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Recognition of general anesthesia-induced loss of consciousness based on the spatial pattern of the brain networks.

J Neural Eng 2021 Sep 17. Epub 2021 Sep 17.

University of Electronic Science and Technology of China, No.2006, Xiyuan Ave, West Hi-Tech Zone, Chengdu, 610054, CHINA.

Objective: Unconsciousness is a key feature related to general anesthesia (GA) but is difficult to be evaluated accurately by anesthesiologists clinically.

Approach: To tracking the loss of consciousness (LOC) and recovery of consciousness (ROC) under GA, in this study, by investigating functional connectivity of the scalp electroencephalogram (EEG), we explore any potential difference in brain networks among anesthesia induction, anesthesia recovery, and the resting state.

Main Results: The results of this study demonstrated significant differences among the three periods, concerning the corresponding brain networks. Read More

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September 2021

A convolutional neural network for estimating cone-beam CT intensity deviations from virtual CT projections.

Phys Med Biol 2021 Sep 17. Epub 2021 Sep 17.

Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, AUSTRALIA.

Extending cone-beam CT (CBCT) use toward dose accumulation and adaptive radiotherapy necessitates more accurate HU reproduction since cone-beam geometries are heavily degraded by photon scatter. This study proposes a novel method that aims to demonstrate how deep learning based on phantom data can be used effectively for CBCT intensity correction in patient images. Four anthropomorphic phantoms were scanned on a CBCT and conventional fan-beam CT system. Read More

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September 2021

Intraparenchymal hemorrhage after serial ventricular reservoir taps in neonates with hydrocephalus and association with neurodevelopmental outcome at 2 years of age.

J Neurosurg Pediatr 2021 Sep 17:1-8. Epub 2021 Sep 17.

7Division of Neuroscience, Department of Neurosurgery, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.

Objective: Decompressing the ventricles with a temporary device is often the initial neurosurgical intervention for preterm infants with hydrocephalus. The authors observed a subgroup of infants who developed intraparenchymal hemorrhage (IPH) after serial ventricular reservoir taps and sought to describe the characteristics of IPH and its association with neurodevelopmental outcome.

Methods: In this multicenter, case-control study, for each neonate with periventricular and/or subcortical IPH, a gestational age-matched control with reservoir who did not develop IPH was selected. Read More

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September 2021

Maturation of the anterior petrous apex: surgical relevance for performance of the middle fossa transpetrosal approach in pediatric patients.

J Neurosurg 2021 Sep 17:1-7. Epub 2021 Sep 17.

2Department of Neurosciences and Pediatrics, University of California, San Diego, San Diego.

Objective: The middle fossa transpetrosal approach to the petroclival and posterior cavernous sinus regions includes removal of the anterior petrous apex (APA), an area well studied in adults but not in children. To this end, the authors performed a morphometric analysis of the APA region during pediatric maturation.

Methods: Measurements of the distance from the clivus to the internal auditory canal (IAC; C-IAC), the distance of the petrous segment of the internal carotid artery (petrous carotid; PC) to the mesial petrous bone (MPB; PC-MPB), the distance of the PC to the mesial petrous apex (MPA; PC-MPA), and the IAC depth from the middle fossa floor (IAC-D) were made on thin-cut CT scans from 60 patients (distributed across ages 0-3, 4-7, 8-11, 12-15, 16-18, and > 18 years). Read More

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September 2021

A multicenter study to evaluate the pharmacokinetics and safety of liposomal bupivacaine for postsurgical analgesia in pediatric patients aged 6 to less than 17 years (PLAY).

J Clin Anesth 2021 Sep 14;75:110503. Epub 2021 Sep 14.

Cleveland Clinic, Cleveland, OH, United States of America.

Study Objective: To evaluate the pharmacokinetics and safety of liposomal bupivacaine in pediatric patients undergoing spine or cardiac surgery.

Design: Multicenter, open-label, phase 3, randomized trial (PLAY; NCT03682302).

Setting: Operating room. Read More

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September 2021

Highly effective pre-concentration of thymol and carvacrol using nano-sized magnetic molecularly imprinted polymer based on experimental design optimization and their trace determination in summer savoury, Origanum majorana and Origanum vulgare extracts.

J Chromatogr B Analyt Technol Biomed Life Sci 2021 Sep 11;1182:122941. Epub 2021 Sep 11.

Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. Electronic address:

To ascertain thymol and carvacrol in pharmaceutical syrups, a valid and effective magnetic molecular imprinted polymer dispersive solid phase microextraction (MMIP-DSPME) process was developed in this study, which was in combination with a high performance liquid chromatography-ultra violet (HPLC-UV) technique for the assessment of thymol and carvacrol separation and pre-concentration. Contact time, eluent kind and volume, pH, the mass of the MMIP were all taken into consideration as key factors. Design expert and multi-objective response surface methodology (RSM) were used to optimize these variables. Read More

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September 2021

Sawtooth patterns in flexural force curves of structural biological materials are not signatures of toughness enhancement: Part II.

J Mech Behav Biomed Mater 2021 Aug 29;124:104787. Epub 2021 Aug 29.

Brown University, School of Engineering, 184 Hope Street, Providence, RI, USA. Electronic address:

Stiff biological materials (SBMs), such as nacre and bone, are composites that display remarkable toughness enhancements over their primary constituents, which are brittle minerals. These enhancements are thought to be a consequence of different mechanisms made possible by the SBMs' internal lamellar architecture. One such mechanism is the Cook-Gordon (crack-arrest-and-reinitiation) mechanism, whose operation manifests in flexural tests as a sawtooth pattern in the force-displacement curves. Read More

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A portable NIR fluorimeter directly quantifies singlet oxygen generated by nanostructures for Photodynamic Therapy.

Spectrochim Acta A Mol Biomol Spectrosc 2021 Sep 4;265:120357. Epub 2021 Sep 4.

Università di Parma, Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Parma (IT), Italy. Electronic address:

This paper reports on the setting up and calibration of a portable NIR fluorimeter specifically developed for quantitative direct detection of the highly reactive singlet oxygen (O) chemical specie, of great importance in Photodynamic therapies. This quantification relies on the measurement of fluorescence emission of O, which is peaked in the near-infrared (NIR) at λ=1270nm. In recent years, several nanostructures capable of generating reactive oxygen species (ROS) when activated by penetrating radiation (X-rays, NIR light) have been developed to apply Photodynamic Therapy (PDT) to tumours in deep tissue, where visible light cannot penetrate. Read More

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September 2021

The impact of acute fracture on interpretation of bone turnover marker measurements for patients starting anti-resorptive therapies.

Bone 2021 Sep 14:116199. Epub 2021 Sep 14.

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea. Electronic address:

Introduction: Bone turnover markers (BTM) are used in evaluating patients' response to anti-resorptive agents (ARA). Fracture and its healing process, however, can influence the measurements, which might make their interpretation difficult in patients with a recent fracture. We aimed to evaluate the effect of oral ARA on changes in BTM levels in patients with a recent distal radius fracture (DRF). Read More

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September 2021

Neuroimaging Correlates of Syndromal Anxiety Following Traumatic Brain Injury: A Systematic Review of the Literature.

J Acad Consult Liaison Psychiatry 2021 Sep 14. Epub 2021 Sep 14.

Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences. Electronic address:

Background: Traumatic brain injury (TBI) can precipitate new-onset psychiatric symptoms or worsen existing psychiatric conditions. To elucidate specific mechanisms for this interaction, neuroimaging is often used to study both psychiatric conditions and TBI. This systematic review aims to synthesize the existing literature of neuroimaging findings among patients with anxiety after TBI. Read More

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September 2021

Impact of electrode size and spacing on electrograms: Optimal electrode configuration for near-field electrogram characterization.

Heart Rhythm 2021 Sep 14. Epub 2021 Sep 14.

CHU Bordeaux, IHU LIRYC, Univ. Bordeaux, Bordeaux, France.

Background: Detailed effects of electrode size on EGMs have not been systematically examined.

Objectives: We aimed to elucidate the effect of electrode size on EGMs and investigate an optimal configuration of electrode-size and interelectrode-spacing for gap detection and far-field reduction.

Methods: This study included 8 sheep where probes with different electrode-size and interelectrode-spacing were epicardially placed on healthy, fatty, and lesion tissues for measurements. Read More

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September 2021

Static Cyclic Fatigue Resistance in Acute Curvature, Surface Topography and Torsional Strength of R-Pilot and Proglider Glide Path Instruments.

J Endod 2021 Sep 14. Epub 2021 Sep 14.

Department of Endodontics, Ondokuz Mayis University Faculty of Dentistry, Samsun, Turkey.

