Short Time Research Articles

인지욕구에 따른 희소성 메시지가 여행상품 구매의도에 미치는 영향 : 시간한정 및 인원한정 가격할인을 중심으로

This study aimed to examine how scarcity messages influence travel product purchase intentions and how the impacts were moderated by consumers' high or low need for cognition. The two types of scarcity messages were presented, one with time-limited price discounts and the other with limited-person price discounts. The results of the experiment were as follows. First, the low need for cognition group showed higher purchase intentions when the time-limited scarcity message featured a longer time limit, whereas the high need for cognition group showed higher purchase intentions when the time-limited scarcity message suggested a shorter time limit. Second, the group with a low need for cognition showed higher purchase intentions when limited-person scarcity messages featured a small number of eligible people, whereas the group with a high need for cognition showed higher purchase intentions when limited-person messages suggested a large number of eligible people. Third, the purchase intentions of the low need for cognition group were higher when limited-person scarcity messages were present than limited-time scarcity messages, whereas the high need for cognition group was more reactive to limited-time scarcity messages than limited-person scarcity messages. Furthermore, the interaction effect between the need for cognition and scarcity messages was significant. These experimental results may provide strategic implications for sales promotion activities, specifically in regard to the types of scarcity messages that travel and tourism service companies should utilize to strengthen purchase intentions.

Risk Factor Analysis and Algorithmic Approach for Managing Deep Brain Stimulation Device-Related Wound Complications

Background: Although implanting deep brain stimulation (DBS) devices carries up to a 15% risk of complications, optimal management strategies remain poorly understood. This study aimed to review the risk factors for wound complications of DBS device implantation and develop an algorithm for proper management.Methods: Patients with Parkinson disease who underwent bilateral subthalamic nucleus DBS device implantation between 2005 and 2022 were retrospectively reviewed. All DBS-related wound complications such as infection, dehiscence, erosion, and displacement were recorded, and factors associated with device explantation were also assessed.Results: A total of 398 patients underwent DBS device implantation using 796 electrodes and implantable pulse generators. During the mean follow-up of 9.8 ± 5.5 years, 28 patients (7.0%) experienced wound complications that required reoperation, including 14 infection (50.0%), 22 dehiscence (78.6%), five skin erosion (17.9%), and two device displacement (7.1%). Complications were resolved with a single reoperation in 13 patients (46.4%), while nine patients underwent 2–3 surgical procedures (32.2%), and six patients in 6–8 operations (21.4%). The device was salvaged in 16 patients (57.1%) and removed in 12 (42.9%). Infection (P = 0.010), shorter time interval from device implantation to complications (P = 0.022), higher C-reactive protein levels (P = 0.026), methicillin-resistant <i>Staphylococcus aureus</i> growth (P = 0.044), and history of multiple previous revisions (P < 0.001) were associated with device removal.Conclusion: To maximize the therapeutic benefit of DBS and minimize the time, effort, and cost required for revision, temporary explantation in early stages followed by reimplantation of the device after the wound subsides should be considered in high-risk cases.

Ship Power System Network Reconfiguration Based on Swarm Exchange Particle Swarm Optimization Algorithm

