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1.
J Dent ; : 105281, 2024 Jul 31.
Article in English | MEDLINE | ID: mdl-39094976

ABSTRACT

OBJECTIVES: This study compared the accuracy of seven intraoral scanners (IOS) by the virtual-fit method. METHODS: Four maxillary arches with tooth abutments were scanned with an industrial reference scanner (n=1) and by Aoralscan3, EmeraldS, Helios600, Lumina, Mediti700, Primescan, and Trios5 IOSs (each n=12). Two complete-arch fixed frameworks were designed on each IOS scan with a 70 µm (group 70) and a 90 µm internal cement space (group 70+20, additional 20 µm at the margin). The virtual-fit method was comprised of superimposing the framework designs onto the reference scan using a non-penetrating algorithm simulating the clinical try-in. Internal and marginal gaps were measured. Precision was estimated by the mean absolute errors (MAE). RESULTS: In group 70, Mediti700 (43 µm), Primescan (42 µm), and EmeraldS were in the best homogenous subset for the marginal gap, followed by the Lumina (67 µm), Aoralscan3 (70 µm), and Trios5 (70 µm), whereas Helios600 (118 µm) was in the third subset. Based on the MAE at the margin, Mediti700, Trios5, and EmeraldS were in the first-best homogenous subset, followed by Primescan. Lumina and Helios600 were in the third subset, and Aoralscan3 was in the fourth subset. In group 70+20, the marginal gap was significantly decreased for Lumina and Aoralscan3, whereas MAE significantly decreased for EmeraldS and Aoralscan3. The rank of IOSs was similar for the internal gap. CONCLUSION: EmeraldS, Mediti700, Primescan, and Trios5 meet the marginal and internal fit criteria for fixed tooth-borne complete arch restorations. Increasing the cement space during design could enhance restoration fit. CLINICAL SIGNIFICANCE: The virtual-fit alignment method can effectively evaluate the accuracy of different intraoral scanners, offering valuable clinical guidance for distinguishing among them. Recent software and hardware versions of long-standing IOS manufacturers are suitable for fabricating complete arch restoration.

2.
Biomed Microdevices ; 26(3): 34, 2024 Aug 05.
Article in English | MEDLINE | ID: mdl-39102047

ABSTRACT

Critical-sized peripheral nerve injuries pose a significant clinical challenge and lead to functional loss and disability. Current regeneration strategies, including autografts, synthetic nerve conduits, and biologic treatments, encounter challenges such as limited availability, donor site morbidity, suboptimal recovery, potential immune responses, and sustained stability and bioactivity. An obstacle in peripheral nerve regeneration is the immune response that can lead to inflammation and scarring that impede the regenerative process. Addressing both the immunological and regenerative needs is crucial for successful nerve recovery. Here, we introduce a novel biodegradable tacrolimus-eluting nerve guidance conduit engineered from a blend of poly (L-lactide-co-caprolactone) to facilitate peripheral nerve regeneration and report the testing of this conduit in 15-mm critical-sized gaps in the sciatic nerve of rats. The conduit's diffusion holes enable the local release of tacrolimus, a potent immunosuppressant with neuro-regenerative properties, directly into the injury site. A series of in vitro experiments were conducted to assess the ability of the conduit to maintain a controlled tacrolimus release profile that could promote neurite outgrowth. Subsequent in vivo assessments in rat models of sciatic nerve injury revealed significant enhancements in nerve regeneration, as evidenced by improved axonal growth and functional recovery compared to controls using placebo conduits. These findings indicate the synergistic effects of combining a biodegradable conduit with localized, sustained delivery of tacrolimus, suggesting a promising approach for treating peripheral nerve injuries. Further optimization of the design and long-term efficacy studies and clinical trials are needed before the potential for clinical translation in humans can be considered.