Introduction: This study aimed to compare ProGlider (Dentsply Sirona, Ballaigues, Switzerland) and R-Pilot (VDW, Munich, Germany) instruments in terms of their cyclic fatigue resistance using an artificial stainless-steel canal showing abrupt apical curvature, torsional resistance according to the ISO specification, and topographic changes on instrument surface following glide path management in mesial canals of mandibular first molars with abrupt curvature selected based on their micro-computed tomography (micro-CT) examination.

Methods: Eighty instruments were used: 40 ProGlider (size 0.16, . Read More

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September 2021

A review and analysis of personal and ambient PM measurements: Implications for epidemiology studies.

Environ Res 2021 Sep 14:112019. Epub 2021 Sep 14.

Gradient, One Beacon Street, Boston, MA, 02108, USA. Electronic address:

Background: In epidemiology studies, ambient measurements of PM are often used as surrogates for personal exposures. However, it is unclear the degree to which ambient PM reflects personal exposures.

Objective: In order to examine potential sources of bias in epidemiology studies, we conducted a review and meta-analysis of studies to determine the extent to which short-term measurements of ambient PM levels are related to short-term measurements of personal PM levels. Read More

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September 2021

Ambient air pollution and COVID-19 risk: Evidence from 35 observational studies.

Environ Res 2021 Sep 14:112065. Epub 2021 Sep 14.

Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China. Electronic address:

Background And Aims: The coronavirus disease 2019 (COVID-19) pandemic is severely threatening and challenging public health worldwide. Epidemiological studies focused on the influence of outdoor air pollution (AP) on COVID-19 risk have produced inconsistent conclusions. We aimed to quantitatively explore this association using a meta-analysis. Read More

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September 2021

Follicular Helper-like T Cells in the Lung Highlight a Novel Role of B Cells in Sarcoidosis.

Am J Respir Crit Care Med 2021 Sep 17. Epub 2021 Sep 17.

University Hospital Schleswig Holstein, 54186, Institute of Immunology, Kiel, Germany;

Rationale: Pulmonary sarcoidosis is generally presumed to be a T helper-1- and macrophage-driven disease. However, mouse models have recently revealed that chronically inflamed lung tissue can also comprise T follicular helper- (Tfh-) like cells and represents a site of active T cell / B cell cooperation.

Objectives: To assess the role of pulmonary Tfh- and germinal center-like lymphocytes in sarcoidosis. Read More

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September 2021

Dynamics of the Upper Respiratory Tract Microbiota and its Association with Mortality in COVID-19.

Am J Respir Crit Care Med 2021 Sep 17. Epub 2021 Sep 17.

Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, China;

Rationale: Alteration of human respiratory microbiota had been observed in COVID-19. How the microbiota is associated with the prognosis in COVID-19 is unclear.

Objectives: To characterize the feature and dynamics of the respiratory microbiota and its associations with clinical features in COVID-19 patients. Read More

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September 2021

Impairments of cerebral blood flow microcirculation in rats brought on by cardiac cessation and respiratory arrest.

J Biophotonics 2021 Sep 17:e202100216. Epub 2021 Sep 17.

Histology, Cytology and Embryology Department, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

The impairments of cerebral blood flow microcirculation brought on by cardiac and respiratory arrest were assessed with multi-modal diagnostic facilities, utilising laser speckle contrast imaging, fluorescence spectroscopy and diffuse reflectance spectroscopy. The results of laser speckle contrast imaging show a notable reduction of cerebral blood flow in small and medium size vessels during a few minutes of respiratory arrest, while the same effect was observed in large sinuses and their branches during the circulatory cessation. Concurrently, the redox ratio assessed with fluorescence spectroscopy indicates progressing hypoxia, NADH accumulation and increase of FAD consumption. Read More

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September 2021

Treatment for vaginal agenesis: A prospective and comparative study between vaginal dilation and surgical neovaginoplasty.

Int J Gynaecol Obstet 2021 Sep 17. Epub 2021 Sep 17.

Urogynecology and Vaginal Surgery Sector, Department of Gynecology, Federal University of Sao Paulo, Sao Paulo, Brazil.

Objective: The purpose of this study was to compare, in terms of anatomical, functional and sexual aspects, two types of treatment for women with vaginal agenesis: progressive dilation or surgical neovaginoplasty.

Methods: The present study included 20 women with vaginal agenesis. Nine were underwent dilation treatment using the Frank method and 11 surgical treatment using the modified Abbé-McIndoe technique with oxidized cellulose. Read More

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September 2021

Adaptation supports short-term memory in a visual change detection task.

