Morphological Characteristics of the Vietnamese Adult Human Acetabulum Using Multiplanar Reconstruction Computed Tomography in Total Hip Replacement Surgery.

Background: The anatomical parameters of the acetabulum vary among races and geographical regions. Multislice Computed Tomography (CT) has proven to be a practical approach to assess morphological parameters of the acetabulum. The purpose of this study was to explore morphological characteristics of the acetabulum measured by CT scans in Vietnamese adults. Methods: Thirty-five consecutive patients aged 18 years and older received indications and eligibility for total hip replacement surgery. Sixty-three acetabulum were examined with multislice computed tomographic system (CT) with multiplanar reconstruction (MPR). Measured morphometric parameters of acetabulum included acetabular inclination angle (AIA), acetabular anteversion angle (AAA), acetabular angle of sharp (AAS), sagittal acetabular angle (SAA), acetabular horizontal offset (AHO), transverse acetabular ligament anteversion (TALA), transverse acetabular ligament inclination (TALI), acetabular depth (ADe), acetabular depth ratio (ADr) and acetabular diameter (ADi). Results: The mean values of acetabular diameter, femoral head diameter, AIA, AAA, AAS, SAA, TALA, TALI, AHO, ADe, ADr were 50.22±3.56 mm, 43.54±3.68 mm, 40.27±5.09 mm, 13.30±5.54 mm, 39.46±5.41 mm, 26.38±9.01 mm, 9.49±3.92 mm, 47.70±6.73 mm, 3.06±0.37 mm, 18.62±2.95 mm and 309.60±41.87 mm. Conclusion: Our initial data has showed morphological characteristics of the acetabulum in Vietnamese adults, different from the populations from other parts of world. Also, significant correlation between the orientation of the acetabulum and the transverse acetabular ligament was documented.

Doubling the life of Cu/ZnO methanol synthesis catalysts via use of Si as a structural promoter to inhibit sintering.

Cu/ZnO/Al2O3 catalysts used to synthesize methanol undergo extensive deactivation during use, mainly due to sintering. Here, we report on formulations wherein deactivation has been substantially reduced by the targeted use of a small quantity of a Si-based promoter, resulting in accrued activity benefits that can exceed a factor of 1.8 versus unpromoted catalysts. This enhanced stability also provides longer lifetimes, up to double that of prior generation catalysts. Detailed characterization of a library of aged catalysts has allowed the most important deactivation mechanisms to be established and the chemical state of the silicon promoter to be identified. We show that silicon is incorporated within the ZnO lattice, providing a pronounced improvement in the hydrothermal stability of this component. These findings have important implications for sustainable methanol production from H2 and CO2.

Reflections on the concept of optimality of single decision point treatment regimes.

In many areas, applied researchers as well as practitioners have to choose between different solutions for a problem at hand; this calls for optimal decision rules to settle the choices involved. As a key example, one may think of the search for optimal treatment regimes (OTRs) in clinical research, that specify which treatment alternative should be administered to each patient under study. Motivated by the fact that the concept of optimality of decision rules in general and treatment regimes in particular has received so far relatively little attention and discussion, we will present a number of reflections on it, starting from the basics of any optimization problem. Specifically, we will analyze the search space and the to be optimized criterion function underlying the search of single decision point OTRs, along with the many choice aspects that show up in their specification. Special attention is paid to formal characteristics and properties as well as to substantive concerns and hypotheses that may guide these choices. We illustrate with a few empirical examples taken from the literature. Finally, we discuss how the presented reflections may help sharpen statistical thinking about optimality of decision rules for treatment assignment and to facilitate the dialogue between the statistical consultant and the applied researcher in search of an OTR.

Mechanochemical preparation of a modified NiAl2O4 structure.

