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Hemiarthroplasty in the Hip Fracture Patient with Renal Impairment: To Cement or Not to Cement
Tong Leng Tan,Sean Wei Loong Ho,Arjunan Edward Kumanan Graetz,Ernest Beng Kee Kwek 대한고관절학회 2019 Hip and Pelvis Vol.31 No.4
Purpose: Patients with chronic kidney disease (CKD) have a higher risk of complications when undergoing hip hemiarthroplasty. The primary aim is to test the null hypothesis that there is no difference between cemented and uncemented stem loosening rates in patients with CKD who receive a hip hemiarthroplasty for femoral neck fractures. The secondary aim is to determine the effect of increasing severity of renal disease on the rate of stem loosening in this CKD patient subset. Materials and Methods: A retrospective study of all patients with CKD who underwent a hip hemiarthroplasty for a traumatic femoral-neck fracture between 2003 and 2013 was performed. Patients with a minimum of twoyear follow-up were included; those with pathological fractures or loosening due to infection were excluded. The outcome measure was radiographic aseptic loosening of the stem, defined as progressive radiolucency of more than 2 mm, progressive subsidence or migration of the implant. Results: One-hundred and nineteen cases were included in this study. Loosening occurred in 11 cases (9.24%). A comparison between cemented and uncemented groups revealed no difference in the rate of loosening (P=0.079). In all cases, worsening renal function did not increase the rate of loosening (P=0.311). The rate of loosening did not increase with worsening renal function in either the cemented (P=0.678) or uncemented groups (P=0.307). Conclusion: There is no difference in the rate of loosening between cemented and uncemented hemiarthroplasty for femoral neck fractures in the elderly with CKD. The rate of loosening did not increase with worsening renal function. All patients with renal impairment, not just those with end-stage renal failure, warrant close follow-up as early loosening can occur throughout the entire spectrum of renal disease.
Detecting the Oxidation of Zircaloy Claddings by Infrared Interference
Hongyi Mi,Solomon Mikael,Edward Swinnich,Todd Allen,Kumar Sridharan,Darryl P. Butt,Shaoqin Gong,Sean M. McDeavitt,James P. Blanchard,서정훈,Zhenqiang Ma 성균관대학교(자연과학캠퍼스) 성균나노과학기술원 2018 NANO Vol.13 No.2
As the expected life of dry cask storage installations increases, it becomes increasingly desirable to monitor the state and performance of the cask internals to ensure that they continue to safely contain the radioactive materials in the fuel. One aspect of this task is the monitoring of oxidation of the cladding. With this consideration in mind, Zircaloy-4 (Zr-4) cladding samples were exposed to air at 500℃ for various duration times to create thin corrosion oxide layers on the surface. The surfaces of the oxidized samples were then systematically scanned by Fourier Transform Infrared (FT-IR) spectroscopy to achieve the infrared (IR) interference spectra and study the relationship between the optical interference and the various thicknesses of the oxide layers. The profiles of the oxide layers were verified througth cross-sectional examination by Scanning Electron Microscopy. The IR interference patterns varied with oxide layer thickness, enabling the determination of oxide layer thickness of values, including half micron thick. Further analysis demonstrated that the interference oscillation period and the oscillation amplitude decreased with increasing oxide layer thickness. Combined with a physical model that describes the optical interference, the interference spectra were directly correlated to the oxide layer thickness quantitatively. The study provides the basis for an accurate, nondestructive and sensitive method to monitor the degree of zirconium-based cladding corrosion due to oxidation.
Boaz Shulruf,Gary Mayer Velan,Sean Edward Kennedy 한국보건의료인국가시험원 2022 보건의료교육평가 Vol.19 No.-
Purpose The study investigates the efficacy of new features introduced to the selection process for medical school at the University of New South Wales, Australia: (1) considering the relative ranks rather than scores of the Undergraduate Medicine and Health Sciences Admission Test and Australian Tertiary Admission Rank; (2) structured interview focusing on interpersonal interaction and concerns should the applicants become students; and (3) embracing interviewers’ diverse perspectives. Methods Data from 5 cohorts of students were analyzed, comparing outcomes of the second year in the medicine program of 4 cohorts of the old selection process and 1 of the new process. The main analysis comprised multiple linear regression models for predicting academic, clinical, and professional outcomes, by section tools and demographic variables. Results Selection interview marks from the new interview (512 applicants, 2 interviewers each) were analyzed for inter-rater reliability, which identified a high level of agreement (kappa=0.639). No such analysis was possible for the old interview since it required interviewers to reach a consensus. Multivariate linear regression models utilizing outcomes for 5 cohorts (N=905) revealed that the new selection process was much more effective in predicting academic and clinical achievement in the program (R2=9.4%–17.8% vs. R2=1.5%–8.4%). Conclusion The results suggest that the medical student selection process can be significantly enhanced by employing a non-compensatory selection algorithm; and using a structured interview focusing on interpersonal interaction and concerns should the applicants become students; as well as embracing interviewers’ diverse perspectives.
