To evaluate the effectiveness of prophylactic closed incision negative pressure wound therapy (ciNPWT) compared to conventional dressings in the prevention of periprosthetic joint infection (PJI) ...post hip and knee revision arthroplasty surgery.
Five databases (MEDLINE, Embase., Emcare, CINAHL and Scopus) were searched with no date or language limits. Two independent reviewers assessed articles against the inclusion criteria and methodological quality of the 3 included studies. Data was extracted using a customised data tool and included the intervention, study methods and outcomes of interest. A meta-analysis was performed, and results presented in narrative form with forest plots.
The three studies, one randomized control trial and two quasi-experimental studies, included 136 intervention and 228 control participants (Sample 364). The PJI rate decreased in the ciNPWT cohort compared to the conservative dressing cohort (2 1.47% vs 27 11.84%). The reoperation rate was lower in the ciNPWT cohort versus the conventional cohort (4 2.94% vs 35 15.35%). The rate of wound complications was significantly decreased in the ciNPWT cohort compared to the conventional dressing cohort (14 10.29% v 85 37.28), p=<0.001).
Prophylactic application of ciNPWT may be effective in reducing wound complications, PJI and reoperation post hip and knee revision arthroplasty surgery. The added cost of ciNPWT may be justified in the reduction of wound complications, PJI and reoperation. Ongoing trials determining if the prophylactic application of ciNPWT post hip and knee revision arthroplasty surgery is beneficial in preventing PJI particularly in high risk patients with additional comorbidities are warranted.
Modern mobile computing devices such as smart phones have become the major user-centric video data sources in future 5G wireless networks. However, battery energy efficiency becomes the critical ...bottleneck for such uplink multimedia contributors. In this paper we propose a new approach to reduce energy consumption while improving Quality of Experience (QoE), by innovatively investigating video encoding frame prioritization, mode, dependency, and rate control overheads, based on communication model of a transmitter device to an access-point via a relay device. In the proposed approach, we investigate various frame level encoding dependencies and different communication data rates to study their impacts on energy efficiency and QoE. We also incorporate some simple game theory concepts to determine the best compromise of energy-quality tradeoff between the transmitter and the relay. Simulation results demonstrate that cross layer exploration of encoding dependency and game theoretical rate control have significant energy saving and quality gain potentials.
Raising standards in mathematics education in Jamaica is an issue of national importance since Jamaican students are underachieving in math at most levels of education. Early childhood teachers are ...therefore entrusted with the responsibility of preparing students to be functional mathematically literate citizens. The purpose of this qualitative phenomenological study was to explore kindergarten teachers’ perception and attitude to teaching math. Vygotsky’s socio-cultural theory was the guiding theoretical framework of the study. Purposive sampling was used to select the sample comprised 15 teachers having at least three years practice teaching kindergarten students age 4-6 years from both public and private kindergartens in Kingston and St Andrew, Jamaica. Data from 15 in-depth semi-structured interviews were audio-recorded then transcribed for analysis using an iterative thematic approach. From the four research questions, exploring kindergarten teachers’ perception of teaching math, kindergarten teachers’ attitude towards the teaching of math, methods used by kindergarten teachers to teach their students math and methods of teaching math students most likely to achieve mastery; the findings revealed, Jamaican kindergarten teachers have negative perception and attitude towards teaching math. Teachers are cognizant their students need positive early start in learning math. This influenced their math pedagogical content knowledge and the methods and strategies utilized in practice, resulting in positive outcomes for their students. Educators, policy makers and researchers are encouraged to pay attention to the findings. Future studies are recommended to gain in-depth knowledge of kindergarten teachers’ math-related pedagogical content knowledge and their theoretical ideology on students’ math learning in general.
For every critically ill adult receiving invasive mechanical ventilation, clinicians must select a mode of ventilation. The mode of ventilation determines whether the ventilator directly controls the ...tidal volume or the inspiratory pressure. Newer hybrid modes allow clinicians to set a target tidal volume; the ventilator controls and adjusts the inspiratory pressure. A strategy of low tidal volumes and low plateau pressure improves outcomes, but the optimal mode to achieve these targets is not known.
