Hasil untuk "Orthopedic surgery"

Shiyao Liu, Congcong Song, Ziyi Liu et al.

Background: Aging is a complex physiological process, regulated by multiple intertwined mechanisms. In this process, Sirt1 played a vital role with evidences increasing continually. Given the rapid expansion of research in this area, a comprehensive overview of the intellectual landscape is needed to guide future investigations. Based on, we conducted a bibliometric analysis of the relevant literature and visualized the results. Our study aimed to consolidate the current knowledge and provide insights into evolving research trends, thereby contributing to a deeper understanding of Sirt1's roles in aging process. Methods: On August 14th, 2024, we retrieved 2434 issues in Web of Science Core Collection (searching period from 2005 to 2024). Using VOSviewer, Citespace and bibliometrix, we analyzed these records in terms of annual publications/citations, spatiotemporal distribution, collaborations between regions/institutions/authors, co-references, and keywords. Result: We identified a stable development trend of researching on Sirt1 and aging. In the last 2 decades, the average growth rate of publication numbers was 34.52%, while in recent 5 years it fell to 10.8%. So far, China and the United States were more conductive and influential in this field. Their publications accounted for 39.56% and 26.17%, respectively. Of interests, since Hungary's publication numbers just accounted for 7% of the publications worldly, it had the strongest average citations. Besides, some institutions and countries had varieties of publications, but weak link strength, meaning further collaborations of them were needed in future study. Importantly, keywords analysis indicated that oxidative stress and calorie restriction were the main hot-spots of this field. Besides, inflammation, DNA damage, metabolism, mitochondrial dysfunction and autophagy might be new research directions in Sirt1 and aging. Conclusions: Above all, this study provided further insights into recent advances and future progression in researches on Sirt1 and aging.

Gheehyun Nahm

We construct a new family of surgery exact triangles in Heegaard Floer theory over the field with two elements. This family generalizes both Ozsváth and Szabó's $n$- and $1/n$-surgery exact triangles for positive integers $n$ and the author's recent 2-surgery exact triangle to all positive rational slopes. The construction reduces to a combinatorial problem that involves triangle and quadrilateral counting maps in a genus 1 Heegaard diagram. The main contribution of this paper is solving this combinatorial problem, which is particularly tricky for slopes $r\neq n,1/n$; one key idea is to use an involution that is closely related to the ${\rm Spin}^{c}$ conjugation symmetry.

Kathleen Chang, Zhiyang He, Theodore J. Yoder et al.

Generalized code surgery is a versatile and low-overhead technique for performing fault-tolerant computation on quantum low-density parity-check (qLDPC) codes. In many settings, surgery exhibits practical space overheads, while its time overhead remains a bottleneck at $O(d)$ syndrome rounds per operation. In this work, we construct surgery gadgets that perform parallel logical measurements on 2D hypergraph product codes in constant time overhead ($O(1)$) and near-constant space overhead ($\tilde{O}(1)$). The reduced time overhead is a result of amortization, as we show, following the formulation by Cowtan et al. (arXiv:2510.14895), that performing $d$ surgery operations in $O(d)$ time is fault tolerant. Our gadgets combine the strengths of different approaches to fault-tolerant logical operations: they partially retain the flexibility of surgery while achieving overheads comparable to transversal gates. Consequently, they are well-suited for near-term experimental realization and demonstrate new possibilities in the design of gadgets for fast logical computation.

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Abstract Özet‹leti?im adresi: Şehremini Mah., Millet Cad., Renk Apt., No: 77/6, 34104 Fındıkzade, Fatih, ‹stanbul. Tel: 0212 530 15 08/21 Faks: 0212 530 15 21 web: http://www.aott.org.tr e-posta: info@aott.org.tr

Charles Poh Thean Ang, Kunalan Ganthel, Jade Pei Yuik Ho et al.

