Does Texting While Walking Affect Gait's Plantar Pressure Parameters?

BACKGROUND: This study aims to examine the possible effects of mobile phone use on plantar pressure and spatiotemporal parameters during walking. MATERIALS AND METHODS: Thirty volunteers (18 males and 12 females) participated in the study. A 10-m walking path was prepared, and a messaging connection was established. They were asked to write three posts without word or character mistakes and participants walked on the path walk as much as they wanted on the trail to make sure they were walking at their own pace. The gait's spatiotemporal parameters and plantar pressure parameters were recorded while walking. A paired samples t-test was used to determine whether there was a difference between normal walking and walking while texting. RESULTS: While walking and writing a message, cadence, speed, and step length decreased significantly (P < 0.05). In the plantar pressure parameters, the fore- and midfoot load and pressure were significantly increased (P < 0.05). CONCLUSIONS: Compared to normal walking, the forces on the forefoot and midfoot and the pressure per unit area increased in walking while texting. It is thought that the pace of walking slows down, and focus and attention shift to the front of the body.

Perceived complexity of total hip arthroplasty: results of a survey of orthopedic surgeons.

OBJECTIVE: No analysis of the perception of the complexity of total hip arthroplasty (THA) has been performed so far. This study aimed to evaluate the perceived complexity of the disorders faced by orthopedic surgeons in the evaluation process prior to THA. SUBJECTS AND METHODS: A three-part online survey was administered to orthopedic surgeons. In the first part, the participants were asked questions about demographic and academic knowledge, as well as their experiences with THA. In the second part, it was asked to rate the complexity of certain disorders, such as soft tissue abnormalities, ankylosis/arthrodesis, dysplastic hip, high dislocated hip, post-traumatic arthrosis, protrusio acetabuli, etc., on a scale of one to five. Perceived complexity was classified as mild if the calculated mean score was <1.67, moderate if it was between 1.67 and 3.34, and complex if it was >3.34. In the last section, the effects of perceived complexity on surgical preferences were investigated. RESULTS: THA administered for femoral neck fracture was graded as the least complex surgical challenge (mean score of 1.85±0.99), while high dislocated hip (Crowe III-IV) was scored with the highest mean score of 4.10±0.99. None of the disorders were evaluated as easy by orthopedic surgeons. Disorders of the high dislocated hip (Crowe III-IV) and protrusio acetabuli were identified as the most complicated cases by surgeons. CONCLUSIONS: Perception of complexity affected preference for surgical approach. Besides, the level of education after participating in a course related to THA may affect the preferences of orthopedic surgeons when planning an operation.

Effect of Nintedanib on healing and fibrosis in rats with experimentally induced urethral injury.

AIM: We aimed to determine the effectiveness of Nintedanib treatment, which has known antifibrotic effect, in preventing fibrosis after urethral trauma. MATERIAL AND METHODS: Twenty-three adult Sprague-Dawley rats were divided randomly into 3 different groups: Sham, Urethral injury group (UI) and Urethral injury+ Nintedanib (UI+N). The urethral injury model was made with a pediatric urethrotome knife. Nintedanib was administered at a dose of 50mg/kg by oral gavage for 14 days at the same time every day. After 14 days of treatment, all rats were performed penectomy under general anesthesia. Urethral tissue was evaluated histopathologically (congestion, inflammatory cell infiltration and spongiofibrosis) and immunohistochemically (transforming growth factor (TBF) Beta-1 and vascular endothelial growth factor receptor 2 (VEBFR2)). RESULTS: Histopathological findings: Group UI had higher scores in all categories (congestion, inflammatory cell infiltration, and spongiofibrosis), followed by Group UI+N and Group Sham, respectively. A statistically significant difference was found between Group UI and Group UI+N in terms of the scores of histopathological parameters (p<0.05). Immunohistochemical findings: Group UI had higher scores in both categories, followed by Group UI+N and Group Sham, respectively. A statistically significant difference was found between Group UI and Group UI+N in TGF Beta-1 and VEGF scores (p<0.05). CONCLUSION: We found that Nintedanib administration after urethral trauma reduced inflammation and fibrosis histologically and immunohistochemically. The positive effect of Nintedanib on inflammation and fibrosis after urethral trauma reported in this animal study is encouraging for a potential clinical human application.

