Medical student perception of force application: An accuracy assessment and pilot training program.

Background: It is unclear how accurately students can reproduce specific forces that are often required for physical examination maneuvers. This study aimed to determine the baseline accuracy of force application for preclinical medical students, evaluate the effectiveness of a quantitative visual feedback intervention, and investigate whether certain demographics influence accuracy.

Materials And Methods: First- and second-year medical students were enrolled and demographic data were collected.

What Is the Prevalence of Hip Abductor Pathology in Patients Undergoing Total Hip Arthroplasty?

Background: Total hip arthroplasty (THA) is generally considered a successful operation for patients with advanced hip arthritis. Hip abductor pathology can lead to diminished outcomes. The prevalence of hip abductor pathology in patients undergoing THA is not well described.

Patient Perspective on Robotic-Assisted Total Joint Arthroplasty.

Background: Robotic-assisted total joint arthroplasty (TJA) has gained popularity in recent years. Despite mixed patient and surgeon perceptions, conflicting evidence regarding efficacy and cost-effectiveness in comparison to manual TJA exists. Patients' beliefs surrounding robotic-assisted TJA remain unclear.

Peripheral Nerve Blocks Are Associated With Decreased Early Medical Complications, Dislocations, and Opioid Consumption Following Total Hip Arthroplasty.

Background: Peripheral nerve blocks (PNBs) may be utilized for postoperative pain control following total hip arthroplasty (THA). The purpose of this study was to evaluate the association between PNBs and postoperative complication rates, healthcare utilization, and opioid consumption following elective THA.

Methods: Opioid-naive patients who received PNBs on the same day as undergoing THA for degenerative etiologies were identified from a large national database and matched 1:5 to a control cohort using propensity scoring.

Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks.

Background: With increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA), maximizing operating room (OR) efficiency is critical. This paper sought to examine the implementation of time benchmarks when performing primary TKA and THA. We hypothesized that implementing benchmarks would improve efficiency and the number of joints performed per day.

Intraprosthetic Dislocation Following Dual Mobility Total Hip Arthroplasty: A Retrieval Analysis Study.

Background: Dual mobility (DM) implants in total hip arthroplasty provide excellent range of motion with low dislocation rates. A complication of this design is intraprosthetic dislocation (IPD), where the polyethylene (PE) liner dissociates from the femoral head. In older designs, IPD occurred due to a small head size and late PE wear with head-capture-mechanism failure.

Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis.

Background: Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs. This study examines the operative time learning curve of RA-TKA using a single robotic system.

Investigating Postoperative Urinary Retention: Risk Factors and Postsurgical Outcomes in Total Joint Arthroplasty.

Background: Postoperative urinary retention (POUR), a known complication following total joint arthroplasty (TJA), remains inconsistent in its diagnostic criteria, prevalence, and risk factors. This study aims to quantify POUR rates, identify risk factors, and assess complications associated with catheterization in TJA.

Methods: A single-center cohort undergoing TJA between January 2015 and December 2022 was retrospectively reviewed.

Frontal plane mechanical leg alignment estimation from knee x-rays using deep learning.

Objective: Lower limb malalignment can complicate symptoms and accelerate knee osteoarthritis (OA), necessitating consideration in study population selection. In this study, we develop and validate a deep learning model that classifies leg alignment as "normal" or "malaligned" from knee antero-posterior (AP)/postero-anterior (PA) radiographs alone, using an adjustable hip-knee-ankle (HKA) angle threshold.

Material And Methods: We utilized 8878 digital radiographs, including 6181 AP/PA full-leg x-rays (LLRs) and 2697 AP/PA knee x-rays (2292 with positioning frame, 405 without).

Postnatal deletion of Phlpp1 in chondrocytes delays post-traumatic osteoarthritis in male mice.

Objective: Osteoarthritis is a chronic, debilitating disease that causes long-term pain and immobility. Germline deletion of Phlpp1 or administration of small molecules that inhibit Phlpp1 prevents post-traumatic osteoarthritis (PTOA) in mice. However, the chondrocyte-intrinsic role of Phlpp1 in PTOA progression is unknown.

Full-thickness arthroscopic rotator cuff repair demonstrates low repair failure rates and high return to sport rates in patients aged 30 years and under at 9-year follow-up: A single-center case series.

Purpose: The purpose of this study is to assess the long-term clinical complications, outcomes, and return to sport (RTS) rates in patients aged 30 or younger with a primary full-thickness arthroscopic rotator cuff repair (ARCR).

Methods: All patients who underwent a primary full-thickness ARCR at age 30 years or younger from 2003 to 2021 with a minimum of a 2-year follow-up were included. Complications, repeat surgeries, and return to sport rates were collected.

Computer-aided robotics for applications in fracture reduction surgery: Advances, challenges, and opportunities.

The advancement of information technology and AI has boosted global economic and social development. Robot systems (RS) and computer-aided technology (CAT) are used in various domains, including social production and human existence. Traditional fracture reduction surgery relies on the expertise and surgical skills of surgeons to realign fractures in patients.

Advances in the application and research of biomaterials in promoting bone repair and regeneration through immune modulation.

With the ongoing development of osteoimmunology, increasing evidence indicates that the local immune microenvironment plays a critical role in various stages of bone formation. Consequently, modulating the immune inflammatory response triggered by biomaterials to foster a more favorable immune microenvironment for bone regeneration has emerged as a novel strategy in bone tissue engineering. This review first examines the roles of various immune cells in bone tissue injury and repair.

Multifunctional nanoparticles confers both multiple inflammatory mediators scavenging and macrophage polarization for sepsis therapy.