Subject(s)
Nerve Regeneration , Peripheral Nerve Injuries , Sciatic Nerve , Tacrolimus , Animals , Tacrolimus/pharmacology , Tacrolimus/administration & dosage , Nerve Regeneration/drug effects , Peripheral Nerve Injuries/drug therapy , Peripheral Nerve Injuries/therapy , Rats , Sciatic Nerve/injuries , Sciatic Nerve/drug effects , Rats, Sprague-Dawley , Polyesters/chemistry , Disease Models, Animal , Guided Tissue Regeneration/methods
3.
Indian J Orthop ; 58(8): 1079-1091, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39087035

ABSTRACT

Background: Advanced osteoarthritis of knees with varus deformity consists of attenuation of lateral structures with contracture of the posteromedial structures and formation of medial osteophytes. The conventional step-wise medial and posteromedial release with measured resection may sometimes hinder achievement of perfectly balanced flexion and extension gaps with maintenance of flexion stability, without the use of a constrained prosthesis. Medial femoral epicondylar sliding osteotomy tailors the balancing to the need of the kinematics of the native knee and precludes the use of a constrained implant. Methods: 15 patients with Ahlbäck Grades III through V osteoarthritic changes at Howrah Orthopaedic Hospital were included in a prospective cohort case series with a minimum period of follow-up being 12 months. Physical examination, clinical questionnaire and radiographic evaluation were done post-operatively for objectification by functional Knee Society and Oxford Knee Scores respectively. Results and Analysis: The mean post-operative femorotibial angulation ameliorated to a value of 3.73 ± 1.58° from 18.67 ± 4.2° in the pre-operative stage. The mean overall Range of Motion of operated knee was 109.87 ± 6.86° with no residual frontal laxity and/or laxity in the coronal plane. The mean amount of resection of tibial plateau in patients with severe varus deformity was kept to a minimum, 6.56 mm from the least deficient portion of the lateral condyle. There were no complications as regards component loosening and/or surgical-site infection. Conclusion: The main objective of balancing a severely varus-afflicted knee is to preserve as much of the Medial Collateral Ligament as possible, to retain its check rein function and not jeopardise the stability. This is ensured by distalisation and posteriorizing the medial epicondyle by an incomplete osteotomy in addition to modest tibial resection fetching a non-isometric point of knee flexion. All osteotomies united by bony union and restoration of kinematic alignment. The limitation of this study however includes the lack of long-term results, such as late instability and polyethylene wear.

4.
J Pediatr Surg ; 2024 Jul 16.
Article in English | MEDLINE | ID: mdl-39097496

ABSTRACT

BACKGROUND: The traction-induced esophageal growth (Foker) process for the treatment of long gap esophageal atresia (LGEA) relies on applying progressive tension to the esophagus to induce growth. Due to its anti-fibrotic and muscle-relaxing properties, we hypothesize that Botulinum Toxin A (BTX) can enhance traction-induced esophageal growth. METHODS: A retrospective two-center cohort study was conducted on children who underwent a BTX-enhanced Foker process for LGEA repair from 2021 to 2023. BTX (10 units/ml, 2 units/kg, per esophageal pouch) was applied at the time of traction initiation. Time on traction, complications, and anastomotic outcomes were compared against historical controls (Foker process without BTX) from 2014 to 2021. RESULTS: Twenty infants (LGEA type A:12, B:4, C:4; 35% reoperative; median [IQR] age 3 [2-5] months), underwent BTX-enhanced Foker process (thoracotomy with external traction: 9; minimally invasive [MIS] multi-staged internal traction: 11). Mean gap lengths were similar between BTX-enhanced external and external traction control patients (mean [SD], 50.6 mm [12.6] vs. 44.5 mm [11.9], p = 0.21). When compared to controls, the BTX-enhanced external traction process was significantly faster (mean [SD], 12.1 [1.6] days vs. 16.6 [13.2] without BTX, p = 0.04) despite similar preoperative gap lengths. There was no difference in time on traction for those undergoing a minimally invasive process. There were no significant differences in complications or anastomotic outcomes in either cohort. CONCLUSION: Botulinum toxin may play a role in accelerating the traction-induced esophageal growth process for LGEA repair. Minimizing time on traction can decrease sedation and paralysis burden while on external traction. Further studies are needed to elucidate the effects of BTX on the esophagus. LEVEL OF EVIDENCE: Level III. TYPE OF STUDY: Retrospective, Two-center, Cohort study.