Assessment of silicon, glass, FR4, PDMS and PMMA as a chip material for acoustic particle/cell manipulation in microfluidics.

In the present study, the capabilities of different chip materials for acoustic particle manipulation have been assessed with the same microfluidic device architecture, under the same actuator and flow conditions. Silicon, glass, epoxy with fiberglass filling (FR4), polydimethylsiloxane (PDMS) and polymethyl methacrylate (PMMA) are considered as chip materials. The acoustophoretic chips in this study were manufactured with four different fabrication methods: plasma etching, chemical etching, micromachining and molding. A novel chip material, FR4, has been employed as a microfluidic chip material in acoustophoretic particle manipulation for the first time in literature, which combines the ease of manufacturing of polymer materials with improved acoustic performance. The acoustic particle manipulation performance is evaluated through acoustophoretic focusing experiments with 2µm and 12µm polystyrene microspheres and cultured breast cancer cell line (MDA-MB-231). Unlike the common approach in the literature, the piezoelectric materials were actuated with partitioned cross-polarized electrodes which allowed effective actuation of different family of chip materials. Different from previous studies, this study evaluates the performance of each acoustophoretic device through the perspective of synchronization of electrical, vibrational and acoustical resonances, considers the thermal performance of the chip materials with their effects on cell viability as well as manufacturability and scalability of their fabrication methods. We believe our study is an essential work towards the commercialization of acoustophoretic devices since it brings a critical understanding of the effect of chip material on device performance as well as the cost of achieving that performance.

The assessment of sexual wellbeing in treatment-seeking transgender individuals: a systematic review of the medical literature.

Sexual-wellbeing is recognized as an important aspect of quality-of-life. Yet, no overview exists of which aspects of sexual-wellbeing have been assessed in trans individuals seeking or undergoing medical treatment, nor is it clear what tools are used to evaluate the effect of medical treatment on sexual-wellbeing. First, to identify which topics pertaining to sexual-wellbeing have been assessed in transgender individuals in a medical context. Second, to determine which tools have been used for measuring aspects of sexual-wellbeing. A conceptual framework of sexual-wellbeing, was used as reference. A literature search (in PubMed, Embase, Cochrane Library) was performed up to March 10th, 2020. Studies that assessed aspects of sexual-wellbeing in transgender individuals' medical context were included in this review. Specific sexual topics addressed in each study were extracted by two independent reviewers. Thematic analysis was performed to identify sexual themes. Additionally, tools used to measure topics related to sexuality in transgender individuals were identified. In 172 papers, a total of 178 topics related to sexual-wellbeing were identified. Ten overarching themes were identified; sexuality, enacted sexual script, sexual activities, sexual relations, sexual response cycle, genital function, sexual function, sexual pleasure, sexual satisfaction, and quality-of-sex-life. Functional aspects of sexuality are assessed most frequently. A variety of methods was used to evaluate aspects related to sexual-wellbeing in trans individuals and over 50 different tools were identified. Self-developed questionnaires were used most frequently (n = 80), followed by chart reviews (n = 50), self-developed structured interviews (n = 37) and physical examination (n = 13). 23 previously developed questionnaires were used, all of which were developed for a cisgender population. Many studies in trans individuals touch on topics related to sexual-wellbeing, however, a comprehensive conceptualisation of (10 themes of) sexual-wellbeing is still lacking. Still, no valid tool exists for assessing sexual-wellbeing in the trans population, but is much needed.

Is laparoscopic surgery risk for surgical teams during the coronavirus disease pandemic? An in vitro study with a laser and high-speed camera.

