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Orthopaedic Journal of Sports Medicine May 2024The labral suction seal has been shown to provide the majority of resistance in the initial phase of hip distraction. However, the effect of an unrepaired interportal...
BACKGROUND
The labral suction seal has been shown to provide the majority of resistance in the initial phase of hip distraction. However, the effect of an unrepaired interportal capsulotomy and capsular repair on the initial phase of hip distractive stability in vivo is not well understood.
PURPOSE
To investigate the effect of capsular repair on the initial phase of distractive stability of hip joints in patients with femoroacetabular impingement (FAI) syndrome.
STUDY DESIGN
Controlled laboratory study.
METHODS
Patients undergoing primary hip arthroscopy for FAI between March and August 2020 were prospectively enrolled. Total joint space was measured on fluoroscopic images at the medial and lateral edges of the sourcil at 12.5-lb (5.7-kg) axial traction intervals (up to 100 lb [45.4 kg]) in 3 capsular states: (1) native capsule, (2) interportal capsulotomy, and (3) capsular repair. Distraction on anteroposterior radiographs was calculated as the difference between total joint space at each traction interval and baseline joint space at 0 lb, normalized to millimeters. The native, capsulotomy, and capsular repair states were compared using Wilcoxon signed-rank and McNemar tests.
RESULTS
Included were 36 hips in 35 patients. The median force required to distract ≥3 mm was 75 lb (34.0 kg; 95% CI, 70-80 lb [31.8-36.3 kg]) in both the native and capsular repair states ( = .629), which was significantly greater than the median force required to distract ≥3 mm in the capsulotomy state (50 lb [22.7 kg]; 95% CI, 45-55 lb [20.4-24.9 kg]) ( < .001). The most rapid rates of change in joint space were observed at the traction interval at which hips first achieved ≥3 mm of distraction (n = 33 hips; 92%).
CONCLUSION
The traction force at which hips distracted ≥3 mm was 75 lb (34.0 kg) in both the native capsular and capsular repair states. Significantly less traction force (50 lb [22.7 kg]) distracted hips ≥3 mm in the capsulotomy state. Complete capsular closure after interportal capsulotomy resulted in restoration of initial distractive stability relative to the unrepaired capsulotomy state at time zero after primary hip arthroscopy.
CLINICAL RELEVANCE
This study provides surgeons with an improved understanding of the additional stability to the hip joint from capsular repair after hip arthroscopy for FAI syndrome.
PubMed: 38784788
DOI: 10.1177/23259671241249719 -
Scientific Data May 2024Remora albescens, also known as white suckerfish, recognized for its distinctive suction-cup attachment behavior and medicinal significance. In this study, we produced a...
Remora albescens, also known as white suckerfish, recognized for its distinctive suction-cup attachment behavior and medicinal significance. In this study, we produced a high-quality chromosome-level genome assembly of R. albescens through the integration of 23.87 Gb PacBio long reads, 64.54 Gb T7 short reads, and 88.63 Gb Hi-C data. Initially, we constructed a contig-level genome assembly totaling 605.30 Mb with a contig N50 of 23.12 Mb. Subsequently, employing Hi-C technology, approximately 99.68% (603.38 Mb) of the contig-level genome was successfully assigned to 23 pseudo-chromosomes. Through the integration of homologous-based predictions, ab initio predictions, and RNA-sequencing methods, we successfully identified a comprehensive set of 22,445 protein-coding genes. Notably, 96.36% (21,629 genes) of these were effectively annotated with functional information. The genome assembly achieved an estimated completeness of 98.1% according to BUSCO analysis. This work promotes the applicability of the R. albescens genome, laying a solid foundation for future investigations into genomics, biology, and medicinal importance within this species.
Topics: Animals; Chromosomes; Decapodiformes; Genome; Molecular Sequence Annotation
PubMed: 38778061
DOI: 10.1038/s41597-024-03363-4 -
Journal of Cystic Fibrosis : Official... May 2024Patient-derived intestinal organoids (PDIOs) show great potential as in vitro drug testing platform for personalised medicine in Cystic Fibrosis and oncology. PDIOs can...
BACKGROUND
Patient-derived intestinal organoids (PDIOs) show great potential as in vitro drug testing platform for personalised medicine in Cystic Fibrosis and oncology. PDIOs can be generated by culturing adult stem cells obtained through rectal forceps biopsy or suction biopsy, but the safety of these procedures and the success rates of generating organoids after shipment to a centralized lab using these procedures has not been studied in this context. We here report the safety and success rates of both biopsy procedures and the subsequent generation of PDIOs in the international multicentre HIT-CF Organoid Study.
