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European Journal of Trauma and... Jun 2024Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and fluid evacuation to...
BACKGROUND
Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and fluid evacuation to improve breathing and circulatory function. It is a simple and life-saving procedure; nevertheless, it carries morbidity, even after its removal. Efforts have been made continuously to shorten the duration of ICD, but mostly in non-trauma patients. In this study, we evaluated the impact of negative pleural suction over the duration of ICD.
METHODS
This study was a prospective randomized controlled interventional trial conducted at Level 1 Trauma Centre. Thoracic trauma patients with ICD, who met the inclusion criteria (sample size 70) were randomized into two groups, the first group with negative pleural suction up to -20 cm H2O, and the second group as conventional, i.e. ICD connected to underwater seal container only. The primary objective was to compare the duration of ICDs and the secondary objectives were the length of hospital stay and various complications of thoracic trauma.
RESULTS
Duration of ICD was measured in median days with minimum & maximum days. For the negative suction group, it was 4 days (2-16 days); for the conventional group, it was also 4 days (2-17 days). There was also no significant difference among both groups in length of hospital stay.
CONCLUSION
The beneficial effect of negative pleural suction to ICD could not be demonstrated over the duration of ICD and hospital stay. In both groups, there was no significant difference in complication rates like recurrent pneumothorax, retained hemothorax, persistent air leak, and empyema.
LEVEL OF EVIDENCE
Therapeutic Study, Level II TRIAL REGISTRATION: This trial was registered with the Clinical Trial Registry of India (CTRI) with registration no. REF/2020/11/038403.
PubMed: 38874624
DOI: 10.1007/s00068-024-02565-0 -
Advanced Science (Weinheim,... Jun 2024The emergence of the field of soft robotics has led to an interest in suction cups as auxiliary structures on soft continuum arms to support the execution of... (Review)
Review
The emergence of the field of soft robotics has led to an interest in suction cups as auxiliary structures on soft continuum arms to support the execution of manipulation tasks. This application poses demanding requirements on suction cups with respect to sensorization, adhesion under non-ideal contact conditions, and integration into fully soft systems. The octopus can serve as an important source of inspiration for addressing these challenges. This review aims to accelerate research in octopus-inspired suction cups by providing a detailed analysis of the octopus sucker, determining meaningful performance metrics for suction cups on the basis of this analysis, and evaluating the state-of-the-art in suction cups according to these performance metrics. In total, 47 records describing suction cups are found, classified according to the deployed actuation method, and evaluated on performance metrics reflecting the level of sensorization, adhesion, and integration. Despite significant advances in recent years, the octopus sucker outperforms all suction cups on all performance metrics. The realization of high resolution tactile sensing in suction cups and the integration of such sensorized suction cups in soft continuum structures are identified as two major hurdles toward the realization of octopus-inspired manipulation strategies in soft continuum robot arms.
PubMed: 38874316
DOI: 10.1002/advs.202400806 -
The Journal of Craniofacial Surgery Jun 2024Surgical simulation has been used extensively for learning microtia reconstruction and has almost exclusively involved framework creation. However, soft tissue...
Surgical simulation has been used extensively for learning microtia reconstruction and has almost exclusively involved framework creation. However, soft tissue reconstruction in microtia is equally challenging and would benefit from a simulation platform. This study aimed to describe the development and preliminary evaluation of a high-fidelity soft tissue microtia simulator. Three-dimensional modeling software, fused deposition 3-dimensional printing, adhesive techniques, silicones, and polyurethane rubbers were utilized to create a right lobular-type microtia simulator that comprises skin, subcutaneous tissue, and cartilage. Two expert microtia surgeons performed a microtia reconstruction on the simulator and evaluated its value and realism using a Likert-type questionnaire. The surgeons utilized a previously developed synthetic framework and successfully performed the critical steps of the soft tissue reconstruction, including marking, incising, dissection, removal of the cartilage remnant, drain insertion, insertion of the framework, closing of the skin, and demonstration of the soft tissue conforming over the framework using suction. A preliminary assessment of the simulator demonstrated that the simulator is anatomically accurate, realistic, and highly valuable as a training tool. A high-fidelity soft tissue microtia simulator was successfully developed and tested. The simulator provides a valuable training platform for learning a critical component of microtia reconstruction.