5.
Reprod Biol Endocrinol ; 22(1): 98, 2024 Aug 06.
Article in English | MEDLINE | ID: mdl-39107809

ABSTRACT

BACKGROUND: At present, a number of clinical trials have been carried out on GLP-1 receptor agonist liraglutide in the treatment of polycystic ovary syndrome (PCOS). However, the effect of liraglutide on follicle development and its specific mechanism are still unclear. METHODS: RNA sequencing was used to explore the molecular characteristics of granulosa cells from patients with PCOS treated with liraglutide. The levels of C-X-C motif chemokine ligand 10 (CXCL10) in follicular fluid were detected by ELISA, the expression levels of ovulation related genes and inflammatory factor genes in follicles and granulosa cells were detected by qPCR and the protein levels of connexin 43 (Cx43), Janus Kinase 2 (JAK2) and phosphorylated JAK2 were detected by Western blot. The mouse ovarian follicles culture system in vitro was used to detect the status of follicle development and ovulation. RESULTS: In the present study, we found that liraglutide inhibited the secretion of inflammatory factors in PCOS granulosa cells, among which CXCL10 was the most significant. In addition, CXCL10 was significantly higher in granulosa cells and follicular fluid in PCOS patients than in non-PCOS patients. We applied in vitro follicle culture and other techniques to carry out the mechanism exploration which revealed that CXCL10 disrupted the homeostasis of gap junction protein alpha 1 (GJA1) between oocyte and granulosa cells before physiological ovulation, thus inhibiting follicular development and ovulation. Liraglutide inhibited CXCL10 secretion in PCOS granulosa cells by inhibiting the JAK signaling pathway and can improved dehydroepiandrosterone (DHEA)-induced follicle development disorders, which is reversed by CXCL10 supplementation. CONCLUSIONS: The present study suggests that liraglutide inhibits CXCL10 secretion in granulosa cells through JAK signaling pathway, thereby improving the homeostasis of GJA1 between oocyte and granulosa cells before physiological ovulation and ultimately improving the follicular development and ovulation of PCOS, which provides more supportive evidence for the clinical application of liraglutide in the treatment of ovulatory disorders in PCOS. TRIAL REGISTRATION: Not applicable.


Subject(s)
Chemokine CXCL10 , Granulosa Cells , Liraglutide , Ovarian Follicle , Polycystic Ovary Syndrome , Polycystic Ovary Syndrome/metabolism , Polycystic Ovary Syndrome/drug therapy , Female , Liraglutide/pharmacology , Liraglutide/therapeutic use , Chemokine CXCL10/metabolism , Chemokine CXCL10/genetics , Humans , Ovarian Follicle/drug effects , Ovarian Follicle/metabolism , Animals , Mice , Granulosa Cells/drug effects , Granulosa Cells/metabolism , Adult , Ovulation/drug effects , Follicular Fluid/metabolism , Cells, Cultured , Hypoglycemic Agents/pharmacology , Hypoglycemic Agents/therapeutic use
6.
Arthroplasty ; 6(1): 45, 2024 Aug 07.
Article in English | MEDLINE | ID: mdl-39107828

ABSTRACT

BACKGROUND: One major goal of total knee arthroplasty (TKA) is to achieve balanced medial and lateral gaps in flexion and extension. While bone resections are planned by the surgeon, soft tissue laxity is largely intrinsic and patient-specific in the absence of additional soft tissue releases. We sought to determine the variability in soft tissue laxity in patients undergoing TKA. METHODS: We retrospectively reviewed 113 patients undergoing TKA. Data on preoperative knee deformity were collected. Data from a dynamic intraoperative stress examination were collected by a robotic tracking system to quantify maximal medial and lateral opening in flexion (85-95 degrees) and extension (-5-20 degrees). T-tests were used to assess the differences between continuous variables. RESULTS: A valgus stress opened the medial compartment a mean of 4.3 ± 2.3 mm (0.0-12.4 mm) in extension and 4.6 ± 2.3 mm (0.0-12.9 mm) in flexion. A varus stress opened the lateral compartment a mean of 5.4 ± 2.4 mm (0.3-12.6 mm) in extension and 6.2 ± 2.5 mm (0.0-13.4 mm) in flexion. The medial compartment of varus knees opened significantly more in response to valgus stress than valgus knees in both extension (5.2 mm vs. 2.6 mm; P < 0.0001) and flexion (5.4 mm vs 3.3 mm; P < 0.0001). The lateral compartment of valgus knees opened significantly more in response to varus stress than varus knees in both extension (6.7 mm vs. 4.8 mm; P < 0.0001) and flexion (7.4 mm vs. 5.8 mm; P = 0.0003). CONCLUSIONS: Soft tissue laxity is highly variable in patients undergoing TKA, contributing anywhere from 0-13 mm to the post-resection gap. Only a small part of this variability is predictable by preoperative deformity. These findings have implications for either measured-resection or gap-balancing techniques. LEVEL OF EVIDENCE: Level III.

