Development and Multi-Site Assessment of a Novel Shoulder Motion Joint Simulator

2021 ◽  
Author(s):  
Aniruddh Nayak ◽  
Stefan Gabriel ◽  
David Spenciner ◽  
Courtney Mason ◽  
Marc Jacofsky
Keyword(s):  
Shoulder Joint ◽  
The Novel ◽  
Muscle Forces ◽  
Site Assessment ◽  
Surgical Interventions ◽  
Cuff Tear ◽  
Test Conditions ◽  
Clinical Scenarios ◽  
Intact Condition ◽  
Repeatability And Reproducibility

Abstract Background: Multiple biomechanical shoulder simulators have been described in the literature, with a trend toward increasing complexity to better simulate clinical scenarios. Our objective was to develop an advanced, novel shoulder joint simulator and compare outcomes at two separate institutions, for a typical shoulder joint motion simulation. Methods: Identical shoulder simulators were developed & deployed at both institutions. Eight cadaveric upper extremities were tested by simulating actively controlled, arm elevation in the plane of the scapula for two sequential test conditions (intact and non-destructive simulated cuff-tear), each repeated for a total of five trials. Muscle forces and joint translations were recorded for both conditions. The intact condition was repeated following simulated cuff-tear to assess effect of testing order. Statistical analyses were aimed at assessing repeatability and reproducibility of results within specimens, between specimens, and between institutions. Results: The highest average forces were observed for the middle deltoid (233N or 32.5% body weight), followed by infraspinatus (99.0N), and posterior deltoid (93.7N) muscles. Differentiation between test conditions was unhindered by variability between repeated trials. Data from testing repeated over time, and between the two institutions were not significantly different. Conclusions: The novel shoulder simulator produced repeatable results with low trial-to-trial variation and outcomes were comparable between the two institutions. The results demonstrated a consistent response in muscle forces and humeral translation for the simulated rotator cuff tear condition. Such advanced shoulder simulators could thus be used for evaluating and optimizing surgical interventions and implant strategies.

scholarly journals Evaluating the effects of arthroscopic Bankart repair and open Latarjet shoulder stabilisation procedures on shoulder joint neuromechanics and function: a single-centre, parallel-arm trial protocol

2021 ◽  
Vol 7 (1) ◽  
pp. e000956
Author(s):  
Aaron Fox ◽  
Jason Bonacci ◽  
Stephen D Gill ◽  
Richard S Page
Keyword(s):  
Shoulder Instability ◽  
Shoulder Joint ◽  
Repeated Measures ◽  
Ethics Committees ◽  
Shoulder Function ◽  
Bankart Repair ◽  
Single Centre ◽  
Surgical Interventions ◽  
Shoulder Range Of Motion ◽  
Arthroscopic Bankart Repair

IntroductionShoulder instability injuries are common in sports involving collisions and overhead movements. Arthroscopic Bankart repair and the open Latarjet are two commonly used surgical stabilisation procedures. There is a lack of knowledge surrounding movement strategies, joint loading and muscle strength after each of these procedures. This study will compare: (1) shoulder joint neuromechanics during activities of daily living and an overhead sporting task; (2) shoulder range of motion; (3) shoulder strength; and (4) self-reported shoulder function and health status, between individuals who have undergone an arthroscopic Bankart repair versus open Latarjet.Methods and analysisThis is a prospective cohort, single-centre, non-randomised parallel arm study of surgical interventions for athletic shoulder instability injuries. Thirty participants will be recruited. Of these, 20 will have experienced one or more traumatic shoulder instability injuries requiring surgical stabilisation—and will undergo an arthroscopic Bankart repair or open Latarjet procedure. The remaining 10 participants will have no history of shoulder instability injury and act as controls. Participants will undergo baseline testing and be followed up at 3, 6 and 12 months. A two-way (group×time) analysis of variance with repeated measures on one factor (ie, time) will compare each outcome measure between groups across time points.Ethics and disseminationThis study was approved by the Barwon Health and Deakin University Human Research Ethics Committees. Outcomes will be disseminated through publications in peer-reviewed journals and presentations at relevant scientific conferences.Trial registration numberAustralian and New Zealand Clinical Trials Registry (ACTRN12620000016932).

