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1.
Nurs Ethics ; : 969733020981761, 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33530872

RESUMO

BACKGROUND: As a non-European Union member state, Albania is increasingly orienting itself on Western models regarding human rights, patient rights, and legal regulations for healthcare. Due to its limited fiscal and legal power, enforcing legal and ethical regulations poses a major problem. AIM: The aim of this study is to investigate nurse's knowledge and experiences regarding ethical and legal issues in Albanian elder care in state-funded and privately run institutions. RESEARCH DESIGN: The study was conducted using an inductive and qualitative design, utilizing a focused ethnographic approach, based on Roper and Shapira's framework. METHOD: Data were collected between June 2017 and September 2018 using participant observation, field notes, and semi-structured interviews with 15 nurses in seven different elder care institutions. In total, 100 h of observation and 15 interviews were performed. Data analysis was based on Mayring's qualitative content analysis. ETHICAL CONSIDERATION: The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria. FINDINGS: The findings of the study fell into the following main categories: "Everyday care issues," "End-of-life issues," "Legal issues," and "Ethical-legal education and conflicts." DISCUSSION: The participants reported many ethical and legal issues when describing their everyday challenges and displayed a strong lack of ethical and legal education. Despite a wide spectrum in the quality of care between private and state-funded nursing homes, older people mostly do not know their own diagnosis. CONCLUSION: This study indicates that further ethical and legal education is needed. Furthermore, nurses need to be better prepared for ethical conflicts with families, as strengthening patient rights could come into conflict with traditional rights of the Albanian family.

2.
J Appl Microbiol ; 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33565669

RESUMO

AIMS: Joint infections cause premature implant failure. The avoidance of bacterial colonisation of implant materials by modification of the material surface is therefore the focus of current research. In this in vitro study the complex interaction of periodic structures on PET and titanium surfaces on the adhesion of Staphylococcus aureus is analysed. METHODS AND RESULTS: Using direct laser interference patterning as well as roll-to-roll hot embossing methods, structured periodic textures of different spatial distance were produced on surfaces and S. aureus were cultured for 24 hours on these. The amount of adhering bacteria was quantified using fluorescence microscopy and the local adhesion behaviour was investigated using scanning electron microscopy. For PET structures, minimal bacterial adhesion was identified for an aspect ratio of about 0.02. On titanium structures, S. aureus adhesion was significantly decreased for profile heights of < 200 nm. Our results show a significantly decreased bacterial adhesion for structures with an aspect ratio range of 0.02 to 0.05. CONCLUSIONS: We show that structuring on surfaces can decrease the amount of S. aureus on titanium and PET as common implant materials. SIGNIFICANCE AND IMPACT OF THE STUDY: The study highlights the immense potential of applying specific structures to implant materials to prevent implant colonization with pathogen bacteria.

3.
Pediatr Infect Dis J ; 40(3): 255-259, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33538544

RESUMO

BACKGROUND: Sepsis is a major cause of death in neonates. Knowledge about epidemiology, risk factors, causative pathogens and outcome of neonatal sepsis is important to improve neonatal care. For Germany, only few data on neonatal sepsis in very low birth weight (VLBW) infants exist. METHODS: Data from 14,926 preterm infants with birth weight <1500 g and gestational age between 22 0/7 weeks and 31 6/7 collected between January 2009 and December 2017 were analyzed for frequency of early-onset sepsis (EOS) and late-onset sepsis (LOS) and for causative pathogens. Risk factors for the development of EOS and LOS and outcomes after EOS and LOS were analyzed by multivariate logistic regression models. RESULTS: EOS occurred in 1.1% of infants and LOS in 11.9%. Escherichia coli was the most common pathogen in EOS, coagulase-negative staphylococci in LOS. Multidrug-resistant organisms were detected in 8.4% of EOS and 3.9% of LOS cases. Risk factors for EOS were lower gestational age, intra-amniotic infection and spontaneous delivery. Risk factors for LOS were lower gestational age, small for gestational age, central lines, endotracheal ventilation and history of EOS. Both EOS and LOS were independently associated with adverse neonatal outcome. CONCLUSIONS: These data from a large German neonatal cohort confirm neonatal sepsis as the most common cause of morbidity and mortality in VLBW infants, as well as E. coli and coagulase-negative staphylococci as the most prevalent pathogens. Multidisciplinary approaches such as antibiotic stewardship, hygiene and feeding strategies are necessary to further reduce the burden of sepsis in VLBW infants.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33486749