As one of the important components of a ship, the ship’s integrated power system is an important safeguard for ships. In order to improve the service life of the ship’s power grid, the power system should be able to realize rapid reconstruction to ensure continuous power supply of important loads when the ship is attacked or fails suddenly. Therefore, it is of vital importance to study the reconfiguration technology of the ship’s integrated power system to ensure that it can quickly and stably cope with all kinds of emergencies in order to guarantee the safe and reliable navigation of the ship. This paper takes the ship’s ring power system as the research object and sets up the maximum recovery load and the minimum number of switching operations. The load is divided uniformly and the generator efficiency is balanced for the reconstruction of comprehensive function. It also sets up the system capacity, topology, and branch current limitations of the constraints to establish a mathematical model. The load branch correlation matrix method is used for branch capacity calculation and generator efficiency equalization calculation, and the load backup power supply path matrix is added on the basis of the matrix to judge the connectivity of some loads before reconfiguration. In this paper, for the network reconfiguration of the ship circular power system, which is a discrete nonlinear problem with multiple objectives, multiple time periods, and multiple constraints, we choose to use the particle swarm algorithm, which is suitable for global optimization, with a simple structure and fewer parameters; improve the particle swarm algorithm using the swarm exchange strategy by setting up two main and auxiliary swarms for global and local search; and exchange some of the particles with the golden ratio in order to keep the diversity of the populations. The simulation results of the network reconfiguration of the ship power system show that the improved algorithm can solve the power system network reconfiguration problem more effectively and provide a feasible reconfiguration scheme in a shorter time compared with the chaotic genetic algorithm under the same fault case test, and it also proves that the use of the swarm exchange particle swarm algorithm greatly improves the performance of reconfiguring the power grid of the ship.

Cerebral hemodynamic plasticity related to potential compensatory self-recirculation network in Moyamoya disease: an observational study

Moyamoya disease (MMD) suffers from impaired cerebrovascular hemodynamics and high perioperative complications occurrence. This study aims to propose and evaluate the relationship between intraoperative hemodynamics and perioperative complications, and propose a potential compensatory self-recirculation network in MMD. We prospectively enrolled 63 MMD patients undergone combined revascularization, and patients were divided into decreased and increased group according to decreased and increased microvascular transit time (MVTT), respectively. Mean age of all patients was 45.9 ± 9.4 years. The post-bypass hyperperfusion syndrome occurrence was significantly higher in the decreased MVTT group, and the cerebral infarction occurrence was significantly higher in the increased MVTT group. For the hemodynamics of the recipient artery around anastomosis, the parameters of distal site demonstrated a significant higher intensity and shorter time in the decreased MVTT group, while the parameters of the proximal site demonstrated a significant higher intensity and shorter time in the increased MVTT group. Pre-bypass and post-bypass collision of blood flow in artery and vein were firstly observed and illustrated. Intraoperative hemodynamics showed close relationship with perioperative complications. The blood flow of MMD seems to develop a unique compensatory self-recirculation system and contribute to the clinical complications, providing a new insight to the clinical management the pathology of the disease.

Optimization-based trajectory planning for reconfigurable unmanned vehicle units with multi-steering modes during the reconfiguration process

Reconfigurable unmanned vehicle unit (RUVU) exhibits three distinct steering modes: Ackermann steering, Diagonal steering, and In-Situ steering. This arises from its capacity for All-Wheel-Independent-Steering (AWIS) and All-Wheel-Independent-Driving (AWID). Given its unique motion characteristics, there is currently a lack of established methods to assist a RUVU in autonomously planning trajectories. In response to this deficiency, this paper proposes the Multi-Steering Modes Trajectory Planning algorithm (MSMTP) based on the framework of optimal control problem (OCP). The approach innovatively formulates the kinematics and Steering-Mode-Switch theory for vehicles with multi-steering modes. Additionally, a safe traveling corridor (STC) is implemented to guarantee non-conflicting interaction with the surrounding environment. Ultimately, the Bonmin solver is utilized to derive optimal results. Our findings demonstrate the effectiveness of the proposed algorithm in RUVU’s trajectory planning. When comparing the trajectory of RUVU to that of a vehicle only with Ackermann steering, the results also reveal that RUVU has the advantage of reaching its destination in a shorter time, especially in narrow environments.

Ecofriendly Dyeing Strategy Based on Dyeing Kinetics and Thermodynamic Analysis for Melt-Spun Polyurethane Fibers.