Mechanochemical synthesis routes offer a sustainable, simple method for preparing materials. In this work, NiAl2O4 was synthesised by a mechanically activated method using a high-energy planetary mill and a calcination step. This study aims to identify the effect of different milling energies on the phases, chemical environments and surface composition of the material. In addition, it explores the thermal impact on the decomposition and structure of the materials. The materials were characterised by X-ray phosphorescence (XPS), solid-state UV-VIS (SS-UV-VIS), X-ray diffraction (XRD), nuclear magnetic resonance (NMR), high-resolution transmission electron microscopy (HR-TEM) and thermal gravimetry differential scanning calorimetry (TGA-DSC). A co-precipitated material is used as a reference along with the ground reagents which were used as a baseline. From this in-depth analysis of the material, a good understanding of the disordered partially inverse spinel structure is provided. This study has found that with calcination temperatures of 750 °C and 900 °C a mixed NiAl2O4 : NiO phase is produced with a Ni enriched surface. The surface is found to be relatively stable with the increase from 750 °C to 900 °C.

Novel technique for scapulothoracic arthroscopy: A case report of the application of intraoperative 3D imaging.

INTRODUCTION: Snapping shoulder syndrome could be effectively treated with scapulothoracic arthroscopy. The excision of the scapular superomedial corner is assumed to help lower the recurrence rate. However, the amount of resection is still controversial. Furthermore, we lack a technique to measure if the resected amount was adequate based only on arthroscopy evaluation. CASE STUDY PRESENTATION: We describe a 47-year-old man who suffered from severe snapping shoulder syndrome as a consequence of a deformity of the left superomedial scapular corner. The patient had endoscopic bursectomy and superomedial corner resection. Intraoperative three-dimensional CT scans (3D-CT) were used to evaluate the amount of resection. The patient recovered without incident and resumed his usual activities within 30 days following surgery. At the six-month follow-up, there were no recurrent symptoms. CONCLUSION: Intraoperative 3D imaging significantly enhances the safety and efficacy of scapulothoracic arthroscopy. This is a novel technique that, to our knowledge, has not been reported previously in the literature.

Partial replacement of pelvis with the hip joint in osteosarcoma treatment: A case report.

INTRODUCTION: and importance: Pelvic osteosarcoma is quite rare and is a challenging task for orthopedic surgeons. This aim of this study is to present the first case report using customized 3D-printed prosthesis in Vietnam. CASE PRESENTATION: 57-year-old male was diagnosed with pelvic osteosarcoma. After neoadjuvant chemotherapy, we did limb-salvage surgery after partial pelvic resection. He had to undergo another surgery due to an infection complication that exposed part of the prosthesis. At 6 months follow-up, the patient's overall status was stable. VAS score when moving is 2/10. He can walk with one crutch. Patient is still being followed up and treated. CLININCAL DISCUSSION: Management of pelvic osteosarcoma remains a challenging task for orthopedic surgeons. Advancements in customized 3D-printed prosthesis have been applied in treatment of pelvic osteosarcoma. Despite the complications, the results are promising. We believe that this is a new and innovative route in surgery of pelvic osteosarcoma. CONCLUSION: Using customized 3D-printed prosthesis is a good way for management of pelvic osteosarcoma.

Non-oncologic indication for elbow megaprothesis replacement: 2 cases report.

INTRODUCTION: Treatment of elbow bone defects is still a huge challenge in orthopaedic in order to restore the shape and function of the elbow joint. Bone defect reconstruction is very difficult due to biomechanical complexity of the elbow joint and the poor coverage tissue of this area, so mega-prothesis can be considered the most optimal solution in these cases. CASE REPORT: We present two clinical cases of megaprosthesis elbow replacement for treatment of bone defects caused by sequelae of trauma. There is one case of 3 cm bone defect at proximal ulna and one case of 3 cm bone defect at distal humerus. In the 1st case, the elbow joint is fusioned and the second case, the elbow joint is degenerated totally after 3 previous surgery. We performed total elbow replacement with a customized megaprosthesis for them. The Mayo elbow function assessment scale [1] pre-surgery was poor at 50 points. The average age is 35 years old. The mean post-operative follow-up time was 14 months. Range of elbow flexed motion was 135 degrees, both patients were maximally extension, the forearm pronation and supination were 90 and 75 degrees, respectively. The Mayo score is very good with 97,5 points. Both patients were completely satisfied with the postoperative results. CONCLUSION: Our results show that megaprosthesis elbow replacement is a very effective option for cases large elbow bone defects due to trauma sequelae. However, careful preoperative preparation is required for the best outcome.