RESUMO

BACKGROUND: The aim of this study is to compare the outcome of the minimally invasive transmuscular approach using a tubular retractor system (Metrx) with the conventional microsurgical standard approach (CM) for microsurgical treatment of lumbar disk herniation. METHODS: This is a prospective randomized controlled study with a 1:1 distribution of patients in CM and Metrx study groups. Two hundred and twenty-seven (117 CM and 110 Metrx) patients were included. The primary outcome parameters are postoperative pain intensity reduction, length of hospitalization, postoperative quality of life, and daily life performance based on the standardized questionnaires: Visual Analog Scale (VAS), 36-Item Short Form Survey (SF-36), Oswestry Disability Index (ODI), and Prolo scores. The secondary outcome parameters are intraoperative variables: surgery duration, blood loss, and fluoroscopy dose. RESULTS: There were no significant statistical differences in the primary outcome measures between the two groups with respect to postoperative pain relief (median VAS pre-op to 3 months post-op for sciatica: 9-2 [CM] vs. 8-2 [Metrx]; for lumbago: 7-2.5 [CM] vs. 6-3 [Metrx]), the length of hospitalization (median of 5 days), or the frequency of occupational reintegration after 3 months (59.1 vs. 60.7%). CONCLUSION: The microsurgical therapy of lumbar disk herniation via a Metrx approach is a safe and effective treatment option and is equivalent to the CM approach.

5.
Ophthalmologe ; 2021 Jan 15.
Artigo em Alemão | MEDLINE | ID: mdl-33449199

RESUMO

BACKGROUND: The first wave of the COVID-19 pandemic posed great challenges for teachers and students, as teaching had to take place despite the restriction of classroom teaching. For attendance lessons and events with patient contact alternatives had to be arranged at short notice between mid-March and the beginning of the semester in mid-April. OBJECTIVE: Description of the concept and implementation in the student teaching at the Department of Ophthalmology of the University Medical Center Mainz in complete digital form in spring 2020. PRESENTATION OF CONCEPT: Lectures, examination course and practical training in ophthalmology take place in the 5th and 6th semester of the study of human medicine. The basis of the new concept were the former course curricula. Implemented concepts included a complete revision and implementation of lectures as video podcasts, examination videos, online examination conferences, interactive patient cases, narrated videos of surgery, anamnesis videos of patients and the design of the virtual patient room, a live online practice with presentation and examination of patients including transmission of the slit-lamp image to reproduce anterior and posterior segment examination. An evaluation showed a very positive reception of the new concept by students. DISCUSSION: Within a tight timeframe of 4 weeks a complete revision of the ophthalmology course was achieved. The implementation was time-consuming, with the largest share in the media production of examination videos, interactive patient cases and video podcasts of the lectures. We consider a reduction of classroom teaching for parts of the learning objectives that can be represented by such videos to be possibly useful. An independent digital appropriation of such content may enable a more productive learning environment in face-to-face teaching.