Melt-spun polyurethane fibers (MSPUFs) have garnered popularity owing to efficient production methods and exceptional stability. However, the development of the MSPUF has been restricted by challenges such as poor dyeability as well as energy and cost concerns associated with the dyeing process. Herein, we devised a highly efficient dyeing technique that operates at a lower temperature and a shorter duration. In comparison to conventional dyeing methods, our novel approach reduces the temperature from 98 to 75 °C, while reducing the amount of dye utilized by 25% and the dyeing time by 50%. In this method, the modifier increases both the positive charge and the amorphous zone of the fiber, while rational dyeing conditions are designed based on thermodynamic and kinetic analyses. This strategy enabled a 76.3% increase in E% and a 45.9% increase in K/S values at reduced temperatures and a shorter time while simultaneously improving the dye-fiber bonding fastness. This research methodology not only enhances the dyeing performance of MSPUF but also reduces energy consumption and dyeing costs, presenting an ecofriendly and economically novel approach for the development of dyeable MSPUF.

Traditional Versus Distal Radial Access for Coronary Diagnostic and Revascularization Procedures: Final Results of the TENDERA Multicenter, Randomized Controlled Study.

Traditional transradial access (TRA) is widely used for coronary and non-coronary interventions with significant improvements in procedural outcomes; however, it is associated with RAO that precludes repeat use of the same artery for possible future TRI and other purposes. Distal radial access (DRA) has been proposed as an effective alternative to decrease RAO rates. Published literature describing the RAO rate after DRA versus TRA from various RCT and clinical registries has shown conflicting results. This study compared the forearm radial artery occlusion (RAO) rate assessed by Doppler ultrasound between distal and conventional radial access at 1-year follow-up after the initial procedure. TENDERA was a multicenter, randomized controlled study comparing DRA versus TRA for coronary diagnostic and interventional procedures using 5 or 6F hydrophilic-coated sheaths. The primary endpoint was forearm RAO at 12 months after radial access. The secondary endpoints included puncture time, sheath insertion and total procedure time, radiation dose, and vascular access site-related complications. Eight hundred and fifty patients were randomized to either TRA (n = 418) and DRA (n = 432) groups. In the intention-to-treat analysis, the rate of forearm RAO at 12 months was observed in 39 patients (4.6%) and was significantly reduced in the DRA group compared with the TRA group (2.5% vs. 6.7%, RR 2.59 [95% CI 1.29-5.59], p = 0.010). Analysis in per protocol population has shown consistent results with forearm RAO rate 2.8% in the DRA group versus 6.5% in the TRA group (p = 0.008). The crossover rate was higher (4.6% vs. 1%, p = 0.013) and median hemostasis time was shorter (156.5 min vs. 180 min, p < 0.001) with DRA. Overall bleeding (BARC 1-2) and postprocedure hematoma > 5 cm occurred less frequently in the DRA group compared with the TRA group (3.2% vs. 20.5%, p < 0.001% and 9.0% vs. 27.0%, p < 0.001, respectively). No significant differences were observed in total procedure time and radiation dose between groups. DRA for coronary diagnostic and interventional procedures is associated with reduced forearm RAO rate and shorter hemostasis time, but a longer sheath insertion time and higher crossover rate compared with TRA. ClinicalTrials.gov: NCT04211584.

Research on extraction and identification of automotive wind noise based on LSTM combined road and drum experiments

Wind noise is a significant source of noise when vehicles are driven at high speeds. While wind tunnel experiments are commonly method to study real automotive wind noise, anechoic wind tunnel laboratory are prohibitive for automakers on account of their high costs and limited experimental period. Therefore, this paper proposes to extract automotive wind noise through combining road experiment and drum experiment, define significant wind noise prime regions, and verify its effectiveness. Subsequently, the Long Short-Term Memory Neural Network algorithm (LSTM) is employed to reveal the complex nonlinear relationship between wind noise and its impact areas, in order to establish an identification model for automotive wind noise. The performance of the model is then compared with Backpropagation Neural Networks (BPNN) and Support Vector Regression (SVR) models. The results indicate that the LSTM wind noise identification model exhibits higher accuracy, shorter training time, and stronger generalization ability, thus demonstrating the superiority of this model.