Production of Sucrolytic Enzyme by Bacillus licheniformis by the Bioconversion of Pomelo Albedo as a Carbon Source.

Recently, there has been increasing use of agro-byproducts in microbial fermentation to produce a variety of value-added products. In this study, among various kinds of agro-byproducts, pomelo albedo powder (PAP) was found to be the most effective carbon source for the production of sucrose hydrolyzing enzyme by Bacillus licheniformis TKU004. The optimal medium for sucrolytic enzyme production contained 2% PAP, 0.75% NH4NO3, 0.05% MgSO4, and 0.05% NaH2PO4 and the optimal culture conditions were pH 6.7, 35 °C, 150 rpm, and 24 h. Accordingly, the highest sucrolytic activity was 1.87 U/mL, 4.79-fold higher than that from standard conditions using sucrose as the carbon source. The purified sucrolytic enzyme (sleTKU004) is a 53 kDa monomeric protein and belongs to the glycoside hydrolase family 68. The optimum temperature and pH of sleTKU004 were 50 °C, and pH = 6, respectively. SleTKU004 could hydrolyze sucrose, raffinose, and stachyose by attacking the glycoside linkage between glucose and fructose molecules of the sucrose unit. The Km and Vmax of sleTKU004 were 1.16 M and 5.99 µmol/min, respectively. Finally, sleTKU004 showed strong sucrose tolerance and presented the highest hydrolytic activity at the sucrose concentration of 1.2 M-1.5 M.

Assessment of oral health in older adults by non-dental professional caregivers-development and validation of a photograph-supported oral health-related section for the interRAI suite of instruments.

OBJECTIVES: An optimized oral health-related section and a video training were developed and validated for the interRAI suite of instruments. The latter is completed by professional non-dental caregivers and used in more than 40 countries to assess care needs of older adults. METHODS: The optimized oral health-related section (ohr-interRAI) consists of nine items and a video training that were developed in consecutive phases. To evaluate psychometric properties, a study was conducted in 260 long-term care residents. Each resident was assessed by a dentist and by four caregivers (two who received the video training, two who did not). RESULTS: Mean kappa values and percent agreement between caregivers and dentist ranged between κ = 0.60 (80.2%) for dry mouth and κ = 0.13 (54.0%) for oral hygiene. The highest inter-caregiver agreement was found for dry mouth with κ = 0.63 [95% CI: 0.56-0.70] (81.6%), while for the item palate/lips/cheeks only κ = 0.27 [95% CI: 0.18-0.36] (76.7%) was achieved. Intra-caregiver agreement ranged between κ = 0.93 [95% CI: 0.79-1.00] (96.4%) for dry mouth and κ = 0.45 [95% CI: 0.06-0.84] (82.8%) for gums. Logistic regression analysis showed only small differences between caregivers who watched the video training and those who did not. CONCLUSIONS: Psychometric properties of the optimized ohr-interRAI section were improved compared to previous versions. Nevertheless, particularly the items based on inspection of the mouth require further refinement and caregiver training needs to be improved. CLINICAL RELEVANCE: Valid assessment of oral health by professional caregivers is essential due to the impaired accessibility of regular dental care for care-dependent older adults.

Latent Ornstein-Uhlenbeck models for Bayesian analysis of multivariate longitudinal categorical responses.