7.
Heliyon ; 10(14): e34417, 2024 Jul 30.
Article in English | MEDLINE | ID: mdl-39114013

ABSTRACT

The evolution of China's industrial structure from 2010 to 2021 is assessed based on the rationalization and sophistication of its industries. The Theil index quantifies spatial variability, while the Quadratic Assignment Procedure (QAP) investigates if changes in industrial structure imbalance will increase wealth disparity. The study's findings indicate a noticeable spatial imbalance in industrial structure change. The overall level of common wealth is low but steadily increasing, following a stepped-down structure of "east-center-west." Additionally, the north and south regions exhibit a pattern of "high in the north and low in the south." There is a pattern of higher values in the north and lower values in the south. In terms of common wealth and its dimensions, there is a ladder-like pattern with high values at the core decreasing towards the west. Between 2010 and 2021, the common wealth development shifted from a lower level to a higher one. Beijing, Jiangsu, and Shanghai constantly ranked in the top echelon, while Guangxi remained in the fifth echelon. The speed and difficulty of transitioning between echelons vary. Moving from the fourth echelon to the third echelon takes longer, while transitioning from the third echelon to higher echelons presents tougher challenges. Spatial imbalances in industrial structure changes widen the gap in common wealth. In particular, the impact of the gap in the advanced industrial structure on the common wealth gap is significantly higher than that of the gap in industrial rationalization. Reducing disparities in advanced industrial structure is more effective in reducing the overall wealth gap.

8.
Front Public Health ; 12: 1388093, 2024.
Article in English | MEDLINE | ID: mdl-39114519

ABSTRACT

Introduction: An educational mismatch is defined as the situation where the education qualifications of an employee do not match the qualifications required for the job they do. A mismatch can be vertical where the level of the employee's qualification is not the one required by the job. This study contributes to the literature on work-related social determinants of health, by carrying out the first assessment of the relationship between educational mismatch and health in Italy. Methods: Data come from PLUS, a national survey of labor supply. The risk of suffering from bad or very bad health associated with educational mismatch is investigated through a logistic regression model accounting for the socioeconomic context and occupation. Results: Our findings show women are at greater risk of suffering from bad or very bad health than men, especially if under-educated. Discussion: Our results show the need to address more research on work-related social determinants of health, which can represent a barrier to achieving health equity.


Subject(s)
Educational Status , Social Determinants of Health , Humans , Italy , Female , Male , Adult , Middle Aged , Socioeconomic Factors , Surveys and Questionnaires , Occupational Health/statistics & numerical data , Logistic Models , Occupations/statistics & numerical data , Sex Factors
9.
Article in English | MEDLINE | ID: mdl-39117791

ABSTRACT

PURPOSE: Peer support networks have been suggested to have significant utility in the care of patients with cancer, especially among racial minorities. This article proposes an approach to integrate peer support networks into the care of racial minorities with cancer. METHODS: Methods to integrate peer support groups across racial minorities with cancer include utilizing language and religion in strategic recruitment of peer supporters, recruiting minority peer supporters in online oncology peer support groups, and emphasizing relationship & trust building for participant retention. RESULTS: Language concordance among peer support groups may enhance patient understandability, emotional expression, and create a sense of community and safety. Religious integration may also promote support group accessibility, particularly among Blacks, who tend to depend on their religious communities for cancer care guidance to a greater extent. In addition to providing knowledge, online opportunities may also decrease cancer-related stress, depression, and trauma. Trust between individuals and their sociocultural environment and healthcare system, as well as between the community and the healthcare system, is necessary, particularly for racial minorities who may harbor a historical mistrust of the healthcare system. CONCLUSIONS: To close the racial cancer care gap, a multi-pronged approach is crucial. This includes establishing tailored peer support networks within minority communities that account for language, religion, and cultural factors to build trust and meet psycho-social needs. However, peer support is just one tool. Other critical tools such as holding healthcare institutions accountable for providing equitable care to racial minorities is equally vital in reducing disparities and improving survival outcomes.