6.
Methods Mol Biol ; 2216: 369-382, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33476011

RESUMO

Renal length and volume are important parameters in the clinical assessment of patients with diabetes mellitus, kidney transplants, or renal artery stenosis. Kidney size is used in primary diagnostics to differentiate between acute (rather swollen kidneys) and chronic (rather small kidney) pathophysiology. Total kidney volume is also an established biomarker in studies for the treatment of autosomal dominant polycystic kidney disease (ADPKD). There are several factors influencing kidney size, and there is still a debate on the value of the measured kidney size in terms of renal function or cardiovascular risk. The renal volume is most often calculated by measuring the three axes of the kidney, on the assumption that the organ resembles an ellipsoid. By default, the longitudinal and transverse diameters of the kidney are measured. In animal models renal length and volume1 are also important parameters in the assessment of organ rejection after transplantation and in determination of kidney failure due to renal artery stenosis, recurrent urinary tract infections, or diabetes mellitus. In general total kidney volume (TKV) is a valuable parameter for predicting prognosis and monitoring disease progression in animal models of human diseases like polycystic kidney disease (PKD) or acute kidney injury (AKI) and chronic kidney disease (CKD).This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This analysis protocol is complemented by two separate chapters describing the basic concept and experimental procedure.

7.
Ophthalmologe ; 2021 Jan 06.
Artigo em Alemão | MEDLINE | ID: mdl-33404686

RESUMO

BACKGROUND: In medical studies digital learning is often achieved by the use of learning management platforms, such as Ilias. Lecture presentations and organizational documents are typical contents. Students use multiple, mostly external learning options for acquisition of knowledge and competences. We present our updated ophthalmology e­learning environment for medical students and its evaluation. OBJECTIVE: Evaluation of an ophthalmology e­learning platform for medical students, which considers prevalent learning habits. MATERIAL AND METHODS: The platform should provide and link a selection of internal and external learning resources following anatomical structures of the eye. For every subject area the platform provides a text with essential matters, clinical cases, lecture presentations, multiple choice questions for practice, links to corresponding chapters of a textbook and the appropriate AMBOSS learning cards (Amboss GmbH, Berlin, Germany). At the end of the semester an evaluation of the platform was carried out. Different statements were rated by the students on ordinal scales and analyzed. RESULTS: The platform was rated with 1.47 ± 0.54 (mean ± standard deviation; n = 107) on a German school grade scale (1 = best, 6 = worst). It was perceived as helpful for the individual learning with 1.62 ± 0.77 (1 = very helpful, 7 = not helpful at all). The structuring of the internal and external learning resources was rated as very good 1.44 ± 0.66 (1 = very good, 7 = very bad). The median for subjective amount of usage was 1-5 h (ordinal scale <1, 1-5, 6-10, 15-20, >20 h). CONCLUSION: It appears to be meaningful to specifically link external learning resources corresponding to the own curricular structure in order to provide medical students with a modern basis for learning in ophthalmology.

8.
Immunity ; 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33484643

RESUMO

Tissue resident mast cells (MCs) rapidly initiate neutrophil infiltration upon inflammatory insult, yet the molecular mechanism is still unknown. Here, we demonstrated that MC-derived tumor necrosis factor (TNF) was crucial for neutrophil extravasation to sites of contact hypersensitivity-induced skin inflammation by promoting intraluminal crawling. MC-derived TNF directly primed circulating neutrophils via TNF receptor-1 (TNFR1) while being dispensable for endothelial cell activation. The MC-derived TNF was infused into the bloodstream by directional degranulation of perivascular MCs that were part of the vascular unit with access to the vessel lumen. Consistently, intravenous administration of MC granules boosted neutrophil extravasation. Pronounced and rapid intravascular MC degranulation was also observed upon IgE crosslinking or LPs challenge indicating a universal MC potential. Consequently, the directional MC degranulation of pro-inflammatory mediators into the bloodstream may represent an important target for therapeutic approaches aimed at dampening cytokine storm syndromes or shock symptoms, or intentionally pushing immune defense.

