Cost savings associated with 10 years of road safety policies in Catalonia,Spain

Objective

To determine whether the road safety policies introduced between 2000 and 2010 in Catalonia, Spain, which aimed primarily to reduce deaths from road traffic collisions by 50% by 2010, were associated with economic benefits to society.

Methods

A cost analysis was performed from a societal perspective with a 10-year time horizon. It considered the costs of: hospital admissions; ambulance transport; autopsies; specialized health care; police, firefighter and roadside assistance; adapting to disability; and productivity lost due to institutionalization, death or sick leave of the injured or their caregivers; as well as material and administrative costs. Data were obtained from a Catalan hospital registry, the Catalan Traffic Service information system, insurance companies and other sources. All costs were calculated in euros (€) at 2011 values.

Findings

A substantial reduction in deaths from road traffic collisions was observed between 2000 and 2010. Between 2001 and 2010, with the implementation of new road safety policies, there were 26 063 fewer road traffic collisions with victims than expected, 2909 fewer deaths (57%) and 25 444 fewer hospitalizations. The estimated total cost savings were around €18 000 million. Of these, around 97% resulted from reductions in lost productivity. Of the remaining cost savings, 63% were associated with specialized health care, 15% with adapting to disability and 8.1% with hospital care.

Conclusion

The road safety policies implemented in Catalonia in recent years were associated with a reduction in the number of deaths and injuries from traffic collisions and with substantial economic benefits to society.     

Do local antibiotics reduce periprosthetic joint infections? A retrospective review of 744 cases

Periprosthetic joint infections (PJI) are uncommon but not rare and have significant morbidity and financial implications. Local antibiotics have been used successfully in other areas of orthopedics to reduce postoperative infections, but this method has not been proven in total joint arthroplasty (TJA). Beginning January 1, 2014, our primary investigators began using surgical site lavage with providone-iodine solution and administering 2 g of vancomcyin powder in the surgical wound prior to capsule closure for all primary and revision total hip and knee arthroplasties. We performed a retrospective chart review of patients two years prior to this date and two years after to compare occurrence of PJI. The groups were broken down into patients who received local antibiotics versus those who did not. The groups were further broken down by type of surgery performed; primary or revision total hip or knee arthroplasty. Administration of local antibiotics was preventative for PJI only in the primary total knee arthroplasty group (aOR = 0.28, 0.09–0.89). Administration of local antibiotics trended towards a preventative effect for PJI in the other groups but was not statistically significant. Patients receiving local antibiotics had similar blood urea nitrogen and creatinine levels postoperatively compared to the no antibiotics group indicating minimal systemic effects of local vancomycin powder. While the use of local antibiotics may prevent PJI, more data is required especially in the revision arthroplasty groups.     

Exploiting domain information for Word Sense Disambiguation of medical documents

Objective

Current techniques for knowledge-based Word Sense Disambiguation (WSD) of ambiguous biomedical terms rely on relations in the Unified Medical Language System Metathesaurus but do not take into account the domain of the target documents. The authors'' goal is to improve these methods by using information about the topic of the document in which the ambiguous term appears.

Design

The authors proposed and implemented several methods to extract lists of key terms associated with Medical Subject Heading terms. These key terms are used to represent the document topic in a knowledge-based WSD system. They are applied both alone and in combination with local context.

Measurements

A standard measure of accuracy was calculated over the set of target words in the widely used National Library of Medicine WSD dataset.

Results and discussion

The authors report a significant improvement when combining those key terms with local context, showing that domain information improves the results of a WSD system based on the Unified Medical Language System Metathesaurus alone. The best results were obtained using key terms obtained by relevance feedback and weighted by inverse document frequency.     

Customized procedure to display T-Scan occlusal contacts

The virtual technique described in this article integrates reverse engineering and mandibular dynamics into dental computer-aided design and computer-aided manufacturing (CAD-CAM) systems. This technique aims to provide more objective information to the dental technician for the diagnosis, planning, and treatment phases. In order to carry out this protocol, the following devices, currently available in many practices, are necessary: an intraoral scanner, a T-Scan system, and some specific open reverse engineering software. By means of a virtual procedure, the T-Scan system detects the occlusal contacts, and the occlusal surfaces are obtained using an intraoral scanner. Once the alignment between the 3-dimensional occlusal surface and the T-Scan registration is carried out, the resulting contacts are projected onto the patient’s occlusal surfaces; in this way, occlusal forces are obtained over time. The results obtained with this procedure demonstrate the feasibility of integrating different tools and software and the full integration of this procedure into a dental digital workflow.     

Lignin for pharmaceutical and biomedical applications – Could this become a reality?

Lignin is an aromatic biopolymer and a primary component of the cell walls in lignocellulosic biomass, where it constitutes between 15 and 40% of its dry mass. This percentage can vary, not only among plant species, but also among different cell types. Currently, the pulping and biorefinery industries worldwide extract large amounts of lignin, which is mostly combusted to generate the power needed to productively transform the lignocellulosic biomass. The specific composition and structure of this technical lignin depends on its botanical origin and on the extraction method applied. In general, however, lignin possesses antioxidant and antimicrobial properties, UV-absorbing capabilities, biocompatibility and low cytotoxicity. Moreover, lignin can increase the mechanical strength of numerous processed biomaterials. Accordingly, lignin is a promising aromatic raw material for the pharmaceutical and biomedical field. This work discusses the recent advances in the valorisation of lignin through the development of drug and gene delivery systems, wound dressings, tissue engineering or sunscreen actives. Finally, a brief overview on the current challenges and opportunities for making lignin-based products for pharmaceutical and medical applications a reality is also discussed.     

Use of measuring gauges for in vivo accuracy analysis of intraoral scanners: a pilot study

PURPOSEThe purpose of this study is to present a methodology to evaluate the accuracy of intraoral scanners (IOS) used in vivo.MATERIALS AND METHODSA specific feature-based gauge was designed, manufactured, and measured in a coordinate measuring machine (CMM), obtaining reference distances and angles. Then, 10 scans were taken by an IOS with the gauge in the patient''s mouth and from the obtained stereolithography (STL) files, a total of 40 distances and 150 angles were measured and compared with the gauge''s reference values. In order to provide a comparison, there were defined distance and angle groups in accordance with the increasing scanning area: from a short span area to a complete-arch scanning extension. Data was analyzed using software for statistical analysis.RESULTSDeviations in measured distances showed that accuracy worsened as the scanning area increased: trueness varied from 0.018 ± 0.021 mm in a distance equivalent to the space spanning a four-unit bridge to 0.106 ± 0.08 mm in a space equivalent to a complete arch. Precision ranged from 0.015 ± 0.03 mm to 0.077 ± 0.073 mm in the same two areas. When analyzing angles, deviations did not show such a worsening pattern. In addition, deviations in angle measurement values were low and there were no calculated significant differences among angle groups.CONCLUSIONCurrently, there is no standardized procedure to assess the accuracy of IOS in vivo, and the results show that the proposed methodology can contribute to this purpose. The deviations measured in the study show a worsening accuracy when increasing the length of the scanning area.