Iris Fixation for Intraocular Lens Dislocation: Relocation with Iris Suture Versus Exchange to Sutureless Iris Claw IOL

Background/Objectives: To compare the clinical outcome of suture and sutureless iris fixation techniques for dislocated intraocular lenses (IOLs). Methods: Retrospective cohort study including patients who underwent surgery for late IOL dislocation over a 10-year period. IOL repositioning was achieved either by suturing the original IOL to the iris using the Siepser slipknot technique or by replacing it with a retropupillary sutureless iris claw IOL. Data collected during surgery included the type of dislocation, the need for anterior or posterior vitrectomy, duration of surgery, and intraoperative complications. Six months after surgery we assessed the eye and iris anatomy; refraction, astigmatism, and visual acuity; endothelial cell damage; and rate of postoperative complications. Results: Included in the study were 60 patients: 32 underwent IOL relocation and 28 underwent IOL exchange. Pseudoexfoliation (43.7% and 39.3%) and retinal surgery (34.4% and 28.6%) were identified as the main possible causes for IOL dislocation. The mean duration of the surgery was 62.9 ± 14.9 min for the Relocation group, and was 42.7 ± 11.4 min for the Exchange group (p &lt; 0.001), with similar low intraoperative complication rates (6.25% and 7.14%, respectively). The studied parameters showed no differences between the two groups postoperatively, except for corneal astigmatism which was 1.31 ± 0.45 D in the Relocation group and was 1.89 ± 0.86 D in the Exchange group (p &lt; 0.001). Conclusions: Both suture and sutureless iris fixation techniques for dislocated IOLs yielded similarly favorable outcomes in this study. IOL relocation resulted in less postoperative astigmatism, while IOL exchange offered the advantage of shorter surgical time.

Practical Remediation of Hg-Contaminated Groundwater by MoS2: Batch and Column Tests

Trace mercury contamination in groundwater poses a serious threat to ecological systems and human health. The kinetics and isotherms of MoS2 (MS) for Hg removal were studied in batch tests under an unfavorable high salinity and low mercury environment. Flower-like MS with nanosheets can effectively remove Hg in the groundwater matrix, with a shorter equilibrium time (3 h), superior removal efficiency (94.26%), excellent distribution coefficient (5.69 × 106 mL g−1), and higher maximum adsorption capacity (926.10 ± 165.25 mg g−1). Furthermore, the Adams-Bohart model (R2 = 0.9052–0.9416) can accurately describe the dynamic interception process of the initial stage (≤40 PVs), and the Yan model (R2 = 0.9765−0.9941) depicts the whole process (140 PVs) of MS in a fixed column well. A higher dosage of m, but lower C0 and νp facilitate the interception efficiency in column tests. Based on the characterizations of X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM), which were used to simultaneously consider the species of Hg and the groundwater matrix, surface complexation, electrostatic attraction, ion exchange, and precipitation is a plausible interfacial adsorption mechanism of MS for mercury. The excellent performance demonstrates that MS with nanosheets is a promising candidate for the PRB remediation of trace Hg in saline groundwater.

Polyaniline prepared by Fe3O4 catalysed eco-friendly synthesis as electrocatalyst for efficient water electrolysis