METHODS
502 biopsy procedures were conducted, on 489 adult people with Cystic Fibrosis from 33 different hospitals across 12 countries. Depending on the preference of the hospital, either rectal forceps biopsies or suction biopsies were obtained and internationally shipped to a central laboratory for organoid generation.
RESULTS
No adverse events were reported for 280 forceps biopsy procedures, while 222 rectal suction biopsy procedures resulted in 2 adverse events, namely continued bleeding and a probably nonrelated gastroenteritis. The success rate of organoid generation from all biopsies was 95%, and the main reason for failure was insufficient sample viability (3.2%).
CONCLUSION
Our results indicate that both rectal suction biopsy and forceps biopsy procedures are safe procedures. The high success rates of PDIO generation from the obtained tissue samples demonstrate the feasibility of the organoid technology for personalised in vitro testing in an international setting.
PubMed: 38763840
DOI: 10.1016/j.jcf.2024.04.016 -
Journal of the Mechanical Behavior of... Jul 2024A full understanding of the material properties of skin tissue is crucial for exploring its tribo-mechanical behaviour. It has been widely accepted that the mechanical...
A full understanding of the material properties of skin tissue is crucial for exploring its tribo-mechanical behaviour. It has been widely accepted that the mechanical behaviour of skin tissue for both small and large deformations can be accurately described using a hyperelastic model, such as the one developed by Ogden. However, obtaining these Ogden parameters for in-vivo skin by in-vivo experiments no matter the indentation or suction tests is a significant challenge. The mathematical model used to describe the material behaviour during the test should consider not only the material nonlinearity but also the geometrical confinement of the tissue, the large deformations induced, and the fact that the specimens are relatively thin. A range of contact models is available to describe the contact behaviour during the indentation test. However, none of them can be used for hyperelastic materials with small thickness under large deformations. Simultaneously explaining material nonlinearity and geometric nonlinearity, either through theoretical equations or numerical calculations, poses a significant challenge. In this research, we propose a pragmatic method to obtain Ogden parameters for in-vivo skin tissue by combining experimental indentation results and numerical simulations. The indentation tests were used to obtain the force-indentation depth curves, while the numerical simulations were used to obtain the strain fields. The method assumes the material behaviour of specimens can be linearized in each small deformation increment, and the contact model developed by Hayes can be applied to accommodate each increment. Then, the linear elastic behaviour in each increment can be described by the elastic modulus E which were obtained using Hayes model, and the principal stresses in each increment were subsequently obtained using Hooke's law. By combining all stress fields, overall stress-strain curves can be constructed, from which the hyperelastic Ogden parameters can be obtained. A second numerical simulation of the hyperelastic indentation was then performed using the obtained Ogden parameters, allowing a comparison of the experimental and simulated relationships between force and indentation.
Topics: Materials Testing; Biomechanical Phenomena; Elasticity; Skin; Mechanical Tests; Stress, Mechanical
PubMed: 38761525
DOI: 10.1016/j.jmbbm.2024.106574 -
European Heart Journal. Case Reports May 2024The use of mechanical circulatory support (MCS) has markedly increased over the last decade, so have the inter-hospital transfers, with the aim of being able to offer...
BACKGROUND
The use of mechanical circulatory support (MCS) has markedly increased over the last decade, so have the inter-hospital transfers, with the aim of being able to offer advanced heart failure (AHF) therapies and centralizing patients to tertiary centres.
CASE SUMMARY
In this article, we present the first in Europe long-distance air transfer of a patient supported by veno-arterial extracorporeal membrane oxygenator and Impella (ECPELLA), as a bridge to successful heart transplant. In our case report, a foreign young patient with AHF due to familiar cardiomyopathy required multiple MCS devices to achieve cardiovascular stability. After appropriate planning and multidisciplinary discussion, the patient was transferred on MCS to his country of origin via a fixed-wing airplane, in order to be assessed for heart transplantation. During take-off, the Impella flows temporarily dropped and a suction alarm was displayed; however, this rectified without intervention, and the rest of the flight was uneventful. One month after transfer, the patient underwent successful heart transplantation and remained clinically stable during the 12-month follow-up.
DISCUSSION
Our experience links together the current challenges in the evolving AHF strategies and the increased need for inter-facility cooperation. Both these clinical and logistic challenges appear to lead to possible improved outcomes, after appropriate assessment, training, and accurate planning. Our experience provides useful information on feasibility of long-distance transport of patients supported by ECPELLA in Europe.
PubMed: 38751900
DOI: 10.1093/ehjcr/ytae151 -
International Journal of Nursing... Jun 2024The release of ChatGPT for general use in 2023 by OpenAI has significantly expanded the possible applications of generative artificial intelligence in the healthcare...