We propose a Bayesian latent Ornstein-Uhlenbeck (OU) model to analyze unbalanced longitudinal data of binary and ordinal variables, which are manifestations of fewer continuous latent variables. We focus on the evolution of such latent variables when they continuously change over time. Existing approaches are limited to data collected at regular time intervals. Our proposal makes use of an OU process for the latent variables to overcome this limitation. We show that assuming real eigenvalues for the drift matrix of the OU process, as is frequently done in practice, can lead to biased estimates and/or misleading inference when the true process is oscillating. In contrast, our proposal allows for both real and complex eigenvalues. We illustrate our proposed model with a motivating dataset, containing patients with amyotrophic lateral sclerosis disease. We were interested in how bulbar, cervical, and lumbar functions evolve over time.

Modeling local dependence in latent vector autoregressive models.

We propose a Bayesian latent vector autoregressive (LVAR) model to analyze multivariate longitudinal data of binary and ordinal variables (items) as a function of a small number of continuous latent variables. We focus on the evolution of the latent variables while taking into account the correlation structure of the responses. Often local independence is assumed in this context. Local independence implies that, given the latent variables, the responses are assumed mutually independent cross-sectionally and longitudinally. However, in practice conditioning on the latent variables may not remove the dependence of the responses. We address local dependence by further conditioning on item-specific random effects. A simulation study shows that wrongly assuming local independence may give biased estimates for the regression coefficients of the LVAR process as well as the item-specific parameters. Novel features of our proposal include (i) correcting biased estimates of the model parameters, especially the regression coefficients of the LVAR process, obtained when local dependence is ignored and (ii) measuring the magnitude of local dependence. We applied our model on data obtained from a registry on the elderly population in Belgium. The purpose was to examine the values of oral health information on top of general health information.

Serial correlation structures in latent linear mixed models for analysis of multivariate longitudinal ordinal responses.

We propose a latent linear mixed model to analyze multivariate longitudinal data of multiple ordinal variables, which are manifestations of fewer continuous latent variables. We focus on the latent level where the effects of observed covariates on the latent variables are of interest. We incorporate serial correlation into the variance component rather than assuming independent residuals. We show that misleading inference may be drawn when misspecifying the variance component. Furthermore, we provide a graphical tool depicting latent empirical semi-variograms to detect serial correlation for latent stationary linear mixed models. We apply our proposed model to examine the treatment effect on patients having the amyotrophic lateral sclerosis disease. The result shows that the treatment can slow down progression of latent cervical and lumbar functions.

Assessment of oral health conditions presented in photographs - is there a difference between dentists and non-dental professional caregivers?

BACKGROUND: Photographs can help non-dental professional caregivers to identify problems when inspecting the mouth of care-dependent older individuals. This study evaluated whether the assessment of oral health-related conditions presented in photographs differed between dentists and non-dental professional caregivers. MATERIALS AND METHODS: One-hundred-and-seventy-nine photographs were taken from long-term care facility residents and from patients at the Department of Dentistry of a University Hospital. The following oral health aspects were depicted: denture hygiene, oral hygiene, teeth, gums, tongue and palate/lips/cheeks. Collection continued until for each oral health aspect a pool of photographs was available that showed conditions from perfect health and hygiene to severe problems. A segmented Visual Analogue Scale was applied to assess the conditions presented in the photographs. Each photograph was assessed by each participant of this study. The benchmark was established by three dentists with academic-clinical expertise in gerodontology, special needs dentistry and periodontology. For each photograph, they provided a collective score after reaching consensus. Photographs were assessed individually by 32 general dentists and by 164 non-dental professional caregivers. Linear mixed effects models and generalized linear mixed effects models were fitted and mean squared errors were computed to quantify differences between both groups. RESULTS: For the different oral health aspects, absolute distances from the benchmark scores were 1.13 (95%CI:1.03-1.23) to 1.51 (95%CI:1.39-1.65) times higher for the caregivers than for the dentists. The odds to overestimate the condition were higher for the caregivers than the dentists for oral hygiene (OR = 0.72, 95%CI = 0.62-0.84) and teeth (OR = 0.74; 95%CI = 0.61-0.88). The odds to underestimate the condition were higher for the caregivers than the dentists for gums (OR = 1.39; 95%CI:1.22-1.59) and palate/lips/cheeks (OR = 1.22; 95%CI = 1.07-1.40). Over all assessments, the variance in caregiver scores was 1.9 (95%CI:1.62-2.23) times higher than that for the dentists. CONCLUSION: Small but significant differences were found between dentists and non-dental professional caregivers assessing oral health-related conditions presented in photographs. When photographs are used to aid non-dental professional caregivers with the oral health assessment, these visualizations should be complemented with comments to facilitate accurate interpretation.

