Angled BIO-RSA leads to better inclination and clinical outcomes compared to Standard BIO-RSA and eccentric reaming: A comparative study

Background Two surgical techniques were compared : Standard BIO-RSA, performed with a glenoid eccentric reaming along with a cylindric bone graft augmentation vs. the Angled BIO-RSA, performed with a glenoid concentric reaming and a defect correction with an angled bone graft. Methods Patients undergoing RSA from January 2016 to April 2019, with one of the two techniques being performed, were retrospectively reviewed. Glenoids were classified according to Favard. Clinical (Constant-Murley, VAS and ROM) and radiographic (superior tilt correction) data were collected pre-operatively and at 12 months post-operatively. Results 141 shoulders were included. Angled BIO-RSA group showed statistically significant better outcomes in terms of forward flexion (149.9° Vs 139.3°) and abduction (136.4° Vs 126.7°). The use of an Angled BIO-RSA showed a statistically significant better superior tilt correction (1.252° Vs 4.09°). Angled BIO-RSA, leads to a better inclination correction and a mean postoperative tilt value inferior to 5° in E1 and E3 differently from standard BIO-RSA. Discussion Both techniques were able to correct glenoid superior inclination with excellent postoperative short-term results. However, angled BIO-RSA technique appears to be more effective in ensuring a correct inclination of the prosthetic glenoid component with better clinical outcomes.

Local defect-correction method based on multilevel discretization for Steklov eigenvalue problem

In this paper, we propose a local defect-correction method for solving the Steklov eigenvalue problem arising from the scalar second order positive definite partial differential equations based on the multilevel discretization. The objective is to avoid solving large-scale equations especially the large-scale Steklov eigenvalue problem whose computational cost increases exponentially. The proposed algorithm transforms the Steklov eigenvalue problem into a series of linear boundary value problems, which are defined in a multigrid space sequence, and a series of small-scale Steklov eigenvalue problems in a coarse correction space. Furthermore, we use the local defect-correction technique to divide the large-scale boundary value problems into small-scale subproblems. Through our proposed algorithm, we avoid solving large-scale Steklov eigenvalue problems. As a result, our proposed algorithm demonstrates significantly improved the solving efficiency. Additionally, we conduct numerical experiments and a rigorous theoretical analysis to verify the effectiveness of our proposed approach.

Post-interventional Evaluation and Follow-Up in Children With Patent Ductus Arteriosus Complicated With Moderate to Severe Pulmonary Arterial Hypertension: A Retrospective Study

Background: Transcatheter closure is an important treatment for patent ductus arteriosus (PDA) complicated with moderate and severe pulmonary arterial hypertension (PAH). This report presents our experience with transcatheter closure of PDA complicated with moderate and severe PAH.Methods: The 49 cases of PDA complicated with moderate and severe PAH were collected in the Second Affiliated Hospital and Yuying Children's Hospital from January 2014 to December 2019 with transcatheter closure of PDA and follow-up. All patients were invited for transthoracic echocardiography, electrocardiogram, and thoracic radiography check-up.Results: Device implantation was successful in 48 of 49 patients (98.0%). Among them, 30 cases were in the PAH after defect correction (CD) group, and 19 examples were in the Non-PAH after defect correction (NCD) group. Pulmonary systolic pressure, left atrial diameter, and left ventricular end-diastolic diameter immediately after interventional therapy and 6 months later were lower than the pre-operative levels (p < 0.05). The incidence of the immediate residual shunt (RS) in this study was 34.9%, most of which were minimal amount shunt. RS disappeared in all patients within 1 year of therapy. Four patients had thrombocytopenia and one patient had left pulmonary artery stenosis. No other serious adverse event occurred during the follow-up period. The pressure gradient tricuspid valve regurgitation (PGTI) and the right heart catheterization (RHC) consistency points were 93.75% (15/16) and were within the 95% consistency limit by the Bland-Altman method. The Logistic regression analysis concluded that the pre-operative Pp/Ps and the narrowest diameter of PDA are risk factors for post-operative PAH (p < 0.05). The cut-off point of the pre-operative Pp/Ps and the narrowest diameter of PDA were calculated to be 0.595 and 4.75 mm, respectively.Conclusion: Interventional occlusion in children with PDA complicated with moderate and severe PAH is safe, effective, and has few complications. Targeted drug therapy has a good clinical effect. The narrowest diameter of PDA and the pre-operative Pp/Ps may be one of the risk factors of residual PAH after interventional therapy.