OBJECTIVE: Laparoscopic surgery has been suggested to pose a risk of infection to the surgical team due to aerosol and gas leakage during the coronavirus (COVID-19) pandemic. However, there have been no studies on the risk of gas and aerosol leakage in laparoscopic surgery. We aimed to answer the question "Is the aerosol and gas leakage in laparoscopy is hazardous in terms of coronavirus infection?" with this study. MATERIALS AND METHODS: In this study, gas and aerosol leaks were documented by simulating the entry and exit maneuvers from a trocar during laparoscopic surgery using a high-speed camera, fog, and laser in a model representing the abdomen. RESULTS: The maximum gas and aerosol leakage were found during wet gauze extraction from the 10 mm trocar, and its velocity reached 7.5 m/s. The fastest aerosol leakage rate was observed when a 5 mm grasper was extracted from the 5 mm trocar. The results of the subsequent trials were consistent with these values. CONCLUSIONS: Higher leakage speeds were observed than the velocity of the exhaled air in a resting person. The surgical crew members, who work very close to the trocars and each other, are at serious risk of infection with COVID-19 which can spread as fast as exhalation speed through trocars. Since there is an evident risk of infection for the surgical crew from laparoscopic surgery of a patient whose intraabdominal fluids are infected with COVID-19, patients must be evaluated elaborately for COVID-19 preoperatively and infected patients should undergo surgery conventionally.

An extended view for acoustofluidic particle manipulation: Scenarios for actuation modes and device resonance phenomenon for bulk-acoustic-wave devices.

For the manipulation of microparticles, ultrasonic devices, which employ acoustophoretic forces, have become an essential tool. There exists a widely used analytical expression in the literature which does not account for the effect of the geometry and acoustic properties of the chip material to calculate the acoustophoretic force and resonance frequencies. In this study, we propose an analytical relationship that includes the effect of the chip material on the resonance frequencies of an acoustophoretic chip. Similar to the analytical equation in the literature, this approach also assumes plane wave propagation. The relationship is simplified to a form which introduces a correction term to the acoustophoretic force equation for the presence of the chip material. The proposed equations reveal that the effect of the chip material on the resonance frequency is significant-and is called the device resonance-for acoustically soft materials. The relationship between the actuation modes of the piezoelectric actuator(s) and position of the nodal lines inside the channel are discussed. Finite element simulations are performed to verify the proposed equations. Simulations showed that even if some of the assumptions in the derivations are removed, the general conclusions about the motion of the microparticles are still valid.

Comparison of incisional hernia models in rats: an experimental study.

PURPOSE: Incisional hernia repair is a frequently performed operation worldwide. In this experimental study, our aim is to present the incisional hernia model after creating midline laparotomy and several type of defects on abdominal wall of the rats. Thereby, the method determined here may be used in future experimental incisional hernia repair studies. METHODS: After approval, 32 male rats were randomly seperated into 4 groups of 8 animals each, and were operated to form an incisional hernia; Sham group, 5 cm incision group, 5 cm incision plus capitonnage group, and 5 cm incision plus 2 × 4 cm muscle excision group, respectively. On the 28th postoperative day after killing, the abdominal anterior wall of rats were removed for histopathological and biomechanic examination. RESULTS: The incisional hernia size was found to be statistically different in at least one group (p = 0.001). The incisional hernia size in Group 4 was found to be significantly higher than Group 2 (p = 0.001). When the tension and elongation values were examined, there was a difference in at least one group (p < 0.001 and p = 0.029, respectively). Histopathological examination shows that the degree of inflammation and fibrosis varies significantly (p = 0.001 and p = 0.002, respectively). CONCLUSION: This study has lead us to believe that the rat model created by applying muscle excision from the midline of the abdomen is the ideal incisional hernia model that can be used in future experimental incisional hernia studies.

