HTX-011 reduced pain intensity and opioid consumption versus bupivacaine HCl in bunionectomy: phase III results from the randomized EPOCH 1 study.

BACKGROUND AND OBJECTIVES: There is a need for local anesthetics that provide consistent analgesia through 72 hours after surgery. This study evaluates the use of HTX-011 (bupivacaine and meloxicam in Biochronomerpolymer technology), an extended-release, dual-acting local anesthetic, in reducing both postoperative pain over 72 hours and postoperative opioid use when compared with bupivacaine hydrochloride (HCl) and saline placebo. Inclusion of low-dose meloxicam in HTX-011 is designed to reduce local inflammation caused by surgery, potentiating the analgesic effect of bupivacaine. Previously, significant synergy has been observed with bupivacaine and meloxicam with both given locally together. METHODS: EPOCH 1 was a randomized, double-blind, placebo-controlled and active-controlled phase III study in subjects undergoing a primary unilateral, distal, first metatarsal bunionectomy in which subjects received either a single intraoperative dose of HTX-011, immediate-release bupivacaine HCl or saline placebo. RESULTS: A total of 412 subjects were dosed. The results for the primary and all four key secondary endpoints were statistically significant in favor of HTX-011. HTX-011 demonstrated superior, sustained pain reduction through 72 hours, significantly reduced opioid consumption and resulted in significantly more opioid-free subjects compared with saline placebo and bupivacaine HCl. Safety was similar across groups with fewer opioid-related adverse events observed in the HTX-011 group. CONCLUSIONS: HTX-011 demonstrated significant reduction in postoperative pain through 72 hours with significant reduction in opioid consumption and a significant increase in the proportion of opioid-free subjects compared with saline placebo and the most widely used local anesthetic, bupivacaine HCl. TRIAL REGISTRATION NUMBER: NCT03295721

Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty

Introduction. Total hip arthroplasty (THA) infections with severe bone loss pose significant reconstructive challenges. We present our experience with two-stage hip reimplantation using an intramedullary, antibiotic-impregnated nail. Methods. Three patients with infected THA with severe proximal femoral bone loss (Mallory type IIIB or greater) were treated using a custom antibiotic spacer. Clinical outcomes and any complications were recorded. Average followup was 49 months from final reimplantation. Results. Mean age at spacer placement (stage 1) was 53 years. The mean Harris Hip Score at final followup was 80. Two patients had asymptomatic heterotopic ossification, and one patient had a 2 cm leg-length discrepancy. Conclusions. A custom intramedullary nail antibiotic spacer is a reliable option in the staged management of the infected THA with severe proximal femoral bone loss. Benefits of this technique include limb salvage with maintenance of leg length, soft tissue tension, and functional status

Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial

Key Findings: An educational video on the risks and benefits of total knee replacement increased the rate of surgery among black patients, in a clinical trial of an intervention that could reduce known racial disparities in treatment of osteoarthritis

Applying Cytogenetics in Phylogenetic Studies

Cytogenetics, with its fundamental role in the field of genetic investigation, continues to be an indispensable tool for studying phylogenetics, given that currently molecular evolutionary analyses are more commonly utilized. Chromosomal evolution indicated that genomic evolution occurs at the level of chromosomal segments, namely, the genomic blocks in the size of Mb‐level. The recombination of homologous blocks, through the mechanisms of insertion, translocation, inversion, and breakage, has been proven to be a major mechanism of speciation and subspecies differentiation. Meanwhile, molecular cytogenetics (fluorescence in situ hybridization‐based methodologies) had been already widely applied in studying plant genetics since polyploidy is common in plant evolution and speciation. It is now recognized that comparative cytogenetic studies can be used to explore the plausible phylogenetic relationships of the extant mammalian species by reconstructing the ancestral karyotypes of certain lineages. Therefore, cytogenetics remains a feasible tool in the study of comparative genomics, even in this next generation sequencing (NGS) prevalent era

IoT-Based Indoor and Outdoor Self-Quarantine System for COVID-19 Patients

Even after two years since the declaration of the new virus Coronavirus Disease 19 (COVID-19), the reported cases are still considerably high in many countries, including Malaysia. The health authorities cannot monitor the health condition and track the location of every home-monitored patient at once due to many confirmed cases in a day. In order to overcome the shortage of manpower, an Internet of Things (IoT)-based self-quarantine system with Radio Frequency Identification (RFID) and Global Positioning System (GPS) tracking is proposed in this paper to monitor the health conditions of the Covid-19 patients and track their real-time location via mobile application. Biomedical sensors are used to measure health conditions such as temperature, pulse oximetry, and heart-rate monitor. In addition, the RFID readers are used to detect patients that intend to leave the quarantine area, and the GPS modules are used to track their actual geometrical location so that the authorities can take further action. The real-time data is automatically pushed to the cloud server for the authorities to remotely view the patient's health condition and location on the Google map using smart devices. Finally, a hardware prototype and a mobile application have been successfully developed in this project. The system is able to display the temperature, heartbeats, and blood oxygen saturation properly on a liquid crystal display (LCD) screen. All these measured values, together with the information from RFID detection and GPS location tracking, can be viewed on a smartphone

Molecular Diagnosis of Periprosthetic Joint Infection by Quantitative RT-PCR of Bacterial 16S Ribosomal RNA

The diagnosis of periprosthetic joint infection is sometimes straightforward with purulent discharge from the fistula tract communicating to the joint prosthesis. However it is often difficult to differentiate septic from aseptic loosening of prosthesis because of the high culture-negative rates in conventional microbiologic culture. This study used quantitative reverse transcription polymerase chain reaction (RT-qPCR) to amplify bacterial 16S ribosomal RNA in vitro and in 11 clinical samples. The in vitro analysis demonstrated that the RT-qPCR method was highly sensitive with the detection limit of bacterial 16S rRNA being 0.148 pg/μl. Clinical specimens were analyzed using the same protocol. The RT-qPCR was positive for bacterial detection in 8 culture-positive cases (including aerobic, anaerobic, and mycobacteria) and 2 culture-negative cases. It was negative in one case that the final diagnosis was confirmed without infection. The molecular diagnosis of bacterial infection using RT-qPCR to detect bacterial 16S rRNA around a prosthesis correlated well with the clinical findings. Based on the promising clinical results, we were attempting to differentiate bacterial species or drug-resistant strains by using species-specific primers and to detect the persistence of bacteria during the interim period before the second stage reimplantation in a larger scale of clinical subjects

Do ceramic femoral heads reduce taper fretting corrosion in hip arthroplasty? A retrieval study.