Inflammatory and Infiltrative Diseases and Tumors

2015 ◽  
Author(s):  
Sharmila Dorbala ◽  
Katarina H. Nelson
Keyword(s):  
Radionuclide Imaging ◽  
Inflammatory Diseases ◽  
Imaging Techniques ◽  
Systemic Vasculitis ◽  
Vascular Inflammation ◽  
Image Interpretation ◽  
Response To Therapy ◽  
Published Data ◽  
The Novel ◽  
Clinical Scenarios

This chapter highlights some of the novel clinical radionuclide imaging strategies beyond perfusion imaging including inflammatory diseases, infiltrative diseases and tumors. Targeted molecular imaging techniques to evaluate cardiac amyloidosis as well as myocardial and vascular inflammation are addressed. Clinical 18F-FDG imaging of cardiac sarcoidosis, cardiovascular prosthetic valve and device infections, systemic vasculitis, and tumors are discussed in detail. For each of these pathologies, a concise overview of the disease pathophysiology and management pertinent to understanding of imaging techniques is provided followed by details of imaging including radiotracers, imaging techniques and image interpretation with a reference to societal guidelines. The published data on the utility of radionuclide imaging tests to assess diagnosis, prognosis and to monitor response to therapy are discussed. Clinical scenarios and available societal recommendations on the use of imaging are illustrated. The strengths and limitations of radionuclide techniques are discussed in the context of a comparison to echocardiography, cardiac magnetic resonance imaging, cardiac CT and endomyocardial biopsy. Future directions in imaging and ongoing clinical trials in these areas are listed at the end of each section.

Method validation by collaborative trial for the quantification of binary mixtures containing polyamide and a novel polypropylene/polyamide bicomponent fibre

2011 ◽  
Vol 81 (20) ◽  
pp. 2160-2167 ◽  
Author(s):  
Paola Piccinini ◽  
Marilena Trantallidi ◽  
Rafael Alvarez-Sarandes ◽  
Maria de Sertorio
Keyword(s):  
Binary Mixtures ◽  
Selective Dissolution ◽  
The Novel ◽  
Collaborative Trial ◽  
Scope Of Application ◽  
Fit For Purpose ◽  
Repeatability And Reproducibility ◽  
Iso 5725 ◽  
Reproducibility Limit ◽  
Accurate Quantification

A method for the quantification of a novel polypropylene/polyamide bicomponent fibre in binary mixtures with polyamide was subjected to validation by collaborative trial. Considering the probable acceptance of the novel fibre in Europe, this method would allow market surveillance and antifraud controls needed for consumer protection. The aim of the study was to extend the scope of application of method 11 of Directive 96/73/EC. The method foresaw selective dissolution of the polyamide component using 75% m/m sulfuric acid at room temperature for 1 h. In order to ensure accurate quantification of the blends, two additional rinsings of the residue with the reagent used for the dissolution had to be included in the washing procedure of method 11. Following ISO 5725, a balanced uniform level test was performed, with the participation of seventeen European laboratories, on loop twisted carpet samples of three levels of concentration. The trueness was evaluated considering, as reference, data values obtained from manual separation. The bias varied from 0.06 to 0.49%. Repeatability and reproducibility limits were in the range 0.70–1.04% and 0.97–1.87%, respectively. In agreement with the members of the European Network of National Experts on Textile Labelling, the optimized method was judged fit-for-purpose and the reproducibility limit was established at 2%. Based on this study, the novel fibre can be inserted in the scope of application of method 11 as the insoluble component ( d factor 1.005) and polyamide as the soluble one, provided that modifications are adopted.

scholarly journals The Studies of Conditions for Inducing Chirality to Cu(II) Complexes by Chiral Zn(II) and Ni(II) Complexes with Schiff Base

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Takashiro Akitsu ◽  
Jun Yamaguchi ◽  
Naoki Uchida ◽  
Yoshikazu Aritake
Keyword(s):  
Schiff Base ◽  
Hybrid Materials ◽  
Dipole Moments ◽  
Model Systems ◽  
Electron Conductivity ◽  
The Novel ◽  
Cd Spectra ◽  
Test Conditions ◽  
Methanol Solutions ◽  
Chiral Schiff Base

