Effect of Clinical and Demographic Variables on the Hospital Stay of Patients Undergoing Total Knee Arthroplasty.

The knee is the joint most affected by osteoarthritis and in its severe form can significantly affect people's physical and functional abilities. The increased demand for surgery leads to greater attention by health care management to be able to keep costs down. A major expense item for this procedure is Length of Stay (LOS). In this study, several Machine Learning algorithms were tested in order to construct not only a valid predictor of LOS but also to know among the selected variables the main risk factors. To do so, activity data from the Evangelical Hospital "Betania" in Naples, Italy, from 2019-2020 were used. Among the algorithms, the best are the classification algorithms with accuracy values exceeding 90%. Finally, the results are in line with those shown by two other comparison hospitals in the area.

The Classification Algorithms Applied to the Inpatient Stay for Lower Limb Surgery.

The revolutions of recent years in health care have involved several areas ranging from patient treatment to resource management. Therefore, several strategies have been put in place to increase patient value while trying to reduce spending. Several indicators have arisen to evaluate the performance of healthcare processes. The main one is Length of Stay (LOS). In this study, classification algorithms were used to predict the LOS of patients undergoing lower extremity surgery, an increasingly common condition given the progressive aging of the population. The context is the Evangelical Hospital "Betania" in Naples (Italy) in 2019-2020, which augments a multicenter study conducted by the same research team on several hospitals in southern Italy. All selected algorithms show an Accuracy above 90% but among them, the best is Logistic Regression with a value reaching 94%.

Fractures around Trochanteric Nails: The "Vergilius Classification System".

INTRODUCTION: The fractures that occurred around trochanteric nails (perinail fractures, PNFs) are becoming a huge challenge for the orthopaedic surgeon. Although presenting some specific critical issues (i.e., patients' outcomes and treatment strategies), these fractures are commonly described within peri-implant ones and their treatment was based on periprosthetic fracture recommendations. The knowledge gap about PNFs leads us to convene a research group with the aim to propose a specific classification system to guide the orthopaedic surgeon in the management of these fractures. MATERIALS AND METHODS: A steering committee, identified by two Italian associations of orthopaedic surgeons, conducted a comprehensive literature review on PNFs to identify the unmet needs about this topic. Subsequently, a panel of experts was involved in a consensus meeting proposing a specific classification system and formulated treatment statements for PNFs. Results and Discussion. The research group considered four PNF main characteristics for the classification proposal: (1) fracture localization, (2) fracture morphology, (3) fracture fragmentation, and (3) healing status of the previous fracture. An alphanumeric code was included to identify each characteristic, allowing to describe up to 54 categories of PNFs, using a 3- to 4-digit code. The proposal of the consensus-based classification reporting the most relevant aspects for PNF treatment might be a useful tool to guide the orthopaedic surgeon in the appropriate management of these fractures.

The development and validation of an ergonomics index for assessing tractor operator work place / Criação e validação de índice ergonômico para avaliação de postos de operação de tratores agrícolas

ABSTRACT: This study aimed to develop and validate an ergonomics index for the operator workplace assessment of agricultural tractors sold in the Brazilian market. To develop the ergonomics index, the operator work places were assessed for compliance with current, national and international, safety and ergonomics standards. The following standards were analyzed to develop ergonomics index: ISO 15077 (1996), which regulates the position of operator controls; ABNT NBR ISO 4254-1(2015) and ABNT NBR ISO 4252 (2011), which regulate the access to operator workplaces; and NR 12 (2010), which determines the mandatory items of operator workplaces.Thirty-four operator work places of 152 models of new agricultural tractors sold in the Brazilian market were analyzed in this study. Ergonomics index was developed and validated using these standards, and the findings enabled the ranking of agricultural tractors. Therefore, the proposed ergonomics index proved feasible and may be applied to other agricultural machines.

RESUMO: Objetivou-se com este trabalho criar e validar um índice ergonômico capaz de qualificar os postos de operação de tratores agrícolas comercializados no mercado brasileiro. Para a composição do índice ergonômico, os postos de operação foram avaliados quanto ao atendimento às normas vigentes, nacionais e internacionais, de segurança e de ergonomia. As seguintes normas foram levadas em consideração para a criação do índice ergonômico: ISO 15077 (1996) - determina o posicionamento dos órgãos de comando; ABNT NBR ISO 4254-1 (2015) e ABNT NBR ISO 4252 (2011) - referem-se à acessibilidade aos postos de operação; e NR 12 (2010) - determina a presença de itens obrigatórios nos postos de operação. Fizeram parte desta análise 34 postos de operação, que são montados em 152 modelos de tratores agrícolas novos, comercializados no mercado brasileiro. Com o auxílio dessas normas o índice ergonômico foi desenvolvido e validado usando esses padrões, e os resultados permitiram ranquear os tratores agrícolas. Conclui-se que o índice ergonômico proposto se mostrou eficiente quanto à exequibilidade e pode ser aplicado em outras máquinas agrícolas.