BACKGROUND: Previous studies regarding modular head-neck taper corrosion were largely based on cobalt chrome (CoCr) alloy femoral heads. Less is known about head-neck taper corrosion with ceramic femoral heads. QUESTIONS/PURPOSES: We asked (1) whether ceramic heads resulted in less taper corrosion than CoCr heads; (2) what device and patient factors influence taper fretting corrosion; and (3) whether the mechanism of taper fretting corrosion in ceramic heads differs from that in CoCr heads. METHODS: One hundred femoral head-stem pairs were analyzed for evidence of fretting and corrosion using a visual scoring technique based on the severity and extent of fretting and corrosion damage observed at the taper. A matched cohort design was used in which 50 ceramic head-stem pairs were matched with 50 CoCr head-stem pairs based on implantation time, lateral offset, stem design, and flexural rigidity. RESULTS: Fretting and corrosion scores were lower for the stems in the ceramic head cohort (p=0.03). Stem alloy (p=0.004) and lower stem flexural rigidity (Spearman\u27s rho=-0.32, p=0.02) predicted stem fretting and corrosion damage in the ceramic head cohort but not in the metal head cohort. The mechanism of mechanically assisted crevice corrosion was similar in both cohorts although in the case of ceramic femoral heads, only one of the two surfaces (the male metal taper) engaged in the oxide abrasion and repassivation process. CONCLUSIONS: The results suggest that by using a ceramic femoral head, CoCr fretting and corrosion from the modular head-neck taper may be mitigated but not eliminated. CLINICAL RELEVANCE: The findings of this study support further study of the role of ceramic heads in potentially reducing femoral taper corrosion

Interpretation Structure Modeler for FOL

Import 05/08/2014Obsahem této diplomové práce je analýza a návrh systému pro podporu výuky předmětu Matematická logika. Vytvářený systém se bude týkat problematiky 3D vizualizace úlohy na hledání modelu množiny formulí v predikátové logice prvního řádu a modelování důležitých vlastností relací. Nástroj bude také obsahovat nápovědu pro vytvoření modelu množiny. V první části práce, je čtenář seznámen s teoretickými základy z dané oblasti, na které plynule navazuje specifikace požadavků na nový systém. Dále je text práce zaměřen především na analýzu a návrh jednotlivých částí systému, která je doplněna o třídní a sekvenční diagramy UML.The goal of this thesis is to Provide design and analysis of a new system, which could then be used as a teaching tool in subject called Mathematical Logic. The new system will consist of two main parts. The first part will be dealing with the problem of 3D visualization of formula set models. The second part will include an environment for modeling important properties of relations. Our system will also include an aid for creating formula set models. In the first part of the thesis we focus on theoretical background and requirement specification for the new system. Following parts ot the thesis are mainly focused on analysis and design of individual system parts, accompanied with class and sequence UML diagrams.460 - Katedra informatikydobř

Nutrient supply in the Southern East China Sea after Typhoon Morakot

Author Posting. © Sears Foundation for Marine Research, 2013. This article is posted here by permission of Sears Foundation for Marine Research for personal use, not for redistribution. The definitive version was published in Journal of Marine Research 71 (2013): 133-149, doi:10.1357/002224013807343425.Recent studies show that typhoons have profound effects on phytoplankton assemblages along their tracks, but it is difficult to quantitatively estimate nutrient supply after a typhoon's passage due to a lack of nutrient information before and after the arrival of a typhoon. During the passage of Typhoon Morakot (July 22 to Aug. 26, 2009), we conducted pre- and post-typhoon field cruises to study nutrient supply in the Southern East China Sea (SECS). The results showed nitrate and phosphate supplies to the water column in the SECS after the typhoon's passage were 5.6 × 1011 g-N/day and 7.8 × 1010 g-P/day which were significantly higher than those before the typhoon occurred (nitrate supply = 1 × 109 g-N/day, phosphate supply = 1.6 × 108 g-P/day). We conclude from this data, and after consulting the available physical data, that the highest nitrate concentration was caused by strong upwelling and/or vertical mixing, and input of nutrient-replete terrestrial waters. The nitrate and phosphate input related to the passage of Typhoon Morakot can account for approximately 86% and 87% of summer nitrate and phosphate supplies to the southern East China Sea.This research was supported by the Top University Program and the National Science Council (NSC101-2116M-110- 001, NSC101-2611-M-110-015-MY3, NSC100-2119-M-110-003, NSC98-2611-M-019-014-MY3, NSC NSC98-2611-M-002-019-MY3) of Taiwan to C.-C. Hung, G.-C.Gong and S. Jan

Corrigendum to “Nutrient supply in the Southern East China Sea after Typhoon Morakot”

Author Posting. © Sears Foundation for Marine Research, 2013. This article is posted here by permission of Sears Foundation for Marine Research for personal use, not for redistribution. The definitive version was published in Journal of Marine Research 71 (2013): 451-452, doi:10.1357/002224013812587609