Preparing cost-effective and highly active catalysts for electrocatalytic hydrogen evolution reaction is crucial for developing hydrogen-based technologies. Hence, four conductive polyanilines, prepared by the environmentally-friendly approach using Fe3O4 nanoparticles/H2O2 as the catalyst/main oxidant system (PANI/Fe3O4), were investi¬gated for the first time as electrocatalysts for hydrogen evolution reaction (HER) in acidic media (0.1 M H2SO4) by using voltammetry and chronoamperometry. PANI/Fe3O4 electrodes exhibited Tafel slope values in the -171 to -246 mV dec-1 range depending on the synthesis conditions ‒ Fe3O4/aniline mass ratio and polymerization time. The sample PANI/Fe3O4-II(3) prepared with shorter reaction time and higher Fe3O4/aniline mass ratio showed the best electrocatalytic behaviour reflected in the lowest onset potential (-0.286 V), the lowest overpotential to reach a current density of -10 mA cm-2, the highest current density, the lowest HER activation energy (10 kJ mol-1), and the lowest charge-transfer resistance (5.3 Ω) under HER conditions. Materials were characterized by scanning electron microscopy with energy dispersive X-ray spectroscopy, X-ray photo¬electron spectroscopy and electrochemical impedance spectroscopy, and differences in their electrocatalytic HER performance were explained by differences in their content of Fe3O4, surface and electrical properties. Moreover, the possibility of using PANI/Fe3O4-II(3) as HER electrocatalyst in a wider range of pH (i.e. in alkaline media as well) and as a bifunc¬tional electrocatalyst, i.e., for oxygen evolution reaction beside HER, was also examined.

Assessment of disability and disease burden in neuromyelitis optica spectrum disorders in the CIRCLES Cohort

Neuromyelitis optica spectrum disorders (NMOSD) comprise autoimmune diseases imposing substantial disability. We compared an NMOSD-targeted disability assessment of mobility, vision, and self-care domains (individually and composite) with the multiple sclerosis-targeted Expanded Disability Status Scale (EDSS) to assess NMOSD disease burden. An overall cohort (n = 505) and a subset of these patients with an enriched dataset (n = 198) were analyzed from the CIRCLES longitudinal, observational database of patients with AQP4-IgG–seropositive or –seronegative NMOSD in North America. Multinomial modeling was used to identify temporal correlates of disability improvement, stability, and worsening. Prior on-study relapse correlated with worsening mobility (OR, 3.08; 95% CI: 1.61–5.90), vision (OR, 3.99; 95% CI: 2.03–7.86), self-care disability (OR, 1.90; 95% CI: 1.07–3.38), and mean composite index disability (OR, 4.20; 95% CI: 1.71–10.34). Higher vision disability was associated with Black race, shorter time on-study, and AQP4-IgG–seropositive status in patients ≥ 18 years (p < 0.05). Disease onset phenotype and sex correlated with pain interference (p < 0.05). These correlates of NMOSD disability were undetected by EDSS. The CIRCLES real-world experience supports the need for NMOSD-specific disability assessment to improve recognition of disease burden, facilitate proactive clinical management, offer insights into resilience, and inform clinical trial design.

The Impact of Next-Generation Sequencing Workflows on Outcomes in Advanced Lung Cancer: A Retrospective Analysis at One Academic Health System

Purpose: Broad-based molecular testing with next-generation sequencing (NGS) is now the standard of care in advanced non-small cell lung cancer (NSCLC). Two approaches to molecular testing are (1) reflexive testing at pathologic NSCLC confirmation, often using an in-house molecular panel, and (2) send-out testing to private vendors, ordered by a clinician. This study explored the outcomes with reflex versus send-out testing. Methods: A retrospective chart review was conducted of patients diagnosed with de novo stage IV NSCLC in 2019 and 2020 at three hospitals in the same system, one academic hospital (Northwestern Memorial Hospital, or NMH) utilizing reflex, in-house NGS, and two community-based hospitals (Central DuPage Hospital, or CDH, and Delnor, or D) sending out tissue samples for testing. The outcomes assessed were the time from biopsy to results, biopsy to treatment, the incidence of first-line targetable mutations and the use of first-line targeted therapies, and overall survival. Results: In total, 191 patients met the inclusion criteria, 85 at NMH, 106 at CDH + D, and in total, 131 in 2019 and 60 in 2020. The time to results was significantly shorter with reflexive NGS when compared with send-out testing; the time to treatment was also shorter but not statistically significant. At CDH + D, the time to results was significantly shorter with a limited panel than with comprehensive testing, but the time to treatment was similar. NGS testing rates were 95% at NMH and 84.5% at CDH + D (p = 0.009), with 31.0% at NMH receiving 1L targeted therapies versus 20.8% at CDH + D (p = 0.08). In 2019, the median time from biopsy to treatment was 35 days at NMH and 38 days at CDH and Delnor; in 2020, time to treatment was 26 days and 37 days, respectively. Overall survival trended longer in 2020 relative to 2019 independent of site. Conclusion: Reflexive NGS testing is associated with a shorter time to actionable results and higher rates of first-line targetable mutations than send-out testing. In practices with send-out testing, limited panels had slightly faster turnaround times but no difference in time to treatment. If resources allow, reflexive NGS should be considered in healthcare systems for patients with NSCLC.

