To study the effect of periodic plasma irradiation on deuterium (D) retention in tungsten (W), an irradiation experiment with low-energy (50 eV) and high-flux (∼1022 m−2 s−1) ions was simulated ...through the coupling with collision and diffusion processes of injected D atoms. The irradiation was interrupted over one and two time intervals until the total fluence reached 1026 Dm−2, in order to compare with the continuous irradiation case. The time evolution of the D atoms retained in W was calculated using the observed time variation of the material temperature and the irradiation sequences used in the experiments. After the periodic irradiation, the thermal desorption spectroscopy spectra were calculated, and the retention properties (depths, D/W ratios, and detrapping energies of the trapping sites) were estimated through comparison with the experimental spectra. At a temperature of 573 K, the irradiation with one interruption interval was found to increase the depth of the trapped D atoms and reduce the D/W ratio of the trapping sites with a low detrapping energy, compared with the continuous irradiation case. However, at 643 K, the depth was found to be decreased, and the D/W ratio of the trapping sites with a high detrapping energy was slightly increased; thus, the total retention was also slightly increased.
This study assessed the serial volume changes in multiple shoulder muscles simultaneously following arthroscopic rotator cuff repair (ARCR) by a three-dimensional (3D) modeling-based sectional ...measurement. These volume changes were correlated with background preoperative factors.
Four consecutive magnetic resonance imaging scans (preoperatively and postoperatively at 3, 6, and 12 months) of 33 shoulders from 31 patients who underwent arthroscopic rotator cuff repair were examined. We focused on the sectional volume differences of the supraspinatus, infraspinatus, teres minor, and subscapularis between preoperatively and 3 months postoperatively (Dif.pre.3mo) and between 3 and 12 months postoperatively (Dif.3.12mo). The correlation between volume differences and clinical/demographic parameters was determined by a multivariate analysis.
No statistically significant differences were observed for most serial changes in the shoulder muscle volumes. The tear-site muscles (supraspinatus and infraspinatus) showed similar tendencies for volume changes, whereas the non-tear-site muscles (teres minor and subscapularis) differed. A negative correlation was observed between Dif.pre.3mo and Dif.3.12mo for the supraspinatus, infraspinatus, and teres minor. These perioperative volume differences might correlate with tear size and symptom duration in the supraspinatus, as well as with a history of steroid injections and work and sports activity levels in the infraspinatus and teres minor.
The serial volume changes in multiple shoulder muscles after ARCR measured using our 3D sectional approach exhibited different tendencies and clinical implications depending on the primary and non-primary site of tears. Our method may serve as a potential indicator to facilitate muscle recovery and prevent the progression of postoperative muscle atrophy.
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In general, the diagnosis of pedicle screw (PS) loosening is evaluated qualitatively based on the presence of a radiolucent area around the implant wider than 1 mm on plain radiographs and computed ...tomography (CT). Digital tomosynthesis is a novel imaging technology that can acquire reconstructed tomographic images of patients in different postures with relatively low radiation. In this study, PS loosening is evaluated quantitatively by measuring the PS displacement angle in the vertebrae using digital tomosynthesis.
We evaluated 41 patients who underwent posterior spinal fusion surgery using PS. The 72 pedicle screws at the cranial end of the fused segments were evaluated. The patients were divided in two groups, one with PS loosening (7 patients, 12 screws) and the other without PS loosening (34 patients, 60 screws), based on conventional CT findings. All patients underwent tomosynthesis in two different postures during a single CT session.
The displacement angles of the PS in patients in a lying position and in a standing position were measured using selected slices of the same cross-sectional view from digital tomosynthesis. The displacement angle was significantly greater in the PS loosening group (5.7°) than in the group without PS loosening (0.6°) (p<0.01). Based on the ROC analysis, the optimal cut-off value of the PS displacement angle for identification of loosened screws was 1.7° with a sensitivity of 100% and specificity of 93% (AUC = 0.98).
This new method using digital tomosynthesis has the potential to aid diagnosis of PS loosening quantitatively and more accurately than conventional evaluations.
The present study investigated the relationships between the median nerve cross-sectional area (CSA) and physical characteristics in patients with unilateral symptomatic carpal tunnel syndrome (CTS).
...Height, weight, body mass index (BMI), disease duration, results of electrodiagnostic testing (EDX), and median nerve CSA at the level of the wrist crease were recorded in 81 patients with CTS who presented with symptoms on only one side. Correlation coefficients between median nerve CSA and physical characteristics, disease duration, and results of EDX were analyzed.
