Optimizing glenoid component positioning is a key determinant of stability, function and implant survival in total shoulder arthroplasty. Postoperative computed tomography (CT) is considered the reference method for assessing guide-pin or implant alignment, but it remains a retrospective evaluation and is often difficult to obtain in cadaveric research settings. Optical navigation systems such as the NDI Polaris provide immediate intraoperative geometric measurements and may represent a pragmatic alternative. This cadaveric validation study aimed to evaluate the agreement between NDI Polaris optical-navigation measurements and postoperative CT analysis for glenoid guide-pin positioning. Eight cadaveric shoulders underwent augmented-reality-guided placement of a glenoid guide-pin, followed by postoperative CT acquisition. Intraoperative optical-navigation measurements were recorded using an NDI Polaris tracking station. Two accuracy domains were analyzed relative to CT: (1) linear entry-point deviation (mm) and (2) angular deviation in version and inclination (degrees). Agreement between both measurement modalities was assessed using Bland-Altman analysis, complemented by descriptive accuracy statistics. Sixteen paired measurements were available for comparison. The mean absolute NDI-CT difference was 0.98 mm (SD 0.55; range 0.15-2.17 mm) for entry-point localization and 1.58° (SD 0.97; range 0.03-3.28°) for trajectory orientation. Bland-Altman analysis demonstrated a small systematic bias for both linear (-0.15 mm) and angular (-0.75°) parameters, with most discrepancies contained within approximately ±2 mm and ±4°, respectively. These results suggest that, under standardized acquisition conditions, optical navigation provides geometric measurements that closely approximate CT-based reference values and may serve as a practical surrogate in cadaveric research when CT access is limited. NDI Polaris optical tracking demonstrated good agreement with postoperative CT for evaluating glenoid pin positioning and may represent a practical alternative for accuracy assessment in cadaveric studies. These preliminary findings require confirmation in larger validation studies.
BACKGROUND:Metallic nail adornments and other charms are increasingly popular additions to traditional nail treatments. Nickel and cobalt are well-recognised causes of allergic contact dermatitis (ACD) in jewellery and other daily consumer exposures. Nickel-releasing nail charms complicating acrylate allergic contact dermatitis in a young woman have been reported. No current studies have evaluated the presence of nickel and cobalt in metallic nail charm products in the United States. OBJECTIVE:To assess nickel and cobalt release and total metal content with x-ray fluorescence spectroscopy (XRF) from nail charm products available in the United States. METHODS:Convenience samples of nail charm products were obtained from nail supply stores in Arizona, Nevada and online retailers. Nickel and cobalt content and release were assessed in 231 nail charms from 25 nail product brands by spot tests and XRF, respectively. In charms with lead content assessed by XRF, confirmatory spot testing was performed. RESULTS:Nickel release was detected in 89/231 (38.5%) products by dimethylglyoxime (DMG) spot test and 156/231 (67.5%) products by XRF. Cobalt release was not detected. Lead was detected in 5/231 (2.2%) products by XRF and 2/231 (0.87%) by spot test. CONCLUSIONS:Nickel release is common from nail charm products purchased in the United States, which could be an emerging novel source of consumer and occupational nickel exposure. Lead was also detected in a small subset of charms, indicating that nail charms may be a rare but emerging source of exposure to lead.
Meniscus informatics is a growing subject of study in the healthcare industry. One of the major hindrances to the healthcare system’s transformation is obtaining knowledge and meaningful information from complicated, high-dimensional and diverse sources. Modern biomedical research, for instance, has seen an increase in the use of complex, dissimilar, poorly documented, and generally unstructured electronic health records, imaging, sensor data and text, even after many current techniques have been used to extract more robust and useful elements from the data for analysis. New efficient standards for building end-to-end learning models from complex data are therefore needed. Therefore, the current study aims to examine the most recent research on the use of deep learning techniques for diagnosing meniscus tears and recommend creating comprehensive and meaningful interpretable structures that might benefit the healthcare industry. We also draw attention to shortcomings and the need for better technique development, and we provide new perspectives about this exciting new development in the field.
