Does overcorrection cause any negative effect on pediatric missed Monteggia lesion?

European Journal of Orthopaedic Surgery & Traumatology - To evaluate the outcome of different types of ulna osteotomy in missed Monteggia fracture with a particular interest in anatomical...     

Cost analysis for efficient management: diabetes treatment at a public district hospital in Thailand

OBJECTIVE The study estimated cost of illness from the provider's perspective for diabetic patients who received treatment during the fiscal year 2008 at Waritchaphum Hospital, a 30-bed public district hospital in Sakhon Nakhon province in northeastern Thailand. METHODS This retrospective, prevalence-based cost-of-illness study looked at 475 randomly selected diabetic patients, identified by the World Health Organization's International Classification of Diseases, 10th revision, codes E10-E14. Data were collected from the hospital financial records and medical records of each participant and were analysed with a stepwise multiple regression. KEY FINDINGS The study found that the average public treatment cost per patient per year was US$94.71 at 2008 prices. Drug cost was the highest cost component (25% of total cost), followed by inpatient cost (24%) and outpatient visit cost (17%). A cost forecasting model showed that length of stay, hospitalization, visits to the provincial hospital, duration of disease and presence of diabetic complications (e.g. diabetic foot complications and nephropathy) were the significant predictor variables (adjusted R(2) = 0.689). CONCLUSIONS According to the fitted model, avoiding nephropathy and foot complications would save US$19 386 and US$39 134 respectively per year. However, these savings are missed savings for the study year and the study hospital only and not projected savings, as that would depend on the number of diabetic patients managed in the year, the ratio of complicated to non-complicated cases and effectiveness of the prevention programmes. Nonetheless, given the high avoidable cost associated with complications of diabetes, healthcare providers in Thailand should focus on initiatives that delay the progression of complications in diabetic patients.     

The Effects of Thermophysical Properties and Environmental Conditions on Fire Performance of Intumescent Coatings on Glass Fibre-Reinforced Epoxy Composites

Intumescent coatings are commonly used as passive fire protection systems for steel structures. The purpose of this work is to explore whether these can also be used effectively on glass fibre-reinforced epoxy (GRE) composites, considering the flammability of the composites compared to non-flammable steel substrate. The thermal barrier and reaction-to-fire properties of three commercial intumescent coatings on GRE composites have been studied using a cone calorimeter. Their thermophysical properties in terms of heating rate and/or temperature dependent char expansion ratios and thermal conductivities have been measured and correlated. It has been suggested that these two parameters can be used to design coatings to protect composite laminates of defined thicknesses for specified periods of time. The durability of the coatings to water absorption, peeling, impact, and flexural loading were also studied. A strong adhesion between all types of coatings and the substrate was observed. Water soaking had a little effect on the fire performance of epoxy based coatings. All types of 1 mm thick coatings on GRE helped in retaining ~90% of the flexural property after 2 min exposure to 50 kW/m² heat flux whereas the uncoated laminate underwent severe delamination and loss in structural integrity after 1 min.     

PEGylated Adenoviruses: From Mice to Monkeys

Covalent modification with polyethylene glycol (PEG), a non-toxic polymer used in food, cosmetic and pharmaceutical preparations for over 60 years, can profoundly influence the pharmacokinetic, pharmacologic and toxciologic profile of protein and peptide-based therapeutics. This review summarizes the history of PEGylation and PEG chemistry and highlights the value of this technology in the context of the design and development of recombinant viruses for gene transfer, vaccination and diagnostic purposes. Specific emphasis is placed on the application of this technology to the adenovirus, the most potent viral vector with the most highly characterized toxicity profile to date, in several animal models.     

Augmented kinematic feedback from haptic virtual reality for dental skill acquisition

We have developed a haptic virtual reality system for dental skill training. In this study we examined several kinds of kinematic information about the movement provided by the system supplement knowledge of results (KR) in dental skill acquisition. The kinematic variables examined involved force utilization (F) and mirror view (M). This created three experimental conditions that received augmented kinematic feedback (F, M, FM) and one control condition that did not (KR-only). Thirty-two dental students were randomly assigned to four groups. Their task was to perform access opening on the upper first molar with the haptic virtual reality system. An acquisition session consisted of two days of ten trials of practice in which augmented kinematic feedback was provided for the appropriate experimental conditions after each trial. One week after, a retention test consisting of two trials without augmented feedback was completed. The results showed that the augmented kinematic feedback groups had larger mean performance scores than the KR-only group in Day 1 of the acquisition and retention sessions (ANOVA, p<0.05). The apparent differences among feedback groups were not significant in Day 2 of the acquisition session (ANOVA, p>0.05). The trends in acquisition and retention sessions suggest that the augmented kinematic feedback can enhance the performance earlier in the skill acquisition and retention sessions.