Fracture prediction on patient-specific tibia model with osteogenesis Imperfecta under various loading direction

This study aims to predict the fracture of bone with osteogenesis imperfecta (OI) by considering the homogenization properties of real patient. A Type-III of osteotomy in OI femur was used as bone specimen. Nine representative volume element (RVE) models were developed based on μCT-images of bone specimen. Homogenized properties particularly the Young's moduli of the RVEs was obtained based on homogenization theory in Voxelcon software. The obtained homogenized properties were then assigned to the OI patient-specific model that was developed from CT-images of real patient. The fracture of OI bone was predicted based on linear static analysis and finite element method under loadings of activity daily living (ADL). The results found that the fracture might be happen to the patient under jumping load case, whereas the subject is expected to be safe under standing still and walking load case

Surgical site infection after gastrointestinal surgery in children: An international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda