Mccainblum7351

Targeted drug delivery using magnetic particles (MPs) and external magnets for focusing them at the diseased regions, called magnetic drug targeting (MDT), is a next-generation therapeutic method that is being continually improved. However, most existing magnetic systems cannot focus MPs in the targeted region due to there not being enough magnetic capturing force and absence of schemes to generate localized high magnetic field at the wall of the target region. This paper suggests a novel scheme to utilize half of a static saddle potential energy configuration generated using four electromagnets that not only enhances the pushing magnetic forces but also simultaneously generates pushing and attracting forces in the desired direction to help focus spherical MPs on the wall of the target region. Furthermore, by changing amplitudes or directions of the currents, the focal point in the target region can be changed. Through extensive simulations and in vitro experiments, we demonstrate that half of a static saddle magnetic potential energy configuration can be successfully utilized to attract and focus MPs at the wall of a target region.

The flow downstream from aortic stenoses is characterised by the onset of shear-induced turbulence that leads to irreversible pressure losses. These extra losses represent an increased resistance that impacts cardiac efficiency. A novel approach is suggested in this study to accurately evaluate the pressure gradient profile along the aorta centreline using modelling of haemodynamic stress at scales that are smaller than the typical resolution achieved in experiments.

We use benchmark data obtained from direct numerical simulation (DNS) along with results from in silico and in vitro threedimensional particle tracking velocimetry (3D-PTV) at three voxel sizes, namely 750 microns, 1 mm and 1.5 mm. A differential equation is derived for the pressure gradient, and the subvoxel-scale (SVS) stresses are closed using the Smagorinsky and a new refined model. Model constants are optimised using DNS and in silico PTV data and validated based on pulsatile in vitro 3D-PTV data and pressure catheter measurements.

Theivo, in vitro 4D flow data or in silico data with limited spatial resolution to assess pressure loss and SVS stresses in disturbed aortic blood flow.

The knowledge of individual joint motion may help to understand the articular physiology and to design better treatments and medical devices. Measurements of in-vivo individual motion are nowadays invasive/ionizing (fluoroscopy) or imprecise (skin markers). We propose a new approach to derive the individual knee natural motion from a three-dimensional representation of articular surfaces.

We hypothesize that tissue adaptation shapes articular surfaces to optimize load distribution. Thus, the knee natural motion is obtained as the envelope of tibiofemoral positions and orientations that minimize peak contact pressure, i.e. that maximize joint congruence. We investigated four in-vitro and one in-vivo knees. Articular surfaces were reconstructed from a reference MRI. Natural motion was computed by congruence maximization and results were validated versus experimental data, acquired through bone im-planted markers, in-vitro, and single-plane fluoroscopy, in-vivo.

In two cases, one of which in-vivo, maximum mean absolute error stays below 2.2 and 2.7 mm for rotations and translations, respectively. The remaining knees showed differences in joint internal rotation between the reference MRI and experimental motion at 0 flexion, possibly due to some laxity. The same difference is found in the model predictions, which, however, still replicate the individual knee motion.

The proposed approach allows the prediction of individual joint motion based on non-ionizing MRI data.

This method may help to characterize healthy and, by comparison, pathological knee behavior. Moreover, it may provide an individual reference motion for the personalization of musculoskeletal models, opening the way to their clinical application.

This method may help to characterize healthy and, by comparison, pathological knee behavior. Moreover, it may provide an individual reference motion for the personalization of musculoskeletal models, opening the way to their clinical application.Viral testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), particularly early in the COVID-19 pandemic, was limited by supply of reagents. We pooled nasopharyngeal samples from patients at low risk of SARS-CoV-2 infection in groups of 3 for testing. Three weeks of testing using this strategy resulted in 530 patient tests in 179 cartridges; 4 positive test groups required the use of 11 additional cartridges with an overall positive rate of 0.8% in a low-risk population. This strategy resulted in the use of 340 fewer cartridges than if each test were performed on one patient sample. Pooled testing of low-risk populations allows for continued testing even when supplies are relatively scarce.

Excess days in acute care (EDAC) after total joint arthroplasty (TJA) represent a large economic burden. We developed an Orthopedic EDAC program that triages TJA patients to the appropriate service line (orthopedic vs medicine) and level of care (observation vs inpatient) on re-presentation. We developed and used evidence-based protocols for the treatment of TJA patients who are rehospitalized.

We defined Orthopedic EDAC as the length of stay (LOS) during readmission and observation stays. Our target population included TJA and revision TJA patients. Patients between April 2017 and September 2017 and between October 2017 and September 2018 were defined as pre-implementation and post-implementation of the Orthopedic EDAC program, respectively.