Abstract Background Achieving soft tissue balance is challenging in valgus arthritic knee because of a combination of anomalies in the soft tissues and bones. It has been stipulated that contemporary robotic systems are more precise than traditional instrumentation. Its advantage lies in the soft tissue algorithms. Presently, there is paucity of information on the use of robotic-assisted TKA in addressing moderate and severe valgus deformities. The aim of this series is to demonstrate the utility of robotic-assisted surgery in TKA for arthritic knees with moderate and severe valgus deformities, including accuracy, soft tissue releases performed and level of constraint required. Methods This is a single surgeon series of 14 cases of moderate and severe valgus osteoarthritic knees who underwent robotic-assisted TKA, utilizing the robotic surgical assistant ROSA® System. Results All patients were restored to within 3° of the planned alignment. 8 patients were implanted with cruciate retaining implants, 2 had ultracongruent implants, 3 had posterior stabilized implants, and 1 had a constrained posterior stabilized implant. No patients required release of the popliteus tendon or origin of the lateral collateral ligament. No perioperative complications were encountered in all cases. All patients reported an improvement in the Forgotten Joint Score of > 10.8 at 1year follow up with a 100% satisfaction rate. Conclusion In this case series, the utilization of robotic assisted the surgeon to achieve a final limb alignment to within 3° of the planned alignment with minimal use of constrained prostheses and good patient-reported outcomes in moderate and severe valgus deformities.

Fernando Suárez-Sánchez, Evelyn Pérez-Ruiz, Claudia Ivonne Ramírez-Silva et al.

Background: Morbid obesity is associated with metabolic alterations and the onset of type 2 diabetes. Patients who undergo a malabsorptive bariatric surgery show an important improvement in several clinical variables and a modification in the gut microbiota balance. In this study, we aimed to identify bacteria related to changes in the body mass index of patients who underwent a bariatric surgery and their relationship with nutrients intake. Results: There were differences in bacterial diversity in the gut microbiota of patients that underwent a bariatric surgery. The Shannon and Simpson indexes decrease after the surgery (p < 0.001) and the beta diversity indexes (Bray-Curtis, Weighted and Unweighted UniFrac) showed differences when comparing pre- and post-surgery (p = 0.001). The abundance of a species in the genus Coprococcus correlated positively with the intake of magnesium and thiamin in post-surgery individuals (rho = 0.816, pFDR = 0.029 and rho = 0.812, pFDR = 0.029, respectively) and was related to BMI in both groups (p = 0.043 pre-surgery and p = 0.036 post-surgery). The abundances of several bacteria belonging to the order Clostridiales, as well as an enrichment of vitamin B1 (thiamin) biosynthesis, sugar degradation, acetate production and some amino acids biosynthesis were higher before the surgery. Conclusions: The abundance of a species of the genus Coprococcus that showed inverse relationships with BMI in pre-surgery and post-surgery patients correlates with the intake of magnesium and thiamin in individuals that underwent a malabsorptive bariatric surgery. It indicates that the well-established beneficial effects of bariatric surgery on BMI may be amplified by modulating the intake of micronutrients and its effect on the gut bacterial.

Mansi Sharma, Antonio Kruger

Robot-assisted surgery has revolutionized the healthcare industry by providing surgeons with greater precision, reducing invasiveness, and improving patient outcomes. However, the success of these surgeries depends heavily on the robotic system ability to accurately interpret the intentions of the surgical trainee or even surgeons. One critical factor impacting intent recognition is the cognitive workload experienced during the procedure. In our recent research project, we are building an intelligent adaptive system to monitor cognitive workload and improve learning outcomes in robot-assisted surgery. The project will focus on achieving a semantic understanding of surgeon intents and monitoring their mental state through an intelligent multi-modal assistive framework. This system will utilize brain activity, heart rate, muscle activity, and eye tracking to enhance intent recognition, even in mentally demanding situations. By improving the robotic system ability to interpret the surgeons intentions, we can further enhance the benefits of robot-assisted surgery and improve surgery outcomes.