Improving Regularization Techniques for Incompressible Fluid Flows via Defect Correction

We propose and investigate two regularization models for fluid flows at higher Reynolds numbers. Both models are based on the reduced ADM regularization (RADM). One model, which we call DC-RADM (deferred correction for reduced approximate deconvolution model), aims to improve the temporal accuracy of the RADM. The second model, denoted by RADC (reduced approximate deconvolution with correction), is created with a more systemic approach. We treat the RADM regularization as a defect in approximating the true solution of the Navier–Stokes equations (NSE) and then correct for this defect, using the defect correction algorithm. Thus, the resulting RADC model can be viewed as a first member of the class that we call “LESC-reduced”, where one starts with a regularization that resembles a Large Eddy Simulation turbulence model and then improves it with a defect correction technique. Both models are investigated theoretically and numerically, and the RADC is shown to outperform the DC-RADM model both in terms of convergence rates and in terms of the quality of the produced solution.

Three Years Follow-Up of Single-Stage Correction with Modified Chula Technique for Frontoethmoidal Encephalomeningocele: The Advantage of The Teamwork Approach (A Case Report)

Backgrounds: The main objective of Frontoethmoidal encephalomeningocele (FE) treatment are neural morbidities defect correction and aesthetically pleasing looks. Staged procedures are used to be performed in Indonesia. This article aimed to reveal the result of FE correction through the single-stage modified Chula technique (ST-MCT) procedure in collaboration with the neurosurgery team. Case Reports: A rare case of 5 years old girl diagnosed with FE was reported in this study. The FE was slowly increased in size, causing apparent facial deformity and the appearance of telecanthus. An ST-MCT procedure in collaboration with the neurosurgery team was conducted to correct the defects. The IOD values, IPD values, postoperative complications, and anesthetic improvements were evaluated in this study. Result: The patient was well after the surgery, with no complications and short length of stay. There were noted improvement of ICD, IOD and IPD postoperative follow up. At three years after the surgery ICD= 29mm; IOD= 26mm; IPD= 52 mm (normal range). Summary: ST-MCT procedure conducted in collaboration with neurosurgery team had shown excellent correction of ICD, IOD, and IPD values, no complication, shorter length of stay, and minimal scars. It considers as the most proper technique to reach a good result of correction and aesthetically pleasing looks in FE cases.

Use of the results of operative-investigative activities: current problems and prospects

The article deals with the most important of the currently existing problems of the use of the results of operative-investigative activity, as well as formulated proposals for improving the legislation that regulates the use of the results of operative-investigative activity. According to the author, scientific development of the optimization of the legal basis for using the results of operative-investigative activity consists in finding the balance between providing stakeholders with a legal possibility to use the results of operational-search activity in socially useful purposes and ensuring respect for all the rights and legitimate interests of citizens, society and the state. The purpose of the study is the search for the currently existing, most important problems of using the results of operative-investigative activity, as well as development of proposals for improving the legislation that regulates the use of the results of operative-investigative activity. The methodology of the study was comprised of a combination of general scientific (analysis, synthesis) and special (formal-legal, comparative-legal) methods. Resulting from the study, a conclusion about the need to improve the legislation regulating the usage of the results of operative-investigative activity was made and directions for its improvement were suggested. Areas indicated for improvement are: expanding the goals and the range of subjects of using the results of operative-investigative activity, reconciliation of federal and departmental legal acts regulating the usage of the results of operative-investigative activity, as well as defect correction of law rules governing the use of the results of operative-investigative activity arising from poor legislative technique. It is the author’s conclusion that the development of theoretical and legal problems that arise when presenting and using the results of OIA is currently a promising area of legal sciences of a criminal law nature.

A Rare Case of a Migrating Inguinal Hernia Mesh Presenting as Acute Appendicitis

Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP right inguinal hernia repair with a PolySoft™ hernia patch eight years before, was admitted in the emergency department with acute appendicitis, and submitted to laparoscopic appendectomy. Intraoperatively, the “recoil ring” from the inguinal hernia patch was extended from the anterior abdominal wall to the appendix, perforating it and progressing intraluminally. Appendectomy was performed, as well as removal of the mesh by an anterior approach. Hernia mesh migration to an intraluminally position is extremely rare with only a few cases described in literature. Pathogenesis of migration is still poorly understood. Clinicians should consider hernia mesh migration in their differential diagnosis for causes of acute appendicitis, in the right clinical setting, when a previous hernia defect correction is present. To the best of our knowledge, this is the first reported case of inguinal hernia mesh migration to the appendix, presenting as acute appendicitis.