Hill‐based musculoskeletal model for a fracture reduction robot

xlomafota13 shared this article with you from Inoreader Hill‐based musculoskeletal model for a fracture reduction robot Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background The introduction of fracture reduction robot can solve the problem of large reduction forces during fracture reduction surgeries and the need to collect multiple medical images. However, because its safety has not been certified, there are few academic achievements on this type of robot. To calculate the safety factor during its operation, a musculoskeletal model needs to be established to study the constraints of muscles on the robot. The existing academic achievements of musculoskeletal modelling are mainly for application such as rehabilitation treatment and collision in car accidents. Methods A musculoskeletal model applied to the fracture reduction robot is proposed in this paper. First, by comparing the characteristics of mainstream muscle models and combining the biological characteristics of the anesthetised muscles, the Hill model was selected as the muscle model for this study. Second, based on the motion composition of six spatial degrees of freedom, five basic fractural malposition situations are proposed. Then, a 170‐cm tall male musculoskeletal model was built in Opensim. Based on this model, the muscle force curves of the above malposition situations are calculated. Finally, a similar musculoskeletal model was established in Adams, and the accuracy of its muscle force data was tested. The study is approved by the ethics committee of the Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing, China. Results The muscle force curve of Opensim and Adams model under situations of five basic malposition are compared. Most of the correlation coefficients are in the range of 0.98–0.99. The overall correlation coefficient is greater than 0.95. Conclusions The simulation results prove that this model can be used for the safety assessment of the fracture reduction robots. This model will be served as an environmental constraint to study the control of fracture reduction robot. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Just Do It—Everyone Should Follow the Guidelines

xlomafota13 shared this article with you from Inoreader Just Do It—Everyone Should Follow the Guidelines Via JAMA Otolaryngology–Head & Neck Surgery Current Issue Hearing loss is the most common congenital sensory impairment, and by age 19 years, 15.2% of participants in the 2009 to 2010 National Health and Nutrition Examination Survey had a measurable degree of hearing loss. In this issue of JAMA Otolaryngology–Head & Neck Surgery, Qian et al investigated factors associated with variability in following 2016 International Pediatric Otolaryngology Group (IPOG) consensus guidelines for diagnostic evaluation in pediatric patients with sensorineural hearing loss (SNHL). They used data for 53 711 unique patients from the Optum Clinformatics Data Mart, a nationally representative database containing claims from a large national private insurer with an annual sample size of 12 million unique patients. They recorded patient visits in hospitals, emergency departments, and outpatient practices in p ediatrics, otolaryngology, and audiology from January 1, 2008, to December 31, 2018. Assessed variables included the degree and type of hearing loss and diagnostic tests ordered, including electrocardiogram, cytomegalovirus (CMV) testing, magnetic resonance imaging (MRI), computed tomography (CT), and genetic testing, and interventions including cochlear implant (CI) surgery, hearing aid (HA)–related services, and speech language pathology (SLP) therapy. They collected demographic characteristics, socioeconomic status, clinician type, and cost data. The results of the study by Qian et al showed that national practice patterns were not consistent with the IPOG guidelines, with only 30% of children with SNHL having some form of diagnostic testing. Undergoing diagnostic testing was associated with increased use of interventions, including HA services, CI, and SLP services. Even after accounting for diagnostic testing, racial/ethnic and economic disparities persisted in SLP and HA ser vices, although not for CI. Although generally genetic testing and MRI use increased and CT use declined, CMV and genetic testing remained underused. After controlling for demographic and clinical factors, racial/ethnic and economic disparities were seen for CT, electrocardiogram, MRI, and genetic testing. Importantly, the type of clinician that the patient saw was associated with the odds of receiving certain diagnostic tests and interventions, with pediatric otolaryngologists and geneticists more likely to order all diagnostic modalities and recommend SLP services compared with general otolaryngologists, neurotologists and nonotolaryngologists. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute Laryngeal Injury After Intubation