PLoS Comput Biol 2021 Sep 17;17(9):e1009246. Epub 2021 Sep 17.

Allen Institute for Brain Science, Seattle, Washington, United States of America.

The maintenance of short-term memories is critical for survival in a dynamically changing world. Previous studies suggest that this memory can be stored in the form of persistent neural activity or using a synaptic mechanism, such as with short-term plasticity. Here, we compare the predictions of these two mechanisms to neural and behavioral measurements in a visual change detection task. Read More

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September 2021

Levator-Urethra Gap: Normative Data in a Nonpregnant Nulliparous Population.

Female Pelvic Med Reconstr Surg 2021 Sep 15. Epub 2021 Sep 15.

From the Division of Urogynecology Department of Obstetrics and Gynecology, OHSU, Portland, OR.

Objective: This study aimed to establish a normative range of the levator-urethra gap (LUG) measurement in nonpregnant, nulliparous women to be used as a standard against which assessments of injury or avulsion of the levator ani could be made.

Methods: Nulliparous women in the Pacific Northwest who were planning pregnancy within the ensuing 12 months underwent high-resolution magnetic resonance imaging (MRI) and 3-dimensional transperineal ultrasonography. In the plane of minimal hiatal dimensions, the LUG was measured on both the right and left sides for 3 contiguous image slices. Read More

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September 2021

Health-Related Quality of Life Following Delirium in the PICU.

Pediatr Crit Care Med 2021 Aug 23. Epub 2021 Aug 23.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA. Center for Clinical & Translational Research, Seattle Children's Research Institute, Seattle, WA. Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA. Center for Child Health, Behavior, & Development, Seattle Children's Research Institute, Seattle, WA.

Objectives: To evaluate whether delirium during pediatric critical illness is associated with post-discharge health-related quality of life.

Design: Retrospective cohort study.

Setting: Academic tertiary care center. Read More

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Temperature Management and Health-Related Quality of Life in Children 3 Years After Cardiac Arrest.

Pediatr Crit Care Med 2021 Aug 23. Epub 2021 Aug 23.

Intensive Care Unit, The Royal Children's Hospital, Melbourne, VIC, Australia. Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.

Objectives: Therapeutic hypothermia minimizes neuronal injury in animal models of hypoxic-ischemic encephalopathy with greater effect when used sooner after the insult. Clinical trials generally showed limited benefit but are difficult to perform in a timely manner. In this clinical study, we evaluated the association between the use of hypothermia (or not) and health-related quality of life among survivors of pediatric cardiac arrest as well as overall mortality. Read More

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Diagnosis Documentation of Critically Ill Children at Admission to a PICU.

Pediatr Crit Care Med 2021 Aug 23. Epub 2021 Aug 23.

University of Iowa Carver College of Medicine, Iowa City, IA. Department of Pediatrics, BronxCare Health System, New York, NY. Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, IA. Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA. Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX. Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA. Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA.

Objectives: Multidisciplinary PICU teams must effectively share information while caring for critically ill children. Clinical documentation helps clinicians develop a shared understanding of the patient's diagnosis, which informs decision-making. However, diagnosis-related documentation in the PICU is understudied, thus limiting insights into how pediatric intensivists convey their diagnostic reasoning. Read More

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Diaphragm Activity Pre and Post Extubation in Ventilated Critically Ill Infants and Children Measured With Transcutaneous Electromyography.

Pediatr Crit Care Med 2021 Aug 23. Epub 2021 Aug 23.

Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands. Faculty of Science and Technology, University of Twente, Enschede, The Netherlands. Pediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands.

Objectives: Swift extubation is important to prevent detrimental effects of invasive mechanical ventilation but carries the risk of extubation failure. Accurate tools to assess extubation readiness are lacking. This study aimed to describe the effect of extubation on diaphragm activity in ventilated infants and children. Read More

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Immune Profiling Demonstrates a Common Immune Signature of Delayed Acquired Immunodeficiency in Patients With Various Etiologies of Severe Injury.

Crit Care Med 2021 Sep 16. Epub 2021 Sep 16.

Pathophysiology of Injury-Induced Immunosuppression (Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux), Joint Research Unit HCL-bioMérieux, Immunology Laboratory & Anesthesia and Critical Care Medicine Department, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France. BIOASTER, Lyon, France. Sanofi Pasteur, Marcy l'Etoile, France. GSK, GSK Medicines Research Centre, Stevenage, United Kingdom. Laboratoire de Biochimie (LBC), ESPCI Paris, PSL Université, CNRS UMR8231, Paris, France.

