Development and Evaluation of Ergonomic Interventions for Bucket Handling on Farms.

OBJECTIVE: The aim of this study was to introduce and evaluate two interventions, Ergo Bucket Carrier (EBC) and Easy Lift (EL), for youths (and adults) to handle water/feed buckets on farms. BACKGROUND: The physical activities of both adult and youth farm workers contribute to the development of low-back disorders (LBDs). Many of the activities youths perform on farms are associated with increased LBD risk, particularly, the handling of water and feed buckets. METHOD: Seventeen adult and youth participants (10 males and seven females) participated in this study. To assess the risk of LBDs, the participants were instrumented with a three-dimensional spinal electrogonio-meter while lifting, carrying, and dumping water buckets using the traditional method and the two interventions. RESULTS: For both the adult and youth groups, the results showed that the two interventions significantly decrease the magnitudes of LBD risk in many of the tasks evaluated. Overall, the use of the EBC resulted in a 41% reduction in the level of LBD risk for the carrying task and a reduction of 69% for the dumping task. Using the EL, on the other hand, is especially effective for lifting tasks (55% reduction in LBD risk). Results of the subjective response were consistent with the objective evaluations. CONCLUSION: This study demonstrated the potential for ergonomic interventions in reducing LBD risk during the common farming task of bucket handling. APPLICATION: Potential application of this study includes the introduction of the EBC and EL in family farms to reduce the LBD risk among youth and adult farmers.

Efficacy and feasibility of 3D printed redesigned Venezia™ applicator for treating advanced cervix and recurrent endometrial cancer.

PURPOSE: Venezia™ is an interstitial brachytherapy applicator for treating advanced cervical and vaginal vault recurrent cancer. However, there are limitations that lead to suboptimal target coverage. 3D printing introduction allows the redesign of Venezia™ for bulky and irregular-shaped tumors. METHODS: This study first describes three new designs included: 1) add-on needles template allowed for an extra layer of straight and oblique needles, 2) redesigned vaginal cap so straight and oblique needles can be used together and 3) redesigned central tube allowed vaginal vault interstitial needle insertion. Drawbacks to original Venezia™ and rationale for using these new designs were discussed. Dosimetric analysis by comparing the original Venezia™ with new design for 10 cases in Oncentra treatment planning system v4.5 (Elekta, Stockholm, Sweden) to observe the dose differences in gross tumor volume (GTV), high risk clinical target volume (HRCTV), intermediate clinical target volume (IRCTV) and organs at risk. RESULTS: For the dosimetric comparison, there were statistically significantly increased median minimal dose to 98% (D98%) of GTV, 90% (D90%) of HRCTV, and IRCTV for the new design with p-value of 0.008, 0.005 and 0.0018, respectively. Comparing the physical dose of D98% of GTV, D90% of HRCTV, and IRCTV when using the new design, it averagely increased by 11.7%, 8.0%, 19.4%, respectively per fraction. CONCLUSIONS: Dosimetric comparison revealed the new designs increased the dose to GTV, HRCTV and IRCTV and fulfilled the dose constraints of bladder, rectum and sigmoid. The 3D printed new design is biocompatible, inexpensive and can be patient specific.

A comparison of sperm aneuploidy rates between infertile men with normal and abnormal karyotypes.

BACKGROUND: Abnormal semen parameters in chromosomally normal men are an indicator of an increased risk of sperm aneuploidy. Male carriers of chromosomal rearrangements may also display an increase in sperm aneuploidy for chromosomes not involved in the rearrangement, known as an interchromosomal effect (ICE), and this may be related to the impaired semen parameters of these men. METHODS: Aneuploidy was examined in ejaculate sperm from 27 men: 8 carriers of chromosomal rearrangements with severe oligoasthenoteratozoospermia (OAT) or severe teratozoospermia; 10 chromosomally normal men with similarly abnormal semen parameters; and 9 proven fertile men with normal semen parameters. Fluorescence in situ hybridization was used to examine aneuploidy for chromosomes 13, 18, 21, X and Y. RESULTS: We observed evidence of an ICE in three of the eight carriers of chromosomal rearrangements. However, men who were chromosomally normal but had severe OAT more frequently displayed increased disomy rates. Although autosomal disomy rates were only modestly increased in some of these men, increased XY disomy ranged from slight to extreme (up to a 100-fold increase). CONCLUSIONS: Despite their similar semen parameters, infertile men with normal karyotypes displayed more frequent increases in sperm aneuploidy, particularly involving the sex chromosomes, than infertile men who were carriers of chromosomal rearrangements. The difference in the magnitude and type of sperm aneuploidy between the two infertile groups is likely related to the different causes of infertility.

Interphase fluorescence in situ hybridization and DNA flow cytometry analysis of medulloblastomas with a normal karyotype.

