Characterization of the insertion site anatomy in anterior cruciate ligament reconstruction has recently received increased attention in the literature, coinciding with a growing interest in anatomic ...reconstruction. The purpose of this study was to visualize and quantify the position of anatomic anteromedial and posterolateral bone tunnels in anterior cruciate ligament reconstruction with use of novel methods applied to three-dimensional computed tomographic reconstruction images.
Careful arthroscopic dissection and anatomic double-bundle anterior cruciate ligament tunnel drilling were performed with use of topographical landmarks in eight cadaver knees. Computed tomography scans were performed on each knee, and three-dimensional models were created and aligned into an anatomic coordinate system. Tibial tunnel aperture centers were measured in the anterior-to-posterior and medial-to-lateral directions on the tibial plateau. The femoral tunnel aperture centers were measured in anatomic posterior-to-anterior and proximal-to-distal directions and with the quadrant method (relative to the femoral notch).
The centers of the tunnel apertures for the anteromedial and posterolateral tunnels were located at a mean (and standard deviation) of 25% +/- 2.8% and 46.4% +/- 3.7%, respectively, of the anterior-to-posterior tibial plateau depth and at a mean of 50.5% +/- 4.2% and 52.4% +/- 2.5% of the medial-to-lateral tibial plateau width. On the medial wall of the lateral femoral condyle in the anatomic posterior-to-anterior direction, the anteromedial and posterolateral tunnels were located at 23.1% +/- 6.1% and 15.3% +/- 4.8%, respectively. The proximal-to-distal locations were at 28.2% +/- 5.4% and 58.1 +/- 7.1%, respectively. With the quadrant method, anteromedial and posterolateral tunnels were measured at 21.7% +/- 2.5% and 35.1% +/- 3.5%, respectively, from the proximal condylar surface (parallel to the Blumensaat line), and at 33.2% +/- 5.6% and 55.3% +/- 5.3% from the notch roof (perpendicular to the Blumensaat line). Intraobserver and interobserver reliability was high, with small standard errors of measurement.
This cadaver study provides reference data against which tunnel position in anterior cruciate ligament reconstruction can be compared in future clinical trials.
Purpose
Recent reports have highlighted the importance of an anatomic tunnel placement for anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to compare the effect of ...different tunnel positions for single-bundle ACL reconstruction on knee biomechanics.
Methods
Sixteen fresh-frozen cadaver knees were used. In one group (
n
= 8), the following techniques were used for knee surgery: (1) anteromedial (AM) bundle reconstruction (AM–AM), (2) posterolateral (PL) bundle reconstruction (PL–PL) and (3) conventional vertical single-bundle reconstruction (PL-high AM). In the other group (
n
= 8), anatomic mid-position single-bundle reconstruction (MID–MID) was performed. A robotic/universal force-moment sensor system was used to test the knees. An anterior load of 89 N was applied for anterior tibial translation (ATT) at 0°, 15°, 30° and 60° of knee flexion. Subsequently, a combined rotatory load (5 Nm internal rotation and 7 Nm valgus moment) was applied at 0°, 15°, 30° and 45° of knee flexion. The ATT and in situ forces during the application of the external loads were measured.
Results
Compared with the intact ACL, all reconstructed knees had a higher ATT under anterior load at all flexion angles and a lower in situ force during the anterior load at 60° of knee flexion. In the case of combined rotatory loading, the highest ATT was achieved with PL-high AM; the in situ force was most closely restored with MIDMID, and the in situ force was the highest AM–AM at each knee flexion angle.
Conclusion
Among the techniques, AM–AM afforded the highest in situ force and the least ATT.
Identification and online monitoring of the dresser wear are necessary to guarantee a desired wheel surface and improve the effectiveness of grinding process to a satisfactory level. However, tool ...wear is a complex phenomenon occurring in several and different ways in cutting processes, and there is a lack of analytical models that can represent the tool condition. On the other hand, neural networks are considered as a good approach to resolve the absence of an analytical or empirical model. This paper describes a method to characterize the dresser wear condition from acoustic emission (AE) signal. To achieve this, some neural network models are proposed. Initially, a study on the frequency content of the raw AE signal was carried out to determine features that correlate the signal and dresser wear. The features of the signal were obtained from the root mean square and ratio of power statistics at nine frequency bands selected from AE spectra. Combinations of two frequency bands were evaluated as inputs to eight neural networks models, which have been compared with their classification ability. It could be verified that the combination of the frequency bands of 28-33 and 42-50 kHz best characterized the dresser wear condition. Some of the models produced very good results and can therefore ensure the ground part will be within project specifications.
