The purpose of our study was to estimate the future incidence rate (IR) and volume of primary total knee arthroplasty (TKA) in the United States from 2015 to 2050 using a conservative projection ...model that assumes a maximum IR of procedures. Furthermore, our study compared these projections to a model assuming exponential growth, as done in previous studies, for illustrative purposes.
A population based epidemiological study was conducted using data from US National Inpatient Sample (NIS) and Census Bureau. Primary TKA procedures performed between 1993 and 2012 were identified. The IR, 95% confidence intervals (CI), or prediction intervals (PI) of TKA per 100,000 US citizens over the age of 40 years were calculated. The estimated IR was used as the outcome of a regression modelling with a logistic regression (i.e., conservative model) and Poisson regression equation (i.e., exponential growth model).
Logistic regression modelling suggests the IR of TKA is expected to increase 69% by 2050 compared to 2012, from 429 (95%CI 374–453) procedures/100,000 in 2012 to 725 (95%PI 121–1041) in 2050. This translates into a 143% projected increase in TKA volume. Using the Poisson model, the IR in 2050 was projected to increase 565%, to 2854 (95%CI 2278–4004) procedures/100,000 IR, which is an 855% projected increase in volume compared to 2012.
Even after using a conservative projection approach, the number of TKAs in the US, which already has the highest IR of knee arthroplasty in the world, is expected to increase 143% by 2050.
BACKGROUND:Total hip arthroplasty (THA) is an effective operation for the management of end-stage hip osteoarthritis, but long-term success can be limited by wear of the polyethylene bearing surface. ...Cross-linking conventional polyethylene has resulted in lower wear rates and a reduction in bone lysis in both laboratory and clinical studies. The aim of this study was to compare the rates of revision between cross-linked polyethylene (XLPE) and conventional non-cross-linked polyethylene (CPE) at 16 years after THAs performed for the treatment of osteoarthritis.
METHODS:We performed an observational study of data, from a national registry, on all patients who underwent THA for osteoarthritis in Australia from 1999 through December 31, 2016. The outcomes of THAs performed with CPE were compared with those of THAs performed with XLPE, along with an analysis of the effect of age, sex, femoral head size, the method of acetabular and femoral component fixation, and the reasons and types of revision. The principal outcome measure was the time to the first revision, determined using Kaplan-Meier estimates of survivorship.
RESULTS:CPE was used in 41,171 procedures, and XLPE was used in 199,131. The mean ages of the men and women treated with CPE were 70.0 years (standard deviation SD = 9.9 years) and 72.5 years (SD = 9.7 years), respectively, whereas the men and women who received XLPE were slightly younger (mean age, 68.6 years SD = 10.3 years and 70.7 years SD = 9.9 years, respectively. XLPE was associated with a lower rate of revision than CPE at 6 months, and this difference became more apparent with time. The 16-year cumulative percentage of revisions of the primary THAs was 11.7% (95% confidence interval CI = 11.1% to 12.3%) in the CPE group and 6.2% (95% CI = 5.7% to 6.7%) in the XLPE group. The hazard ratio at 9 years was 3.02 (p = 0.001).
CONCLUSIONS:The use of XLPE has resulted in a significant reduction in the rate of revision at 16 years following THA for osteoarthritis. This evidence suggests that the longevity of THA is likely to be improved, which may enable younger patients to undergo surgery, confident of a reduced need for revision in the long term.
LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Titan has a methane cycle akin to Earth's water cycle. It has lakes in polar regions, preferentially in the north; dry low latitudes with fluvial features and occasional rainstorms; and tropospheric ...clouds mainly (so far) in southern middle latitudes and polar regions. Previous models have explained the low-latitude dryness as a result of atmospheric methane transport into middle and high latitudes. Hitherto, no model has explained why lakes are found only in polar regions and preferentially in the north; how low-latitude rainstorms arise; or why clouds cluster in southern middle and high latitudes. Here we report simulations with a three-dimensional atmospheric model coupled to a dynamic surface reservoir of methane. We find that methane is cold-trapped and accumulates in polar regions, preferentially in the north because the northern summer, at aphelion, is longer and has greater net precipitation than the southern summer. The net precipitation in polar regions is balanced in the annual mean by slow along-surface methane transport towards mid-latitudes, and subsequent evaporation. In low latitudes, rare but intense storms occur around the equinoxes, producing enough precipitation to carve surface features. Tropospheric clouds form primarily in middle and high latitudes of the summer hemisphere, which until recently has been the southern hemisphere. We predict that in the northern polar region, prominent clouds will form within about two (Earth) years and lake levels will rise over the next fifteen years.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, KISLJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We summarize procedures for producing 'nanoemulsions' comprised of nanoscale droplets, or 'nanoemulsions', methods for controlling the droplet size distribution and composition, and interesting ...physical properties of nanoemulsions. In contrast to more common microscale emulsions, nanoemulsions exhibit optical transparency at high droplet volume fractions, D*q, surprisingly strong elasticity at low D*q, and enhanced diffusive transport and shelf stability. For these reasons, nanoemulsions have great potential in a wide range of industries including pharmaceuticals, foods, and personal care products.
FOXO1, TGF-β regulation and wound healing Hameedaldeen, Alhassan; Liu, Jian; Batres, Angelika ...
International journal of molecular sciences,
09/2014, Letnik:
15, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Re-epithelialization is a complex process that involves migration and proliferation of keratinocytes, in addition to the production of cytokines and growth factors that affect other cells. The ...induction of transcription factors during these processes is crucial for successful wound healing. The transcription factor forkhead boxO-1 (FOXO1) has recently been found to be an important regulator of wound healing. In particular, FOXO1 has significant effects through regulation of transforming growth factor-beta (TGF-β) expression and protecting keratinocytes from oxidative stress. In the absence of FOXO1, there is increased oxidative damage, reduced TGF-β1 expression, reduced migration and proliferation of keratinocytes and increased keratinocytes apoptosis leading to impaired re-epithelialization of wounds.
Mitochondrial Dysfunction and Multiple Sclerosis Barcelos, Isabella Peixoto de; Troxell, Regina M; Graves, Jennifer S
Biology (Basel, Switzerland),
05/2019, Letnik:
8, Številka:
2
Journal Article
Recenzirano
Odprti dostop
In recent years, several studies have examined the potential associations between mitochondrial dysfunction and neurodegenerative diseases such as multiple sclerosis (MS), Parkinson's disease and ...Alzheimer's disease. In MS, neurological disability results from inflammation, demyelination, and ultimately, axonal damage within the central nervous system. The sustained inflammatory phase of the disease leads to ion channel changes and chronic oxidative stress. Several independent investigations have demonstrated mitochondrial respiratory chain deficiency in MS, as well as abnormalities in mitochondrial transport. These processes create an energy imbalance and contribute to a parallel process of progressive neurodegeneration and irreversible disability. The potential roles of mitochondria in neurodegeneration are reviewed. An overview of mitochondrial diseases that may overlap with MS are also discussed, as well as possible therapeutic targets for the treatment of MS and other neurodegenerative conditions.
The objective of our study was to determine the utility of radiomics features in differentiating CT cases of pancreatic ductal adenocarcinoma (PDAC) from normal pancreas.
In this retrospective ...case-control study, 190 patients with PDAC (97 men, 93 women; mean age ± SD, 66 ± 9 years) from 2012 to 2017 and 190 healthy potential renal donors (96 men, 94 women; mean age ± SD, 52 ± 8 years) without known pancreatic disease from 2005 to 2009 were identified from radiology and pathology databases. The 3D volume of the pancreas was manually segmented from the preoperative CT scans by four trained researchers and verified by three abdominal radiologists. Four hundred seventy-eight radiomics features were extracted to express the phenotype of the pancreas. Forty features were selected for analysis because of redundancy of computed features. The dataset was divided into 255 training cases (125 normal control cases and 130 PDAC cases) and 125 validation cases (65 normal control cases and 60 PDAC cases). A random forest classifier was used for binary classification of PDAC versus normal pancreas of control cases. Accuracy, sensitivity, and specificity were calculated.