PubMed: 38869279
DOI: 10.1097/SCS.0000000000010322 -
The Journal of International Medical... Jun 2024We herein report a rare case of simultaneous intrauterine molar pregnancy and tubal pregnancy. A woman of childbearing age who had never been pregnant underwent an...
We herein report a rare case of simultaneous intrauterine molar pregnancy and tubal pregnancy. A woman of childbearing age who had never been pregnant underwent an ultrasound examination 70 days after the onset of menopause. She had a history of ovulation induction. The ultrasound findings suggested a partial hydatidiform mole. She was then pathologically confirmed to have a complete hydatidiform mole after uterine suction dilation and curettage. On postoperative day 4, an ultrasound examination before discharge showed an inhomogeneous mass in the left adnexal region with mild lower abdominal pain. On postoperative day 17, the blood human chorionic gonadotropin level did not drop as expected, and a follow-up examination still indicated a mass in the left adnexal region. We were unable to rule out an ectopic hydatidiform mole. Hysteroscopy with laparoscopic exploration of the left adnexal mass and salpingotomy suggested a diagnosis of intrauterine hydatidiform mole combined with left tubal pregnancy.
Topics: Humans; Female; Pregnancy; Hydatidiform Mole; Pregnancy, Tubal; Adult; Uterine Neoplasms; Pregnancy, Heterotopic; Ultrasonography
PubMed: 38869107
DOI: 10.1177/03000605241258572 -
Arthroscopy : the Journal of... Jun 2024Hip arthroscopy is an effective procedure with rapidly improving techniques and implants. Routine labral and capsular repair are broadly agreed upon as standard of care...
Hip arthroscopy is an effective procedure with rapidly improving techniques and implants. Routine labral and capsular repair are broadly agreed upon as standard of care in most cases, which is now supported by long-term outcome studies. A crucial component of patient postoperative success is physical therapy. While accelerated programs are appealing, biomechanical studies have consistently demonstrated decreased stability at time-zero following hip arthroscopy, particularly labral repairs. Therefore, though we want to help our patients get back to their lives as soon as possible, it remains our responsibility to protect their hip in the early postoperative period. If, in ideal laboratory conditions, we cannot restore stability to an intact state, then we must presuppose that the suction seal improves as the capsule, and more importantly, the labrum, heals after surgical manipulation. This means we are not able to rely solely on the strength of our repair, and there is a distinct period where the repaired hip is particularly vulnerable. Most hip arthroscopy protocols utilize a protective period, ranging from 4-8 weeks, where there is an emphasis on passive range of motion only, with a strict moratorium on "pushing beyond pain."
PubMed: 38866375
DOI: 10.1016/j.arthro.2024.06.006 -
Journal of Morphology Jun 2024The neurocranial elevation generated by axial muscles is widespread among aquatic gnathostomes. The mechanism has two functions: first, it contributes to the orientation...
