The Achilles tendon is the most frequently ruptured tendon. Both acute and chronic (neglected) tendon ruptures can dramatically affect a patient's quality of life, and require a prolonged period of ...recovery before return to pre-injury activity levels. This paper describes the use of an adhesive-coated biologic scaffold to augment primary suture repair of transected Achilles tendons. The adhesive portion consisted of a synthetic mimic of mussel adhesive proteins that can adhere to various surfaces in a wet environment, including biologic tissues. When combined with biologic scaffolds such as bovine pericardium or porcine dermal tissues, these adhesive constructs demonstrated lap shear adhesive strengths significantly greater than that of fibrin glue, while reaching up to 60% of the strength of a cyanoacrylate-based adhesive. These adhesive constructs were wrapped around transected cadaveric porcine Achilles tendons repaired with a combination of parallel and three-loop suture patterns. Tensile mechanical testing of the augmented repairs exhibited significantly higher stiffness (22-34%), failure load (24-44%), and energy to failure (27-63%) when compared to control tendons with suture repair alone. Potential clinical implications of this novel adhesive biomaterial are discussed.
Limited quantitative, physiological evidence exists regarding the effectiveness of Kinesio® Taping methods, particularly with respect to the potential ability to impact underlying physiological joint ...space and structures. To better understand the impact of these techniques, the underlying physiological processes must be investigated in addition to the examination of more subjective measures related to pain in unhealthy tissues.
The purpose of this study was to determine whether the Kinesio® Taping Space Correction Method created a significant difference in patellofemoral joint space, as quantified by diagnostic ultrasound.
Pre-test/post-test prospective cohort study.
Thirty-two participants with bilaterally healthy knees and no past history of surgery took part in the study. For each participant, diagnostic ultrasound was utilized to collect three measurements: the patellofemoral joint space, the distance from the skin to the superficial patella, and distance from the skin to the patellar tendon. The Kinesio® Taping Space Correction Method was then applied. After a ten-minute waiting period in a non-weight bearing position, all three measurements were repeated. Each participant served as his or her own control.
Paired
tests showed a statistically significant difference (mean difference = 1.1 mm,
= 2.823,
= 0.008,
= .465) between baseline and taped conditions in the space between the posterior surface of the patella to the medial femoral condyle. Neither the distance from the skin to the superficial patella nor the distance from the skin to the patellar tendon increased to a statistically significant degree.
The application of the Kinesio® Taping Space Correction Method increases the patellofemoral joint space in healthy adults by increasing the distance between the patella and the medial femoral condyle, though it does not increase the distance from the skin to the superficial patella nor to the patellar tendon.
3.
We report on extragalactic sources detected in a 455 deg2 map of the southern sky made with data at a frequency of 148 GHz from the Atacama Cosmology Telescope (ACT) 2008 observing season. We provide ...a catalog of 157 sources with flux densities spanning two orders of magnitude: from 15 mJy to 1500 mJy. Comparison to other catalogs shows that 98% of the ACT detections correspond to sources detected at lower radio frequencies. Three of the sources appear to be associated with the brightest cluster galaxies of low-redshift X-ray-selected galaxy clusters. Estimates of the radio to millimeter-wave spectral indices and differential counts of the sources further bolster the hypothesis that they are nearly all radio sources, and that their emission is not dominated by re-emission from warm dust. In a bright (>50 mJy) 148 GHz selected sample with complete cross-identifications from the Australia Telescope 20 GHz survey, we observe an average steepening of the spectra between 5, 20, and 148 GHz with median spectral indices of Delta *a5-20 = --0.07 ? 0.06, Delta *a20-148 = --0.39 ? 0.04, and Delta *a5-148 = --0.20 ? 0.03. When the measured spectral indices are taken into account, the 148 GHz differential source counts are consistent with previous measurements at 30 GHz in the context of a source count model dominated by radio sources. Extrapolating with an appropriately rescaled model for the radio source counts, the Poisson contribution to the spatial power spectrum from synchrotron-dominated sources with flux density less than 20 mJy is C Sync = (2.8 ? 0.3) X 10--6 Delta *mK2.
Endophyte-infected tall fescue (TF) contains alkaloids that can adversely affect the productivity and health of livestock. These effects are exacerbated when livestock forage on TF grown in ...monoculture, but they are mitigated when livestock forage on pastures that contain TF in mixture with tannin-containing plants, evidently because tannins bind to the steroidal and protein-like alkaloids found in TF. Cattle and sheep will drink water that contains up to 20g/L condensed tannins. We hypothesized that cattle (n=8) offered water containing quebracho tannins (10g/L) would eat more TF than cattle (n=8) offered plain water. During the trial, cattle were offered 9kg/(animal*d) of freshly harvested TF. Cattle drank less water with than without tannins (17.7kg/d vs. 24.6kg/d; P<0.005), and they tended to eat less TF (4.3kg/d vs. 5.1kg/d; P=0.10). No differences in weight change occurred during the trial (P=0.83) or between groups (P=0.70). The negative impacts of tannins on water intake likely depressed intake of TF, but the lower intakes of tannin water and TF did not adversely affect BW. On the one hand, water restriction and dehydration reduce food intake and any agent that limits intake of water will adversely affect food intake and animal performance. On the other hand, while cattle with fresh water maintained BW during the trial, so did cattle with tannin water, which suggests the tannin may have benefited the cattle fed a diet of orchard grass hay and TF. Further studies are required to assess the role of tannins in water on both the intake and performance of livestock eating TF.
Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations.
This is a COVID-19 and ...Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity.
1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 95% CI, 1.32-1.67); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70-6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 95% CI, 4.83-12.5); pre-existing cardiovascular (aOR, 2.26 95% CI, 1.63-3.15)/pulmonary comorbidities (aOR, 1.65 95% CI, 1.20-2.29); diabetes mellitus (aOR, 2.25 95% CI, 1.66-3.04); and active and progressing cancer (aOR, 12.5 95% CI, 6.89-22.6). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status.
Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to non-Hispanic White patients.
This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.
CCC19 registry is registered on ClinicalTrials.gov, NCT04354701.
We determined if sequence of ingestion affected USC of endophyte-infected tall fescue (TF) when cattle also grazed birdsfoot trefoil (BFT) or alfalfa (ALF). Based on chemical characteristics of TF ...(alkaloids), BFT (tannins), and ALF (saponins), we hypothesized that cattle first allowed to graze ALP or BFT would subsequently spend more time grazing TIP than cattle that first grazed TF followed by ALF or BFT. Sixteen bred heifers (478 ± 39 kg initial BW) were randomly assigned to 4 replicated pasture units. Each replicated unit consisted of 4 treatment sequences (TFarrow rightBFT, TFarrow rightALF, BFTarrow rightTF, or ALFarrow rightTF), with 2 cows per sequence. Pastures were in the vegetative stage of growth at a height of 20 to 30 cm and provided ad libitum forage to cattle. We recorded foraging on TF, BFT, and ALF using scan sampling of individuals at 2-min intervals. The study was conducted in 4 phases run sequentially, for a total of 30 d. In phases 1 arid 3, cattle in group 1 grazed TF pastures for 45 min and were then moved to BFT pastures for the next 45 mm (TFarrow rightBFT); cattle in group 2 grazed in the reverse sequence (BFTarrow rightTF). In phases 2 and 4, cattle in group 1 grazed TF pastures for 45 min and then subsequently grazed ALF pastures for the remaining 45 min (TFarrow rightALF); cattle in group 2 grazed in the reverse sequence (ALFarrow rightTF). Sequence of plant ingestion affected food selection. In phase 1, scans revealed grazing of TF by heifers was cyclic, and heifers tended to have more scans (P = 0.52) grazing TF when they grazed BFTarrow rightTF; scans for heifers grazing TF were consistently greater (P < 0.05) throughout phase 3 of the trial. In phase 2, heifers that grazed in the sequence ALFarrow rightTF spent considerably more scans (P = 0.03) foraging on TF from d 4 to 10 than heifers that grazed in the sequence TFarrow rightALF, and they remained greater throughout phase 4 of the trial. Although the sequence ALFarrow rightTF appeared to be more effective than BFTarrow rightTF, consistent with the hypothesis of a complementary relationship between the steroidal alkaloids in TF and saponins in ALF, tannin concentrations in BFT were minimal (1.8%), which likely reduced the presumed inactivation of alkaloids by tannins. We also speculate that heifers needed to learn about the positive postingestive influence of sequence, a notion consistent with more similar scans spent foraging BFT and TF early in phases 1 (BFTarrow rightTF) and 2 (ALFarrow rightTF), and with the consistent and marked increase in scans spent foraging on TF for animals foraging in phases 3 (BFTarrow rightTF) and 4 (ALFarrow rightTF). PUBLICATION ABSTRACT
Cost of Gram-negative resistance Evans, Heather L; Lefrak, Shayna N; Lyman, Jason ...
Critical care medicine
35, Številka:
1
Journal Article
Recenzirano
It is unclear that infections with Gram-negative rods resistant to at least one major class of antibiotics (rGNR) have a greater effect on patient morbidity than infections caused by sensitive ...strains (sGNR). We wished to test the hypothesis that rGNR infections are associated with higher resource utilization.
Retrospective observational cohort study of prospectively collected data.
University hospital surgical intensive care unit and ward.
Surgical patients with at least one GNR infection.
We compared admissions treated for rGNR infection with those with sGNR infections. Primary outcomes were total hospital costs and hospital length of stay. Other outcomes included antibiotic treatment cost, in-hospital death, and intensive care unit length of stay. After univariate analysis comparing outcomes after rGNR infection with those after sGNR infection, multivariate linear regression models for hospital cost and length of stay were created to account for potential confounders.
Cost data were available for 604 surgical admissions treated for at least one GNR infection (Centers for Disease Control and Prevention criteria), 137 (23%) of which were rGNR infections. Admissions with rGNR infections were associated with a higher severity of illness at the time of infection (Acute Physiology and Chronic Health Evaluation II score, 17.6 +/- 0.6 vs. 13.9 +/- 0.3), had higher median hospital costs ($80,500 vs. $29,604, p < .0001) and median antibiotic costs ($2,607 vs. $758, p < .0001), and had longer median hospital length of stay (29 vs. 13 days, p < .0001) and median intensive care unit length of stay (13 days vs. 1 day, p < .0001). Infection with rGNR within the first 7 days of admission was independently predictive of increased hospital cost (incremental increase in median hospital cost estimated at $11,075; 95% confidence interval, $3,282-$20,099).
Early infection with rGNR is associated with a high economic burden, which is in part related to increased antibiotic utilization compared with infection with sensitive organisms. Efforts to control overuse of antibiotics should be pursued.
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