xlomafota13 shared this article with you from Inoreader Acute Laryngeal Injury After Intubation Via JAMA Otolaryngology–Head & Neck Surgery Current Issue Although intubation is often necessary and lifesaving, there are known laryngotracheal consequences. Otolaryngologists are all too familiar with the vocal-fold damage and inflammatory conditions that are associated with prolonged intubation because patients often present in the hospital or clinic with dysphonia or dyspnea. The size of the endotracheal tube and the duration of intubation are known to be risk factors for postintubation damage. The pathophysiology is well understood to be caused by pressure-induced damage to the mucosal and cartilaginous structures of the larynx. However, despite this knowledge, laryngeal damage is often considered unavoidable, accrued as a result of a lifesaving stay in an intensive care unit. The resulting disease state can be so functionally devastating and difficult to treat that many otolaryngologists are left wondering: is there something we can do to prevent this from happening? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Resection of Nodular Lymphocyte‐Predominant Hodgkin Lymphoma of the Parotid Gland

xlomafota13 shared this article with you from Inoreader Surgical Resection of Nodular Lymphocyte‐Predominant Hodgkin Lymphoma of the Parotid Gland Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cardiopulmonary Testing before Pediatric Adenotonsillectomy for Severe and Very Severe Obstructive Sleep Apnea Syndrome

xlomafota13 shared this article with you from Inoreader Cardiopulmonary Testing before Pediatric Adenotonsillectomy for Severe and Very Severe Obstructive Sleep Apnea Syndrome Via The Laryngoscope Objectives/Hypothesis Adenotonsillectomy is first‐line treatment for pediatric obstructive sleep apnea syndrome (OSAS) when not otherwise contraindicated. There is concern severe OSAS increases risk of comorbid cardiopulmonary abnormalities, such as ventricular hypertrophy or pulmonary hypertension, which preoperative testing could detect. Our objective is to determine if there is a severity of pediatric OSAS where previously undetected cardiopulmonary comorbidities are likely. Study Design Retrospective chart review. Methods We performed a retrospective review of 358 patients ≤21 years with severe OSAS who underwent adenotonsillectomy at a tertiary hospital June 1, 2016 to June 1, 2018. We extracted demographics, comorbidities, polysomnography, and preoperative tests. Wilcoxon rank‐sum and logistic regression estimated associations of OSAS severity (based on obstructive apnea‐hypopnea index [OAHI], hypoxia, hypercarbia) with preoperative echocardiograms and chest X‐rays (CXRs). Results Mean age was 5.9 (±3.6) years and 52% were male. Mean OAHI and oxygen saturation nadir were 30.3 (±23.8) and 80.7% (±9.2), respectively. OAHI ≥60 was associated with having a preoperative echocardiogram (OR, 3.8; 95% CI, 1.7–8.5) or CXR (OR, 3.0; 95% CI, 1.4–6.8) compared to OAHI 10–59. There were no significant associations between OSAS severity and test abnormalities. The presence of previously diagnosed cardiopulmonary comorbidities was associated with abnormalities on echocardiogram (OR, 36; 95% CI, 4.1–320.1) and CXR (OR, 4.1; 95% CI, 1.2–14.4). Conclusions Although pediatric patients with very severe OSAS (OAHI ≥60) underwent more pre‐adenotonsillectomy cardiopulmonary tests, OSAS severity did not predict abnormal findings. Known cardiopulmonary comorbidities may be a better indication for cardiopulmonary testing than polysomnographic parameters, which could streamline pre‐adenotonsillectomy evaluation and reduce cost. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty

xlomafota13 shared this article with you from Inoreader Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty Via Ear infections by Ethan I. Huang, Yu-Chieh Wu, Hsiu-Mei Chuang, Tzu-Chi Huang Postoperative hearing improvement is one of the main expectations for patients receiving tympanoplasty. The capacity to predict postoperative hearing may help to counsel a patient properly and avoid untoward expectations. It is difficult to predict postoperative hearing without knowing the disease process in the middle ear, which can only be assessed intraoperatively. However, the duration and extent of the underlying pathologies may represent in bone-conduction threshold and air-bone gap. Here in patients undergoing tympanoplasty without ossiculoplasty, we sorted and separated the surgery dates into the first group to build the predicting models and the second group to test the predictions. There were 87 and 30 ears, respectively. No specific enrollment or exclusion criteria were based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions. The results show that bone-conduction threshold and air-bone gap together predicted air-co nduction threshold after the surgery, including each frequency of 0.5k, 1k, 2k, and 4k Hz. The discrepancies between the predictions and recordings did not differ among these four frequencies. Of the variance in mean postoperative air-conduction threshold, 56.7% was linearly accounted for by these two preoperative predictors in this sample. The results suggest a trend that, the higher the frequency, the larger the part was accounted for by these two preoperative predictors. These together may help a surgeon to estimate frequency-specific hearing outcome after the surgery, answer patients' questions with quantitative statistics, and counsel patients with proper expectations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review