A total of 2,662 patients underwent TJA and revision TJA during the pre-implementation and post-implementation periods. Twenty-three patients were managed on observation status during the study period. Readmissions decreased from 49 (6.1%) during pre-implementation to 37 (2.0%) during post-implementation (P = .004). By design, more rehospitalized patients were on the orthopedic surgery service after implementation of the Orthopedic EDAC program (n = 49; 70%) versus before (n = 22; 35%; P = .028). EDAC LOS decreased from 7.75 days to 4.73 days (P = .005).

In this single-center, before-after pilot of a novel Orthopedic EDAC program, we demonstrated a reduction in readmissions and Orthopedic EDAC LOS, as well as improved continuity of care for TJA patients on representation.

In this single-center, before-after pilot of a novel Orthopedic EDAC program, we demonstrated a reduction in readmissions and Orthopedic EDAC LOS, as well as improved continuity of care for TJA patients on representation.

Native Hawaiian and Asian American populations are the most understudied racial/ethnic groups in chronic kidney disease (CKD) research. The objective of our study was to describe sociodemographic and comorbidity risk factors of chronic kidney disease among 2,944 community-dwelling Native Hawaiian, Filipino, Chinese, Japanese, and non-Hispanic white participants who attended the National Kidney Foundation of Hawaii Kidney Early Detection Screening program during 2006-2017.

We used multivariable logistic regression models to examine the association between age, sex, race/ethnicity, and the major risk factors for CKD (diabetes, hypertension, cardiovascular disease, hypercholesterolemia, overweight and obesity, and smoking) with elevated urine albumin to creatinine ratio (ACR) among adults aged 18 or older in 5 racial/ethnic groups in Hawaii Native Hawaiian, Filipino, Chinese, Japanese, and non-Hispanic white.

In the age- and sex-adjusted model, Native Hawaiian participants were significantly more likely thng Native Hawaiians and Asian Americans, particularly Filipinos, with CKD. Such interventions should focus on early kidney disease management so that disease progression can be delayed.

Physical activity overall and during school-related opportunities among homeschool adolescents are poorly documented.

We used data from the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating (FLASHE) study, a national sample of parent-child dyads. L-Histidine monohydrochloride monohydrate ic50 We examined reported frequency of physical activity in middle-school and high-school respondents (N = 1,333). We compared the overall physical activity by school type (ie, public school, private school, and homeschool), compared school-related contexts (eg, recess, physical education [PE] class), and tested for level of physical activity by school for those reporting PE.

Middle-school homeschool adolescents reported less physical activity during school hours compared with public school, but not private school, adolescents. Physical activity was not different by school type for out of school or weekends. Physical activity of high-school homeschool adolescents was not different from that of high-school adolescents at traditional schools; homeschool adolescents in both middle and high school reported less physical activity in PE compared with public and private school adolescents. Other school-related contexts of physical activity were not different by school type. More homeschool students reported not having PE (middle school, 54.8%; high school, 57.5%) compared with public (middle school, 18.7%; high school, 38.0%) or private schools (middle school, 13.5%; high school, 41.5%).

Homeschool adolescents in middle school reported less physical activity compared with middle-school adolescents in traditional schools during school hours, likely because of having fewer PE classes and less physical activity during PE.

Homeschool adolescents in middle school reported less physical activity compared with middle-school adolescents in traditional schools during school hours, likely because of having fewer PE classes and less physical activity during PE.

Since the 1950s, heart disease deaths have declined in the United States, but recent reports indicate a plateau in this decline. Heart disease death rates increased in Maine from 2011-2015. We examined reasons for the trend change in Maine's heart disease death rates, including the contributing types of heart disease.

We obtained Maine's annual heart disease death data for 1999-2017 from CDC's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). We used joinpoint regression to determine changes in trend and annual percentage change (APC) in death rates for heart disease overall and by demographic groups, types of heart disease, and geographic area.

Joinpoint modeling showed that Maine's age-adjusted heart disease death rates decreased during 1999-2010 (-4.2% APC), then plateaued during 2010-2017 (-0.1% APC). Death rates flattened for both sexes and age groups ≥45 years. Although death rates for acute myocardial infarction (AMI) decreased through 2017, hypertensive heart disease (HHD) and heart failure death rates increased. Death rates attributable to diabetes-related heart disease and non-AMI ischemic heart disease (IHD) plateaued.

Declines in Maine's heart disease death rates have plateaued, similar to national trends. Flattening rates appear to be driven by adverse trends in HHD, heart failure, diabetes-related heart disease, and non-AMI IHD. Increased efforts to address cardiovascular disease risk factors, chronic heart disease, and access to care are necessary to continue the decrease in heart disease deaths in Maine.

Declines in Maine's heart disease death rates have plateaued, similar to national trends. Flattening rates appear to be driven by adverse trends in HHD, heart failure, diabetes-related heart disease, and non-AMI IHD. Increased efforts to address cardiovascular disease risk factors, chronic heart disease, and access to care are necessary to continue the decrease in heart disease deaths in Maine.