Dissociation Between the Growing Opioid Demands and Drug Policy Directions Among the U.S. Older Adults with Degenerative Joint Diseases

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital stays among 65 and older in the nation, Oregon and Washington states from 2008 through 2017. Orthopedic operations (knee arthroplasty, total or partial hip replacement, spinal fusion or laminectomy) and opioid-related hospital stays were measured. The compound annual growth rate (CAGR) was used to quantify temporal trends of orthopedic operations by age groups as well as opioid-related hospital stays and was tested by Rao–Scott correction of χ2 for categorical variables. The CAGR (4.06%) of orthopedic operations among age 65 and older increased (P...) (See full abstract in article

Effects of Additional Pleurodesis with Dextrose and Talc-Dextrose Solution after Video Assisted Thoracoscopic Procedures for Primary Spontaneous Pneumothorax

Recurrence after thoracoscopic surgery for primary spontaneous pneumothorax is a lingering problem, and many intraoperative methods to induce pleural symphysis have been introduced. We analyzed the effects of chemical pleurodesis during thoracoscopic procedures. Between August 2003 and July 2005, 141 patients among indicated surgical treatment for primary spontaneous pneumothorax in two hospitals of our institution allowed this prospective study. The patients were randomly assigned to 3 groups: thoracoscopic procedure only (group A, n=50), thoracoscopic procedure and pleurodesis with dextrose solution (group B, n=49), and thoracoscopic procedure and pleurodesis with talc-dextrose mixed solution (group C, n=42). There was no significant difference in demographic data among the three groups. The two groups that underwent intraoperative pleurodesis had significantly longer postoperative hospital stays (A/B/C: 2.50±1.85/4.49±2.10/6.00±2.58 days; p=0.001) and a higher incidence of postoperative fever (A/B/C: 10.0/22.45/52.38%; χ2=21.598, p=0.00). No significant differences were found for recurrence rates or the number of postoperative days until chest tube removal. Therefore, the results of our study indicate that intraoperative chemical pleurodesis gives no additional advantage to surgery alone in deterring recurrence for patients with primary spontaneous pneumothorax. Thus, the use of such scarifying agents in the operating room must be reconsidered

The 2021 flexible and printed electronics roadmap

This roadmap includes the perspectives and visions of leading researchers in the key areas of flexible and printable electronics. The covered topics are broadly organized by the device technologies (sections 1–9), fabrication techniques (sections 10–12), and design and modeling approaches (sections 13 and 14) essential to the future development of new applications leveraging flexible electronics (FE). The interdisciplinary nature of this field involves everything from fundamental scientific discoveries to engineering challenges; from design and synthesis of new materials via novel device design to modelling and digital manufacturing of integrated systems. As such, this roadmap aims to serve as a resource on the current status and future challenges in the areas covered by the roadmap and to highlight the breadth and wide-ranging opportunities made available by FE technologies

Regional Variation in States’ Naloxone Accessibility Laws in Association With Opioid Overdose Death Rates-Observational Study (STROBE Compliant)

Though overall death from opioid overdose are increasing in the United States, the death rate in some states and population groups is stabilizing or even decreasing. Several states have enacted a Naloxone Accessibility Laws to increase naloxone availability as an opioid antidote. The extent to which these laws permit layperson distribution and possession varies. The aim of this study is to investigate differences in provisions of Naloxone Accessibility Laws by states mainly in the Northeast and West regions, and the impact of naloxone availability on the rates of drug overdose deaths. This cross-sectional study was based on the National Vital Statistics System multiple cause-of-death mortality files. The average changes in drug overdose death rates between 2013 and 2017 in relevant states of the Northeast and West regions were compared according to availability of naloxone to laypersons. Seven states in the Northeast region and 10 states in the Western region allowed layperson distribution of naloxone. Layperson possession of naloxone was allowed in 3 states each in the Northeast and the Western regions. The average drug overdose death rates increased in many states in the both regions regardless of legalization of layperson naloxone distribution. The average death rates of 3 states that legalized layperson possession in the West region decreased (-0.33 per 100,000 person); however, in states in the West region that did not allow layperson possession and states in the Northeast region regardless of layperson possession increased between 2013 and 2017. The provision to legalize layperson possession of naloxone was associated with decreased average opioid overdose death rates in 3 states of the West region