10.
J Prosthodont ; 2024 Aug 08.
Article in English | MEDLINE | ID: mdl-39118292

ABSTRACT

PURPOSE: To evaluate the seating accuracy of removable partial denture (RPD) frameworks fabricated by two digital workflows involving selective laser melting (SLM) in comparison to the conventional workflow. MATERIALS AND METHODS: A Kennedy class III modification 1 partially edentulous mandibular arch was used as a master model. Three RPD framework groups were included: (1) a conventional workflow group with conventional impression and casting (CC), (2) a partial digital workflow group with conventional impression and digital fabrication (CD), and (3) a complete digital workflow group with digital impression and digital fabrication (DD). A total of 10 frameworks were produced for each group. The marginal gaps at the occlusal rests, retention arms, and reciprocating arms were measured by a traveling microscope. The data were analyzed with the one-way analysis of variance test. RESULTS: At the framework level, the most superior fit was observed for the CD group (79.5 µm) followed by DD (85.3 µm) and CC (114.2 µm) groups. The CD and DD groups were significantly superior to CC (p < 0.001). This fit pattern was consistent for the retention and reciprocating arms, while the occlusal rest fit was similar among all the groups. CONCLUSIONS: The SLM frameworks had a promising seating accuracy in comparison to conventional frameworks. The type of impression, conventional or digital, did not affect the accuracy of SLM frameworks. The differences observed in the present study are likely to be of minimal clinical significance.

11.
Front Vet Sci ; 11: 1324233, 2024.
Article in English | MEDLINE | ID: mdl-39109352

ABSTRACT

Introduction: Antimicrobial resistance (AMR) poses a significant global threat to public, animal, and environmental health, consequently producing downstream economic impacts. While top-down approaches to addressing AMR (e.g., laws regulating antimicrobial use) are common in high-income countries, limited enforcement capacities in low- and middle-income countries highlight the need for more bottom-up approaches. Within agriculture, efforts to apply bottom-up approaches to AMR have often focused on the promotion of biosecurity, which should reduce the need for antimicrobials by mitigating disease risk and limiting AMR transmission. Traditionally, efforts to encourage biosecurity adoption have emphasized training and awareness-raising initiatives. However, a growing body of research suggests a disconnect between knowledge and behavior, highlighting the existence of a knowledge-action gap. Method: To understand the barriers and enablers patterning the knowledge-action gap in on-farm biosecurity uptake, we draw upon models from behavioral science. We analyzed in-depth interviews and two focus group discussions with smallholder poultry producers in Ghana to understand factors underlying the intention-action gap in adopting biosecurity. As an analytical framework, we draw upon the Theoretical Domains Framework in combination with the Capability-Opportunity-Motivation Behavioral Model. Results and discussion: While smallholder poultry farmers in Ghana were aware of the importance of biosecurity practices, they struggled with consistent implementation. Financial constraints, challenges in adapting practices to the local context, and limited resources hindered adoption. Additionally, cognitive biases like prioritizing short-term gains and underestimating disease risks played a role. However, some farmers found motivation in professional identity and social influences. These findings highlight the need for designing biosecurity interventions that consider human behavioral factors and the context in which behavior occurs. This underscores the importance of collaboration across disciplines, including veterinary science and the social and behavioral sciences. Implications and recommendations for researchers and practitioners are discussed.