Benjamin B. McMillan

We define a general procedure extending surgery to manifolds with foliation or Haefliger structure. We find a single obstruction to foliation surgery along an attaching sphere. When unobstructed, the surgery can be chosen to preserve characteristic numbers. Studying these obstructions, we obtain two results. First, on every stably trivial manifold of dimension \( n \le 2q+2 \), a transversely framed codimension-\( q \) Haefliger structure can be surgered to a Haefliger structure on the sphere \( S^{n} \), characteristic numbers unchanged. As an application, we modify a construction of Thurston's to give explicit Haefliger structures on \( S^{2q+1} \) whose Godbillon-Vey numbers surject to the real line. Second, the foliation connected sum gives, for each dimension \( n \) and codimension \( q \), a group structure on concordance classes of transversely oriented Haefliger structures on \( S^{n} \). These groups may be identified with the homotopy groups of the Haefliger classifying spaces \( BΓ^{+}_{q} \).

Maksim V. Stogov, Alexander L. Shastov, Elena A. Kireeva et al.

Introduction The search for materials for bone defect filling that would provide a release of antibiotics in therapeutic levels over a long period is a pressing issue in the treatment of patients with osteomyelitis. The purpose of the work was to compare the kinetics of antibiotic release from materials based on polyurethane polymers for filling post-osteomyelitic bone defects. Materials and methods A comparative in vitro analysis of the kinetic release of cefotaxime, vancomycin, and meropenem from two materials was performed: one was based on polyurethane polymers (RK series) and the other on polymethyl methacrylate (PMMA series). In each series, antibiotics were added to the original materials in three proportions: polymer/ antibiotic — 10:1 (group 1); 10:0.5 (group 2), and 10:0.25 (group 3). The samples were incubated in 10 ml of saline at 37 °C. The incubation solution was changed daily during the first week, and then once a week. Six samples were incubated in each group. Results It was revealed that the volume of eluted cefotaxime in the PMMA series was higher than in the RK series for all antibiotic concentrations. In turn, for vancomycin and meropenem, it was observed only for group 1 samples. For groups 0.5 and 0.25, a larger volume of released antibiotics was noted in the RK series than in the PMMA series. It was found that in the RK series, the release of vancomycin and cefotaxime in an effective (therapeutic) concentration was more prolonged. In the RK series, there was prolonged release of effective concentrations but in a smaller volume of released antibiotic than in the PMMA series. Discussion Each material showed its own antibiotic elution profile and each of them may have its own indications. The RK-based material has advantages in terms of the duration of antibiotic elution in therapeutic doses. Conclusion The release of the studied antibiotics in effective concentrations from the material based on polyurethane polymers is longer than from the PMMA-based material.

Jonas Hein, Frédéric Giraud, Lilian Calvet et al.

Surgery digitalization is the process of creating a virtual replica of real-world surgery, also referred to as a surgical digital twin (SDT). It has significant applications in various fields such as education and training, surgical planning, and automation of surgical tasks. In addition, SDTs are an ideal foundation for machine learning methods, enabling the automatic generation of training data. In this paper, we present a proof of concept (PoC) for surgery digitalization that is applied to an ex-vivo spinal surgery. The proposed digitalization focuses on the acquisition and modelling of the geometry and appearance of the entire surgical scene. We employ five RGB-D cameras for dynamic 3D reconstruction of the surgeon, a high-end camera for 3D reconstruction of the anatomy, an infrared stereo camera for surgical instrument tracking, and a laser scanner for 3D reconstruction of the operating room and data fusion. We justify the proposed methodology, discuss the challenges faced and further extensions of our prototype. While our PoC partially relies on manual data curation, its high quality and great potential motivate the development of automated methods for the creation of SDTs.

David Azriel, Yosef Rinott, Orna Tal et al.

