KINEMATIC SYNTHESIS OF A MEDICAL BED FOR DECUBITUS ULCER PATIENTS

ABSTRACT A decubitus ulcer or bedsore is a pressure-induced ulceration of the skin occurring in persons confined to bed for long periods of time. Reduction of pressure over bony prominences is of primary importance to prevent and cure bedsores. For this purpose, specially designed mattresses can be used and/or the patient should be turned frequently to avoid ischemia of soft tissue. In addition to pressure, other principal factors causing bedsore are friction and shear forces. In this paper, we designed a new 5 degree of freedom bed mechanism that can be used to change the posture of pressure ulcer patients, which generates 7 motions including backrest elevation, kneerest elevation, lounge position, left and right rotation, trendelenberg and reverse trendelenberg motion, and straight elevation. Particularly, we focused on the synthesis of a backrest and seatrest assembly that can reduce sliding between the bed and the patient

Hippocampal atrophy is associated with hearing loss in cognitively normal adults

Objectives: A growing body of evidence suggests that age-related hearing loss (HL) is associated with morphological changes of the cerebral cortex, but the results have been drawn from a small amount of data in most studies. The aim of this study is to investigate the correlation between HL and gray matter volume (GMV) in a large number of subjects, strictly controlling for an extensive set of possible biases.// Methods: Medical records of 576 subjects who underwent pure tone audiometry, brain magnetic resonance imaging (MRI), and the Korean Mini-Mental State Exam (K-MMSE) were reviewed. Among them, subjects with normal cognitive function and free of central nervous system disorders or coronary artery disease were included. Outliers were excluded after a sample homogeneity check. In the end, 405 subjects were enrolled. Pure tone hearing thresholds were determined at 0.5, 1, 2, and 4 kHz in the better ear. Enrolled subjects were divided into 3 groups according to pure tone average: normal hearing (NH), mild HL (MHL), and moderate-to-severe HL (MSHL) groups. Using voxel-based morphometry, we evaluated GMV changes that may be associated with HL. Sex, age, total intracranial volume, type of MRI scanner, education level, K-MMSE score, smoking status, and presence of hypertension, diabetes mellitus and dyslipidemia were used as covariates. // Results: A statistically significant negative correlation between the hearing thresholds and GMV of the hippocampus was elucidated. Additionally, in group comparisons, the left hippocampal GMV of the MSHL group was significantly smaller than that of the NH and MHL groups. // Conclusion: Based on the negative correlation between hearing thresholds and hippocampal GMV in cognitively normal old adults, the current study indicates that peripheral deafferentation could be a potential contributing factor to hippocampal atrophy

18.教室における内反足外来の現況と難治例について(第595回千葉医学会例会,整形外科例会)

Monthly distribution of rotavirus infections in children during pre-vaccine (2004–2006), early-vaccine (2008–2010), and post-vaccine (2011–2015) periods. (JPG 272 kb

Hemorrhagic Transformation of Ischemic Stroke: Severe Complications of Prosthetic Valve Endocarditis

Ischemic stroke is a common complication of infective endocarditis (IE), occurring in 20-40% of left side IE cases. In these subsets, anticoagulation therapy may provoke hemorrhagic transformation (HT) of ischemic stroke, and complications of this magnitude deteriorate the clinical course for IE patients. However, in cases of IE complicated with a mechanical prosthetic valve, the physician can be concerned over the maintenance of anticoagulation due to the risk of thrombotic complication. According to our retrospective review, HT of ischemic stroke in prosthetic valve endocarditis occurred 13.8% (4/29) of the time in a variety of situations. Some of these even arose in patients with a subtherapeutic range of prothrombin time

Effect of software version and parameter settings on the marginal and internal adaptation of crowns fabricated with the CAD/CAM system

Objective This study investigated the marginal and internal adaptation of individual dental crowns fabricated using a CAD/CAM system (Sirona’s BlueCam), also evaluating the effect of the software version used, and the specific parameter settings in the adaptation of crowns.Material and Methods Forty digital impressions of a master model previously prepared were acquired using an intraoral scanner and divided into four groups based on the software version and on the spacer settings used. The versions 3.8 and 4.2 of the software were used, and the spacer parameter was set at either 40 μm or 80 μm. The marginal and internal fit of the crowns were measured using the replica technique, which uses a low viscosity silicone material that simulates the thickness of the cement layer. The data were analyzed using a Friedman two-way analysis of variance (ANOVA) and paired t-tests with significance level set at