Median nerve CSA at the wrist crease (mm
) was significantly larger on the symptomatic side (14.1 ± 3.8) than on the asymptomatic side (11.5 ± 2.9). Median nerve CSA correlated with body weight (correlation coefficient = 0.39) and BMI (correlation coefficient = 0.44) on the asymptomatic side, but not on the symptomatic side. These correlations were slightly stronger in females (correlation coefficient = 0.46) than in males (correlation coefficient = 0.40). No correlations between median nerve CSA and disease duration and the results of EDX were observed in both sides.
In patients with unilateral symptomatic CTS, median nerve CSA correlated with BMI only on the asymptomatic side. The present results suggest that the relationship between median nerve CSA and BMI in CTS is significant until symptom onset but may be masked by edema and pseudoneuroma after its onset. A higher BMI is associated with a larger CSA of the median nerve, which may be a risk factor for the development of CTS.
A distributed activation energy model (DAEM) was applied to the kinetic analysis of CO2 and H2O gasification reactions for pulverized metallurgical coke. The results of the scanning electron ...microscopy observations and CO2 gas adsorption suggested that the gasification reaction occurs at the particle surface. Therefore, a grain model was employed as a gasification reaction model. The reaction rates of CO2 and H2O gasification were evaluated based on the DAEM. The activation energy changed as the reaction progressed and hardly depended on the particle size. The activation energies were 200–260 kJ/mol in CO2 gasification and 220–290 kJ/mol in H2O gasification. The frequency factor of H2O gasification was approximately 10 times larger than that of CO2 gasification, regardless of the progress of the reaction. At the same activation energy level, the frequency factor showed a higher value with a decrease in the particle size. This result was consistent with the theory of the grain model and indicated that the gasification reaction of the pulverized coke with a micrometer scale occurs on the surface of the coke particle. Furthermore, the value predicted by the DAEM was in good agreement with the experimental one.
Abstract
Background
Correctly identifying anaerobic bloodstream infections (BSIs) is difficult. However, a new technique, matrix-assisted laser desorption ionization-time of flight mass spectrometry ...(MALDI-TOF MS), enables more accurate identification and appropriate treatment. Anaerobic BSIs identified by MALDI-TOF MS were retrospectively analyzed to determine the clinical and microbiological features and patient outcomes based on the anaerobic genera or group.
Methods
Medical records of patients with anaerobic BSIs were used to conduct a single-center retrospective cohort study from January 2016 to December 2020 in Nagoya, Japan. Multivariate logistic regression analysis was performed to determine the independent risk factors for in-hospital mortality.
Results
Of the 215 patients with anaerobic BSIs, 31 had multiple anaerobic organisms in the blood culture, including 264 total episodes of anaerobic BSIs.
Bacteroides
spp. were isolated the most (n = 74), followed by gram-positive non-spore-forming bacilli (n = 57),
Clostridium
spp. (n = 52), gram-positive anaerobic cocci (GPAC) (n = 27), and gram-negative cocci (n = 7). The median patient age was 76 years; 56.7% were male. The most common focal infection site was intra-abdominal (36.7%). The in-hospital mortality caused by anaerobic BSIs was 21.3%, and was highest with
Clostridium
spp. (36.5%) and lowest with GPAC (3.7%). Age, solid tumors, and
Clostridium
spp. were independent risk factors for in-hospital mortality.
Conclusions
We identified current anaerobic BSI trends using MALDI-TOF MS and reported that mortality in patients with anaerobic BSIs patients was highest with
Clostridium
spp. infections.
Hypertensive emergency is a critical disease that causes multifaceted sequelae, including end-stage kidney disease and cardiovascular disease. Although the renin-angiotensin-aldosterone (RAA) system ...is enormously activated in this disease, there are few reports that attempt to characterize the effect of early use of RAA inhibitors (RASi) on the temporal course of kidney function.
This retrospective cohort study was conducted to clarify whether the early use of RASi during hospitalization offered more favorable benefits on short-term renal function and long-term renal outcomes in patients with hypertensive emergencies. We enrolled a total of 49 patients who visited our medical center with acute severe hypertension and multiple organ dysfunction between April 2012 and August 2020. Upon admission, the patients were treated with intravenous followed by oral antihypertensive drugs, including RASi and Ca channel blockers (CCB). Kidney function as well as other laboratory and clinical parameters were compared between RASi-treated and CCB- treated group over 2 years.
Antihypertensive treatment effectively reduced blood pressure from 222 ± 28/142 ± 21 to 141 ± 18/87 ± 14 mmHg at 2 weeks and eGFR was gradually restored from 33.2 ± 23.3 to 40.4 ± 22.5 mL/min/1.73m
at 1 year. The renal effect of antihypertensive drugs was particularly conspicuous when RASi was started in combination with other conventional antihypertensive drugs at the early period of hospitalization (2nd day IQR: 1-5.5) and even in patients with moderately to severely diminished eGFR (< 30 mL/min/1.73 m
) on admission. In contrast, CCB modestly restored eGFR during the observation period. Furthermore, renal survival probabilities were progressively deteriorated in patients who had manifested reduced eGFR (< 15 mL/min/1.73 m
) or massive proteinuria (urine protein/creatinine ≥ 3.5 g/gCr) on admission. Early use of RASi was associated with a favorable 2-year renal survival probability (0.90 95%CI: 0.77-1.0 vs. 0.63 95%CI: 0.34-0.92 for RASi ( +) and RASi (-), respectively, p = 0.036) whereas no apparent difference in renal survival was noted for CCB.
Early use of RASi contributes to the renal functional recovery from acute reduction in eGFR among patients with hypertensive emergencies. Furthermore, RASi offers more favorable effect on 2-year renal survival, compared with CCB.
Spontaneous tendon rupture is a rare entity. Herein, we report a case of spontaneous rupture of the extensor pollicis longus (EPL) tendon in a 61-year-old woman with systemic lupus erythematosus ...(SLE). The patient worked as an aesthetician and had a 42-year history of SLE that was well controlled using oral steroids. She presented with an inability to extend her left thumb, with no prior history of trauma or symptoms. On imaging, there was no evidence of degenerative changes or osteophyte formation in the gliding area of the EPL tendon. Intraoperatively, there was evidence of tendon rupture around Lister's tubercle. We performed a tendon transfer of the extensor indicis proprius for repair. The patient recovered active thumb extension and returned to work 4 months after surgery without any complications. We suspected that spontaneous EPL tendon rupture was caused by a combination of disease-related factors, including long-term steroid use, chronic inflammation, and continuous mechanical stress from her work and daily activity. This case report demonstrates the multifactorial aetiology of spontaneous tendon rupture in patients with SLE and the importance of monitoring for this complication during routine follow-up.
Spinal instrumentation surgery for older patients with osteoporosis is increasing. Implant loosening may occur due to inappropriate fixation in osteoporotic bone. Developing implants that achieve ...stable surgical results, even in osteoporotic bone, can reduce re-operation, lower medical costs, and maintain the physical status of older patients. Fibroblast growth factor-2 (FGF-2) promotes bone formation; thus, coating pedicle screws with an FGF-2-calcium phosphate (FGF-CP) composite layer is hypothesized to enhance osteointegration in spinal implants. We designed a long-term implantation pilot study that estimated the safety and bone-forming efficacy of pedicle screws coated with an FGF-CP composite layer in cynomolgus monkeys. Titanium alloy screws, either uncoated (controls) or aseptically coated with an FGF-CP composite layer, were implanted in the vertebral bodies of six female adult cynomolgus monkeys (three monkeys per group) for 85 days. Physiological, histological, and radiographic investigations were performed. There were no serious adverse events, and no radiolucent areas were observed around the screws in either group. The bone apposition rate in the intraosseous region was significantly higher in the FGF-CP group than in the controls. Moreover, as analyzed by Weibull plots, the bone formation rate of the FGF-CP group exhibited a significantly higher regression line slope than the control group. These results demonstrated that there was significantly less risk of impaired osteointegration in the FGF-CP group. Our pilot study suggests that FGF-CP-coated implants could promote osteointegration, be safe, and reduce the probability of screw loosening.
Purpose: To investigate speech-language pathologists' current perceptions, previous training experiences, resources, barriers, and training needs in terms of evidence-based practices (EBPs) in two ...Asian countries.
Method: Their knowledge and attitudes about EBP were explored using an online questionnaire. A descriptive analysis was conducted with consideration of the effect of demographic variables on knowledge and attitudes about EBP.
Result: Malaysian speech-language pathologists (n = 98) displayed more positive attitudes toward EBPs, with a significantly higher (t (143) = 5.91, p < .01) total mean score (Mean = 120.7, SD = 11) compared to the Japanese speech-language pathologists (n = 47, Mean = 107.8, SD = 13.5). Malaysian practitioners who were female, worked full-time, and worked in government settings reported higher motivation to develop EBP skills. Japanese practitioners who worked in private sectors reported higher EBPs training needs than those in government settings. In both countries, speech-language pathologists with higher education levels tended to express fewer perceived barriers towards EBP.
Conclusion: Findings could help local governance and speech-language pathologist associations to understand the current practices and professional development needs of speech-language pathologists, leading to more effective training programs and educating employers and managers who can reinforce EBP among practitioners.
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