9.
J Cell Biol ; 220(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33326005

RESUMO

Microtubules play a major role in intracellular trafficking of vesicles in endocrine cells. Detailed knowledge of microtubule organization and their relation to other cell constituents is crucial for understanding cell function. However, their role in insulin transport and secretion is under debate. Here, we use FIB-SEM to image islet ß cells in their entirety with unprecedented resolution. We reconstruct mitochondria, Golgi apparati, centrioles, insulin secretory granules, and microtubules of seven ß cells, and generate a comprehensive spatial map of microtubule-organelle interactions. We find that microtubules form nonradial networks that are predominantly not connected to either centrioles or endomembranes. Microtubule number and length, but not microtubule polymer density, vary with glucose stimulation. Furthermore, insulin secretory granules are enriched near the plasma membrane, where they associate with microtubules. In summary, we provide the first 3D reconstructions of complete microtubule networks in primary mammalian cells together with evidence regarding their importance for insulin secretory granule positioning and thus their supportive role in insulin secretion.

10.
Ther Umsch ; 77(10): 505-510, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33272049

RESUMO

Update on Shoulder Arthroplasty Abstract. Shoulder arthroplasty is indicated for treatment of primary osteoarthritis, cuff tear athropathy, complex proximal humerus fractures, and posttraumatic situations. The rotator cuff plays an important role. In case of an intact rotator cuff, anatomical shoulder arthroplasty is preferred. Over the past decades, the number of hemi prostheses has declined in favor of total shoulder arthroplasties. Reverse shoulder arthroplasty is used for severe and irreparable rotator cuff tears, advanced cuff tear athropathy, and increasingly for complex proximal humerus fractures. Reverse shoulder arthroplasties account for almost 80 % of all shoulder prostheses. Modern implants allow conversion from an anatomic to a reverse situation if needed. Improved understanding of the pathology, new implant designs, and preoperative 3D planning have improved the overall outcome.

11.
Praxis (Bern 1994) ; 109(16): 1241-1242, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33292006

RESUMO

CME Sonography 95/Answers: Sonographic Differential Diagnosis of Anterior Shoulder Pain Abstract. Anterior shoulder pain is common, and, compared to high-resolution dynamic sonography, the clinical examination is usually not precise enough for the exact classification of the cause of the pain. In this review we discuss possible causes of anterior shoulder pain with special emphasis on the ultrasound diagnosis of causes of subcoracoidal impingement and of anterior snapping syndrome. We use high-resolution ultrasound images to illustrate various possible underlying pathologies in anterior shoulder pain.

12.
Zootaxa ; 4892(1): zootaxa.4892.1.1, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33311101

RESUMO

Morocco is a well known hot-spot of biodiversity in the Mediterranean basin. While some taxa like vascular plants are relatively well recorded, important groups of pollinators like bees are still understudied. This article presents an updated checklist of the bee species of Morocco and includes a summary of global and regional distribution of each species. A total of 961 species belonging to six bee families and 68 genera are recorded: Andrenidae (8 genera, 217 species); Apidae (15 genera, 241 species); Colletidae (2 genera, 74 species), Halictidae (12 genera, 144 species), Megachilidae (28 genera, 271 species) and Melittidae (3 genera, 14 species). Among them, 67 species are recorded for the first time in Morocco. Around 70% of the bee fauna of Morocco consists of widespread Palaearctic species. Only 18% of Moroccan species recorded are restricted to North Africa and 8% are Moroccan single-country endemics (81 species). Afrotropical elements in the Moroccan fauna are few, with only 3% of Morocco species co-occuring in that region. This checklist is intended to stimulate new regional research on bees including their taxonomy and biogeography. As many groups of bees have been understudied, discovery of new species for science and new records for the country can be expected. Additional research including inventorying, monitoring, and integrative taxonomic studies are needed to develop a comprehensive strategy for bee conservation in Morocco.


