Intercalary and geographic lower limb tumor resections with the use of 3D printed Patient Specific Instruments- when less is more.

Background: Primary bone sarcomas are associated with critically sized bone defects and require complete resection with negative margins. Recent advancements in health care have pioneered novel approaches such as the implementation of 3D surgical technologies. This study presents oncological and functional outcomes following tumor resections of long bones with the use of customized 3D-printed Patient Specific Instruments (PSIs). Methods: This single-center retrospective study is comprised of seventeen patients who underwent either intercalary (N = 12) or geographic (N = 5) resections with various reconstruction methods including allograft (N = 8), vascularized fibula (Capanna) (N = 7), and 3D printed customized titanium implants (N = 2), between the years 2016-2020. All patients were operated on with a 3D surgical workflow, including intraoperative PSIs, and were followed up postoperatively for at least 12 months (average 31.40 ± 12.13 months) to assess oncological and functional outcomes. Results: All patients demonstrated negative surgical margins, apart from one patient who had planned positive margins. Three patients suffered from short-term complications, and three patients underwent revision surgery due to graft non-union or pathological fracture. One patient suffered from local recurrence and underwent above-knee amputation. Three patients suffered from lung metastasis. MSTS at 12-month follow-up was 26.9.±5.87. Conclusion: Customized 3D-printed osteotomy PSIs provide surgeons with a novel tool for optimizing bone resection and reconstruction in long bones surgeries, thus minimizing overall tissue trauma and reducing the risk of damage to nervous and vascular structures. This study demonstrates that the use of PSIs has the potential to improve functional and oncological outcomes. We believe that this technique will become increasingly popular in the future as a widely applicable, highly accurate, cost-effective optimization tool.

The Personal Autonomous Car: Personality and the Driverless Car.

Road traffic accidents, congestion and their ensuing issues are of international concern. A recent technological development to alleviate this situation is the autonomic car. A driverless vehicle will transport its passengers to their destinations. User experience would be enhanced by adapting the workings of the vehicle in line with the personality of its user. An autonomic car information system preference questionnaire was designed, focusing on different components of a futuristic information system. Participants comprised 155 students. The results demonstrated two factors: willingness to share information and need for control. A regression analysis on the automatic car preferences, personality (the Big 5), gender, and age showed that openness, consciousnesses, and age were related to different preferences. The results are assessed, followed by a discussion on personality in relation to the autonomic car.

Gaps Between Immigrant Spouses in Host Country Language Proficiency: Longitudinal Effects on Marital Satisfaction.

Research on immigration underscores the importance of language acculturation in successful adjustment to life in a new country. However, the profound impact of different levels of language proficiency between immigrant spouses on their married life is an understudied topic. The current study explores whether differences between immigrant spouses in host language proficiency predict marital satisfaction in their first four years in the host country. Using a three-wave longitudinal study, with intervals of one to two years, we collected data from 316 married couples who immigrated from the Former Soviet Union to Germany and Israel. Language proficiency and marital satisfaction were measured via self-report questionnaires. We conducted an Actor-Partner Interdependence Model analysis to control for dyadic and time data dependencies. The results indicate that differences between spouses in their host language proficiency predict marital dissatisfaction, and that this effect is exacerbated over time. These associations held across gender and host country. The findings are discussed in light of the gap-distress model.