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equired to identify changes in these factors. Further studies should be performed in middle- and low-income countries using the Dentist Satisfaction Survey, including stress evaluation.

Most dentists maintain awkward and restricted postures for prolonged periods that stress the body while providing direct patient care. Information about working posture must be analysed in a more systematic manner to provide a deeper understanding of the relationship between working posture and work-related musculoskeletal disorders (MSD). Therefore, the present study aimed to clarify the effects of different lines of vision during tooth preparation, such as the direct and the mirror view technique, on-body tilt (angle), muscle activity, and sitting balance, which may correlate with the reduction or prevention of MSD.

A mannequin head with a maxillary right first molar embedded in a model was attached to the dental chair headrest. Two different techniques for tooth preparation were selected direct view and mirror view. Muscle activity, body tilt (angle), and sitting balance were analysed as independent parameters.

Different tooth preparation techniques had a distinct influence on body tilt (angle), muscle activity, and sitting balance. The direct view technique resulted in significantly larger values for all parameters, except for the activity of the spinal column erector muscles than the mirror view technique.

Based on these results, the direct view technique for tooth preparation, which is used by most dentists in practice, imposes a burden on the lower back, shoulders, and neck of the dentist.

Based on these results, the direct view technique for tooth preparation, which is used by most dentists in practice, imposes a burden on the lower back, shoulders, and neck of the dentist.

We aimed to elucidate management patterns and outcomes of high-risk patients with rib fractures (elderly or flail chest) across non-trauma and trauma centers. We hypothesized highest-capacity (level I) centers would have best outcomes for high-risk patients.

We queried the 2016 National Emergency Department Sample to identify adults presenting with rib fractures. Multivariable regression assessed ED and inpatient events across non-trauma and level III/II/I trauma centers.

Among 504,085 rib fracture encounters, 46% presented to non-trauma centers. Elderly patients with multiple rib fractures had stepwise increase in inpatient admission odds and stepwise decrease in pneumonia odds at higher-capacity trauma centers compared to non-trauma centers. Among patients with flail chest, odds of undergoing surgical stabilization (SSRF) increased at trauma centers. Undergoing SSRF was associated with reduced mortality but remained underutilized.

Half of patients with rib fractures present to non-trauma centers. Nationwide care-optimization for high-risk patients requires further effort.

Half of patients with rib fractures present to non-trauma centers. Nationwide care-optimization for high-risk patients requires further effort.

Drug-specific agents for the reversal of direct oral anticoagulants (DOACs) were recently approved. We hypothesized that the approval of these reversal agents would lead improved outcomes for trauma patients taking DOACs.

A multicenter, prospective (2015-2018), observational study of all adult trauma patients taking DOACs who were admitted to one of fifteen participating trauma centers was performed. The primary outcome was mortality.

For 606 trauma patients on DOACs, those reversed were older (78 vs. 74, p=0.007), more severely injured (ISS 16 vs. 5, p<0.0001), had more severe head injuries (Head AIS 2.9 vs. Selleckchem AT-527 1.3, p<0.0001), and higher mortality (11% vs. 3%, p=0.001). Patients who received drug-specific agents (idarucizumab, andexanetalfa) had higher mortality (30% vs. 8%, p=0.04) than those reversed with factor concentrates. However, the low usage of drug-specific reversal agents limits our ability to assess their efficacy and safety.

DOAC reversal was not independently associated with mortality. At present, the overall usage of drug-specific reversal agents is too sparing to meaningfully assess outcomes in trauma.

DOAC reversal was not independently associated with mortality. At present, the overall usage of drug-specific reversal agents is too sparing to meaningfully assess outcomes in trauma.

To quantitatively compare the articular exposure of the proximal tibia with a lateral parapatellar arthrotomy through a straight midline incision (ML) versus a lateral submeniscal arthrotomy through a curvilinear anterolateral incision (AL).

Eight surgical approaches (4 ML and 4 AL) were performed on 4 fresh cadavers. Access to key articular landmarks was assessed, including divisions of the lateral meniscus, lateral tibial spine, and anterior cruciate ligament. The boundary of the exposed articular surface of the tibia was marked, and the proximal tibias were then stripped of soft tissues. A calibrated digital image was taken of each proximal tibia, and exposed articular surface area was calculated with ImageJ software (NIH, Bethesda, MD). Statistical analysis was performed using a two-sample t-test.

Average articular surface area exposed was 2.2 times greater through the midline approach compared with the anterolateral approach (11.2 vs 5.1 cm

, p = 0.010). All key anatomic landmarks were directly vir minimally invasive techniques. It may be of most use when treating fractures with extension into the posteromedial quadrant of the lateral plateau, fractures with extensive comminution of the lateral plateau, or fractures with complex lateral meniscus tears and fractures with tibial spine involvement.

According to the National Hip Fracture Database (NHFD), in 2018 31.4% of patients with displaced intracapsular neck of femur (NOF) fracture who, National Institute for Health and Care Excellence (NICE) viewed eligible for total hip replacement (THR), received this operation. We aimed to identify the compliance of performing THR for those patients in our unit and identify the reasons for proceeding with the alternative type of surgery.

A five-year retrospective review of eligible patients was conducted between January 2014 and Dec 2018. Statistical analysis was performed between groups who did or didn't receive THR. Reasons for not performing THR were identified from pre-operative ward rounds notes.

In 2018 our unit performed THR for 44% of eligible cases. This was the highest result over five-years and higher than the national average. Out of the 348 eligible cases, pathological or undisplaced intracapsular fractures were excluded. Reminder received THR (138), hip hemiarthroplasty (166) or internal fixation (11).