In vivo measures of cartilage deformation: patterns in healthy and osteoarthritic female knees using 3T MR imaging

ObjectiveTo explore and to compare the magnitude and spatial pattern of in vivo femorotibial cartilage deformation in healthy and in osteoarthritic (OA) knees.MethodsOne knee each in 30 women (age: 55 ± 6 years; BMI: 28 ± 2.4 kg/m(2); 11 healthy and 19 with radiographic femorotibial OA) was examined at 3Tesla using a coronal fat-suppressed gradient echo SPGR sequence. Regional and subregional femorotibial cartilage thickness was determined under unloaded and loaded conditions, with 50% body weight being applied to the knee in 20° knee flexion during imaging.ResultsCartilage became significantly (p < 0.05) thinner during loading in the medial tibia (-2.7%), the weight-bearing medial femur (-4.1%) and in the lateral tibia (-1.8%), but not in the lateral femur (+0.1%). The magnitude of deformation in the medial tibia and femur tended to be greater in osteoarthritic knees than in healthy knees. The subregional pattern of cartilage deformation was similar for the different stages of radiographic OA.ConclusionOsteoarthritic cartilage tended to display greater deformation upon loading than healthy cartilage, suggesting that knee OA affects the mechanical properties of cartilage. The pattern of in vivo deformation indicated that cartilage loss in OA progression is mechanically driven

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Evaluación de la estrategia pedagógica "aprendizaje basado en proyectos": percepción de los estudiantes Evaluation of the pedagogical strategy "project-based learning": perception of the students

El propósito de este trabajo es mostrar la percepción que tienen los estudiantes del programa de Ingeniería Agrícola de la Universidad Nacional de Colombia, sede Medellín sobre la evaluación y el desarrollo de la estrategia pedagógica "aprendizaje basado en proyectos", utilizada en diferentes cursos teórico-prácticos. Esta estrategia consiste en adquirir el aprendizaje del curso por medio de la elaboración y desarrollo de un proyecto durante el semestre académico. El proyecto contribuye a la transferencia del conocimiento de los principios teóricos presentados en clase, al desarrollo del pensamiento crítico y reflexivo, e incentiva el interés por la investigación. El análisis de los resultados de la encuesta aplicada a los estudiantes que participaron en esta experiencia pedagógica, mostró que el aprendizaje basado en proyectos es importante para su desarrollo profesional y cumple con sus expectativas educativas. La mayoría de los encuestados afirman que se aplicaron los conceptos vistos en clase durante el desarrollo del proyecto, la metodología propuesta fue la adecuada, y estuvieron de acuerdo con la valoración final del proyecto y el tiempo dedicado a la parte experimental.<br>The purpose of this study is to show the perception of the agricultural engineering students from Universidad Nacional de Colombia on the evaluation and performance of the pedagogical strategy called "project-based learning", involved in different theoretical-practice courses. This model consists of a learning strategy through the implementation of a project during the academic semester. The project contributes to the transfer of theoretical concepts, the development of critical and reflexive thinking, and to the increase of interest in research and investigation. The survey results from the students who participate in this pedagogical experience showed that project-based learning is important for their professional development and achieves their educational expectations. Most of the students affirmed that the information learned in class was applied during the project development, the methodology was suitable, and the final assessment of the project and the experimental time were adequate