Objectives: The host response plays a central role in the pathophysiology of sepsis and severe injuries. So far, no study has comprehensively described the overtime changes of the injury-induced immune profile in a large cohort of critically ill patients with different etiologies.

Design: Prospective observational cohort study. Read More

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September 2021

Effect of a Multicomponent Sepsis Transition and Recovery Program on Mortality and Readmissions After Sepsis: The Improving Morbidity During Post-Acute Care Transitions for Sepsis Randomized Clinical Trial.

Crit Care Med 2021 Sep 16. Epub 2021 Sep 16.

Department of Internal Medicine, Atrium Health, Charlotte, NC. Transition Services, Department of Internal Medicine, Atrium Health, Charlotte, NC. Ambulatory Care Management, Atrium Health, Charlotte, NC. Department of Internal Medicine and Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC. Division of Infectious Diseases, Department of Internal Medicine, Atrium Health, Charlotte, NC. Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC. Division of Hepatology, Department of Internal Medicine, Atrium Health, Charlotte, NC. Department of Emergency Medicine, Atrium Health, Charlotte, NC.

Objectives: To evaluate whether a nurse navigator-led, multicomponent Sepsis Transition And Recovery program improves 30-day mortality and readmission outcomes after sepsis hospitalization.

Design: Multisite pragmatic randomized clinical trial.

Setting: Three hospitals in North Carolina from January 2019 to March 2020. Read More

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September 2021

Descriptive Epidemiology and Outcomes of Nonventilated Hospital-Acquired, Ventilated Hospital-Acquired, and Ventilator-Associated Bacterial Pneumonia in the United States, 2012-2019.

Crit Care Med 2021 Sep 16. Epub 2021 Sep 16.

Division of Health Services Research, EviMed Research Group, LLC, Goshen, MA. OptiStatim, LLC, Longmeadow, MA. Merck, Kenilworth, NJ. Department of Pulmonary and Critical Care Medicine, Washington Hospital Center, Washington, DC.

Objectives: Multiple randomized controlled trials exploring the outcomes of patients with ventilator-associated bacterial pneumonia and hospital-acquired bacterial pneumonia have noted that hospital-acquired bacterial pneumonia patients who require subsequent ventilated hospital-acquired bacterial pneumonia suffered higher mortality than either those who did not (nonventilated hospital-acquired bacterial pneumonia) or had ventilator-associated bacterial pneumonia. We examined the epidemiology and outcomes of all three conditions in a large U.S. Read More

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September 2021

International Sex Survey: Study protocol of a large, cross-cultural collaborative study in 45 countries.

J Behav Addict 2021 Sep 16. Epub 2021 Sep 16.

2 Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.

Background And Aims: Limitations of research into sexuality and compulsive sexual behavior disorder (CSBD) include the use of simplistic methodological designs and the absence of quality and unified measurements, empirically supported theoretical models, and large, collaborative studies between laboratories. We aim to fill these gaps with the International Sex Survey (ISS, http://internationalsexsurvey.org/). Read More

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September 2021

An Automatic and Optimal MPA Design Method.

IEEE Trans Image Process 2021 Sep 17;PP. Epub 2021 Sep 17.

Raw polarimetric images are captured by a focal plane polarimeter which is covered by a micro-polarizer array (MPA). The design of the MPA plays a crucial role in polarimetric imaging. MPAs are predominantly designed according to expert engineering experience and rules of thumb. Read More

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September 2021

[Accuracy of Alignment of Femoral and Tibial Component of the Oxford Medial Unicompartmental Knee Arthroplasty Using Zimmer Microplasty® Instrumentation].

Acta Chir Orthop Traumatol Cech 2021 ;88(4):291-301

Nemocnice České Budějovice, a.s., Ortopedické oddělení, České Budějovice.

PURPOSE OF THE STUDY The purpose of the study is to verify the correct alignment of components of the Oxford medial unicompartmental knee arthroplasty using the Zimmer Microplasty® instrumentation at the beginning of the learning curve. The implantation of prosthetic components of partial knee arthroplasty in proper alignment has an effect on long-term survival of the prosthesis and should eliminate the occurrence of frequent complications. MATERIAL AND METHODS The study group includes 20 patients, 9 men with the mean age of 68 years (range 62-78 years) and 11 women with the mean age of 69 years (range 52-81 years). Read More

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January 2021