Assuntos
Abelhas , Himenópteros , Animais , Sequência de Bases , Himenópteros/genética , Marrocos
13.
Adv Otorhinolaryngol ; 85: 112-119, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33166972

RESUMO

Laryngeal synkinesis as a form of defective healing is the rule rather than the exception in persistent vocal fold paralysis. It typically occurs 4-6 months after the onset of the recurrent laryngeal nerve paralysis. The incidence is up to 85%. Not all laryngeal muscles need to be equally affected. Reliable evidence can only be provided by a laryngeal electromyography. Physiological co-activation of the laryngeal muscles during antagonistic maneuvers must be considered. Although synkinesis undeniably worsens the prognosis for a motion recovery, it protects the muscle fibers from degeneration. A differentiation is required between favorable synkinesis (type I according to Crumley), which does not always require further therapy in the case of unilateral paralysis, and unfavorable forms of synkinesis (type II-IV) according to Crumley, which are associated with a functionally relevant malposition of the vocal fold(s) or with vocal fold jerks. Particularly when bilateral vocal fold motion does not return, type I synkinesis can be a good prerequisite for new dynamic therapy approaches, such as laryngeal pacing. The rarely occurring type II-IV synkinesis should, whenever possible, be transformed into a more favorable type I synkinesis by selective or non-selective reinnervation at an early stage of the disease. The latter applies to expected muscle atrophy with insufficient regrowth of nerve fibers.

14.
PLoS One ; 15(11): e0242189, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33216764

RESUMO

In this article, we present the development and validation of an implicit association test for measuring secondary school students' associations between genetics concepts and teleology concepts on the one hand, and between genetics concepts and essentialism concepts on the other hand. In total, 169 students from 16 school classes took part in the study, from January 2018 to May 2018. We investigated the strength of the aforementioned associations and the influence of various covariates such as gender, age, school class, or previous learning of biology on the association of teleology or essentialism concepts with genetics concepts through an analysis of covariance and a multi-level analysis. We found moderate associations between genetics and teleology concepts, as well as between genetics and essentialism concepts. These results might reflect a tendency of students of different ages and with various backgrounds to think about genes in terms of goals (teleology) and stability (essentialism), which should be investigated further in future research.

15.
Praxis (Bern 1994) ; 109(15): 1165-1176, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33234045

RESUMO

CME Sonography 95: Sonographic Differential Diagnosis of Anterior Shoulder Pain Abstract. Anterior shoulder pain is common, and, compared to high-resolution dynamic sonography, the clinical examination is usually not precise enough for the exact classification of the cause of the pain. In this review we discuss possible causes of anterior shoulder pain with special emphasis on the ultrasound diagnosis of causes of subcoracoidal impingement and of anterior snapping syndrome. We use high-resolution ultrasound images to illustrate various possible underlying pathologies in anterior shoulder pain.


Assuntos
Síndrome de Colisão do Ombro , Articulação do Ombro , Diagnóstico Diferencial , Humanos , Exame Físico , Síndrome de Colisão do Ombro/diagnóstico , Dor de Ombro/diagnóstico por imagem , Dor de Ombro/etiologia , Ultrassonografia
16.
Swiss Med Wkly ; 150: w20343, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-33035354