Misoprostol ameliorates doxorubicin induced cardiac damage by decreasing oxidative stress and apoptosis in rats.

We investigated the potential cardioprotective effects of misoprostol (MP) on doxorubicin (DOX) induced cardiac damage using histologic and biochemical assessment of rat heart. We used 21 male rats divided randomly into three groups: group 1, control; group 2, DOX; group 3, DOX + MP. The control group was given 0.5 ml 0.9% NaCl intraperitoneally (i.p.) and 1 ml 0.9% NaCl orally for 6 days. DOX was administered as a single dose of 20 mg/kg i.p. on day 3. MP was administered orally for 6 days. We found that treatment with MP decreased significantly serum cardiac troponin-I, brain natriuretic peptide levels, and lactate dehydrogenase, aspartate aminotransferase, alanine transaminase and creatine kinase isoenzyme-MB activities. DOX increased the malondialdehyde level and decreased the catalase, superoxide dismutase activities and glutathione levels; MP prevented these alterations. MP also decreased NADPH oxidase-4 and caspase-3 levels. In the DOX + MP group, oxidative stress was decreased, antioxidant activity was increased and histopathological changes were decreased compared to the DOX group. Cardiac damage caused by DOX was attenuated by MP treatment owing to the antioxidative and anti-apoptotic effects of MP. MP may be useful for reducing the severity of DOX induced damage.

Correction: An insight into circumcised men seeking foreskin reconstruction: a prospective cohort study.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

'An insight into circumcised men seeking foreskin reconstruction: a prospective cohort study'.

The aim of this study was to present a cohort of men seeking assistance with foreskin reconstruction, with the objective to broaden the general understanding for this specific request. All men between January 2015 and May 2019 seeking assistance with foreskin reconstruction were included. We prospectively collected data on patient demographics and outcomes such as their motivations, treatment trajectory, and experiences. A total of 11 patients were identified and included (age range 20-62). The majority were circumcised during adulthood for medical reasons. Among the most prominent motivations to pursue reconstruction were experiencing impairment of body integrity, feeling mutilated, increasing glans sensitivity and having issues with an imposed cultural or religious identity. Most patients stated that they experienced little support from healthcare professionals and that the Internet was their main source of information. Furthermore, almost all patients practiced penile tissue stretching to reconstruct the foreskin with unregistered devices. Foreskin reconstruction is a scarcely reported topic and is sought out for different reasons. Although rare, these patients experience a heavy burden and will go to great lengths to reconstruct their foreskin, more often so without the involvement of healthcare professions. In contrary to the surgical treatment options, the nonsurgical methods seem promising, but these rely heavily on lay-sources found online.

Minimally invasive perineal redo surgery for rectovesical and rectovaginal fistulae: A case series.

INTRODUCTION: Iatrogenic recto-urogenital fistulae are refractory complications that rarely heal without surgical intervention. The ongoing local infection causes pain, discomfort and substantially impacts quality of life. Surgical repair requires adequate exposure and space to fill with healthy tissue, which is a major challenge in pelvic redo surgery. An abdominal approach to repair the fistula is associated with major morbidity and often fails to expose the deep pelvis. In our experience a novel transperineal minimally invasive approach a utilizing single incision laparoscopic surgery (SILS) technique could offer improved results. PRESENTATION OF CASES: In the present study, three cases of patients with recto-urogenital fistulae after pelvic surgery are described. Two patients were diagnosed with a rectovesical fistula and one patient with a rectovaginal fistula. In all three cases, a minimally invasive perineal approach, using a SILS port, was used to perform surgical repair. The closure of the fistulae involved: a separate repair of the urethra/bladder or vaginal defect and the rectal defect, followed by interposition of vascularized tissue by either a pudendal thigh fasciocutaneous flap or omentoplasty. DISCUSSION AND CONCLUSION: This study is the first to report on a minimally invasive perineal approach, utilizing a SILS technique for recto-urogenital fistulae repair after previous pelvic surgery. The current approach improves exposure, creates surgical space, optimizes view and allows the interposition of vascularized tissue, without causing substantial blood loss and avoiding major abdominal surgery.