Sepsis is a serious and life-threatening condition, which can lead to organ failure and death clinically. Abnormally increased cell-free DNA (cfDNA) and inflammatory cytokines are involved in the development and progression of sepsis. Thus, cfDNA clearance and down-regulation of inflammatory factors are essential for the effective treatment of sepsis.

The immunoglobulin of yolk and cerium oxide-based fibrous poly(L-lactide-co-glycolide)/gelatin dressings enable skin regeneration in an infectious wound model.

The bacterial infection and oxidative wound microenvironment delay skin repair and necessitate intelligent wound dressings to enable scarless wound healing. The immunoglobulin of yolk (IgY) exhibits immunotherapeutic potential for the potential treatment of antimicrobial-resistant pathogens, while cerium oxide nanoparticles (CeO NPs) could scavenge superoxide dismutase (SOD) and inflammation. The overarching objective of this study was to incorporate IgY and CeO NPs into poly(L-lactide-co-glycolide)/gelatin (PLGA/Gel)-based dressings (P/G@IYCe) for infected skin repair.

Antibacterial carbon dots.

Bacterial infections significantly threaten human health, leading to severe diseases and complications across multiple systems and organs. Antibiotics remain the primary treatment strategy for these infections. However, the growing resistance of bacteria to conventional antibiotics underscores the urgent need for safe and effective alternative treatments.

Adie's pupil and systemic manifestations: a rare unilateral presentation.

We present a case of a young woman who presented with blurring of vision in her right eye, worsening on near work. Detailed ophthalmic and neurological evaluation was done, which revealed light near dissociation, vermiform iris movements, constriction to diluted pilocarpine with absent deep tendon reflexes. Laboratory investigation indicated mild iron deficiency anemia and reduced vitamin D3 level.

3D-printed constructs deliver bioactive cargos to expedite cartilage regeneration.

Cartilage is solid connective tissue that recovers slowly from injury, and pain and dysfunction from cartilage damage affect many people. The treatment of cartilage injury is clinically challenging and there is no optimal solution, which is a hot research topic at present. With the rapid development of 3D printing technology in recent years, 3D bioprinting can better mimic the complex microstructure of cartilage tissue and thus enabling the anatomy and functional regeneration of damaged cartilage.

Pre-Operative Management of the Penicillin Allergic Patient: A Narrative Review.

Penicillin is a frequently reported medication allergy. The beta-lactam ring shared between cephalosporins and penicillin often leads to the use of alternative antibiotics for surgical prophylaxis due to concern for cross-reactivity, despite a true IgE-mediated hypersensitivity being very rare. This misconception leads to the use of less effective second line antibiotics, such as clindamycin or vancomycin, for penicillin-allergic patients which has been shown to increase odds of postoperative infection in elective knee arthroplasty, shoulder arthroplasty and spine surgery.

How do Rates of Return to Sports Following Direct Anterior Approach Total Hip Arthroplasty Compare to Other Approaches? A Systematic Review and Meta-analysis.

Background: There is a paucity of literature analyzing data for return to sport (RTS) and return to work (RTW) in the setting of direct anterior approach (DAA) total hip arthroplasty (THA).

Objective: The aims of this systematic review are to identify existing literature and to aggregate rates of RTS/RTW following DAA THA in a meta-analysis.

Methods: A query of major databases yielded 1819 initial studies.

Identifying internal and external shoulder rotation using a kirigami-based shoulder patch.

Internal and external rotation of the shoulder is often challenging to quantify in the clinic. Existing technologies, such as motion capture, can be expensive or require significant time to setup, collect data, and process and analyze the data. Other methods may rely on surveys or analog tools, which are subject to interpretation.

A self-hygroscopic, rapidly self-gelling polysaccharide-based sponge with robust wet adhesion for non-compressible hemorrhage control and infected wounds healing.

Uncontrollable non-compressible hemorrhage and traumatic infection have been major causes of mortality and disability in both civilian and military populations. A dressing designed for point-of-care control of non-compressible hemorrhage and prevention of traumatic infections represents an urgent medical need. Here, a novel self-gelling sponge OHN@ε-pL is developed, integrating N-succinimidyl ester oxidized hyaluronic acid (OHN) and ε-poly-L-lysine (ε-pL).

The pathogenesis and management of heatstroke and heatstroke-induced lung injury.

In the past two decades, record-breaking heat waves have caused an increasing number of heat-related deaths, including heatstroke, globally. Heatstroke is a life-threatening systemic condition characterized by a core body temperature >40°C and the subsequent development of multiple organ dysfunction syndrome. Lung injury is a well-documented complication of heatstroke and is usually the secondary cause of patient death.

Lipopolysaccharide-induced active telocyte exosomes alleviate lipopolysaccharide-induced vascular barrier disruption and acute lung injury via the activation of the miRNA-146a-5p/caspase-3 signaling pathway in endothelial cells.

Background: Lipopolysaccharide (LPS)-induced apoptosis of lung microvascular endothelial cells (ECs) is the main reason of lung edema and acute lung injury (ALI) in septic conditions. Telocytes (TCs) are a distinct type of interstitial cells found around the lung microvasculature, which may protect ECs through the release of shed vesicles. However, whether TCs protect against LPS-induced EC apoptosis and ALI has not been determined.

The relationship between fractional amplitude of low-frequency fluctuations (fALFF) and the severity of neglect in patients with unilateral spatial neglect (USN) after stroke: A functional near-infrared spectroscopy study.

Objective: Unilateral spatial neglect (USN) following right hemisphere stroke is more pronounced, severe, and persistent than in the left hemisphere. However, the pathophysiological mechanisms underlying USN remain largely unknown. This study aims to investigate the relationship between the fractional amplitude of low-frequency fluctuations (fALFF) in the right hemisphere of patients with post-stroke USN and the severity of neglect using resting-state functional near-infrared spectroscopy (fNIRS) technology.