Multicenter comparison of non-operative techniques of intussusception reduction: saline versus air versus barium

Purpose: Intussusception is a common pediatric surgical emergency and non-operative reduction is its first line of management. We aimed to compare 3 contemporary techniques of intussusception reduction.Methods: A retrospective study was performed in 3 tertiary care centers in India from January 2017 through December 2019. In the 3 centers, the primary reduction techniques were ultrasound-guided saline reduction (USR), fluoroscopy-guided pneumatic reduction (FPR), and fluoroscopy-guided barium reduction (FBR), respectively. As per these techniques used, we compared clinical characteristics, such as the successful reduction.Results: A total of 255 patients underwent one of the 3 reduction techniques in the study period. Reduction was successful in 90.3%, 85.1%, and 87.7% in the USR, FPR, and FBR groups, respectively (P = 0.961). Mean time to reduction was shorter in the FPR group (30.8 ± 8.9 seconds), compared with the USR (575.0 ± 242.3 seconds) and FBR groups (495.0 ± 118.4 seconds; P &lt; 0.001). Recurrence rates were 11.8%, 20.3%, and 15.8% in the USR, FPR, and FBR groups, respectively (P = 0.522). No association was found between the patients’ age or symptom duration and the successful reduction. One patient in the USR group, 3 in the FPR group, and 4 in the FBR group reported second recurrences. Perforation occurred in 1 patient in the FPR group while no complications occurred in the other groups. There was no in-hospital mortality.Conclusion: All 3 techniques are equally effective, with FPR requiring a shorter time than the other 2 techniques. The reduction technique should be chosen based on the strengths and weaknesses of each technique, as well as local availability.

Patient controlled epidural analgesia during labor: Protocol for a scoping review.

Childbirth remains one of the most painful experiences for women. Patient-controlled epidural analgesia provides the women in labor with self-control and thereby a shorter time interval between onset of pain and administration of analgesia, thus potentially improving the childbirth experience. This scoping review aims to investigate PCEA during labor involving maternal satisfaction, risks of adverse effects and obstetric interventions by mapping the evidence and identifying gaps in the current evidence base. The forthcoming review will adhere to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) and the JBI methodology for scoping reviews. A systematic search will be carried out across major peer-reviewed databases and gray literature will be sought. All study types involving women in labor receiving PCEA will be eligible for inclusion. The extracted data will be charted regarding trial characteristics, population/participation characteristics, interventions, outcomes, and key findings. The results will be presented through relevant tables, figures, and graphs when appropriate. Alongside this, we present the data descriptively to explain how the results align with the objectives of the review. PCEA offers women greater autonomy during childbirth, making it essential to examine its effects and potential risks. By mapping current evidence regarding PCEA, this review aims to identify knowledge gaps and provide insights to enhance maternal care and improve childbirth experiences.