Disruption of Stamp/Ttll5 Gene in Male Mice Causes Sperm Malformation and Infertility
Geun-Shik Lee,Yuanzheng He,Edward J. Dougherty,Maria Jimenez-Movilla,Matteo Avella,Sean erullon,David S. Sharlin,Chunhua Guo,Smita Auasthi,Zhenhuan Zhang,Stephen P. Armstrong,Edra C. London,Weiping Ch 한국동물생명공학회(구 한국동물번식학회) 2012 발생공학 국제심포지엄 및 학술대회 Vol.2012 No.1
( Janeesh Plakkal Ayyappan ),( Kezia Lizardo ),( Sean Wang ),( Edward Yurkow ),( Jyothi F Nagajyothi ) 한국응용약물학회 2019 Biomolecules & Therapeutics(구 응용약물학회지) Vol.27 No.4
Trypanosoma cruzi infection results in debilitating cardiomyopathy, which is a major cause of mortality and morbidity in the endemic regions of Chagas disease (CD). The pathogenesis of Chagasic cardiomyopathy (CCM) has been intensely studied as a chronic inflammatory disease until recent observations reporting the role of cardio-metabolic dysfunctions. In particular, we demonstrated accumulation of lipid droplets and impaired cardiac lipid metabolism in the hearts of cardiomyopathic mice and patients, and their association with impaired mitochondrial functions and endoplasmic reticulum (ER) stress in CD mice. In the present study, we examined whether treating infected mice with an ER stress inhibitor can modify the pathogenesis of cardiomyopathy during chronic stages of infection. T. cruzi infected mice were treated with an ER stress inhibitor 2-Aminopurine (2AP) during the indeterminate stage and evaluated for cardiac pathophysiology during the subsequent chronic stage. Our study demonstrates that inhibition of ER stress improves cardiac pathology caused by T. cruzi infection by reducing ER stress and downstream signaling of phosphorylated eukaryotic initiation factor (P-elF2α) in the hearts of chronically infected mice. Importantly, cardiac ultrasound imaging showed amelioration of ventricular enlargement, suggesting that inhibition of ER stress may be a valuable strategy to combat the progression of cardiomyopathy in Chagas patients.
비골을 이용한 3차원적 하악골 재건 시 가상모의수술 및 입체조형기법을 이용한 골절단 가이드의 활용: 증례보고
Nam, Woong,Makhoul, Nicholas,Ward, Brent,Helman, Joseph I.,Edwards, Sean 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.5
The osseous or osteocutaneous free fibula flap has become the gold standard for most mandibular reconstructions because of its favorable osseous characteristics. However, disadvantages, such as the time-consuming reconstructive step, difficulty in performing the osteotomies to precisely recreate the shape of the missing segment of mandible and poor bone-to-bone contact play a role in making the surgeons look for alternative flaps. With the advent of computerized design software, which accurately plans complex 3-dimensional reconstructions, has become a process that is more efficient and precise. However, the ability to transfer the computerized plan into the surgical field with stereolithographic models and guides has been a significant development in advancing reconstruction in the maxillofacial regions. The ability to "pre-plan" the case, mirror and superimpose natural structures into diseased and deformed areas, as well as the ability to reproduce these plans with good surgical precision has decreased overall operative time, and has helped facilitate functional and esthetic reconstruction. We describe a complex case treated with this technique, showing the power and elegance of computer assisted maxillofacial reconstruction from the University of Michigan, Oral and Maxillofacial Surgery.
Pin-Hsiang Huang,Boaz Shulruf,Gary Velan,Greg Smith,Melanie Fentoullis,Sean Edward Kennedy,Karen Jane Gibson,Kerry Uebel 한국보건의료인국가시험원 2023 보건의료교육평가 Vol.20 No.-
Purpose This study evaluated the validity of student feedback derived from Medicine Student Experience Questionnaire (MedSEQ), as well as the predictors of students’ satisfaction in the Medicine program. Methods Data from MedSEQ applying to the University of New South Wales Medicine program in 2017, 2019, and 2021 were analyzed. Confirmatory factor analysis (CFA) and Cronbach’s α were used to assess the construct validity and reliability of MedSEQ respectively. Hierarchical multiple linear regressions were used to identify the factors that most impact students’ overall satisfaction with the program. Results A total of 1,719 students (34.50%) responded to MedSEQ. CFA showed good fit indices (root mean square error of approximation=0.051; comparative fit index=0.939; chi-square/degrees of freedom=6.429). All factors yielded good (α>0.7) or very good (α>0.8) levels of reliability, except the “online resources” factor, which had acceptable reliability (α=0.687). A multiple linear regression model with only demographic characteristics explained 3.8% of the variance in students’ overall satisfaction, whereas the model adding 8 domains from MedSEQ explained 40%, indicating that 36.2% of the variance was attributable to students’ experience across the 8 domains. Three domains had the strongest impact on overall satisfaction: “being cared for,” “satisfaction with teaching,” and “satisfaction with assessment” (β=0.327, 0.148, 0.148, respectively; all with P<0.001). Conclusion MedSEQ has good construct validity and high reliability, reflecting students’ satisfaction with the Medicine program. Key factors impacting students’ satisfaction are the perception of being cared for, quality teaching irrespective of the mode of delivery, and fair assessment tasks which enhance learning.