imagen , Adulto , Cadáver , Articulación del Codo/anatomía & histología , Epífisis , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Osteoartritis/diagnóstico por imagen , Osteoartritis/fisiopatología , Radio (Anatomía)/diagnóstico por imagen , Rango del Movimiento Articular/fisiología , Muestreo , Estrés Mecánico , Tomografía Computarizada por Rayos X/métodos , Cúbito/anatomía & histología , Adulto JovenRESUMEN
Gradual screw loosening is a well-known failure mechanism in internal fixation. Loosening is primarily due to progressive bone loss caused by stress shielding, a phenomenon in which a medical device absorbs a disproportionate amount of load within the screw-bone construct. The proximity of elastic moduli of magnesium and bone presents the potential for alleviating screw loosening by allowing optimum stress to be transferred between screw and bone, and in turn, supporting bone remodeling around the screw. In this study, the effect of thread profile on stress transfer in a magnesium fixation was simulated using a 2-D finite element model. Modified stress parameters from a previous study were used to estimate stress transfer across three thread profiles. Results showed highest stress transfer in trapezoidal-shaped magnesium screw thread. In accordance, this study corroborates the potential for magnesium as an ultimate screw material to eliminate progressive screw loosening.
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Tornillos Óseos , Huesos/patología , Análisis de Elementos Finitos , Estrés Mecánico , Fenómenos Biomecánicos , Módulo de Elasticidad , HumanosRESUMEN
BACKGROUND/OBJECTIVE: In anterior cruciate ligament âreconstruction, a tendon graft, anchored by interference screws (IFSs), is frequently used as a replacement for the damaged ligament. Generally, IFSs are classified as being either metallic or polymeric. Metallic screws have sharp threads that lacerate the graft, preventing solid fixation. These constructs are difficult to image âand can limit bone--screw integration because of the higher stiffness of the screw. Polymeric materials are often a better match to bone's material properties, but lack the strength needed to hold grafts in place. Magnesium (Mg) is a material of great promise for orthopaedic applications. Mg has mechanical properties similar to bone, ability to be seen on magnetic resonance imagings, and promotes bone healing. However, questions still remain regarding the strength of Mg-based screws. Previous ex vivo âanimal experiments found stripping of the screw drive when the full torque was applied to Mg screws during surgery, preventing full insertion and poor graft fixation. The similar design of the Mg screw led to questions regarding the relationship between material properties and design, and the ultimate impact on mechanical behaviour. Thus, the objective of this study was to analyze the stresses in the screw head, a key factor in the stripping mechanism of IFS, then use that information to improve screw design, for this material. METHODS: Using finite element analysis, a comparison study of six drive designs (hexagonal, quadrangle, torx, trigonal, trilobe, and turbine) was performed. This was followed by a parametric analysis to determine appropriate drive depth and drive width. RESULTS: It was observed that with a typical torque (2 âNm) used for screw insertion during anterior cruciate ligament reconstruction, the maximum von Mises and shear stress values were concentrated in the corners or turns of the drive, which could lead to stripping if the values were greater than the yield stress of Mg (193 âMPa). With a four-time âincrease in drive depth to be fully driven and a 30% greater drive width, these maximum stress values were significantly decreased by more than 75%. CONCLUSION: It was concluded that improving the design of a Mg-based screw may increase surgical success rates, by decreasing device failure at insertion. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE: The results of this work have the potential to improve designs of degradable IFSs, allowing for greater torque to be applied and thus greater screw fixation between host bone and the graft. Such a fixation will allow greater integration, better patient healing, and ultimately improved patient outcomes.
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Chagas disease, caused by the parasite Trypanosoma cruzi, can cause a potentially life-threatening cardiomyopathy in approximately 10-40% of afflicted individuals. The decline in cardiac function characteristically progresses over the course of many years. We report a case of Chagas disease in which the patient experienced an atypical rapid deterioration to severe cardiomyopathy over the course of 16 months. This case argues the need for increased routine surveillance for patients with confirmed T. cruzi infection, who are determined to be at high-risk for worsening cardiomyopathy.