RESUMO

INTRODUCTION: Sudden cardiac death caused by malignant arrhythmia can be prevented by the use of defibrillators. Although the wearable cardioverter defibrillator (WCD) can prevent such an event, its role in clinical practice is ill defined. We investigated the use of the WCD in Switzerland with emphasis on prescription rate, therapy adherence and treatment rate. MATERIALS AND METHODS: The Swiss WCD Registry is a retrospective observational registry including patients using a WCD. Patients were included from the first WCD use in Switzerland until February 2018. Baseline characteristics and data on WCD usage were examined for the total study population, and separately for each hospital. RESULTS: From 1 December 2011 to 18 February 2018, a total of 456 patients (67.1% of all WCDs prescribed in Switzerland and 81.1% of all prescribed in the participating hospitals) were included in the registry. Up to 2017 there was a yearly increase in the number of prescribed WCDs to a maximum of 271 prescriptions per year. The mean age of patients was 57 years (± 14), 81 (17.8%) were female and mean left ventricular ejection fraction (EF) was 32% (± 13). The most common indications for WCD use were new-onset ischaemic cardiomyopathy (ICM) with EF ≤35% (206 patients, 45.2%), new-onset nonischaemic cardiomyopathy (NICM) with EF ≤35% (115 patients, 25.2%), unknown arrhythmic risk (83 patients, 18.2%), bridging to implantable cardioverter-defibrillator implantation or heart transplant (37 patients, 8.1%) and congenital/inherited heart disease (15 patients, 3.3%). Median wear duration was 58 days (interquartile range [IQR] 31–94) with a median average daily wear time of 22.6 hours (IQR 20–23.2). Seventeen appropriate therapies from the WCD were delivered in the whole population (treatment rate: 3.7%) to a total of 12 patients (2.6% of all patients). The most common underlying heart disease in patients with a treatment was ICM (13/17, 76.5%). There were no inappropriate treatments. CONCLUSION: The use of WCDs has increased in Switzerland over the years for a variety of indications. There is high therapy adherence to the WCD, and a treatment rate comparable to previously published registry data.  .

17.
Zootaxa ; 4778(2): zootaxa.4778.2.1, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-33055819

RESUMO

Osmia (Hemiosmia), O. (Tergosmia) and O. (Erythrosmia) are three related Palaearctic osmiine bee subgenera (Megachilidae, Megachilinae, Osmiini) comprising eight, seven and four species, respectively. Analysis of female pollen loads and field observations revealed that the species of both O. (Hemiosmia) and O. (Tergosmia) have a distinct or even exclusive preference for Fabaceae as pollen hosts. Species of O. (Erythrosmia) also collect pollen on Fabaceae, but additionally frequently visit nototribic flowers of Lamiaceae and Antirrhineae (Plantaginaceae), which they exploit by rubbing a specialized facial pilosity over the raised anthers. The representatives of O. (Hemiosmia) and the basal members of O. (Tergosmia) build their brood cells in self-excavated burrows in the ground, whereas the more derived O. (Tergosmia) species as well as the O. (Erythrosmia) species place them in preexisting cavities above-ground, which are empty snail shells hidden under prominences of rocks or under stones in the latter subgenus. In O. (Hemiosmia) and O. (Tergosmia), the brood cells are entirely constructed from foreign material and either consist of chewed leaves ("leaf pulp") in the former subgenus or are distinctly three-layered with a thin layer of mud sandwiched between two layers of large pieces of petals in the latter subgenus. In O. (Erythrosmia), the brood cells within the shell whorls are delimited by one-layered partitions of leaf pulp and the nests are closed by a barricade of densely packed small particles followed by a double wall of leaf pulp at the shell opening. The taxonomic revision of the three subgenera revealed the existence of an undescribed species, O. (Hemiosmia) spinicoxa spec. nov., which occurs in southwestern Morocco. The subgenus O. (Ozbekosmia) Zanden, 1994 syn. nov. is newly put into synonymy with O. (Tergosmia) Warncke, 1988. Osmia (Tergosmia) rhodoensis arquata Warncke, 1988 syn. nov. and O. (Tergosmia) tergestensis ononidis Ferton, 1897 syn. nov. are no longer accepted as valid subspecies of O. (Tergosmia) rhodoensis (Zanden, 1983) and O. (Tergosmia) tergestensis Ducke, 1897, respectively. Identification keys for all species of the three subgenera are given.