Efficient optimization of operating room (OR) activity poses a significant challenge for hospital managers due to the complex and risky nature of the environment. The traditional "one size fits all" approach to OR scheduling is no longer practical, and personalized medicine is required to meet the diverse needs of patients, care providers, medical procedures, and system constraints within limited resources. This paper aims to introduce a scientific and practical tool for predicting surgery durations and improving OR performance for maximum benefit to patients and the hospital. Previous works used machine-learning models for surgery duration prediction based on preoperative data. The models consider covariates known to the medical staff at the time of scheduling the surgery. Given a large number of covariates, model selection becomes crucial, and the number of covariates used for prediction depends on the available sample size. Our proposed approach utilizes multi-task regression to select a common subset of predicting covariates for all tasks with the same sample size while allowing the model's coefficients to vary between them. A regression task can refer to a single surgeon or operation type or the interaction between them. By considering these diverse factors, our method provides an overall more accurate estimation of the surgery durations, and the selected covariates that enter the model may help to identify the resources required for a specific surgery. We found that when the regression tasks were surgeon-based or based on the pair of operation type and surgeon, our suggested approach outperformed the compared baseline suggested in a previous study. However, our approach failed to reach the baseline for an operation-type-based task.

Sarah N. Pierrie, MD, Michael J. Beltran, MD

Summary:. Reestablishing an intact, healthy soft tissue envelope is a critical step in managing lower extremity injuries, particularly high-grade open tibia fractures. Acute shortening and angulation can be used independently or together to address complex soft tissue injuries, particularly when bone loss is present. These techniques facilitate management of difficult wounds and can be combined with local soft tissue rearrangement or pedicled flaps as needed, avoiding the need for free tissue transfer. After angular deformity correction, adjacent bone loss can be addressed with bone grafting or distraction histogenesis. This article discusses the indications for, surgical technique for, and limitations of acute shortening and angulation for management of open lower extremity fractures.

Jay N. Paranjape, Shameema Sikder, Vishal M. Patel et al.

Surgical tool presence detection is an important part of the intra-operative and post-operative analysis of a surgery. State-of-the-art models, which perform this task well on a particular dataset, however, perform poorly when tested on another dataset. This occurs due to a significant domain shift between the datasets resulting from the use of different tools, sensors, data resolution etc. In this paper, we highlight this domain shift in the commonly performed cataract surgery and propose a novel end-to-end Unsupervised Domain Adaptation (UDA) method called the Barlow Adaptor that addresses the problem of distribution shift without requiring any labels from another domain. In addition, we introduce a novel loss called the Barlow Feature Alignment Loss (BFAL) which aligns features across different domains while reducing redundancy and the need for higher batch sizes, thus improving cross-dataset performance. The use of BFAL is a novel approach to address the challenge of domain shift in cataract surgery data. Extensive experiments are conducted on two cataract surgery datasets and it is shown that the proposed method outperforms the state-of-the-art UDA methods by 6%. The code can be found at https://github.com/JayParanjape/Barlow-Adaptor

Umito Kuwashima, Masafumi Itoh, Junya Itou et al.

Abstract We report a case of tibial shaft fracture after open‐wedge distal tibial tuberosity osteotomy (OWDTO). The use of a lag screw for a lateral hinge fracture in OWDTO requires careful postoperative rehabilitation and follow‐up. We discuss concerns related to the mechanical strength at the osteotomy site after OWDTO to prevent fracture.

Alexander Cowtan

We observe that lattice surgery, a model of fault-tolerant qubit computation, generalises straightforwardly to arbitrary finite-dimensional qudits. The generalised model is based on the group algebras $\mathbb{C}\mathbb{Z}_d$ for $d \geq 2$. It still requires magic state injection for universal quantum computation. We relate the model to the ZX-calculus, a diagrammatic language based on Hopf-Frobenius algebras.

Kai Nakamura

Manolescu and Piccirillo recently initiated a program to construct an exotic $S^4$ or $\# n \mathbb{CP}^2$ by using zero surgery homeomorphisms and Rasmussen's $s$-invariant. They find five knots that if any were slice, one could construct an exotic $S^4$ and disprove the Smooth $4$-dimensional Poincaré conjecture. We rule out this exciting possibility and show that these knots are not slice. To do this, we use a zero surgery homeomorphism to relate slice properties of two knots \textit{stably} after a connected sum with some $4$-manifold. Furthermore, we show that our techniques will extend to the entire infinite family of zero surgery homeomorphisms constructed by Manolescu and Piccirillo. However, our methods do not completely rule out the possibility of constructing an exotic $S^4$ or $\# n \mathbb{CP}^2$ as Manolescu and Piccirillo proposed. We explain the limits of these methods hoping this will inform and invite new attempts to construct an exotic $S^4$ or $\# n \mathbb{CP}^2$. We also show a family of homotopy spheres constructed by Manolescu and Piccirillo using annulus twists of a ribbon knot are all standard.

