Patient Perception of Robotic-Assisted Total Joint Arthroplasty in a Hispanic Population.

Background: Robotic-assisted orthopaedic surgery has become popular and widely available, mainly for total joint arthroplasty. However, there has been a persistent concern regarding access to robotic-assisted surgery and the utilization rate of total joint arthroplasty among minority groups. As an imperative effort to close the gap regarding health inequalities, we assessed the knowledge and perspective of Hispanics regarding robotic-assisted orthopaedic surgery. Methods: A 28-item questionnaire was established to evaluate Hispanics' perceptions of robotic-assisted orthopaedic surgery. Participants answered questions about demographic features, knowledge about robotic-assisted orthopaedic surgery, and preferences regarding manual vs robotic-assisted procedures. Results: A total of 580 questionnaires were analyzed in our study, with an average age of participants of 49.1 years. Only 44.2% of the participants were familiar with robotic-assisted orthopaedic surgery. Fifty-three percent of the respondents preferred robotic-assisted surgery over conventional procedures, with many participants believing that robotic-assisted surgery leads to better outcomes (54.7%) and faster recovery (53.1%). Conclusions: Knowledge about specific factors such as clinical outcomes and costs may influence the perception and preference of Hispanics toward robotic-assisted orthopaedic surgery. Therefore, patient education may play a crucial role in the informed decision-making process in Hispanics when opting between robotic-assisted or traditional orthopaedic surgery.

Development of nanostructured formulation from naringenin and silk fibroin and application for inhibition of lipoxygenase (LOX).

A simple low-energy method was used to obtain polymeric nanoparticles containing silk fibroin (SF), fatty butyl esters (oily phase) and the flavonoid naringenin. Experimental planning (Box-Behnken) was applied to investigate the optimal conditions for three factors (variation of the concentrations of SF, naringenin and fatty butyl ester) at three levels, with evaluation of particle size, polydispersity index (PDI) and zeta potential (ZP) as responses. The results showed that the polymeric particle was formed with sizes of 179.6 to 633.9 nm, PDI of 0.33 to 0.77 and ZP of -60.4 to -38.8 mV. The best responses under the optimized conditions (Nari-SF 9 and 15) were characterized through transmission electron microscopy (TEM), Fourier-transform infrared (FT-IR), visible ultraviolet (UV-vis) and fluorescence, which confirmed that coated nanoparticles had been obtained. It was shown that the nanoformulation had excellent stability, the bioavailability of naringenin had been improved through use of the biopolymer and high inhibition of the enzyme lipoxygenase had been achieved in vitro.

Digital sextortion: Internet predators and pediatric interventions.

PURPOSE OF REVIEW: Sextortion is defined as the act of coercing people into sending explicit images of themselves and subsequently blackmailing victims with the public release of said images. Prosecutions of sextortion cases involving minors have increased almost two-fold in the past 5 years. The purpose of this review is to explore the literature regarding the behavior of both victims and perpetrators, the effects on victims, and the support resources available for clinicians, victims, and parents. RECENT FINDINGS: Sextortion begins as an unassuming request for personal pictures and quickly escalates. Minors targeted by predators fear both punishment by guardians and the social consequences that follow the release of their explicit pictures. This cycle of victimization endangers minors and may lead to mental health problems, such as anxiety and depression. Recently, sextortion cases have risen to the forefront of national attention through the mainstream media with celebrities revealed as both perpetrators and victims. This higher visibility of sextortion highlights the importance of reviewing recent research regarding minors and their online behavior and the tactics of perpetrators. SUMMARY: Sextortion, an extreme form of cyber abuse, endangers minors and may lead to anxiety and depression. Pediatricians should be familiar with the concept of sextortion and discuss its dangers and available resources with parents and minors.

Availability of Naloxone in Pharmacies and Knowledge of Pharmacy Staff Regarding Dispensing Naloxone to Younger Adolescents.

PURPOSE: This study assessed the immediate availability of naloxone in pharmacies and the knowledge of pharmacy staff regarding naloxone dispensing protocols, especially as it relates to younger adolescents. METHODS: The primary sample included pharmacies in the 10 states with the highest number of opioid-related overdose deaths in 2016; in addition, pharmacies in the 2 states with the highest prevalence of opioid-related overdose deaths in 2016 were also contacted. Researchers simulated a routine conversation between pharmacy staff and a potential customer about the immediate availability of and requirements to purchase naloxone. RESULTS: The primary sample included 120 pharmacies (82.5% chain pharmacies; 50.8% rural). The majority (80.3%) had at least one form of naloxone in stock. Pharmacy staff were knowledgeable about prescription and third-party purchasing requirements. However, almost half incorrectly responded that there was a minimum age requirement to purchase naloxone. CONCLUSION: This study reveals barriers to obtaining naloxone, including a lack of immediate in-store availability and a common misperception that naloxone cannot be dispensed to minors.