3D additive-manufactured nanocomposite magnetic scaffolds: Effect of the application mode of a time-dependent magnetic field on hMSCs behavior.

Over the past few years, the influence of static or dynamic magnetic fields on biological systems has become a topic of considerable interest. Magnetism has recently been implicated to play significant roles in the regulation of cell responses and, for this reason, it is revolutionizing many aspects of healthcare, also suggesting new opportunities in tissue engineering. The aim of the present study was to analyze the effect of the application mode of a time-dependent magnetic field on the behavior of human mesenchymal stem cells (hMSCs) seeded on 3D additive-manufactured poly(ɛ-caprolactone)/iron-doped hydroxyapatite (PCL/FeHA) nanocomposite scaffolds.

Fuel consumption efficiency of an agricultural tractor equipped with continuously variable transmission / Eficiência no consumo de combustível de um trator agrícola equipado com transmissão continuamente variável

ABSTRACT: The correct choice of modern power transmissions can help farmers decrease production costs. The following research aimed to assess fuel consumption efficiency of an agricultural tractor equipped with continuously variable transmission, at different travel speed and load levels applied on the tractor drawbar. Standard procedure has been applied considering six load levels (30; 40; 50; 60; 70 and 80% of Q0) by means of breaking with a dynamometer car instrumented in a concrete test track, at three travel speeds (5.16; 7.29 and 10.48km h-1). Throughout the experiment, engine speed, traction force and hourly fuel consumption were monitored. The results indicated that there was an average increase of 2.67; 2.82; and 2.61L h-1 in the hourly fuel consumption for each 10% increase in the load level on the tractor, for travel speed of 5.16; 7.29 and 10.48km h-1, respectively. In general, the specific fuel consumption of the tractor decreased as the load levels and the travel speeds were increased.

RESUMO: A escolha correta de modernas transmissões de potência pode auxiliar os agricultores a diminuírem os custos de produção. Este trabalho teve como objetivo avaliar a eficiência de consumo de combustível de um trator agrícola equipado com transmissão continuamente variável, em diferentes velocidades de deslocamento e cargas parciais impostas à barra de tração do trator. Para a avaliação utilizou-se procedimento normalizado, com aplicação de seis cargas parciais (30; 40; 50; 60; 70 e 80% de Q0), por meio da frenagem com um carro dinamométrico instrumentado, em pista de concreto, em três velocidades de deslocamento (5,16; 7,29 e 10,58km h-1). Durante a condução do experimento, monitoraram-se a rotação do motor, a força de tração e o consumo horário de combustível. Os resultados indicaram que houve acréscimo, médio, de 2,67; 2,82; e 2,61L h-1 no consumo horário de combustível para o aumento de cada 10% na carga imposta ao trator, para as velocidades de 5,16; 7,29 e 10,48km h-1, respectivamente. Ao considerar o consumo específico do trator, de forma geral, diminuiu à medida que as cargas parciais e as velocidades de deslocamento foram incrementadas.

Case report: bipartite tibial epiphysis: radiologic and arthroscopic presentation.

We report the case of a bilateral bipartite ossification center of the proximal tibia in a 15-year-old boy with a history of knee injury. The presence of the duplicated ossific centers was an incidental finding on radiography and computed tomography performed after injury. Arthroscopy showed continuous hyaline cartilage between the two ossific centers confirming the diagnosis of a developmental abnormality; however, the articular surface was depressed in the region overlying the smaller ossific center. We presume the presence of an accessory center in the posteromedial aspect of the tibial plate could be a source of instability for the corresponding capsular and meniscal structures. This is, to our knowledge, the first report of tibial bipartite epiphysis.

The CT-arthrography in the antero-inferior glenoid labral lesion: Pictorial presentation and diagnostic value.

OBJECTIVE: To present the Computed Tomography (CT)-Arthrography appearance of the most common types of anterior labral lesion and to assess the diagnostic value of this technique in the detection and classification of the antero-inferior labral tears in glenohumeral joint instability. MATERIALS AND METHODS: The pre-operative CT-Arthrography records of 43 patients, who underwent surgery for anterior shoulder instability, were retrospectively evaluated independently by two radiologists. The data were compared with arthroscopic results and the diagnostic accuracy of CT-Arthrography was calculated to detect the labral lesion and the agreement between the CT-Arthrography lesions classification and the arthroscopy classification. RESULTS: The CT-Arthrography sensitivity, specificity and accuracy were: 92% / 89% (reader 1/reader 2), 86% / 86% and 91% / 88% respectively. The CT-Arthrography classification was correct in 86% of cases. CONCLUSIONS: CT-Arthrography appears to be an accurate means for identification and classification of the anterior labral tears and, identifying the labral degeneration, this technique can be very helpful in the selection of patient for arthroscopic stabilization of the shoulder.