The femoral intercondylar notch has been an anatomic site of interest as it houses the anterior cruciate ligament (ACL). The objective of this study was to arthroscopically evaluate the femoral notch ...in patients with known ACL injury. This evaluation included establishing a classification for notch shapes, identifying the shape frequency, measuring notch dimensions, and determining correlation between notch shape, notch dimensions, and demographic patient data. In this clinical cohort study, 102 consecutive patients underwent diagnostic arthroscopic evaluation of the notch. Several intra-operative photos, videos, and measurements were taken of the notch. Demographic data for each patient were recorded including age, gender, height, weight, and BMI. Three categories of notch shape were established: 1. A-shaped; 2. U-shaped; and 3. W-shaped. Two blinded independent orthopedic surgeons were asked to categorize the recorded notches. Notch shape, dimensions, and demographic factors were correlated. Of the 102 notches evaluated, 55 notches were found to be “A-shaped,” 42 “U-shaped,” and 5 “W-shaped.” “A-shaped” notches were narrower in all width dimensions than “U-shaped” notches. Only patient height was found to influence notch shape with a positive association between taller patients and “U-shaped” and “W-shaped” notches (
P
= 0.011). Women had a smaller notch width at the base and middle of the notch. With this data, surgeons who enter the knee and appreciate an “A-shaped” notch should consider placing the arthroscope in the anteromedial portal and drill the femoral tunnel through an accessory medial portal to improve visualization and accuracy in anatomic femoral tunnel creation.
Purpose The purpose of this study was to evaluate intraobserver and interobserver reliability of anterior cruciate ligament tunnel location measurement by use of 3-dimensional reconstructed computed ...tomography (CT). Methods Three-dimensional reconstructed CT images of 31 cadaveric knees were used in this study. Twenty-one knees were operated on with a double-bundle technique, and ten knees were operated on with a single-bundle technique. Femoral tunnel location was measured with 3 methods on the medial-lateral view of the lateral femoral condyle in the strictly lateral position. Tibial tunnel location was measured in the top view of the proximal tibia. The images were evaluated independently by 2 orthopaedic surgeons. A second measurement was performed, by both testers, after a 4-week interval. Results The 3 methods of femoral tunnel location measurement had intraobserver intraclass correlation coefficients (ICCs) that ranged from 0.963 to 0.998 and interobserver ICCs that ranged from 0.993 to 0.999. Tibial tunnel measurement had intraobserver ICCs that varied between 0.957 and 0.998 and interobserver ICCs that varied between 0.993 and 0.996. Conclusions The measurement of the anterior cruciate ligament tunnel location on 3-dimensional reconstructed CT provided excellent intraobserver and interobserver reliability. Clinical Relevance Three-dimensional reconstructed CT can be used for further studies to assess the effect of tunnel position on knee stability and patient outcomes.
Environmental noise in hospitals: a systematic review de Lima Andrade, Erik; da Cunha e Silva, Darllan Collins; de Lima, Eligelcy Augusta ...
Environmental science and pollution research international,
04/2021, Letnik:
28, Številka:
16
Journal Article
Recenzirano
Odprti dostop
Environmental noise has been growing in recent years, causing numerous health problems. Highly sensitive environments such as hospitals deserve special attention, since noise can aggravate patients’ ...health issues and impair the performance of healthcare professionals. This work consists of a systematic review of scientific articles describing environmental noise measurements taken in hospitals between the years 2015 and 2020. The researchers started with a consultation of three databases, namely, Scopus, Web of Science, and ScienceDirect. The results indicate that for the most part, these studies are published in journals in the fields of medicine, engineering, environmental sciences, acoustics, and nursing and that most of their authors work in the fields of architecture, engineering, medicine, and nursing. These studies, which are concentrated in Europe, the Americas, and Asia, use as reference values sound levels recommended by the World Health Organization. L
eq
measured in hospital environments showed daytime values ranging from 37 to 88.6 dB (A) and nighttime values of 38.7 to 68.8 dB (A). L
eq
values for outdoor noise were 74.3 and 56.6 dB (A) for daytime and nighttime, respectively. The measurements were taken mainly inside hospitals, prioritizing more sensitive departments such as intensive care units. There is a potential for growth in work carried out in this area, but research should also include discussions about guidelines for improvement measures aimed at reducing noise in hospitals.