Thymoquinone protection from amikacin induced renal injury in rats.

We investigated whether thymoquinone (TQ) exerts a beneficial effect on renal injury due to amikacin (AK) administration in rats. To generate kidney damage with AK, a single 1.2 g/kg dose of AK was administered intraperitoneally. TQ was administered orally to the AK treated group at a dose of 40 mg/kg for five days. At the end of the experiment, rats were sacrificed and blood samples were used to measure blood urea nitrogen (BUN) and creatinine (Cr) levels. Kidney samples were taken to measure the oxidative stress biomarker, malondialdehyde (MDA), and expression of the antioxidant enzymes, superoxide dismutase (SOD) and catalase (CAT). Because reactive oxygen species (ROS) and apoptosis contribute to tissue damage associated with NADPH oxidase (NOX), we also investigated NOX-2, NOX-4 and apoptosis marker, caspase-3, expression using immunohistochemistry. MDA, BUN, Cr, NOX-2, NOX-4 and caspase-3 production were increased, and SOD and CAT were decreased in the AK treated group compared to controls. MDA, BUN, Cr, NOX-2, NOX-4 and caspase-3 levels were decreased, and SOD and CAT levels were increased in TQ + AK treated rats compared to AK treated animals. TQ appears to protect the kidney from the toxic effects of AK.

Comparison of single-incision and conventional laparoscopic cholecystectomy in terms of quality of life, body image, and cosmesis.

BACKGROUND: Clinical studies indicate that single-incision laparoscopic cholecystectomy (SILC) has many advantages over conventional laparoscopic cholecystectomy (CLC), such as improved cosmesis, reduced postoperative pain, and shorter hospital stay. The aim of this study was to compare quality of life, body image, and cosmesis between single-incision laparoscopic and conventional laparoscopic approaches in patients undergoing cholecystectomies. SUBJECTS AND METHODS: This retrospective study between SILC and CLC and was conducted among 58 patients undergoing SILC and CLC from January 2011 to March 2013 in Turkey. After the surgery, the EuroQol-5 Dimension Questionnaire (EQ-5D™), and body image questionnaire (BIQ) were administered to the patients. RESULTS: Differences between the early and late postoperative scores in the EQ-5D were statistically significant (P < 0.001). Differences between most BIQ areas favored SILC, especially regarding cosmesis (P = 0.016); SILC patients had higher satisfaction with their scar's appearance. CONCLUSION: SILC is a promising alternative to traditional laparoscopic cholecystectomy in terms of quality of life, body image, and cosmesis in selected patients.

The multilayered structure of the human corpus spongiosum.

PURPOSE: Urethral reconstruction is performed in patients with urethral strictures or for correction of congenital disorders. In the case of shortage of tissue, engineered tissue may enhance urethral reconstruction. As the corpus spongiosum (CS) is important in supporting the function of the urethra, tissue engineering of the urethra should be combined with reconstruction of a CS. For that purpose, detailed knowledge of the composition of the CS, more specifically its extracellular matrix (ECM) and vascularization is needed for scaffold design. The objective of this study is to analyze the microarchitecture of the CS through (immuno) histology and scanning electron microscopy (SEM). METHODS: The CS including the urethra of patients undergoing male-to-female genital confirming surgery was harvested. This CS was fixed and processed for either (immuno) histology or for SEM. RESULTS: Four layers could be distinguished in the CS; first a transition zone from urethra epithelium to a collagen rich layer, which was highly vascularized, followed by a second, elastin rich layer. The third layer was formed by veins, arteries and vascular spaces and the last layer showed the transition from this vascular rich region to the collagen rich tunica albuginea. In this layer collagen bundles intertwined with elastic fibres. In the CS different components of the ECM were visible and distinguishable. CONCLUSION: This study provides novel and detailed information on the microarchitecture of the CS and the distribution of vascularization, which is important for scaffold design in tissue engineering.