xlomafota13 shared this article with you from Inoreader Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review Via Speech therapy by Kamrun Nahar Koly, Susanne P. Martin-Herz, Md. Saimul Islam, Nusrat Sharmin, Hannah Blencowe, Aliya Naheed Objective Parent-mediated programmes have been found to be cost effective for addressing the needs of the children and adolescents with Neurodevelopmental Disorders (NDD) in high-income countries. We explored the impact of parent-mediated intervention programmes in South Asia, where the burden of NDD is high. Methods A systematic review was conducted using the following databases; PUBMED, MEDLINE, PsycINFO, Google Scholar and Web of Science. Predefined MeSH terms were used, and articles were included if published prior to January 2020. Two independent researchers screened the articles and reviewed data. Outcomes measures The review included studies that targeted children and adolescents between 1 and 18 years of age diagnosed with any of four specific NDDs that are commonly reported in South Asia; Autism Spectrum Disorder (ASD), Intellectual Disability (ID), Attention Deficit Hyperactivity Disorder (ADHD) and Cerebral Palsy (CP). Studies that reported on parent or ch ild outcomes, parent-child interaction, parent knowledge of NDDs, or child activities of daily living were included for full text review. Results A total of 1585 research articles were retrieved and 23 studies met inclusion criteria, including 9 Randomized Controlled Trials and 14 pre-post intervention studies. Of these, seventeen studies reported effectiveness, and six studies reported feasibility and acceptability of the parent-mediated interventions. Three studies demonstrated improved parent-child interaction, three studies demonstrated improved child communication initiations, five studies reported improved social and communication skills in children, four studies demonstrated improved parental knowledge about how to teach their children, and four studies reported improved motor and cognitive skills, social skills, language development, learning ability, or academic performance in children. Conclusion This systematic review of 23 studies demonstrated improvements in parent and child skills following parent-mediated intervention in South Asia. Additional evaluations of locally customized parent-mediated programmes are needed to support development of feasible interventions for South Asian countries. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparison of the head lift exercise and recline exercise in patients with chronic head and neck cancer post-radiation

xlomafota13 shared this article with you from Inoreader A comparison of the head lift exercise and recline exercise in patients with chronic head and neck cancer post-radiation Via swallowing exercises Support Care Cancer. 2021 Mar 10. doi: 10.1007/s00520-020-05925-9. Online ahead of print. ABSTRACT BACKGROUND: Patients who undergo surgery and adjuvant radiation treatment for head and neck cancer often develop dysphagia as a result of this treatment. Improvements in swallow function may be achieved with exercise. The goal of this pilot study was to compare the effectiveness and perceived difficulty of using the head lift exercise and the recline exercise to activate the suprahyoi d musculature in 8 individuals with a history of head and neck cancer. METHOD: Muscle activation using surface electromyography was examined to determine if the recline exercise activates the suprahyoid muscle groups to the same degree as the head lift exercise. Participants also rated the exertion they experienced to assess how easily patients are able to complete the exercises. RESULTS: The majority of participants completed both exercises in their entirety on their first attempt. However, ratings of perceived exertion were significantly lower for the recline exercise than the head lift exercise. The head lift exercise activated the suprahyoid musculature to a significantly greater degree than the recline exercise. CONCLUSION: The recline exercise, in comparison with the head lift exercise, is easier for participants to complete and results in significantly reduced perceptions of fatigue. Results of this study indicate that the recline exercise may be a good pote ntial substitute for the head lift exercise in patient populations that are incapable of performing the head lift exercise, but that the head lift exercise should be prescribed whenever it is viable as it activates target musculature more effectively than the recline exercise. PMID:33694087 | DOI:10.1007/s00520-020-05925-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Outcomes of Endonasal Sphenopalatine Artery Cauterization in Endoscopic Sinus Surgery