Characteristics and Antibiotic Treatment of Patients with Cellulitis in the Emergency Department

Background: Cellulitis is a common infection in Emergency Departments (EDs), and unclear diagnostics may lead to unnecessary treatment with broad-spectrum antibiotics. The aim of this study was to characterize patients with cellulitis admitted to the ED, describe the type and route of antibiotic treatment and compare the prognosis for cellulitis to that for other infections. Methods: This multicenter, cross-sectional study prospectively included adult patients admitted to the ED suspected of having an infection. Data were collected from medical records, and an expert panel assigned a final diagnosis to each patient. Only patients diagnosed with an infection were included in this study. Results: A total of 777 patients were included, of which 77 were diagnosed with cellulitis. Diabetes, obesity and prior cellulitis were associated with cellulitis with an OR of 2.01 [95% CI: 1.17–3.46], OR 2.66 [95% CI: 1.54–4.59] and OR 14.88 [95% CI: 7.88–28.08], respectively. The majority of the patients were treated, according to the regional guidelines, with narrow-spectrum antibiotics. Broad-spectrum antibiotics were rarely used. The patients with cellulitis were hospitalized for a shorter time compared to those with other infections, but 26% were readmitted within 30 days. The 30-day mortality of the patients with cellulitis was 3.9% and did not differ significantly from other infections.

Open Reduction and Internal Fixation Is a Feasible Alternative to Femoral Revision Arthroplasty in Geriatric Patients with Vancouver B2/3 Type Periprosthetic Fractures: A Study Analyzing In-Hospital Outcomes

Purpose: The surgical management of periprosthetic femoral fractures is particularly challenging in geriatric patients due to physiological limitations. The choice between open reduction and internal fixation (ORIF) and hip revision arthroplasty for treating Vancouver B2 and B3 fractures remains controversial. This study aims to contribute further evidence by analyzing the in-hospital outcomes in geriatric patients with Vancouver B2/3 fractures. Methods: This retrospective study analyzed 133 patients treated for Vancouver B2/3 fractures at a level I trauma center from 2017 to 2023. Data were collected on preclinical characteristics, comorbidities, Vancouver classification, surgery-related parameters, and postoperative outcomes for an age- and gender-matched analysis. A subgroup analysis was also conducted on patients classified as American Society of Anesthesiologists (ASA) class 3 and 4. Results: Among the 133 patients, 85 suffered Vancouver B2 fractures and 48 Vancouver B3 fractures. Age-and-gender-matched analysis revealed that ORIF was more commonly performed in patients with higher ASA grades. A subgroup analysis of ASA 3 and 4 patients and an age-and-gender-matched analysis showed that ORIF resulted in shorter operation times and less blood loss. No significant differences were found in mortality or complication rates. Conclusions: ORIF is associated with shorter operation times, less bleeding, and comparable in-hospital outcomes in treating Vancouver B2/3 fractures in higher-risk geriatric patients compared to revision arthroplasty. The retrospective design and small sample size in the ORIF group are limitations of the study. Further studies with functional evaluation are still required.

Transforming Subdural Hematoma Treatment in the Elderly: Insights from an Endoscopic Case Series.

Subdural hematoma (SDH), a critical brain condition, significantly affects the elderly, making traditional surgeries risky due to their length and potential for blood loss. Endoscope-assisted evacuation offers a safer, less invasive alternative by reducing operation time and minimizing damage, providing an effective solution for older patients. This study evaluated six patients treated with endoscopic evacuation for different stages of SDH from August 2019 to July 2023. Selection criteria were based on altered consciousness, lack of severe brain contusion, SDH thickness over 1 cm, or midline shift over 0.5 cm. The technique used a burr hole and rigid lens endoscope for hematoma removal, focusing on shorter surgery times and better outcomes. Patients aged between 63 to 84 years showed no surgical fatalities, with all recovering well by discharge. Hematoma clearance rates were 76.9% at three days, improving to 96.8% after one month. Endoscope-assisted evacuation is a safe, efficient treatment for elderly patients with various stages of SDH, offering a less invasive option with potential for better outcomes. It supports the trend towards minimally invasive neurosurgery, with further research needed to optimize patient selection and understand long-term benefits.