ABSTRACT Background Patch test results obtained with the European Baseline Series (EBS) in its current version serve both contact allergy surveillance and (re‐)assessing the diagnostic value of EBS allergens. Objectives To present results of current EBS patch testing, obtained in 59 departments in 14 European countries during 2021 and 2022. Methods Anonymised or pseudonymised individual data, and partly aggregated results, on demographic/clinical characteristics and patch test results with the EBS were prospectively collected, centrally pooled, and retrospectively analysed. Results In 2021 and 2022, 18 832 patients were patch tested with the EBS. Sensitization to nickel remained most common (18.85 (18.29–19.43)% positivity (95% confidence interval)). Fragrance mix I and Myroxylon pereirae resin yielded very similar results with 6.39 (6.04–6.76)% and 6.5 (6.15–6.87)% positivity, respectively. Concerning preservatives, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) 0.02% aq. yielded 5.52 (5.11–5.96)% and MI 0.2% aq. yielded 5.28 (4.94–5.64)% positives. Testing formaldehyde 2% aq. identified almost one percentage point more positive reactions than 1% aq. (2.05 (1.81–2.32)% vs. 1.22 (0.99–1.48)). Positive reactions to the recently added allergens were most frequently seen to propolis (5.47 (5.12–5.84)%) and 2‐hydroxyethyl methacrylate (3.63 (3.32–3.96)%). Conclusions Compared to the previous reporting period, surveillance results with the EBS were mostly stable. The results regarding Quaternium 15 (0.4 (0.29–0.53)% positives) justified its exclusion from the 2023 EBS version.
ABSTRACT Background Allergens are periodically added to the European Baseline Series (EBS) to audit their value in consecutive patch testing. Objectives To present results of audit allergens tested in consecutive patients in 54 departments in 13 European countries during 2021 and 2022. Methods Anonymized or pseudonymized individual data, and partly aggregated data on patch test rest results and their clinical relevance were prospectively collected and centrally pooled and analyzed. Results In 2021 and 2022, 18 832 patients were patch tested with the EBS, and 2860 with the TRUE Test baseline series (supplemented with some missing EBS allergens). Of these patients, 17 359 were additionally tested with one or more of the 19 audit allergen preparations examined. Apart from the terpene hydroperoxides (OOH) which yielded the highest numbers of positive patch test reactions (linalool‐OOH 1% pet.: 7.65 (7.09%–8.23%) [95% CI] and limonene‐OOH 0.3% pet. 6.78 (6.26%–7.32%)), positive reactions were most often seen to benzisothiazolinone (3.71 (3.3%–4.15%)), sodium metabisulfite (3.49 (3.14%–3.88%)), Evernia furfuracea (tree moss, 1.79 (1.4%–2.26%)), and decyl and lauryl glucoside, at 1.49 (1.25%–1.76%) and 1.26 (1.05%–1.51%), respectively. The other allergens yielded around 1% or fewer positive patch test reactions. Clinical relevance varied, with Evernia furfuracea , 2‐bromo‐2‐nitropropane‐1,3‐diol and terpene hydroperoxides considered relevant in more than 2/3 cases, while for other frequent sensitizers benzisothiazolinone and sodium metabisulfite, relevance could be confirmed in half of the cases or less often. Conclusions The current results, along with other published data, will serve to inform decisions concerning possible revision of the EBS, considering frequency of positive reactions, their clinical relevance and the overall reaction profile of each of the allergens.