Recently, we have discovered that some chiral Schiff-base nickel(II) complexes induced d-d bands of CD spectra of some achiral copper(II) complexes. However, the novel phenomenon could be observed only a few systems of hybrid materials or limited conditions so far. In order to test conditions about copper(II) ions, we investigated model systems (1) metal-dendrimer (Cu-PAMAM; G4-NH2terminal) containing relatively small amount of copper(II) ions (4.5 equivalent to PAMAM) for modeling separated systems of achiral copper(II) complex from chiral Schiff-base nickel(II) or zinc(II) complexes, Bis(N-R-1-naphtylethyl-3,5-dichlorosalicydenaminato)nickel(II) or zinc(II) by polymer matrix. (2) equilibrium of copper(II)N-ethylethylenediamine complexes to measure absorption spectra of d-d band, pH, and electron conductivity during titration of copper(II) ions. The results showed that (1) 4.5Cu-PAMAM could not be induced their d-d bands by the chiral nickel(II) or zinc(II) complexes, which suggested that separation by polymers prevented from inducing CD peaks. (2) Although 36Cu-PAMAM was known, uncoordinated copper(II) ions excess to ligands mainly attributed to increase electron conductivity by remained ions in methanol solutions, which was not associated with intermolecular interaction or dipole moments being effective for the induced CD mechanism by using molecular recognition between neutral molecules of metal complexes.

scholarly journals Assessment of functional outcome of mini-open rotator cuff repair: a hospital based prospective study

2018 ◽  
Vol 4 (2) ◽  
pp. 285 ◽  
Author(s):  
Vikas Sharma ◽  
Shailesh V. Udapudi ◽  
Somnath T. Sanikop ◽  
Sameer Haveri ◽  
Mahantesh Y. Patil
Keyword(s):  
Rotator Cuff ◽  
Functional Outcome ◽  
Shoulder Joint ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Cuff Tear ◽  
Ucla Score ◽  
Cuff Repair ◽  
Mini Open

<p class="abstract"><strong>Background:</strong> The mini-open repair is considered to be the gold standard for rotator cuff repair. This study was aimed to assess functional outcome of mini-open rotator cuff repair of shoulder joint in adult patients<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This was a one year hospital based prospective study conducted from January 2016 to December 2016. A total of 20 patients diagnosed to have rotator cuff tear of shoulder joint undergoing rotator cuff repair in the department of Orthopaedics, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, and KLES Dr. Prabhakar Kore Charitable Hospital, Belagavi were studied.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients (85%) of the patients was male and male to female ratio was 5.6:1. Most of the patients were aged between 31 to 40 years (30%). The mean age was 41.90±13.98 years. Most of patients had degenerative rotator cuff tear (45%) and (70%) presented with features of swelling. At enrollment all the patients (100%) had poor constant score (&gt;30) and fair/poor UCLA score (&lt;27) suggestive of severe pain functional restriction. There were gradual but steady increase in scores from enrollment to each follow up till six month follow up with respect to mean flexion (6.25±5.35 to 163.50±7.63),abduction (5.50±5.10 to 112.0±5.94),external rotation (3.00±4.7 to 82.50±2.56 ),internal rotation (2.50±4.44 to 67.25±3.43 ) and UCLA score (5.35±1.63 to 29.60±0.82 ) (p&lt;0.001) also there was gradual but steady decrease in mean VAS score from enrolment (7.70±0.47 ) to six months follow up (0.00±0.00) and constant score ( from 85.70±1.98 to 7.85±1.46 respectively) (p&lt;0.001). The constant score and UCLA score at six month follow up revealed excellent functional outcome<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The mini-open rotator cuff repair of shoulder joint results in excellent functional outcome among adult patients with rotator cuff tear of shoulder joint especially after six month with no complications and complete pain relief<span lang="EN-IN">.</span></p>

scholarly journals Asymmetries in Perceptual Adjustments to Non-Canonical Pronunciations

2021 ◽  
Author(s):  
Molly Babel ◽  
Khia A. Johnson ◽  
Christina Sen
Keyword(s):  
American English ◽  
General Category ◽  
The Novel ◽  
Perceptual Adaptation ◽  
Corpus Study ◽  
Specific Adaptation ◽  
Test Conditions ◽  
Evaluation Stage ◽  
Sound Category