Web Unevenness Due to Thermal Deformation in the Roll-to-Roll Manufacturing Process

In roll-to-roll (R2R) processing, web uniformity is a crucial factor that can guarantee high coating quality. To understand web defects due to thermal deformation, we analyzed the effect of web unevenness on the coating quality of an yttria-stabilized zirconia (YSZ) layer, a brittle electrolyte of solid oxide fuel cells (SOFCs). We used finite-element analysis to study thermal and mechanical deformations at different drying temperature levels. A YSZ layer was also coated using R2R slot-die coating to observe the effect of web unevenness on coating quality. Web unevenness was generated by thermal deformation due to conduction and convection heat from the dryer. Because of varying web unevenness with time, the YSZ layer developed cracks. At higher drying temperatures, more coating defects with larger widths were generated. Results indicated that web unevenness at the coating section led to coating defects that could damage the SOFCs and decrease yield in the R2R process. Coating defects generated by web unevenness caused by convection and conduction heat should be considered in the high-volume production of brittle electrolytes using the R2R process

Experimental Qualification of the Process of Electrostatic Spray Deposition

The electrostatic spray deposition (ESD) is a method of coating thin films based on electrostatic atomization. This paper proposes a method of quantifying the transport of droplets using images of spray patterns measured by the vision system during the ESD process, and verifies by experiment the correlation between the quantified parameters for the dispersion shape of the spray and the thickness of the deposited thin film. When using the proposed method, the ESD process can be optimized simply by monitoring variations of the spray shapes caused by the process conditions. In addition, the proposed method can be applicable to the in-line monitoring method of the variation in the transport of droplets during the ESD process

Strain Optimization of Tensioned Web through Computational Fluid Dynamics in the Roll-to-Roll Drying Process

Unpredictable web temperature distributions in the dryer and strain deviations in the cross-machine (CMD) and machine (MD) directions could hamper the manufacture of smooth functional layers on polymer-based webs through the roll-to-roll (R2R) continuous process system. However, research on this topic is limited. In this study, we developed a structural analysis model using the temperature distribution of the web as a boundary condition to analyze the drying mechanism of the dryer used in an R2R system. Based on the results of this model, we then applied structural modifications to the flow channel and hole density of the aluminum plate of the dryer. The model successfully predicted the temperature and strain distributions of the web inside the dryer in the CMD and MD by forming a tension according to the speed difference of the driven rolls at both ends of the span. Our structural improvements significantly reduced the temperature deviation of the moving web inside the dryer by up to 74% and decreased the strain deviation by up to 46%. The findings can help prevent web unevenness during the drying process of the R2R system, which is essential to minimize the formation of defects on functional layers built over polymer-based webs

Hybrid Device Fabrication Using Roll-to-Roll Printing for Personal Environmental Monitoring

Roll-to-roll (R2R) printing methods are well known as additive, cost-effective, and ecologically friendly mass-production methods for processing functional materials and fabricating devices. However, implementing R2R printing to fabricate sophisticated devices is challenging because of the efficiency of material processing, the alignment, and the vulnerability of the polymeric substrate during printing. Therefore, this study proposes the fabrication process of a hybrid device to solve the problems. The device was created so that four layers, composed of polymer insulating layers and conductive circuit layers, are entirely screen-printed layer by layer onto a roll of polyethylene terephthalate (PET) film to produce the circuit. Registration control methods were presented to deal with the PET substrate during printing, and then solid-state components and sensors were assembled and soldered to the printed circuits of the completed devices. In this way, the quality of the devices could be ensured, and the devices could be massively used for specific purposes. Specifically, a hybrid device for personal environmental monitoring was fabricated in this study. The importance of environmental challenges to human welfare and sustainable development is growing. As a result, environmental monitoring is essential to protect public health and serve as a basis for policymaking. In addition to the fabrication of the monitoring devices, a whole monitoring system was also developed to collect and process the data. Here, the monitored data from the fabricated device were personally collected via a mobile phone and uploaded to a cloud server for additional processing. The information could then be utilized for local or global monitoring purposes, moving one step toward creating tools for big data analysis and forecasting. The successful deployment of this system could be a foundation for creating and developing systems for other prospective uses