Can a cluster-randomized trial design be used to assess whether the mode of mandatory ventilation affects the number of days alive and free of invasive mechanical ventilation among critically ill adults?
The Mode of Ventilation During Critical Illness (MODE) trial is a cluster-randomized, multiple-crossover pilot trial being conducted in the medical ICU at an academic center. The MODE trial compares the use of volume control, pressure control, and adaptive pressure control. The study ICU is assigned to a single-ventilator mode (volume control vs pressure control vs adaptive pressure control) for continuous mandatory ventilation during each 1-month study block. The assigned mode switches every month in a randomly generated sequence. The primary outcome is ventilator-free days to study day 28, defined as the number of days alive and free of invasive mechanical ventilation from the final receipt of mechanical ventilation to 28 days after enrollment. Enrollment began November 1, 2022, and will end on July 31, 2023.
This manuscript describes the protocol and statistical analysis plan for the MODE trial of ventilator modes comparing volume control, pressure control, and adaptive pressure control.
Prespecifying the full statistical analysis plan prior to completion of enrollment increases rigor, reproducibility, and transparency of the trial results.
The trial was registered with clinicaltrials.gov on October 3, 2022, before initiation of patient enrollment on November 1, 2022 (ClinicalTrials.gov identifier: NCT05563779).
Although computing and battery technology has improved for mobile devices, the advancement in battery technology is falling behind that of computing technology. Also, as more and more people are ...using mobile devices throughout everyday and for more applications, such as uploading or downloading multimedia directly on mobile devices, improving energy efficiency for this is necessary to prolong battery usage and life. This thesis presents a cross-layer scheduling approach for Quality of Experience (QoE) oriented energy efficiency in multimedia uplink communications for mobile device networks. We study the energy-quality tradeoffs and apply our strategy to the network communication model of a transmitter device to an access-point via a relay device. The strategy also incorporates some simple game theory concepts to determine the best compromise of the energy-quality tradeoff between the transmitter and relay. We investigate the different communication data rates of the standard IEEE 802.11b network protocol and various frame level dependency to examine their effects on energy efficiency and QoE.
Culinary spices are a rich source of dietary phytonutrients that may attenuate postprandial triglyceridemia. We assessed the effects of adding 14.5 g of spice blend (cloves, cinnamon, oregano, ...rosemary, ginger, black pepper, paprika, garlic powder, and turmeric) to a standardized meal in 20 healthy middle‐aged men and women in a randomized, placebo controlled, crossover design. Spiced test meals (1200 kcal, 50 g fat) consisted of a chicken and rice curry, corn muffin, and dessert pastry. Blood was sampled prior to the meal and at 4 additional time points (last sample 210 minutes after starting the meal). The addition of spices significantly reduced postprandial triglycerides (p < 0.0001). To examine a potential mechanism for reduction of postprandial lipemia, the spice blend was extracted with acetone:water:acetic acid (80:20:0.1) and tested for its ability to inhibit pancreatic lipase in vitro. The extract demonstrated potent inhibition of pancreatic lipase (IC50 = 32.7 ug/ml). This work demonstrates that adding spices to a meal decreases postprandial serum triglyceride concentrations and this effect may be due to inhibition of pancreatic lipase.
Grant Funding Source: McCormick Science Institute
Change during a 20-week group therapy program was researched for 40 women who were survivors of childhood sexual abuse. Results indicated that the women who participated in group therapy, compared ...with a quasi-experimental control group, decreased significantly on measures of depression, social maladjustment, self-blame, and posttraumatic stress responses, with no significant increases in anger. Scores on the main variables remained stable during assessment and follow-up periods for the women who participated in group therapy. In addition, there were no significantly different patterns of change based on either sexual abuse variables (number of perpetrators, sexual abuse by a father figure, nature of sexual abuse, and duration) or participation in concurrent individual therapy.