xlomafota13 shared this article with you from Inoreader Clinical Outcomes of Endonasal Sphenopalatine Artery Cauterization in Endoscopic Sinus Surgery Via Otolaryngology Indian Abstract Endoscopic sinus surgery (ESS) is one of the common ENT surgeries performed. Various techniques are available for reducing the blood loss during ESS. The efficacy of cauterization of the SPA in reducing the per-operative blood loss has not been explored in the literature. This study evaluates the efficacy of SPA cauterization prior to sinus surgery and its per-operative and post-operative outcomes. To study the outcomes of endonasal SPA cauterization in patients undergoing ESS. This is a prospective observational study conducted in a tertiary care centre from October 2018 to October 2020. 30 patients underwent ESS where SPA was cauterized by bipolar diathermy in one side of the nasal cavity and in the contralateral side, SPA was not cauterized. The results were tabulated and compared between the cauterized and non cauterized side. p value < 0.05 was considered as statistically significant. Mean blood loss (p value = 0.20), operating t ime (p value = 0.19), surgical field grade, post operative Lund Kennedy Score at 1st, 4th and 12th week were compared and the difference between cauterized and non cauterized was found to be statistically insignificant. In this study, endonasal SPA cauterization did not significantly reduce the intra operative bleeding and surgical field grade in patients undergoing ESS. SPA cauterization did not adversely affect the per operative and post operative outcome and hence authors highlight the fact that it can be safely performed in cases where severe intra operative bleeding is expected and its effectiveness can be studied better in such cases. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Microbiological Assessment of Chronic Otitis Media: Aerobic Culture Isolates and Their Antimicrobial Susceptibility Patterns

xlomafota13 shared this article with you from Inoreader Microbiological Assessment of Chronic Otitis Media: Aerobic Culture Isolates and Their Antimicrobial Susceptibility Patterns Via Otolaryngology Indian Abstract As there are changing trends in the microbiology of chronic otitis media, this study was carried out to look for the current aerobic microbes and their antimicrobial susceptibilities in patients of chronic otitis media from north Indian region. A total of 322 patients who met the inclusion criteria were studied and aerobic ear swab culture was done under aseptic conditions. Gram staining was performed and antibiotic susceptibility testing was done using Kirby–Bauer disc diffusion method on Mueller–Hinton Agar. A total of 341 culture positive results were obtained from 322 patients. The culture results revealed 10 different aerobic microbes. Gram-positive floras were seen in 152 (44.57%), and Gram-negative in 189(55.43%) isolates. Staphylococcus aureus was the most common isolate present in 131 samples (38.41%), followed by pseudomonas aeruginosa in 101 (29.62%) and proteus in 36 (10.56%). In overall susceptibility of antibiotics aga inst Gram-positive culture isolates, Vancomycin was most effective (97.37%). For Gram-negative microbes, Piperacillin–Tazobactum combination was most effective with overall susceptibility of 79.37% susceptibility. Microbiological assessment of Chronic Otitis Media should be carried out in an area on regular intervals because of the changing patterns of bacteriology and their antimicrobial susceptibilities. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epigenetic regulation of cellular functions in wound healing

xlomafota13 shared this article with you from Inoreader Epigenetic regulation of cellular functions in wound healing Via Experimental Dermatology Abstract Stringent spatiotemporal regulation of the wound healing process involving multiple cell types is associated with epigenetic mechanisms of gene regulation, such as DNA methylation, histone modification and chromatin remodeling, as well as non‐coding RNAs. Here we discuss the epigenetic changes that occur during wound healing and the rapidly expanding understanding of how these mechanisms affect healing resolution in both acute and chronic wound milieu. We provide a focused overview of current research into epigenetic regulators that contribute to wound healing by specific cell type. We highlight the role of epigenetic regulators in the molecular pathophysiology of chronic wound conditions. The understanding of how epigenetic regulators can affect cellular functions during normal and impaired wound healing could lead to novel therapeutic approaches, and we outline questions that can provide guidance for future research on epigenetic‐based interventions to promote healing. Disse cting the dynamic interplay between cellular subtypes involved in wound healing and epigenetic parameters during barrier repair will deepen our understanding of how to improve healing outcomes in patients affected by chronic non‐healing wounds. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.