This paper examines two plausible mechanisms supporting sound category adaptation: directional shifts towards the novel pronunciation or a general category relaxation of criteria. Focusing on asymmetries in adaptation to the voicing patterns of English coronal fricatives, we suggest that typology or synchronic experience affect adaptation. A corpus study of coronal fricative substitution patterns confirmed that North American English listeners are more likely to be exposed to devoiced /z/ than voiced /s/. Across two perceptual adaptation experiments, listeners in test conditions heard naturally produced devoiced /z/ or voiced /s/ in critical items within sentences, while control listeners were exposed to identical sentences with canonical pronunciations. Perceptual adaptation was tested via a lexical decision test, with devoiced /z/ or voiced /s/, as well as a novel alveopalatalized pronunciation, to determine whether adaptation was targeted in the direction of the exposed variant or reflected a more general relaxation. Results indicate there was directional and word-specific adaptation for /z/-devoicing with no evidence for generalization. Conversely, there was evidence of /s/-voicing generalizing and eliciting general category relaxation. These results underscore the role of perceptual experiences, and support an evaluation stage in perceptual learning, where listeners assess whether to update a representation.

scholarly journals An Investigation of a Novel Dural Repair Device for Intraoperative Incidental Durotomy Repair

2021 ◽  
Vol 8 ◽  
Author(s):  
Kartik Shenoy ◽  
Chester J. Donnally ◽  
Evan D. Sheha ◽  
Krishn Khanna ◽  
Srinivas K. Prasad
Keyword(s):  
Simulation Model ◽  
Csf Leak ◽  
The Novel ◽  
Clinical Experiences ◽  
Dural Repair ◽  
Novel Device ◽  
Clinical Scenarios ◽  
Dural Tears ◽  
Incidental Durotomy ◽  
Tools And Techniques

Incidental durotomies, or dural tears, can be very difficult and time consuming to repair properly when they are encountered in confined spaces. A novel dural repair device was developed to address these situations. In this paper, the novel device was assessed against the use of traditional tools and techniques for dural repairs in two independent studies using an intricate clinical simulation model. The aim was to examine the results of the two assessments and link the outcomes to the clinical use of the novel device in the operating room. The novel device outperformed conventional techniques as measured by dural repair time, CSF leak pressure and nerve root avoidance in the simulation. The results were generally replicable clinically, however, numerous additional clinical scenarios were also encountered that the simulation model was unable to capture due to various inherent limitations. The simulation model design, potential contributors to watertightness, clinical experiences, and limitation are discussed.

scholarly journals Hidden ileostomy as a rescue procedure in major colorectal surgeries: a novel technique to prevent re-laparotomy in anastomotic leak cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohsen Ezzy ◽  
Moustafa Elshafei ◽  
Khalid Hamdi ◽  
Thomas Kraus ◽  
Peter Heinz ◽  
...  
Keyword(s):  
Anastomotic Leak ◽  
Clinical Success ◽  
The Novel ◽  
Novel Technique ◽  
Clinical Scenarios ◽  
Protective Ileostomy ◽  
Grade 3 ◽  
Associated Risk Factors ◽  
Rescue Procedure

Abstract Background Anastomotic leak is a major cause of morbidity and mortality of patients worldwide, and it has remained stable over the last years. Routine construction of protective ileostomy is associated with stoma and negatively affects patients’ quality of life. Developing another technique to minimize those drawbacks with at least the same clinical success can help patients with anastomotic leak. We present the novel technique “Hidden Ileostomy” as an alternative to protective ileostomy that can achieve that balance. Materials and methods Eight patients presented to our department underwent the novel technique “Hidden Ileostomy” as a rescue procedure for different reasons. The associated risk factors and clinical scenarios, together with the follow-up data, are presented. Results For the eight cases in this study, one patient was ASA grade 1, 3 patients were classified as ASA grade 2, and 4 were grade 3. The mean ± SD operative time and blood loss were 196.3 ± 16.4 min and 325 ± 204.6 ml, respectively. The hidden ileostomy was removed after an average of 8 days. Only Case 6 reported an anastomotic leak on a postoperative day 10. Conclusion A hidden ileostomy is an alternative and feasible technique in selected cases in colorectal surgery. This technique could be adopted in our practice instead of routine instruction of ileostomy, especially in the equivocal anastomosis.

scholarly journals Evaluation of the effectiveness of the use of low-traumatic surgical access in the reverse shoulder arthroplasty