12.
Article in English | MEDLINE | ID: mdl-39113616

ABSTRACT

PURPOSE: Robotic-assisted technology in medial unicompartmental knee arthroplasty (mUKA) allows for customized adjustments of joint laxity through virtual preoperative component positioning before bone preparation. Nevertheless, the optimal balancing curve has yet to be delineated. This study sought to investigate if varying intraoperative knee laxity patterns had any impact on postoperative patient outcomes. MATERIALS AND METHODS: A retrospective analysis was conducted on prospectively collected data from 326 fixed-bearing RAUKA procedures performed between 2018 and 2022 with a minimum 2-year follow-up. Patients were categorized into three cohorts based on intraoperative joint laxity patterns (millimetres of joint gap during valgus stress) imparted at 20°, 60°, 90° and 120° of knee flexion: cohort 1 < +0.5 mm (tight); cohort 2 between 0.6 and 1.9 mm (physiologic); cohort 3 > 2 mm (loose). Wilcoxon and Kruskal-Wallis tests were conducted to assess patient-reported outcome measure (PROM) improvements and preoperative and postoperative differences across the cohorts. A Spearman's test evaluated the correlation between knee balance at all degrees of flexion and preoperative and postoperative HKA. RESULTS: No differences in preoperative and postoperative PROMs were identified across the cohorts (p > 0.05). All three cohorts with different joint laxity patterns showed a significant improvement in the postoperative PROMS (p < 0.05). The preoperative or postoperative limb alignment did not significantly affect clinical outcomes relative to different laxity patterns. CONCLUSION: No differences were found in the outcomes across different joint laxity patterns in robotic-assisted medial UKA using fixed-bearing mUKAs. There was no evident advantage for maintaining a closer to physiologic laxity compared to tighter or looser balancing. LEVEL OF EVIDENCE: Level III therapeutic study.

13.
Liver Int ; 2024 Aug 08.
Article in English | MEDLINE | ID: mdl-39115254

ABSTRACT

Cell junctions, including anchoring, occluding and communicating junctions, play an indispensable role in the structural and functional organization of multicellular tissues, including in liver. Specifically, hepatic cell junctions mediate intercellular adhesion and communication between liver cells. The establishment of the hepatic cell junction network is a prerequisite for normal liver functioning. Hepatic cell junctions indeed support liver-specific features and control essential aspects of the hepatic life cycle. This review paper summarizes the role of cell junctions and their components in relation to liver physiology, thereby also discussing their involvement in hepatic dysfunctionality, including liver disease and toxicity.

14.
Dent Med Probl ; 2024 Aug 08.
Article in English | MEDLINE | ID: mdl-39115543

ABSTRACT

BACKGROUND: The durability of indirect restorations is significantly influenced by marginal adaptation and internal fit. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) with digital impressions has reduced dental prosthesis fabrication errors, improving the long-term survivability of the restorations. OBJECTIVES: The present study assessed the impact of intraoral and extraoral scanning methods on the marginal adaptation and internal fit of 2 different types of monolithic crowns manufactured using CAD/CAM. MATERIAL AND METHODS: A total of 40 three-dimensional (3D) resin-printed dies were randomly assigned to 2 groups based on the type of crown material (n = 20 per group). Each group was divided into 2 subgroups (n = 10 per group) according to the die-scanning technique: subgroup A, scanned using the intraoral scanner (IOS) Primescan; and subgroup B, scanned using the extraoral scanner (EOS) inEos X5. The digitized photos were converted into a 3D virtual crown design using CAD software. The internal discrepancy values, and the marginal gap between the 3D resin-printed die and the crown were assessed using a ×50 digital microscope. The data was checked for normality with the Kolmogorov-Smirnov test, and the Mann-Whitney U test was used to compare the tested groups. The collected data was analyzed at a significance level set at p < 0.05. RESULTS: The different scanning techniques used had a statistically significant effect on the vertical marginal gap and the internal fit [µm] (p < 0.05). As far as the crown materials are concerned, BRILLIANT Crios showed a significantly higher marginal gap as compared to Tetric CAD when scanned with inEos X5 (p = 0.004), whereas the differences were insignificant with regard to the internal fit (p > 0.05).The crown parameters tested with both scanning systems were within the clinically acceptable ranges. CONCLUSIONS: Scanning methods and crown materials had an impact on the internal fit and vertical marginal gap of monolithic crowns.