Assuntos
Abelhas , Fabaceae , Comportamento de Nidação , Animais , Feminino , Flores , Pólen
18.
Artigo em Inglês | MEDLINE | ID: mdl-32989047

RESUMO

OBJECTIVE: To evaluate current screening criteria for retinopathy of prematurity (ROP) by investigating the incidence of ROP requiring treatment in infants with gestational age (GA) ≥30 weeks or postmenstrual age (PMA) <32 weeks in Germany. METHODS: Three patient databases were analysed, that is, the German Quality Assurance Procedure in Neonatology (years 2011-2017; n=52 461 infants screened for ROP, 1505 infants treated for ROP), the German Retina.net ROP Registry (years 2011-2018; n=281 treated infants) and the ROP screening programme of two German university hospitals (years 2012-2016; n=837 screened infants). RESULTS: In the analysed cohorts, infants with GA ≥30 weeks represented 33.1%-38.5% of the screening populations but only 1.40%-1.42% of the cases requiring ROP treatment. In a cohort of 281 infants treated for ROP, all 4 infants with GA ≥30 weeks had additional risk factors for ROP including prolonged oxygen supplementation and/or significant comorbidities. Five infants (1.8%) were treated at 32 weeks PMA and none at PMA <32 weeks. CONCLUSIONS: In the investigated cohorts, preterm infants with GA ≥30 weeks carried a very low or no risk for developing treatment-requiring ROP unless additional risk factors were present, and no treatment was performed earlier than 32 weeks PMA. These findings are of relevance for the ongoing re-evaluation of ROP screening criteria.

19.
Med Eng Phys ; 84: 193-202, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32977918

RESUMO

The analysis of human movements rests on a realistic human body model. Deducing model parameters from anthropomorphic data is challenging since these are inherently imprecise. An approach to improve model accuracy is the parameter adaptation based on motion data. 3D motion capture data are already being used for generating the trajectories of a human body model, so combining motion tracking and parameter identification seems most natural. This paper introduces a holistic approach to simultaneously identify the geometric parameters of a kinematic human lower limb model and the parameters defining a (cyclic) gait trajectory, based on 3D marker positions. The result is a time-continuous description of a physiologically compatible lower extremity movement along with optimal model parameters so to best reproduce the captured motion. The method takes into account restrictions such as the range of motion of human body joints and is robust against missing data due to marker occlusions or failures of the measurement system. Considering multiple gait cycles of a movement trial, we derive the characteristic motion pattern (CMP) of a specific subject walking at a specific speed. Our method further allows for motion analysis and assessment, but also for motion synthesis with arbitrary time span and time resolution and can thus be used for simulations and trajectory planning of rehabilitation and movement assistance systems, such as exoskeletons.

20.
JSES Int ; 4(3): 508-514, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32939477

RESUMO

Background: The goal of this study was to evaluate whether plating and cortical bone grafting of shortened clavicular nonunions would restore clavicular length and enable bone healing. The association between the clavicular length difference (CLD) between sides and long-term functional outcome was also explored. Methods: For this retrospective 2-center study, patients who underwent plate fixation with cortical bone grafting of a clavicular nonunion were assessed after ≥2 years. The CLD and bone union were assessed using radiography and navigation ultrasound. The functional outcome was determined by the Constant score, Simple Shoulder Test score, and Subjective Shoulder Value, as well as local pain (0-10 numeric rating scale). Results: Between 2 and 13 years after surgery, 25 patients (mean age, 53 years; 13 female patients) were examined. The median CLD was 0 mm (range, -17 to 13 mm) on ultrasound measurements and 2 mm (range, -32 to 9 mm) on radiographs. At follow-up, the median Constant score, Simple Shoulder Test score, Subjective Shoulder Value, and pain level were 82 points (range, 38-95 points), 12 points (range, 3-12 points), 95% (range, 60%-100%), and 0 (range, 0-8), respectively. There was no correlation between the CLD and all functional outcome scores. Bone union was achieved in all patients. After plate removal, 4 refractures occurred, 3 of which required revision. Conclusions: Plate fixation with cortical bone grafting of clavicular nonunions is associated with restoration of clavicular length and a high rate of bone union. There is, however, a considerable risk of refracture following plate removal. There was no association between the CLD and clinical outcome.

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