2021 ◽  
Vol 28 (2) ◽  
pp. 21-28
Author(s):  
Gurgen A. Kesyan ◽  
Grigoriy S. Karapetyan ◽  
Artem A. Shuyskiy ◽  
Rashid Z. Urazgil'deev ◽  
Igor' G. Arsen'ev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Shoulder Arthroplasty ◽  
Shoulder Joint ◽  
Subcutaneous Tissue ◽  
Reverse Shoulder Arthroplasty ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Surgical Access

BACKGROUND: The number of reversible shoulder joint endoprostheses installed in the world at the present stage is several times greater than the number of hemiarthroplasty performed. Nevertheless shoulder arthroplasty is considered a traumatic operation and can be accompanied by a number of complications, both from the side of implants and due to the traumatic nature of the surgical technique. During surgical interventions on the shoulder joint with a wide dissection of the skin and subcutaneous tissue, iatrogenic damage to structures such as the axillary nerve, posterior and anterior arteries and veins surrounding the humerus can often be detected, which triggers a whole cascade of pathophysiological and regulatory processes in which Interventions immediately release inflammatory mediators. Therefore, orthopedic traumatologists strive to reduce the risk of intra- and postoperative complications, and it is necessary to improve the surgical technique of surgical interventions towards their less traumatic performance. AIM: Development and evaluation of the effectiveness of the use of low-traumatic surgical access when performing reverse shoulder arthroplasty. MATERIALS AND METHODS: In the period 20172020, 169 patients with various diseases, injuries of the shoulder joint and their consequences were operated on in the Department of Adult Orthopedics of the N.N. Priorov National Research Medical Center of the Russian Federation, who underwent reverse shoulder arthroplasty according to generally accepted indications. In the main group (84 patients), surgical treatment was performed using a low-traumatic surgical approach, while the control group (85 patients) underwent standard procedures. Functional, clinical and radiological results of surgical treatment of patients of the main and control groups were evaluated and compared after 3, 6 and 12 months. RESULTS: In the main group, excellent results (25 points on DASH) were observed in 73 patients, good results (2650 points) in 10 patients. In 1 patient, the results were assessed as satisfactory (5175 points). In the control group of observation, the clinical result was worse (68 excellent, 16 good and 1 satisfactory result). CONCLUSION: On the basis of the performed study, taking into account the better results in the main group of patients, the technique of low-traumatic surgical access for reverse shoulder arthroplasty can be recommended for wide use in clinical practice.

scholarly journals Emergency surgical care for patients with COVID-19 and tuberculosis coinfection at multispecialty hospital

2021 ◽  
Author(s):  
MN Reshetnikov ◽  
DV Plotkin ◽  
ON Zuban ◽  
EM Bogorodskaya
Keyword(s):  
Psoas Abscess ◽  
Postoperative Mortality ◽  
Surgical Care ◽  
Surgical Patients ◽  
The Novel ◽  
Lung Involvement ◽  
Double Burden ◽  
Surgical Interventions ◽  
Global Challenge ◽  
Novel Coronavirus

The double burden of the novel coronavirus infection and tuberculosis (TB) is a global challenge. The aspects of emergency surgical care for patients with COVID-19 and TB coinfection remain understudied. The aim of this study was to assess treatment outcomes in acute surgical patients with COVID-19 and preexisting TB coinfection. In 2020, our Center delivered surgical care to 465 patients with COVID-19 and preexisting TB; a total of 64 emergency surgeries were performed on 36 (5.6%) patients, of whom 16 had HIV. Thirteen patients (36.1%) were diagnosed with pulmonary TB; 23 patients (63.9%) had disseminated TB. Chest CT scans showed >25% lung involvement in 61.9% of the patients with COVID-19 pneumonia, 25–50% lung involvement in 30.6% of the patients, and 50–75% lung involvement in 5.6% of the patients. By performing abdominal CT, we were able to detect abdominal TB complications, including perforated tuberculous ulcers of the intestine, intestinal obstruction and tuberculous peritonitis, as well as tuberculous spondylitis complicated by psoas abscess. Of all surgical interventions, 28.2% were abdominal, 23.2% were thoracic, 15.6% were surgeries for soft tissue infection, and 32.8% were other types of surgery. Postoperative mortality was 22.2%. We conclude that COVID-19 did not contribute significantly to postoperative mortality among acute surgical patients with TB.

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