15.
Int J Cardiol Cardiovasc Risk Prev ; 21: 200268, 2024 Jun.
Article in English | MEDLINE | ID: mdl-39118991

ABSTRACT

Women receive similar or greater benefits than men from Cardiac Rehabilitation (CR). However, they are less likely to participate. An integrated and gender-sensitive approach to cardiovascular disease is required to enhance the quality and experience of care for women with different cardiovascular issues throughout their lives. The Italian Alliance for Cardiovascular Rehabilitation and Prevention (ITACARE-P) is committed to developing a gender-specific approach to CR that will more effectively meet the needs of both women and men.

16.
J Robot Surg ; 18(1): 308, 2024 Aug 06.
Article in English | MEDLINE | ID: mdl-39105993

ABSTRACT

Understanding alignment and gap balancing in Total Knee Arthroplasty (TKA) can be challenging for trainee and experienced orthopedic surgeons. Traditional learning methods may not effectively translate to real-life scenarios. The advent of advanced technologies like robotic surgery and navigation systems has revolutionized intraoperative understanding of gap balancing techniques. This trial aims to investigate the effectiveness of robotic TKA planning software in educating trainees about alignment and ligament balancing. We hypothesize that a single session with the software will significantly enhance trainees' understanding of these techniques. This UK-based single-center, two-arm, group parallel randomized controlled trial was conducted during a national robotic arthroplasty symposium. It aims to evaluate the effect of robotic knee arthroplasty software training on understanding TKA alignment and gap balancing principles using Multiple Choice Questions (MCQs). The MCQ test was crafted based on established guidelines from a different institution with expert consensus in the field. Our study revealed that baseline knowledge of gap balancing and alignment principles was generally low among all participants. However, the intervention group, which received comprehensive robotic software training, demonstrated a significant improvement in their MCQ scores compared to the control group, which did not undergo the training. In conclusion, our study demonstrates that robotic arthroplasty software training significantly improves the understanding of TKA alignment and balancing principles among orthopedic trainees. Level of Evidence II.


Subject(s)
Arthroplasty, Replacement, Knee , Robotic Surgical Procedures , Software , Arthroplasty, Replacement, Knee/education , Arthroplasty, Replacement, Knee/methods , Humans , Robotic Surgical Procedures/education , Robotic Surgical Procedures/methods , Male , Female , Knee Joint/surgery , Clinical Competence
17.
Appl Spectrosc ; : 37028241268158, 2024 Aug 11.
Article in English | MEDLINE | ID: mdl-39094004

ABSTRACT

The aim of this work was the development and morphological/chemical, spectroscopic, and structural characterization of titanium dioxide, niobium pentoxide, and titanium:niobium (Ti:Nb) oxides, as well as materials modified with ruthenium (Ru) with the purpose of providing improvement in photoactivation capacity with visible sunlight radiation. The new materials synthesized using the sol-gel methodology were characterized using the following techniques: scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), photoacoustic spectroscopy (PAS), and X-ray diffraction (XRD). The SEM-EDS analyses showed the high purity of the bases, and the modified samples showed the adsorption of ruthenium on the surface with the crystals' formation and visible agglomerates for higher calcination temperature. The nondestructive characterization of PAS in the ultraviolet visible region suggested that increasing calcination temperature promoted changes in chemical structures and an apparent decrease in gap energy. The separation of superimposed absorption bands referring to charge transfers from the ligand to the metal and the nanodomains of the transition metals suggested the possible absorption centers present at the absorption threshold of the analyzed oxides. Through the XRD analysis, the formation of stable phases such as T-Nb16.8O42, o-Nb12O29, and rutile was observed at a lower temperature level, suggesting pore induction and an increase in surface area for the oxides studied, at a calcination temperature below that expected by the related literature. In addition, the synthesis with a higher temperature level altered the previously existing morphologies of the Ti:Nb, base and modified with Ru, forming the new mixed crystallographic phases Ti2Nb10O29 and TiNb2O7, respectively. As several semiconductor oxide applications aim to reduce costs with photoexcitation under visible light, the modified Ti:Ru oxide calcined at a temperature of 800 °C and synthesized according to the sol-gel methodology used in this work is suggested as the optimum preparation point. This study presented the formation of a stable crystallographic phase (rutile), a significant decrease in gap energy (2.01 eV), and a visible absorption threshold (620 nm).