BACKGROUND
The release of ChatGPT for general use in 2023 by OpenAI has significantly expanded the possible applications of generative artificial intelligence in the healthcare sector, particularly in terms of information retrieval by patients, medical and nursing students, and healthcare personnel.
OBJECTIVE
To compare the performance of ChatGPT-3.5 and ChatGPT-4.0 to clinical nurses on answering questions about tracheostomy care, as well as to determine whether using different prompts to pre-define the scope of the ChatGPT affects the accuracy of their responses.
DESIGN
Cross-sectional study.
SETTING
The data collected from the ChatGPT was collected using the ChatGPT-3.5 and 4.0 using access provided by the University of Hong Kong. The data from the clinical nurses working in mainland China was collected using the Qualtrics survey program.
PARTICIPANTS
No participants were needed for collecting the ChatGPT responses. A total of 272 clinical nurses, with 98.5 % of them working in tertiary care hospitals in mainland China, were recruited using a snowball sampling approach.
METHOD
We used 43 tracheostomy care-related questions in a multiple-choice format to evaluate the performance of ChatGPT-3.5, ChatGPT-4.0, and clinical nurses. ChatGPT-3.5 and GPT-4.0 were both queried three times with the same questions by different prompts: no prompt, patient-friendly prompt, and act-as-nurse prompt. All responses were independently graded by two qualified otorhinolaryngology nurses on a 3-point accuracy scale (correct, partially correct, and incorrect). The Chi-squared test and Fisher exact test with post-hoc Bonferroni adjustment were used to assess the differences in performance between the three groups, as well as the differences in accuracy between different prompts.
RESULTS
ChatGPT-4.0 showed significantly higher accuracy, with 64.3 % of responses rated as 'correct', compared to 60.5 % in ChatGPT-3.5 and 36.7 % in clinical nurses ( = 74.192, < .001). Except for the 'care for the tracheostomy stoma and surrounding skin' domain ( = 6.227, = .156), scores from ChatGPT-3.5 and -4.0 were significantly better than nurses' on domains related to airway humidification, cuff management, tracheostomy tube care, suction techniques, and management of complications. Overall, ChatGPT-4.0 consistently performed well in all domains, achieving over 50 % accuracy in each domain. Alterations to the prompt had no impact on the performance of ChatGPT-3.5 or -4.0.
CONCLUSION
ChatGPT may serve as a complementary medical information tool for patients and physicians to improve knowledge in tracheostomy care.
TWEETABLE ABSTRACT
ChatGPT-4.0 can answer tracheostomy care questions better than most clinical nurses. There is no reason nurses should not be using it.
PubMed: 38746816
DOI: 10.1016/j.ijnsa.2024.100181 -
Nature Communications May 2024Snails can stably slide across a surface with only a single high-payload sucker, offering an efficient adhesive locomotion mechanism for next-generation climbing robots....
Snails can stably slide across a surface with only a single high-payload sucker, offering an efficient adhesive locomotion mechanism for next-generation climbing robots. The critical factor for snails' sliding suction behaviour is mucus secretion, which reduces friction and enhances suction. Inspired by this, we proposed an artificial sliding suction mechanism. The sliding suction utilizes water as an artificial mucus, which is widely available and evaporates with no residue. The sliding suction allows a lightweight robot (96 g) to slide vertically and upside down, achieving high speeds (rotation of 53°/s and translation of 19 mm/s) and high payload (1 kg as tested and 5.03 kg in theory), and does not require energy during adhesion. Here, we show that the sliding suction is a low-cost, energy-efficient, high-payload and clean adhesive locomotion strategy, which has high potential for use in climbing robots, outdoor inspection robots and robotic transportation.
PubMed: 38740752
DOI: 10.1038/s41467-024-48293-2 -
Journal of Thoracic Disease Apr 2024The postoperative outcomes of suction drainage versus non-suction drainage after uniportal video-assisted thoracoscopic surgery (UniVATS) come with little consensus....
BACKGROUND
The postoperative outcomes of suction drainage versus non-suction drainage after uniportal video-assisted thoracoscopic surgery (UniVATS) come with little consensus. This study aimed to prospectively compare the postoperative outcomes of suction drainage versus non-suction drainage in patients who underwent UniVATS.
METHODS
Between October 2022 and January 2023, patients undergoing UniVATS were prospectively enrolled. The choice of drainage strategy (suction or non-suction) was at the surgeon's discretion. The primary outcome was chest tube duration, with secondary outcomes including postoperative drainage volume, pain scores, postoperative complications, length of hospital stay, and hospitalization cost. Baseline characteristics and postoperative outcomes were compared. Univariable and multivariable analyses were used to identify risk factors for postoperative outcomes.