Bioprocessing of Squid Pens Waste into Chitosanase by Paenibacillus sp. TKU047 and Its Application in Low-Molecular Weight Chitosan Oligosaccharides Production.

Chitosan oligosaccharide (COS) has become of great interest in recent years because of its worthy biological activities. This study aims to produce COS using the enzymatic method, and investigates Paenibacillus sp. TKU047, a chitinolytic-producing strain, in terms of its chitosanase productivity on several chitinous material-containing mediums from fishery process wastes. The highest amount of chitosanase was produced on the medium using 2% (w/v) squid pens powder (0.60 U/mL) as the single carbon and nitrogen (C/N) source. The molecular mass of TKU047 chitosanase, which could be the smallest one among chitinases/chitosanases from the Paenibacillus genus, was approximately 23 kDa according to the sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) method. TKU047 chitosanase possessed the highest activity at 60 °C, pH 7, and toward chitosan solution with a higher degree of deacetylation (DDA) value. Additionally, the hydrolysis products of 98% DDA chitosan catalyzed by TKU047 chitosanase showed the degree of polymerization (DP) ranging from 2 to 9, suggesting that it was an endo-type activity chitosanase. The free radical scavenging activity of the obtained chitosan oligosaccharide (COS) was determined. The result showed that COS produced with Paenibacillus sp. TKU047 chitosanase expressed a higher 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity than that from the commercial COSs with maximum activity and IC50 values of 81.20% and 1.02 mg/mL; 18.63% and 15.37 mg/mL; and 15.96% and 15.16 mg/mL, respectively. As such, Paenibacillus sp. TKU047 may have potential use in converting squid pens waste to produce chitosanase as an enzyme for bio-activity COS preparation.

The oral health-related section of the interRAI: Evaluation of test content validity by expert rating and assessment of potential reasons for inaccurate assessments based on focus group discussions with caregivers.

OBJECTIVES: To explore the failure of the oral health-related section of the interRAI (ohr-interRAI), this study investigated test content validity (A.) and reasons for inaccurate assessments (B.). BACKGROUND: Poor oral health negatively affects quality of life and is associated with a number of systemic diseases. The interRAI instruments, internationally used for geriatric assessment, should accurately detect oral conditions that require care. Previous research showed that the ohr-interRAI and related precursor versions do not achieve this goal. MATERIALS AND METHODS: (A.) A group of 12 experts rated completeness, relevance, clarity of wording and feasibility of the ohr-interRAI. Content validity indices were calculated per item (threshold 0.78). (B.) Focus group discussions with 23 caregivers were organized. A semi-structured question guide made sure that all topics of interest were covered. Qualitative content structuring analysis was applied after transcription. RESULTS: (A.) Experts agreed on the relevance of the items on chewing, pain, gingival inflammation and damaged teeth. They regarded none of the items as worded clearly and only prosthesis use and pain were considered to be assessable by untrained caregivers. All experts agreed that the ohr-interRAI was incomplete. (B.) Focus group discussions revealed that in the care environment oral health had low priority. Aspects related to the ohr-interRAI itself and aspects related to the assessment situation impeded the oral health assessment. The approach of the caregivers to complete the ohr-interRAI was inappropriate to accurately detect oral care needs. CONCLUSIONS: Findings challenge test content validity of the ohr-interRAI and reveal reasons for inaccurate assessments.