Geographical Access to Point-of-care diagnostic tests for diabetes, anaemia, Hepatitis B, and human immunodeficiency virus in the Bono Region, Ghana

BackgroundDiabetes mellitus, human immunodeficiency virus (HIV), hepatitis B and anaemia are major global public health issues according to the World Health Organization (WHO). Access to diagnostic testing is essential for their prompt detection and treatment. The WHO has recommended a list of essential in-vitro diagnostics for testing at all levels of care. However, a survey preceding this study showed limited availability of point-of-care (POC) tests for these conditions in the Bono Region (BR) of Ghana. This study assessed the geographical access to diabetes, anaemia, hepatitis B, and HIV POC testing in the BR, Ghana for targeted improvement.MethodsWe gathered the geolocated data of 137 facilities (CHPS, Clinics, healthcare centres, and hospitals) in the BR that were providing glucose, haemoglobin (Hb), Hepatitis B Surface Antigen (Hep B), and HIV POC testing services in July 2022. We used ArcGIS 10.1 to quantify the geographical access (distance and travel time) to the nearest available testing site for each test and show places with inadequate access, for targeted improvement. The journey time was calculated assuming a speed of 20 kilometres (km)/h. ArcMap 10.1 was employed to run spatial autocorrelation (Moran Index (MI)) to determine the spatial distribution of the facilities providing the tests investigated.ResultsOf the 137 facilities, the glucose test was available in 67 (49%), the Hb test in 55 (40%), the Hep B test in 44 (32%), and the HIV test in 73 (53%). The mean (standard deviation (SD)) for obtaining glucose tests in the region was 7.4 ± 3.7 km, Hb was 8.1 ± 4.06 km, Hep B was 8.2 ± 4.1 km, and HIV test was 7.3 ± 3.7 km by a motorised cycle. The mean SD travel time in the region to obtain the glucose test was 94.4 ± 47.2 min compared to 95.7 ± 47.8 min for Hb, 95.9 ± 47.93 min for Hep B, and 92.7 ± 46.3 min for the HIV test. Three districts (Berekum East, Dormaa East, and Jaman North) recorded shorter distances (< 10 km) and a shorter travel time to the glucose, Hb, Hep B, and HIV tests compared to the Banda district, which recorded more than 10 km for all tests investigated. Positive IM values were recorded for all the POC tests, suggesting that the health facilities providing the glucose, Hb, Hep B, and HIV tests in the BR were spatially distributed at random.ConclusionsThe findings revealed moderate access to all the tests in districts across the region. However, geographical access to glucose, Hb, Hep B, and HIV POC testing was poor (distance ≥ 10 km and travel time of ≥ 93 min), in the Banda district. This study showed the need to prioritise the Banda district for targeted improvement for all the tests. A further study is recommended to identify potential solutions to addressing the POC testing implementation in the BR, as demonstrated by this study.

Effect of different calcium sulfate aspect ratios and chitosan addition methods on the interface properties of calcium sulfate/chitosan composite bone cement

AbstractIt is a great challenge to improve the properties of pure calcium sulfate bone cement. Here, two calcium sulfate hemihydrate powders with different aspect ratios were prepared, and three chitosan addition methods were adopted to investigate the effect on the surface and interface properties of calcium sulfate/chitosan composite bone cement. The results showed that it lacked chemical bond between chitosan and calcium sulfate, and the short rod calcium sulfate displayed better interface adhesion with chitosan owing to its smaller size, so it possessed shorter setting time, better compressive strength and slower degradation than the long rod calcium sulfate, while the biocompatibility had no remarkable difference. Moreover, chitosan solution as liquid phase was a better solidification mode than citric acid, and calcium sulfate/chitosan composite as solid phase was the worst mode because of poor interface compatibility. Conclusively, it was a simple, low‐cost, and effective preparation process to choose short rod calcium sulfate powder as solid phase and 1 wt% chitosan solution as liquid phase, which could achieve calcium sulfate/chitosan composite bone cement with the best properties, including setting time, compressive strength, degradation rate, and biocompatibility, displaying a promising application in bone defect repair.