The neurocranial elevation generated by axial muscles is widespread among aquatic gnathostomes. The mechanism has two functions: first, it contributes to the orientation of the mouth gape, and second, it is involved in suction feeding. To provide such mobility, anatomical specialization of the anterior part of the vertebral column has evolved in many fish species. In modern chimaeras, the anterior part of the vertebral column develops into the synarcual. Possible biological roles of the occipital-synarcual joint have not been discussed before. Dissections of the head of two species of ratfishes (Chimaera monstrosa and Chimaera phantasma) confirmed the heterocoely of the articulation surface between the synarcual and the neurocranium, indicating the possibility of movements in the sagittal and frontal planes. Muscles capable of controlling the movements of the neurocranium were described. The m. epaxialis is capable of elevating the head, the m. coracomandibularis is capable of lowering it if the mandible is anchored by the adductor. Lateral flexion is performed by the m. lateroventralis, for which this function was proposed for the first time. The first description of the m. epaxialis profundus is given, its function is to be elucidated in the future. Manipulations with joint preparations revealed a pronounced amplitude of movement in the sagittal and frontal planes. Since chimaeras generate weak decrease in pressure in the oropharyngeal cavity when sucking in prey, we hypothesised the primary effect of neurocranial elevation, in addition to the evident lateral head mobility, is accurate prey targeting.
Topics: Animals; Fishes; Skull; Adaptation, Physiological; Joints
PubMed: 38858850
DOI: 10.1002/jmor.21740 -
Scientific Reports Jun 2024Multi-grain hole-forming sowing and uniform hole spacing are important agronomic requirements for precise hole-direct seeding of rice.This paper designs a kind of...
Multi-grain hole-forming sowing and uniform hole spacing are important agronomic requirements for precise hole-direct seeding of rice.This paper designs a kind of impeller type seed guiding device. The main structural parameters of the impeller seed guide device were analyzed by constructing the kinematics model of the rice seed in the impeller seed guide process. The experiment analysis were carried out with the long-grain rice variety Chuangliangyou 4418 as the seeding object. The optimal structural parameter combination of seeding-guiding device was determined as inner impeller radius 56 mm, blade offset angle 11° and seeding angle 36°. On this basis, the seeding performance test of different seed guiding devices of internal suction seed-metering device was carried out by using rice seeds with different external dimensions. The test results show that the impeller has better cavitation and hole spacing uniformity than the seed guide tube. The average hole diameter is not higher than 21.7 mm, the qualified rate of hole diameter is not lower than 96.1%, and the coefficient of variation of hole spacing is not higher than 10.1%. Compared with the seed guide tube, which is increased by 32%, 16% and 34% respectively, and the average hole distance is about 200 mm in theory.
PubMed: 38858428
DOI: 10.1038/s41598-024-64002-x -
PloS One 2024Clear amniotic fluid aspiration syndrome (CAF-AS) is a very rare event occurring in 0.25% of our term clear amniotic fluids deliveries. The study's aims were: 1. to... (Observational Study)
Observational Study
BACKGROUND
Clear amniotic fluid aspiration syndrome (CAF-AS) is a very rare event occurring in 0.25% of our term clear amniotic fluids deliveries. The study's aims were: 1. to characterize the risk factors and outcomes associated with Clear Amniotic Fluid Aspiration Syndrome and 2. to compare the outcomes of Clear Amniotic Fluid Aspiration to Meconium Aspiration.
METHODS
This was an observational study over a 22-year period in a single level-3 medical center. Compared were parturient/labor characteristics and neonatal outcomes in cases with suspected Clear Amniotic Fluid Aspiration to cases suspected for Meconium Aspiration.
RESULTS
Out of 79,620 term deliveries there were 66,705 (83.8%) clear amniotic fluids and 12,915 (16.2%) meconium stained amniotic fluid (MSAF). Of neonates born with clear amniotic fluid, 166 (0.25%) were diagnosed with Clear Amniotic Fluid Aspiration Syndrome (CAF-AS), while 202 (15.7%) of those born with MSAF, were diagnosed with aspiration syndrome (MSAF-AS). Both conditions had comparable rates of mild manifestation (67.5% vs 69.2%, p = 0.63). Persistent pulmonary hypertension (PPH) occurred 5 times less in CAF-AS than MSAF-AS (4% vs 20%, OR 0.17, P< 0.0001) Both conditions presented similar rates of surfactant without PPH (11.1% vs 13.4%, p = 0.87). There was 1 postnatal death in CAF-AS vs 10 in MSAF.