Insight into the synergistic effect of 2D/2D layered metal selenides wrapped nickel boride nanoparticles based ternary heterostructure for constructing asymmetric supercapacitors with excellent energy density

Tuning the structural and electronic properties of layered metal selenides is a highly feasible approach for developing high-performance asymmetric supercapacitors (ASCs). In this work, a ternary heterostructure of yttrium diselenide/molybdenum diselenide (YSe2/MoSe2) with amorphous nickel boride nanoparticles (NixB NPs) was prepared by a simple hydrothermal method followed by a liquid phase route. Interestingly, this ternary heterostructure consists of multiple layers of YSe2/MoSe2 nanosheets uniformly wrapped by NixB NPs over the entire surface. The characterization results by X-ray diffraction, Raman, and X-ray photoelectron spectroscopy showed that the strong synergism between YSe2/MoSe2 and NixB NPs indicates an obvious electron transfer from NixB to the YSe2/MoSe2 hybrid, which contributes to the enhancement of the electrical conductivity of the electrode. Due to its exclusive heterostructure network, the single YSe2/MoSe2/NixB electrode achieved a specific capacitance of 893.3 F/g at 1 A/g and a capacity retention of 128.17% over 5000 cycles. In addition, the asymmetric YSe2/MoSe2/NixB||rGO device with a working potential of 1.6 V showed an impressive energy density of 39.5 Wh kg− 1 with a power density of 800 W kg− 1 and excellent cycling stability with 85.60% capacity retention after 5000 cycles in aqueous electrolyte. This result of the designed ASC device encourages the development of a new platform for the design of electrode materials based on metal selenides and metal boride

Theoretical Estimation of Cannulation Methods for Left Ventricular Assist Device Support as a Bridge to Recovery

Left ventricular assist device (LVAD) support under cannulation connected from the left atrium to the aorta (LA-AA) is used as a bridge to recovery in heart failure patients because it is non-invasive to ventricular muscle. However, it has serious problems, such as valve stenosis and blood thrombosis due to the low ejection fraction of the ventricle. We theoretically estimated the effect of the in-series cannulation, connected from ascending aorta to descending aorta (AA-DA), on ventricular unloading as an alternative to the LA-AA method. We developed a theoretical model of a LVAD-implanted cardiovascular system that included coronary circulation. Using this model, we compared hemodynamic responses according to various cannulation methods such as LA-AA, AA-DA, and a cannulation connected from the left ventricle to ascending aorta (LV-AA), under continuous and pulsatile LVAD supports. The AA-DA method provided 14% and 18% less left ventricular peak pressure than the LA-AA method under continuous and pulsatile LVAD conditions, respectively. The LA-AA method demonstrated higher coronary flow than AA-DA method. Therefore, the LA-AA method is more advantageous in increasing ventricular unloading whereas the AA-DA method is a better choice to increase coronary perfusion

The p38 MAPK pathway is essential for skeletogenesis and bone homeostasis in mice

Nearly every extracellular ligand that has been found to play a role in regulating bone biology acts, at least in part, through MAPK pathways. Nevertheless, much remains to be learned about the contribution of MAPKs to osteoblast biology in vivo. Here we report that the p38 MAPK pathway is required for normal skeletogenesis in mice, as mice with deletion of any of the MAPK pathway member–encoding genes MAPK kinase 3 (Mkk3), Mkk6, p38a, or p38b displayed profoundly reduced bone mass secondary to defective osteoblast differentiation. Among the MAPK kinase kinase (MAP3K) family, we identified TGF-β–activated kinase 1 (TAK1; also known as MAP3K7) as the critical activator upstream of p38 in osteoblasts. Osteoblast-specific deletion of Tak1 resulted in clavicular hypoplasia and delayed fontanelle fusion, a phenotype similar to the cleidocranial dysplasia observed in humans haploinsufficient for the transcription factor runt-related transcription factor 2 (Runx2). Mechanistic analysis revealed that the TAK1–MKK3/6–p38 MAPK axis phosphorylated Runx2, promoting its association with the coactivator CREB-binding protein (CBP), which was required to regulate osteoblast genetic programs. These findings reveal an in vivo function for p38β and establish that MAPK signaling is essential for bone formation in vivo. These results also suggest that selective p38β agonists may represent attractive therapeutic agents to prevent bone loss associated with osteoporosis and aging