Sravya P. Vajapey, Paul M. Alvarez, Douglas Chonko

Abstract Background We present two cases of unicompartmental knee arthroplasty (UKA) bearing failure in this report—one case of bearing dislocation and one case of bearing fracture. The causes of failure in both cases are evaluated in depth and recommendations are provided regarding intraoperative technique to reduce risk of bearing failure in mobile bearing UKAs. Case presentation In the first case, intraoperative evidence of metallosis and chronic pain preceding the traumatic event may indicate that the patient had attenuation of her collateral ligaments that precipitated the instability event. In the second case, the relatively atraumatic nature of the bearing fracture-dislocation and intraoperative evidence of extensive poly wear suggest that the bearing fracture was likely due to a 3-mm bearing selection in the initial surgery. Conclusions This case report shows that late bearing in mobile bearing unicompartmental knee arthroplasty can often be a multifactorial event and treatment must address all the risk factors that led to bearing dislocation. Bearing fracture is a very rare complication associated with mobile bearing UKA and patients with thin polyethylene inserts are at risk for bearing fracture even in the absence of poly wear.

Victor Garcia-Martin MD, Ana Verdejo-González MD, David Ruiz-Picazo MD et al.

Introduction: Physiological aging frequently leads to degenerative changes and spinal deformity. In patients with hypolordotic fusions or ankylosing illnesses such as diffuse idiopathic skeletal hyperostosis or ankylosing spondylitis, compensation mechanisms can be altered causing severe pain and disability. In addition, if a total hip replacement and/or knee replacement is performed, both pelvic and lower limbs compensation mechanisms could be damaged and prosthetic dislocation or impingement syndrome could be present. Pedicle subtraction osteotomy has proven to be the optimal correction technique for spinal deformation in patients suffering from a rigid spine. Case Presentation: A 70-year-old male patient with diffuse idiopathic skeletal hyperostosis criteria and a rigid lumbar kyphosis, who previously underwent a total hip and knee replacement, had severe disability. We then performed corrective surgery by doing a pedicle subtraction osteotomy. The procedure and outcomes are presented here. Conclusion: In symptomatic patients with sagittal imbalance and a rigid spine, pedicle subtraction osteotomy can indeed correct spinal deformity and re-establish sagittal balance.

Edward R. Floyd, M.S., Gregory B. Carlson, M.D., Robert F. LaPrade, M.D., Ph.D.

Lateral meniscus allograft transplantation is performed in predominantly young, active patients and is an option to stabilize the joint in lateral meniscus–deficient patients after anterior cruciate ligament reconstruction. The lateral meniscus functions as an important restraint to anterior tibial translation, and meniscal transplant in such a patient may improve survivability of the graft in addition to preserving the patient’s articular cartilage in the long term. A ligamentous extra-articular tenodesis procedure may be performed simultaneously to augment rotational stability of the joint, particularly in a patient with underlying ligamentous hyperlaxity.

Malcolm R. DeBaun, MD, Cara Lai, BS, Mark Sanchez, BS et al.

Abstract. Antibiotic resistance remains a global public health concern with significant patient morbidity and tremendous associated health care costs. Drivers of antibiotic resistance are multifaceted and differ between developing and developed countries. Under evolutionary pressure, microbes acquire antibiotic tolerance through a variety of mechanisms at the cellular level. Patients after orthopaedic trauma are vulnerable to drug-resistant pathogens, particularly after open fractures. Traumatologists practicing appropriate antibiotic prophylaxis and treatment regimens mitigate infection and propagation of antibiotic resistance.