Investigation of Lake Hévíz Mineral Water Balneotherapy and Hévíz Mud Treatment in Murine Osteoarthritis and Rheumatoid Arthritis Models

Arthritic diseases are the most frequent causes of chronic pain and disability. Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and progressive structural joint damage. Osteoarthritis is a degenerative process of the articular cartilage associated with hypertrophic changes in the bone. The aim of the present study was to investigate the anti-inflammatory and analgesic effects of Hévíz thermal water and mud in monosodium iodoacetate- (MIA-) (25 mg/ml, 20 μl i.a.) induced osteoarthritis and Complete Freund’s adjuvant- (CFA-) (1 mg/ml, 50–50 μl s.c) induced rheumatoid arthritis murine models. The mechanonociceptive threshold of female NMRI mice (n=6– 8 mice/ group) was measured by aesthesiometry, and paw volume was monitored with plethysmometry, knee joint diameter with digital micrometer, and dynamic weight bearing on the hind limbs with a Bioseb instrument. Periarticular bone destruction was assessed by SkyScan 1176 in vivo micro-CT. Inflammatory cytokines were detected by ELISA in plasma samples. Treatments (30 min, every working day) with tap water, sand, and a combined therapy of tap water and sand served as controls. Hévíz medicinal water and combined treatment with water and mud significantly decreased the mechanical hyperalgesia and knee oedema in MIA-induced osteoarthritis model. However, balneotherapy did not influence mechanical hyperalgesia, weight bearing, or oedema formation induced by CFA. Neither medicinal water nor mud treatment ameliorated deep structural damage of the bones or the joints in the animal models. On the basis of the present findings, we conclude that balneotherapy is an effective complementary treatment to reduce the pain sensation and swelling in degenerative joint diseases such as osteoarthritis. Our experimental data are in agreement with the previous human studies that also confirmed antinociceptive and anti-inflammatory effects of thermal water and Hévíz mud treatments

Opioid Consumption Rate After Foot and Ankle Surgery

Category: Opioid consumption rate and risk factors investigation after foot and ankle surgery Introduction/Purpose: The rapid increase in the consumption of prescription opioids has become one of the leading medical, economical, and sociological burdens in North America. In the United States, orthopedic surgery is the fourth leading specialty in the number of opioids prescribed, and the largest among surgical specialties. There is insufficient evidence to guide surgeons about appropriate opioid prescription amounts after orthopaedic foot and ankle (F&A) procedures. The aim of this study was to determine the opioid consumption rate after foot and ankle procedures, and to identify patient risk factors associated with higher use. Methods: A total of 535 patients who underwent a F&A surgery performed by one orthopedic surgeon from August 2016 to March 2018 were investigated. The study was approved by our IRB. Each patient received a preoperative discussion about postoperative pain and expectations alongside a standardized handout. At the two-week postoperative visit, the patient-reported amount of consumed opioids was recorded. Prescription details, the amount of opioids taken, refill requests, pain-issue related telephone calls, and additional MD/ED visits were also documented. Patient demographics and co-morbidities, use of regional anesthesia, postoperative inpatient hospitalization, surgery type and severity, and pre-operative opioid use were collected retrospectively. Total amounts of morphine equivalents were calculated and converted into oxycodone 5 mg pills for standardization. P-values of <0.05 were considered significant. Results: Two hundred forty-four patients with a mean age of 50 years (±16.3) and a BMI of 29 (±6.1) were included. Sixty-six (27%) patients underwent a soft tissue procedure alone and 178 (73%) underwent a bony procedure. 225 (92.2%) patients received regional block. Patients reported that they consumed only 51.2% of prescribed pills after a bony procedure and 42.4% after a soft tissue procedure, respectively, which resulted in a total of 4,496.2 left over pills that derived from this study amongst only 244 patients enrolled. There were 11 refill requests (4.5%), two (0.8%) additional MD/ED visits, and 19 (7.8%) telephone calls related to pain. BMI, procedure type, and number of opioids prescribed were positively correlated with the consumption rate (P =.002, P<.001, P<0.001, respectively). Conclusion: BMI, surgery type (bony vs. soft tissue), and a higher number of pills dispensed were correlated with higher use in the postoperative period. After an educative discussion on postoperative pain, patients took 42.4% of the prescribed opioid after soft tissue procedures and 51.2% after bony procedures, resulting in a significant number of unused pills now available to the community. Future guidelines are necessary to improve our postoperative pain management, but this study suggests that current amounts of dispensed pills after orthopaedic F&A procedures are approximately twice as high as necessary

Atypical transistor-based chaotic oscillators: Design, realization, and diversity

In this paper, we show that novel autonomous chaotic oscillators based on one or two bipolar junction transistors and a limited number of passive components can be obtained via random search with suitable heuristics. Chaos is a pervasive occurrence in these circuits, particularly after manual adjustment of a variable resistor placed in series with the supply voltage source. Following this approach, 49 unique circuits generating chaotic signals when physically realized were designed, representing the largest collection of circuits of this kind to date. These circuits are atypical as they do not trivially map onto known topologies or variations thereof. They feature diverse spectra and predominantly anti-persistent monofractal dynamics. Notably, we recurrently found a circuit comprising one resistor, one transistor, two inductors, and one capacitor, which generates a range of attractors depending on the parameter values. We also found a circuit yielding an irregular quantized spike-train resembling some aspects of neural discharge and another one generating a double-scroll attractor, which represent the smallest known transistor-based embodiments of these behaviors. Through three representative examples, we additionally show that diffusive coupling of heterogeneous oscillators of this kind may give rise to complex entrainment, such as lag synchronization with directed information transfer and generalized synchronization. The replicability and reproducibility of the experimental findings are good. Published by AIP Publishing

IoT security, privacy, safety and ethics

The Internet of Things (IoT) represents a revolution of the Internet which can connect nearly all environment devices over the Internet to share their data to create novel services and applications for improving our quality of life. Using cheap sensors, the IoT enables various devices and objects around us to be addressable, recognizable and locatable. Although the IoT brought infinite benefits, it creates several challenges, especially in security and privacy. Handling these issues and ensuring security and privacy for IoT products and services must be a fundamental priority. Users need to trust IoT devices and related services are secure. Moreover, the IoT safety must be considered to prevent the IoT system and its components from causing an unacceptable risk of injury or physical damage and at the same time considering social behaviour and ethical use of IoT technologies to enable effective security and safety. This chapter provides a discussion of IoT security, privacy, safety and ethics. It starts by providing an overview of the IoT system, its architecture and essential characteristics. This is followed by discussing IoT security challenges, requirements and best practices to protect IoT devices. The IoT privacy is also discussed by highlighting various IoT privacy threats and solutions to preserve the privacy of IoT devices. The IoT safety, ethics, the need for the ethical design and challenges encountered are also discussed. In the end, smart cities are introduced as a case study to investigate various security threats and suggested solutions to maintain a good security level in a smart city.N/