Mean tumor size was 4.1 ± 1.7 (SD) cm. The overall accuracy of the random forest binary classification was 99.2% (124/125), and AUC was 99.9%. All PDAC cases (60/60) were correctly classified. One case from a renal donor was misclassified as PDAC (1/65). The sensitivity was 100%, and specificity was 98.5%.
Radiomics features extracted from whole pancreas can be used to differentiate between CT cases from patients with PDAC and healthy control subjects with normal pancreas.
Multiple sclerosis (MS) is an autoimmune disease affecting the central nervous system that causes significant disability and healthcare burden. The treatment of MS has evolved over the past three ...decades with development of new, high efficacy disease modifying therapies targeting various mechanisms including immune modulation, immune cell suppression or depletion and enhanced immune cell sequestration. Emerging therapies include CNS-penetrant Bruton's tyrosine kinase inhibitors and autologous hematopoietic stem cell transplantation as well as therapies aimed at remyelination or neuroprotection. Therapy development for progressive MS has been more challenging with limited efficacy of current approved agents for inactive disease and older patients with MS. The aim of this review is to provide a broad overview of the current therapeutic landscape for MS.
Long-term neuropsychiatric sequelae of autoimmune encephalitis (AE) remain understudied, particularly in pediatric-onset AE. We aimed to synthesize the published data on ongoing psychiatric symptoms ...in pediatric-onset AE.
The Pubmed, PyscINFO, Web of Science databases were searched from their inception years to August 23, 2021, and 29 studies were identified and analyzed. We also performed a quantitative synthesis of available patient data from the 29 studies combined with a cohort of anti-NMDA receptor (NMDAR) AE from our institution to examine the associations between acute treatment course and long-term psychiatric outcome.
At long-term follow up, 52.4% of the cases with pediatric-onset AE had any persistent symptom and 36.0% had at least one psychiatric symptom. Pooled data found that 36.3% of pediatric-onset anti-NMDAR AE had ongoing psychiatric symptoms. Using a univariate logistic regression analysis, we found that abnormal initial EEG, use of certain immunotherapies, and persistent cognitive impairments were associated with ongoing psychiatric symptoms.
Limitations of the existing literature included a significant paucity of outcomes measured using consistent, objective methods. Limitations of the systematic review included the wide variability among the studies reviewed, which rendered a meta-analysis impossible and beyond the scope of the paper.
Chronic psychiatric and behavioral problems remain present in one-third of children months to years after onset of AE. Larger scaled prospective observational studies with a consistent standardized battery of testing are needed to examine impact of specific clinical features and immunotherapies on long-term mental health outcomes.
•There is very little data on long-term psychiatric outcome data for pediatric-onset autoimmune encephalitis (AE).•A total of 29 studies were analyzed in the systematic review, and study quality was mostly low to medium.•One-third of children with AE have long-term psychiatric symptoms.•Longitudinal psychiatric testing and care are essential to the management of patients with AE.
A novel method of producing intense short wavelength radiation from relativistic electrons is described. The electrons are periodically bunched at the wavelength of interest enabling in-phase ...superradiant emission that is far more intense than from unbunched electrons. The periodic bunching is achieved in steps beginning with an array of beamlets emitted from a nanoengineered field emission array. The beamlets are then manipulated and converted to a longitudinal density modulation via a transverse-to-longitudinal emittance exchange. Periodic bunching at short wavelength is shown to be possible, and the partially coherent x-ray properties produced by inverse Compton scattering from an intense laser are estimated. The proposed method increases the efficiency of x-ray production by several orders of magnitude, potentially enabling compact x-ray sources to produce brilliance and flux similar to major synchrotron facilities.
PDF