Effects of molsidomine on retinal ischemia/reperfusion injury in rabbits.

We investigated the effect of molsidomine (MOL) on ischemia/reperfusion (I/R) injury. Rabbits were assigned to four groups: group 1, sham; group 2, I/R; group 3, MOL treatment for 4 days after I/R; group 4, MOL treatment for 1 day before I/R and 3 days after I/R. Retinal I/R was produced by elevating the intraocular pressure to 150 mm Hg for 60 min. Seven days after I/R, the eyes were enucleated. Retinal changes were examined using histochemistry. The levels of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) also were measured. We found a significant increase in the thickness of the outer nuclear layer of group 3 compared to the other groups. In groups 3 and 4, caspase-3 stained cells in the ganglion cell layer were decreased compared to group 2. We found a significant increase in caspase-3 stained cells in the inner nuclear layer (INL) of group 2 compared to the other groups. We found a significant increase in caspase-3 stained cells in group 3 compared to group 4 in the INL. The MDA level in group 2 was significantly higher than group 1 and MOL significantly decreased MDA levels in groups 3 and 4. We found that MOL protected the retina from I/R injury by enhancing antioxidative effects and inhibiting apoptosis of retinal cells.

Effects of intravitreous sodium hydrosulfide on intraocular pressure and retinopathy in ocular hypertensive rats.

We investigated the possible neuroprotectant and intraocular pressure (IOP) lowering effects of intravitreous injection of sodium hydrosulfide (NaSH) in a rodent model of experimental glaucoma. Glaucoma currently is treated by controlling IOP using medications and/or surgery. These methods are not entirely adequate for all patients. We divided 24 rats into three groups. For the control group, the right eye was treated with intravitreous saline. For the glaucoma group, ocular hypertension was induced by photocoagulating three episcleral veins and the limbal plexus of the right eye using an argon laser, then saline was injected into the vitreous of these eyes during the third week. For the NaSH group, rats were treated with intravenous NaSH 3 weeks after photocoagulation. IOP was measured each week during the 6 week experimental period. Coagulating the episcleral veins rapidly increased the IOP of rat eyes. Intravitreous injection of NaSH significantly reduced IOP. Intravitreous NaSH prevented degeneration of the retina and decreased the number of apoptotic cells. Intravitreous NaSH appeared to reduce IOP and to prevent IOP induced retinopathy in rats.

The protective effect of thymoquinone over olanzapine-induced side effects in liver, and metabolic side effects.

OBJECTIVES: The aim of the study was to investigate the possible protective qualities of thymoquinone (TQ) against the side-effects of olanzapine (OLZ) in an experimental model in rat liver with histologic and biochemical assessments. METHODS: Experimental procedures were performed on 35 female Sprague Dawley rats. Rats were randomly divided into five groups as: group 1: control; group 2: OLZ; group 3: OLZ+TQ-1; group 4: OLZ+TQ-2; and group 5: OLZ+TQ-3. RESULTS: The results showed that a 2­week administration of OLZ (4 mg/kg, once a day for the first week, 8 mg/kg once a day for the second week, p.o.) and treatment with TQ (25, 50, 100 mg/kg, once daily, p.o.) significantly reduced weight gain induced by OLZ. In addition, TQ increased the total antioxidant status (TAS), high-density lipoprotein cholesterol (HDL), insulin levels and decreased serum oxidative stress index (OSI), total oxidant status (TOS), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), low density lipoprotein cholesterol (LDL), glucose, triglycerides (TG) and total cholesterol (CH) levels significantly (p < 0.05). CONCLUSION: This study revealed that treatment with TQ might protect liver tissue against the side-effects of OLZ. TQ could be an effective course of therapy to enhance therapeutic efficacy (Tab. 4, Fig. 4, Ref. 47).