BACKGROUND:Glove occlusion increases skin susceptibility to irritants ('occlusion effect'). Previous experimental data showed that applying protective creams (PCs) before glove occlusion does not prevent this effect and may even aggravate irritant responses. OBJECTIVES:To assess whether the application of PCs after glove occlusion modifies the occlusion effect. METHODS:In a randomized, single-blind (participants were blinded) study, 68 healthy volunteers were examined over 10 days. Two commercially available PCs (A, B) and one standardized model cream (C) were applied after occlusion for over 4 h to defined forearm sites. On day 8, sites were exposed to 0.5% sodium lauryl sulphate (SLS) for 24 h to evaluate skin irritation susceptibility. Additional conditions included (I) daily application of cream C without occlusion until day 7 or (II) until Day 8, with the final application 10 min before SLS exposure. Skin responses were assessed by TEWL, corneometry, colourimetry and clinical scoring. Wilcoxon signed-rank tests were used to compare control areas to sides after PC application. RESULTS:Post-occlusion application of the PCs did not demonstrate a consistent protective effect. Cream A slightly reduced SLS-induced TEWL (10.88 g/m2/h after application following glove use vs. 12.13 g/m2/h without application; adjusted p > 0.05), whereas cream B increased TEWL (13.44 vs. 12.42 g/m2/h; adjusted p > 0.05). Cream C showed no significant effect on TEWL (11.99 vs. 12.38 g/m2/h; p > 0.05). In contrast, application of cream C shortly before SLS exposure in the absence of occlusion (condition II) significantly reduced TEWL (7.09 vs. 12.38 g/m2/h; adjusted p < 0.0001) and erythema. However, earlier application (condition I) did not yield a protective effect (11.92 vs. 12.38 g/m2/h). CONCLUSIONS:In the majority of study scenarios, application of PCs after glove occlusion did not have a clinically relevant positive effect on the skin responses studied. Protective efficacy probably depends on formulation and timing, underscoring the need for evidence-based recommendations.
Robot-assisted surgery (RAS) is increasingly utilized in arthroplasty, with emerging evidence suggesting potential benefits, however, the overall evidence base remains immature. Given the heterogeneity of available systems, device-specific evaluation is required. The VELYS Robotic-Assisted Solution (VRAS; Johnson & Johnson MedTech) is an imageless, semi-active robotic platform for knee arthroplasty. This study provides a structured strategic evaluation of VRAS aligned with the National Institute for Health and Care Excellence Early Value Assessment (EVA) and proposes a roadmap for future evidence generation. 16 relevant studies were identified in a systematic literature search, predominantly retrospective and lacking randomized controlled trials. Findings were synthesized using a strengths, weaknesses, opportunities, and threats framework, with subsequent analysis to inform strategic recommendations. Key strengths of VRAS include avoidance of pre-operative computed tomography imaging, integration with established implant systems, a relatively short learning curve, and early signals of improved short-term outcomes. Weaknesses center on the limited quality and maturity of the evidence base, absence of long-term outcome data, and system-specific design considerations such as lack of haptic feedback boundaries. Opportunities include reduced resource burden with imageless workflows and potential optimization of patient outcomes, while threats involve high capital costs, competition from more established RAS platforms, and the risk of unmet evidence requirements within defined timelines. Across EVA domains, evidence for patient-reported outcomes, cost-effectiveness, and long-term clinical benefit remains insufficient. High-quality, adequately powered studies, comprehensive health-economic analyses, and registry-linked longitudinal studies are essential to define the clinical and economic value of VRAS in light of the EVA.
BACKGROUND:Propylene glycol (PG) is widely used in cosmetic and pharmaceutical products, yet data on the prevalence of contact allergy to PG and related glycols, and their potential cross-reactivity, remain limited. OBJECTIVES:To determine the prevalence of glycol contact allergy, describe clinical characteristics and assess potential cross-reactivity. METHODS:We retrospectively analysed 1979 patients patch tested at Antwerp University Hospital between January 2021 and December 2024 who were tested with at least one glycol. RESULTS:Fifty-five patients (2.79%) were allergic to PG. Detection rates for PG increased with concentration: 5% petrolatum (1.06%), 10% aqueous (0%), 20% aqueous (0.66%), 30% aqueous (2.19%) and 100% (7.82%, selectively tested). Pentylene glycol allergy was found in 6.74% (6/89) and caprylyl glycol in 0.77% (5% petrolatum) and 0.12% (1% petrolatum). Concomitant reactions to PG occurred in 4/6 pentylene glycol-allergic and 2/9 caprylyl glycol-allergic patients. PG-allergic patients were predominantly female (63.6%), with dermatitis mainly affecting the face and hands. Cosmetics (67.3%) were the most common exposure source, followed by topical pharmaceuticals (41.8%). CONCLUSIONS:Thirty percent aqueous PG appears more suitable for screening than lower concentrations, and 100% PG may improve detection in selected cases. Cross-reactivity seems limited and is most evident among structurally similar short-chain glycols.