CONCLUSION
CAF-AS were quantitatively quite similar in terms of need of actual active intervention of the neonatologists in the delivery room (166 vs 202, i.e. in terms of numbers of cases and not prevalence) to MSAF-AS.We identified in these cases two major specific causes: hyperkinetic explosive deliveries in multiparas and long-lasting episodes of maternal hypotension due to epidural/spinal anaesthesia during labor. Out of 140 million births per year in the world, it should be of concern that 3 million cases are neglected nowadays. Future studies should evaluate if this CAF-AS should benefit from a more active intervention such as immediate endotracheal suction at birth, this clear fluid being very easy to suction.
Topics: Humans; Female; Amniotic Fluid; Pregnancy; Meconium Aspiration Syndrome; Infant, Newborn; Adult; Risk Factors; Male
PubMed: 38857215
DOI: 10.1371/journal.pone.0301595 -
Applied Optics Apr 2024Retinal damage is a common intraoperative complication during vitrectomy, caused by a complex interplay between the suction of the vitrectome, the cut- and aspiration...
Retinal damage is a common intraoperative complication during vitrectomy, caused by a complex interplay between the suction of the vitrectome, the cut- and aspiration rate, and the distance of the instrument to the retina. To control this last factor, we developed two miniaturized fiber-optic distance sensors based on low-coherence interferometry for direct integration into the vitrectome. Both sensors have a diameter of 250 µm, which makes them compatible with a 25G vitrectome. The first sensor measures distance in the lateral direction. The second sensor is capable of simultaneously measuring distance in both the lateral and the axial direction. Axial and lateral directions correspond to the direction of the cutter port of the vitrectome and the direction along the vitrectome's shaft, respectively. In both sensors, a free-form mirror deflects and focuses the beam in the lateral direction. In the dual-axis distance sensor, an additional lens is integrated into the free-form mirror for distance measurement in the axial direction. The beam-shaping micro-optics at the tip of the sensor fibers were fabricated through two-photon polymerization and are selectively gold coated for increased reflectivity of the mirror. Distance measurements were successfully demonstrated in artificial samples and in ex vivo pig eyes with a back-end that uses a current-tuned VCSEL as a swept-source. We experimentally demonstrate that the complete sensor system can attain a of up to 80 dB. The small dimensions of the developed sensors make them a potential solution for various other medical applications.
PubMed: 38856375
DOI: 10.1364/AO.518950 -
Ultrasonics Sonochemistry Jul 2024Slightly acidic (pH 5.1) waste sludge with 4.7 % Total Solids (TS) was treated on a laboratory scale pined disc rotary generator of hydrodynamic cavitation (PD RGHC)....
Slightly acidic (pH 5.1) waste sludge with 4.7 % Total Solids (TS) was treated on a laboratory scale pined disc rotary generator of hydrodynamic cavitation (PD RGHC). Influence of four rotor discs with different number of cavitation generation units (CGUs) was investigated: 8-pins, 12-pins, 16-pins and 8-prism elements. The effect of hydrodynamic cavitation (HC) was investigated by analyzing rheological properties, surface tension, dewaterability, and particle size distribution. After subjecting the sludge to 30 cavitation passes, the dewatering ability of the sludge significantly decreased, resulting in a more than two-fold increase in Capillary Suction Time (CST). All regimes were successful in disintegrating particles to smaller sizes. A slight increase of sludge surface tension was measured post cavitation. Cavitated samples displayed a zero-shear viscosity, in contrast to the untreated sample, where viscosity noticeably increased as shear stress decreased. HC did not improve methane yield. Statistically significant correlations between physio-chemical properties and apparent viscosity at low shear stress were identified. Although there were no discernible statistical differences in sludge characteristics, some trends are visible among investigated CGU designs and warrant further research.
PubMed: 38852537
DOI: 10.1016/j.ultsonch.2024.106943