Interphase fluorescence in situ hybridization (FISH) with chromosome 3 and 17 centromeric probes and DNA flow cytometry were used for a retrospective study of nine pediatric medulloblastomas with normal karyotypes after tissue culture. The FISH analysis of medulloblastoma touch preparations showed that in seven of nine tumors, a significant proportion of nuclei had an increased number of centromeric signals for the selected chromosomes. In six of seven cases, this increase was caused by the presence of triploid and tetraploid clones as established by flow cytometry of paraffin-embedded tumors. These findings show that molecular cytogenetic analysis combined with DNA flow cytometry is necessary for all pediatric medulloblastomas diagnosed as cytogenetically normal on cultured tumor tissue.

Laparoscopy, dorsal lumbotomy and flank incision live donor nephrectomy: comparison of donor outcomes.

BACKGROUND: Flank incision (FL), dorsal lumbotomy (DL) and laparoscopic surgery have been effective approaches to donor nephrectomy. While laparoscopic donor nephrectomy (LDN) has become increasingly popular, there has yet to be a direct comparison of the three modalities. METHODS: We performed a retrospective chart review of FL, DL and LDN operations between 2002 and 2010 within a single institution. Donor and recipient characteristics, as well as surgical outcomes, were assessed. RESULTS: There were 496 donor nephrectomy operations available for analyses. Patients in the LDN group had the lowest estimated blood loss, compared to the DL and FL groups (p < 0.001), lowest rate of complications (p < 0.01), and shortest hospital stay (p < 0.0001). Donors who underwent DL used an average of 60.12 ± 5.0 mg of morphine, which was significantly less than that used by patients in the LDN (93.2 mg, p < 0.0001) and FL (111.82 mg, p < 0.001) groups. Mean serum creatinine of recipients at day 1 post-op was the highest in the FL group (p < 0.0001 FL vs. LDN, p < 0.001 FL vs. DL), but there were no significant differences between the three groups at 2 weeks, 6, 12, 18, and 24 months post-operation (p > 0.45). CONCLUSIONS: Although a lower pain experience of LDN was not indicated, the use of LDN should be favoured over DL and FL as it is associated with fewer complications, and shorter length of stay. Of note, DL appears to be associated with higher complications and is likely not a preferred option for donor nephrectomy.

CONTEXTE: L'incision du flanc, la lombotomie dorsale et la laparoscopie sont des techniques efficaces pour une néphrectomie chez un donneur vivant. Même si la laparoscopie a connu une montée en popularité, aucune comparaison directe entre les trois modalités n'a été effectuée. MÉTHODOLOGIE: Nous avons procédé à un examen rétrospectif des dossiers de patients ayant subi une néphrectomie par incision du flanc, par lombotomie dorsale et par laparoscopie entre 2002 et 2010 dans un même établissement. Les caractéristiques des donneurs et des receveurs ainsi que les résultats de la chirurgie ont été évalués. RÉSULTATS: Les analyses ont porté sur 496 néphrectomies. En comparaison avec les donneurs ayant subi une incision du flanc ou une lombotomie dorsale, les donneurs ayant subi une laparoscopie présentaient la perte sanguine estimée la plus faible (p < 0,001), le taux le plus bas de complications (p < 0,01) et la plus courte durée du séjour en hôpital (p < 0,0001). Les donneurs qui ont subi une lombotomie dorsale ont utilisé en moyenne 60,12 ± 5,0 mg de morphine, soit une valeur significativement plus faible que celle notée chez les patients ayant subi une laparoscopie (93,2 mg, p < 0,0001) et une incision du flanc (111,82 mg, p < 0,001). Le taux moyen de créatinine sérique le lendemain de l'intervention était le plus élevé chez les patients ayant subi une incision du flanc p ( < 0,0001 incision du flanc vs laparoscopie, p < 0,001 incision du flanc vs lombotomie dorsale), mais les différences entre les trois groupes n'étaient pas significatives 2 semaines, 6, 12, 18 et 24 mois après l'opération (p > 0,45). CONCLUSIONS: Même si aucune réduction de la douleur n'a été observée avec la laparoscopie, il faut tout de même favoriser le recours à cette technique plutôt qu'à une lombotomie dorsale ou une incision du flanc, car elle est associée à moins de complications et à un séjour plus court en hôpital. Il est à noter que la lombotomie dorsale semble associée à un taux plus élevé de complications et n'est probablement pas une option à privilégier pour une néphrectomie chez un donneur.

Scrotal lymphangiomatosis: a case report.

Lymphangiomas are benign tumours of the lymphatic system, and there are several reported cases of scrotal lymphangioma in the literature to date. We report a rare case of multilocular cutaneous lymphangiomatosis treated with surgical excision (total scrotectomy and reconstruction using split-thickness skin grafts with vacuum-assisted closure dressing).