Enantioselective ene-reduction of E-2-cyano-3-(furan-2-yl) acrylamide by marine and terrestrial fungi and absolute configuration of (R)-2-cyano-3-(furan-2-yl) propanamide determined by calculations of electronic circular dichroism (ECD) spectra.

This work reports the green organic chemistry synthesis of E-2-cyano-3(furan-2-yl) acrylamide under microwave radiation (55 W), as well as the use of filamentous marine and terrestrial-derived fungi, in the first ene-reduction of 2-cyano-3-(furan-2-yl) acrylamide to (R)-2-cyano-3-(furan-2-yl)propanamide. The fungal strains screened included Penicillium citrinum CBMAI 1186, Trichoderma sp. CBMAI 932 and Aspergillus sydowii CBMAI 935, and the filamentous terrestrial fungi Aspergillus sp. FPZSP 146 and Aspergillus sp. FPZSP 152. A compound with an uncommon CN-bearing stereogenic center at the α-C position was obtained by enantioselective reactions mediated in the presence of the microorganisms yielding the (R)-2-cyano-3-(furan-2-yl) propanamide 3a. Its isolated yield and e.e. ranged from 86% to 98% and 39% to 99%, respectively. The absolute configuration of the biotransformation products was determined by time-dependent density functional theory (TD-DFT) calculations of electronic circular dichroism (ECD) spectra. Finally, the tautomerization of 2-cyano-3-(furan-2-yl) propanamide 3a to form an achiral ketenimine was observed and investigated in presence of protic solvents.

Atmospheric dispersion of methane emissions from sugarcane burning in Mexico.

Methane is a potent greenhouse gas whose atmospheric dispersion may have different implications at distinct scales. One significant contributor to methane emissions is sugarcane farming in tropical areas like in Mexico, which has the sixth highest production level in the world. A consequence of the industrial use of this resource is that sugarcane preharvest burning emits large quantities of methane and other pollutants. The objective of this research is to estimate the methane emissions by sugarcane burning and to analyze their atmospheric dispersion under the influence of meteorological parameters, according to different concentration scenarios generated during a period. The methane emissions were investigated using the methodology of Seiler and Crutzen, based on the stage production during the harvest periods of 2011/2012, 2012/2013 and 2013/2014. Average of total emissions (1.4 × 103 Mg) at the national level was comparable in magnitude to those of other relevant sugarcane-producing countries such as India and Brazil. Satellite images and statistical methods were used to validate the spatial distribution of methane, which was obtained with the WRF model. The results show a dominant wind circulation pattern toward the east in the San Luis Potosi area, to the west in Jalisco, and the north in Tabasco. In the first two areas, wind convergence at a certain height causes a downward flow, preventing methane dispersion. The concentrations in these areas varied from 9.22 × 10-5 to 1.22 × 102 ppmv and 32 × 10-5 to 2.36 × 102 ppmv, respectively. Wind conditions in Tabasco contributed to high dispersion and low concentrations of methane, varying from 8.74 × 105 to 0.33 × 102 ppmv. Methane is a potent greenhouse gas for which it is essential to study and understand their dispersion at different geographic locations and atmospheric conditions.

Paging Dr. Google: The Effect of Online Health Information on Trust in Pediatricians' Diagnoses.

This study investigates how parental trust in physician diagnoses and likelihood of seeking a second opinion (SO) are affected by Internet sources. In an anonymous survey, 1374 parents of minors viewed a vignette describing their child's symptoms followed by Internet results that either supported or contradicted the pediatrician's diagnosis (Dx). A control group did not view any Internet results. After learning the Dx, participants rated trust in the Dx and likelihood of seeking a SO on a 7-point Likert-type scale. Participants who viewed contradicting results were less likely to trust the Dx ( P < .001) and more likely to seek a SO than the control ( P < .001). Participants who viewed supporting results were more likely to trust the Dx ( P < .001) and less likely to seek a SO than the control ( P < .001). Physicians must be aware of the influence the Internet may have on patients' trust.