18.
Sensors (Basel) ; 24(15)2024 Jul 25.
Article in English | MEDLINE | ID: mdl-39123883

ABSTRACT

Bluetooth Low Energy (BLE) is a prominent short-range wireless communication protocol widely extended for communications and sensor systems in consumer electronics and industrial applications, ranging from manufacturing to retail and healthcare. The BLE protocol provides four generic access profile (GAP) roles when it is used in its low-energy version, i.e., ver. 4 and beyond. GAP roles control connections and allow BLE devices to interoperate each other. They are defined by the Bluetooth special interest group (SIG) and are primarily oriented to connect peripherals wirelessly to smartphones, laptops, and desktops. Consequently, the existing GAP roles have characteristics that do not fit well with vehicular communications in cooperative intelligent transport systems (C-ITS), where low-latency communications in high-density environments with stringent security demands are required. This work addresses this gap by developing two new GAP roles, defined at the application layer to meet the specific requirements of vehicular communications, and by providing a service application programming interface (API) for developers of vehicle-to-everything (V2X) applications. We have named this new approach ITS-BLE. These GAP roles are intended to facilitate BLE-based solutions for real-world scenarios on roads, such as detecting road traffic signs or exchanging information at toll booths. We have developed a prototype able to work indistinctly as a unidirectional or bidirectional communication device, depending on the use case. To solve security risks in the exchange of personal data, BLE data packets, here called packet data units (PDU), are encrypted or signed to guarantee either privacy when sharing sensitive data or authenticity when avoiding spoofing, respectively. Measurements taken and their later evaluation demonstrated the feasibility of a V2X BLE network consisting of picocells with a radius of about 200 m.

19.
Sensors (Basel) ; 24(15)2024 Jul 30.
Article in English | MEDLINE | ID: mdl-39123973

ABSTRACT

This paper presents a wireless chipless resonator-based sensor for measuring the absolute value of an external time-varying electric field. The sensor is developed using contactless air-filled substrate-integrated waveguide (CLAF-SIW) technology. The sensor employs a low-impedance electromagnetic band gap structure to confine the electric field within the sensor's air cavity. The air cavity is loaded with varactor diodes whose reverse bias voltage is modified by the to-be-measured external electric field. Variation in the external electric field results in a variation of the sensor's resonant frequency. The CLAF-SIW sensor offers a high unloaded quality factor, which is required for a long-distance ringback-based interrogation system. A prototype of the proposed sensor is fabricated and tested. It can measure a time-varying external electric field up to 6.9 kV/m, has a sensitivity of 1.86 (kHz)/(V/m), and can be interrogated from a distance of 80 cm. The feasible maximum bandwidth of the external electric field is 25 kHz. The proposed sensor offers a compact planar multilayer structure that can easily be incorporated with a planar antenna and its size can be reduced by selecting a higher operating frequency without an increase in dielectric loss.

20.
Sensors (Basel) ; 24(15)2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39124044

ABSTRACT

To enhance the synchronous detection of the horizontal and vertical positions of the torch in swing arc narrow gap welding, a torch pose detection (TPD) method is proposed. This approach utilizes passive visual sensing to capture images of the arc on the groove sidewall, using advanced image processing methods to extract and fit the arc contour. The coordinates of the arc contour center point and the highest point are determined through the arc contour fitting line. The torch center position is calculated from the average horizontal coordinates of the arc contour centers in adjacent welding images, while the height position is determined from the vertical coordinate of the arc's highest point. Experimental validation in both variable and constant groove welding conditions demonstrated the TPD method's accuracy within 0.32 mm for detecting the torch center position. This method eliminates the need to construct the wire centerline, which was a requirement in previous approaches, thereby reducing the impact of wire straightness on detection accuracy. The proposed TPD method successfully achieves simultaneous detection of the torch center and height positions, laying the foundation for intelligent detection and adaptive control in swing arc narrow gap welding.

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