RESULTS
A total of 206 patients were enrolled in this study, with 103 patients in each group. Baseline characteristics were well-balanced. The chest tube duration did not significantly differ between the two groups. However, suction drainage exhibited a significantly lower total drainage volume compared to non-suction drainage (280.00 400.00 mL, P=0.03). Suction drainage was associated with a significantly shorter postoperative hospital stay (3.00 4.00 days, P<0.001) and lower pain score on the second postoperative day (POD). Multivariable analyses also confirmed that suction drainage was significantly correlated with a lower total drainage volume and a shorter postoperative hospital stay.
CONCLUSIONS
These findings suggested that the suction drainage was superior to non-suction drainage in terms of postoperative drainage volume and length of hospital stay in patients undergoing UniVATS.
PubMed: 38738235
DOI: 10.21037/jtd-23-1852 -
The Journal of Maternal-fetal &... Dec 2024Postpartum hemorrhage is a leading cause of maternal mortality and morbidity around the globe. The novel low-suction vacuum hemorrhage device (VHD) provides an... (Review)
Review
OBJECTIVE
Postpartum hemorrhage is a leading cause of maternal mortality and morbidity around the globe. The novel low-suction vacuum hemorrhage device (VHD) provides an alternative treatment option for cases of postpartum hemorrhage when first-line uterotonic agents fail. This systematic review aims to review current data evaluating the overall efficacy and safety of VHDs in treating postpartum hemorrhage.
METHODS
We searched CINAHL Ultimate, Academic Search Premier, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE with Full Text, and PubMed and reference lists of retrieved studies for eligible studies that included outcomes of effectiveness, efficacy, or safety. Two independent reviewers used Covidence.org to screen Titles and Abstracts for 69 studies of which six were included in the analysis. Secondary outcomes measured across studies included time to bleeding control, total device deployment time, and adverse effects.
RESULTS
Six nonrandomized trials ( = 1018 participants) included studies conducted in Indonesia, the United States, Switzerland, and Canada. The VHDs were found to have 90% effectiveness in achieving bleeding control across the studies. For most patients, this was achieved in <5 min and required a total device deployment time of 3 h. Reported adverse events were not considered life-threatening, including endometritis in 11 patients and red blood cell transfusions in 38% of patients.
CONCLUSION
VHDs have the potential to be used as a rapidly effective means for mechanical intervention of postpartum hemorrhage. The efficacy and safety of VHDs must be further studied at the randomized controlled trial level to determine their clinical usage.
Topics: Humans; Postpartum Hemorrhage; Female; Pregnancy
PubMed: 38735867
DOI: 10.1080/14767058.2024.2349957 -
The Journal of Maternal-fetal &... Dec 2024Presently, the efficacy of neonatal resuscitation techniques interventions such as oral, nasal, and endotracheal suction for preventing meconium aspiration syndrome...
BACKGROUND
Presently, the efficacy of neonatal resuscitation techniques interventions such as oral, nasal, and endotracheal suction for preventing meconium aspiration syndrome (MAS) after delivery has not been satisfactory.
OBJECTIVE
This study aimed to investigate the role of intratracheal instillation of budesonide on oxidative stress in MAS.
METHODS
Sixty-two neonates with MAS admitted to Huai'an Maternity and Child Healthcare Hospital from January 2018 to June 2020 were divided into a study group (intratracheal instillation of 2 ml budesonide suspension; = 31) and a control group (intratracheal instillation of 2 ml normal saline; = 31). Collect data from two groups of patients and evaluate clinical outcomes, including oxygenation index (OI), as well as serum total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI) and 8-Isoprostane before treatment and 72h after admission.
RESULTS
We found no statistical differences in mortality, complication rate, total oxygen inhalation time, OI before treatment and 72h after admission between the two groups of neonates with MAS, while the duration of invasive respiratory support in the study group was significantly shorter than in the control group. Also, serum TAC, TOS, OSI and 8-isoprostane levels were not statistically different before treatment between the two groups. After 72h of admission, OSI and 8-Isoprostane in neonates with MAS in the study group were much lower than those in the control group. TOS, OSI, 8-Isoprostane in the control group and 8-Isoprostane in the study group were significantly higher than those before treatment. As for TAC and TOS, no significant differences were observed between the two groups.
CONCLUSION
Intratracheal instillation of budesonide was shown to alleviate oxidative stress and shorten invasive ventilation time in neonates with MAS.
Topics: Humans; Meconium Aspiration Syndrome; Infant, Newborn; Oxidative Stress; Budesonide; Female; Male; Saline Solution; Instillation, Drug; Case-Control Studies; Dinoprost
PubMed: 38735865
DOI: 10.1080/14767058.2024.2337708