Effect of Ultrasound Frequency and Treatment Duration on Antibiotic Elution from Polymethylmethacrylate Bone Cement

Introduction. The objective of this study was to evaluate the effect ofultrasound frequency and treatment duration on antibiotic-impregnatedpolymethylmethacrylate (PMMA) antibiotic elution rates andmechanical strength.Methods.xTwo batches of PMMA were prepared: one with five gramsof vancomycin powder and one without. Each batch was dividedinto two frequency groups: kHz and MHz. Each frequency groupwas divided into two duration groups: two minutes and ten minutes.Elution samples were measured daily using flow injection analysis.After one week of elution, ultrasound treatments were done daily untileach group’s average concentration fell below those of non-ultrasoundcontrol groups. After elution testing, compression testing determinedmechanical properties. Paired t-tests were used to compare dailyelution amounts to baseline values. Univariate ANOVAs were used totest for effects of both frequency and treatment duration on antibioticelution amounts and on mechanical properties.Results. All ultrasound treatments resulted in significant increasesin antibiotic elution. Frequency and duration had significant effects ofincreasing antibiotic elution (p < 0.001). The kHz group produced significantlygreater antibiotic elution than the MHz group (p < 0.001).The 10-minute duration produced significantly greater antibioticelution than the two-minute duration (both p < 0.001). Frequencyand duration did not have significant effects on yield stress (p = 0.841and p = 0.179, respectively). Frequency had a significant effect (p =0.024) on modulus, but duration did not (p = 0.136).Conclusions. Ultrasound frequency and treatment duration significantlyaffect antibiotic elution from PMMA which may be helpful fortreatment of periprosthetic joint infections during revision arthroplasty.Kans J Med 2019;12(2):45-49

Initial Response of Mature, Experienced Runners to Barefoot Running: Transition to Forefoot Strike

Introduction Forefoot strike has been advocated for many runnersbecause of the relatively lower impact and push-off forces comparedto a heel strike. The purpose of this study was to explore the abilityof mature (> 30 years old), experienced runners to transition from aheel foot strike to a forefoot strike when first introduced to barefootrunning on a treadmill. We hypothesized: 1) mature runners who heelstrike while wearing traditional training shoes would persist in heelstriking immediately following a switch to barefoot, 2) mean shoeheel-to-toe drop would be significantly greater in runners who persistin heel striking when running barefoot compared to those who transitionto a forefoot strike pattern, and 3) there would be a significantdecrease in heel striking in the barefoot condition as running speedsincreased. Methods This was a controlled crossover laboratory study. Thirty-three experienced runners (average 23.4 miles per week) withan average age of 45.6 years were recruited for this study. The participantsfirst ran in their standard running shoes and subsequentlybarefoot. A motion capture system was utilized to detect and analyzeany transition from heel strike to forefoot strike made by study participants. Results Of the 26 participants who were classified as heel strikerunners in their running shoes, 50% (13/26, p = 0.001) transitionedto forefoot strike when changing from running in shoes to runningbarefoot. Conclusions The injuries associated with transition from standardrunning shoes to barefoot running or minimalist shoes may be influencedby the persistence of heel striking in mature runners. Olderexperienced runners may have limited ability to transition from heelto forefoot striking when first introduced to barefoot running. Maturerunners should be cautious when beginning a minimalist shoe orbarefoot running regimen

Cenozoic magmatism and extension in western Mexico: Linking the Sierra Madre Occidental Silicic Large Igneous Province and the Comondú Group with the Gulf of California rift

Emerging over the past decade has been a new view on the genesis of, and links between, the Sierra Madre Occidental silicic large igneous province, the Comondú Group of Baja California and the Gulf of California rift. Underpinning this has been a wealth of new data from both margins of the Gulf of California including offshore sampling, and marine geophysical data, in part seeded by the NSF Margins program where the Gulf of California was a principal focus site. Previously, the Sierra Madre Occidental silicic large igneous province and Comondú Group had been widely regarded as supra - subduction volcanism with the Comondú Group in particular, defining the location of the early to mid - Miocene supra - subduction zone volcanic arc, and therefore acting as both a spatial and temporal barrier to when rifting of the Gulf of California could begin. More broadly, this continental magmatism occurring during the last phase of subduction of the Farallon Plate between the Late Eocene and the Middle Miocene, shows little to n o petrogenetic connection to the active plate boundary and is more strongly linked to the progressive thinning of the upper plate and establishment of a shallow asthenospheric mantle beneath western Mexico. A database developed for this study of 4255 ages and chemical analyses for igneous rocks from 100 to 5 Ma from across western Mexico, reveals a significant transition period between 50 and 40 Ma where relatively low - volume magmatism was established across a broad area up to 800 km wide and extended up to 1000 km in board of the paleotrench. Since 40 Ma, magma fluxes greatly increased across this broad belt and compositions were initially silicic - dominated but quickly became bimodal by ~30 Ma. The space - time pattern of crustal extension is constrained in 39 areas, for which the approximate age of extension can be established on the basis of geologic relations or thermochronology. The onset of continental extension is constrained to the Eocene when extensional basins developed across the Central Plateau and the easternmost part of the Sierra Madre Occidental, approximately 500 km in board of the paleo - plate boundary. By the end of Oligocene, crustal extension had affected a wide region (250 km width) from the eastern Sierra Madre Occidental to the site of the future Gulf of California (wide rift mode). Concomitant with this extension was:\ud \ud 1) a widespread invasion of the mid to upper crust by mafic magmas with lithospheric signatures (the southern cordillera orogenic basaltic andesite suite or SCORBA), and lesser erupted volumes of uncontaminated asthenosphere - derived within - plate lavas, and;\ud \ud 2) crustal melting producing voluminous pulses of silicic ignimbrite eruptions (the SMO SLIP) with a ferroan (dry) and transitional within - plate signature. At ~19 Ma, ortho gonal extension became focused between the western side of the SMO and eastern Baja California in a ~80 - 100 km wide belt

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Abstract Background Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). Methods In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung–Knapp–Sidik–Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care