Graphical abstract
Marine gateways play a critical role in the exchange of water, heat, salt and nutrients between oceans and seas. As a result, changes in gateway geometry can significantly alter both the pattern of ...global ocean circulation and associated heat transport and climate, as well as having a profound impact on local environmental conditions. Mediterranean–Atlantic marine corridors that pre-date the modern Gibraltar Strait, closed during the Late Miocene and are now exposed on land in northern Morocco and southern Spain. The restriction and closure of these Miocene connections resulted in extreme salinity fluctuations in the Mediterranean, leading to the precipitation of thick evaporites. This event is known as the Messinian Salinity Crisis (MSC). The evolution and closure of the Mediterranean–Atlantic gateways are a critical control on the MSC, but at present the location, geometry and age of these gateways are still highly controversial, as is the impact of changing Mediterranean outflow on Northern Hemisphere circulation. Here, we present a comprehensive overview of the evolution of the Late Miocene gateways and the nature of Mediterranean–Atlantic exchange as deduced from published studies focussed both on the sediments preserved within the fossil corridors and inferences that can be derived from data in the adjacent basins. We also consider the possible impact of evolving exchange on both the Mediterranean and global climate and highlight the main enduring challenges for reconstructing past Mediterranean–Atlantic exchange.
Drug-induced photosensitivity refers to the development of cutaneous disease due to the interaction between a given chemical agent and sunlight. Photosensitivity reactions can be classified as ...phototoxic or photoallergic. Sometimes, there is an overlap between these two patterns, making their distinction particularly difficult for the clinician. We review the drugs that have been implicated as photosensitizers, the involved mechanism, and their clinical presentations. The main topical agents that cause contact photosensitivity are the nonsteroidal antiinflammatory drugs, whereas the main systemic drugs inducing photosensitivity are antimicrobials, nonsteroidal antiinflammatory agents, and cardiovascular drugs. Drug-induced photosensitivity remains a common clinical problem and is often underdiagnosed.
The Paranaguá Estuarine Complex (PEC) is an important socioeconomic estuary of the Brazilian coast that is influenced by the input of pollutants like polycyclic aromatic hydrocarbons (PAHs). Because ...of the apparent lack of comparative studies involving PAHs in different estuarine compartments, the aim of this study was to determine and compare PAH concentrations in surface sediment and suspended particulate material (SPM) in the PEC to evaluate their behaviour, compositions, sources and spatial distributions. The total PAH concentrations in the sediment ranged from 0.6 to 63.8 ng g−1 (dry weight), whereas in the SPM these concentrations ranged from 391 to 4164 ng g−1. Diagnostic ratios suggest distinct sources of PAHs to sediments (i.e., pyrolytic sources) and SPM (i.e., petrogenic sources such as vessel traffic). Thus, the recent introduction of PAHs is more clearly indicated in the SPM since oil related-compounds (e.g., alkyl-PAHs) remain present in similar concentrations. Further, this matrix may better reflect the current state of the environment at the time of sampling because of the absence of significant degradation.
Display omitted
•PAH content was determined in surface sediment and suspended particulate material.•SPM showed a petrogenic contamination, which was not observed in surface sediment.•Environmental monitoring of PAH should consider assessments of both sediment and SPM.
Distinct distribution of individual polycyclic aromatic hydrocarbon on suspended particulate matter and sediment occurred in a subtropical estuary.
Supernumerary B chromosomes (Bs) are extra karyotype units in addition to A chromosomes, and are found in some fungi and thousands of animals and plant species. Bs are uniquely characterized due to ...their non-Mendelian inheritance, and represent one of the best examples of genomic conflict. Over the last decades, their genetic composition, function and evolution have remained an unresolved query, although a few successful attempts have been made to address these phenomena. A classical concept based on cytogenetics and genetics is that Bs are selfish and abundant with DNA repeats and transposons, and in most cases, they do not carry any function. However, recently, the modern quantum development of high scale multi-omics techniques has shifted B research towards a new-born field that we call "B-omics". We review the recent literature and add novel perspectives to the B research, discussing the role of new technologies to understand the mechanistic perspectives of the molecular evolution and function of Bs. The modern view states that B chromosomes are enriched with genes for many significant biological functions, including but not limited to the interesting set of genes related to cell cycle and chromosome structure. Furthermore, the presence of B chromosomes could favor genomic rearrangements and influence the nuclear environment affecting the function of other chromatin regions. We hypothesize that B chromosomes might play a key function in driving their transmission and maintenance inside the cell, as well as offer an extra genomic compartment for evolution.
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