Cross-Country Validation of the Association Between Oral Health and General Health in Community-Dwelling Older Adults.

OBJECTIVE: Oral health is known to be associated with general health, but longitudinal relationships between oral health and general health indicators have not yet been fully explored in international research. SETTING AND PARTICIPANTS: The sample consisted of 3 longitudinal databases: a sample from Belgium from the Protocol 3 project (n = 8359), a combined sample from 6 European countries (n = 2501) from the IBenC study (Belgium, Finland, Iceland, Germany, Italy, and the Netherlands), and a sample from New Zealand (n = 15,012). All clients were 65 years or older and received long-term home care services. METHODS: Bayesian models were used to analyze the associations between 3 oral health indicators (chewing difficulty, nonintact teeth, and dry mouth) and 4 aspects of general health (activities of daily living functioning, cognition, depression, and health instability). In addition, the models explored the associations between current oral health and general health status and future oral health and general health status. RESULTS: Clients who had poorer oral health had a higher risk of suffering from poor general health. Especially chewing difficulty was associated with all general health indicators in all data sets (odds ratios > 1). Dry mouth and nonintact teeth showed significant associations with almost all general health indicators. Additionally, having poor oral health (respectively general health) was predictive of poor general health (respectively oral health) at future assessments (significant cross-lagged parameters). CONCLUSIONS/IMPLICATIONS: The results point out the need of the inclusion of oral health assessment and advice from dentists or oral health practitioners into the multidisciplinary conversation. In addition, identifying older people with oral health problems is essential in order to provide treatment and monitoring. Raising awareness for oral health is important, and policy makers should foster oral health promotion and care for older adults in order to keep them in good health.

A cadaveric study on the anatomy of anterior cruciate ligament in Vietnamese adults.

OBJECTIVES: To report the anatomical characteristics of the ACL in Vietnamese individuals. SUBJECTS AND METHODS: Ten fresh knees were dissected to investigate the anatomical characteristics of ACL. The insertion position, length and diameter of ACL were measured. RESULTS: The average lengths of AM and PL bundle of the ACL were 30.6 mm and 25.6 mm, respectively. The average sizes of the femoral and tibial ACL attachment sites were 13.8 × 10.6 mm and 13.4 × 10.2 mm, respectively. CONCLUSION: The anatomical characterisitcs of the ACL in Vietnamese individuals were reported.

Association between oral health and general health indicators in older adults.

Oral health (OH) and general health (GH) indicators are representations of the health status of the body. The OH indicators provide information about the oral health status while the GH indicators are used to assess the functional, cognitive, and mental conditions. OH is reported to be associated with GH. However, some specific associations, especially longitudinal relationships between OH and GH indicators, have not been fully explored. We examined the prediction ability from OH to GH and vice versa using a Belgian registry. We collected information from 8359 elderly participants, who were older than 65, lived at home, and received home care. The demographic and clinical information including three binary OH indicators and four ordinal GH indicators were collected. The participants were recorded at baseline and every six months afterwards. We opted for a generalization of a vector autoregressive model to ordinal responses. This model allows to estimate autocorrelations and cross-lagged correlations, addressing the prediction of GH from OH in a cross-sectional and longitudinal manner. We showed that individuals who had poorer OH had a higher risk of suffering from poor GH status. The percentages of correct or close prediction for GH indicators from OH indicators are high, being around 80% for all GH indicators. Additionally, having a poor OH (resp. GH) status was additionally predictive of a poor GH (resp. OH) status at following assessments. Our finding suggests using historical records of OH as well as GH indicators to draw better health care plan for geriatrics population.