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Intramedullary bone pedestal formation contributing to femoral shaft fracture nonunion:A case report and review of the literature

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World journal of Orthopedics 2022年第5期13卷 528-537页

作者： Charles B Pasque alexander j Pappas Chad A Cole jr Department of Orthopaedic Surgery and Rehabilitation University of Oklahoma College of MedicineOklahoma CityOK 73104United States University of Colorado School of Medicine AuroraCO 80045United States

BACKGROUND Femoral shaft fracture is a commonly encountered orthopedic injury that can be treated operatively with a low overall delayed/nonunion *** the case of delayed union after antegrade or retrograde intramedullary nail fixation,fracture dynamization is often attempted *** after dynamization has been shown to occur due to infection and other aseptic *** present a unique case of diaphyseal femoral shaft fracture nonunion after dynamization due to intramedullary cortical bone pedestal formation at the distal tip of the *** SUMMARY A 37-year-old male experienced a high-energy trauma to his left thigh after coming down hard during a motocross *** was consistent with an isolated,closed,left mid-shaft femur *** was initially managed with reamed antegrade intramedullary nail fixation but had continued thigh *** at four months demonstrated no evidence of fracture union and failure of the distal locking screw,and dynamization by distal locking screw removal was *** patient continued to have pain eight months after the initial procedure and 4 mo after dynamization with serial radiographs continuing to demonstrate no evidence of fracture *** decision was made to proceed with exchange nailing for aseptic fracture *** the exchange procedure,an obstruction was encountered at the distal tip of the failed nail and was confirmed on magnified fluoroscopy to be a pedestal of cortical bone in the *** obstruction required further distal reaming.A longer and larger diameter exchange nail was placed without difficulty and without a distal locking screw to allow for dynamization at the fracture ***-operative radiographs showed proper fracture and hardware *** was subsequently radiographic evidence of callus formation at one year with subsequent fracture consolidation and resolution of thigh pain at eighteen *** The risk of fracture nonunion caused by int

关键词： Nonunion Femoral shaft fracture Diaphysis Fracture fixation Antegrade intramedullary nail Case report

A Fragmentation Mechanism of Homemade Explosive TMDD Using DART-MS and Isotopic Labeling

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火炸药学报 2018年第1期41卷 16-20,30页

作者： alexander Pedroza Zarate Fredy Colpas-Castillo Daniel j.Alcazar Franco Wilman A.Cabrera-Lafaurie Eduardo A.Espinosa-Fuentes Department of Chemistry Universidad de Cartagena Facultad de Ciencias Exactas Cartagena Colombia Department of Natural and Exact Science Corporación Universidad de la Costa (CUC) Barranquilla Colombia Department of Civil and Environmental Sciences Corporación Universidad de la Costa (CUC) Barranquilla Colombia

A fragmentation mechanism and characterization for the first time using Direct Analysis in Real Time- Time of Flight-Mass Spectrometry(DART-TOF-MS)of the tetramethylene diperoxide dicarbamide(TMDD)compound were *** MS-spectrum may support other research about devices and detection in real *** mass spectrum of TMDD obtained using DART ionization in the positive-ion detection mode exhibited a strong peak at m/z254representing an ammonium adduct([TMMD·NH_4]~+).There was another peak at m/z237,which represented the protonated molecule([TMDD·H]~+)of *** two peaks corroborated the identity of the *** DART-MS spectra of the TMDD-isotopomer successfully corroborated the respective molecular tails. The principal fragmentation residues also showed coherence according to the number of isotopically labeled atoms on the TMDD *** contrast with other organic peroxides analyzed by this technique,TMDD exhibited substantial *** theoretical modeling results showed that the fragmentation mechanism of the TMDD ion adduct is strongly dependent of the TMDD ring flexibility and the hydrogen bonding formed between the nitrogen and oxygen atoms and the atmospheric proton.

关键词： direct analysis in real time Time of Flight-Mass Spectrometry TMDD isotopomers

Applying reticular synthesis to the design of Cu-based MOFs with mechanically interlocked linkers

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Nano Research 2021年第2期14卷 417-422页

作者： alexander j.Stirk Benjamin H.Wilson Christopher A.O’Keefe Hazem Amame Kelong Zhu Robert W.Schurko Stephen j.Loeb Department of Chemistry and Biochemistry University of WindsorWindsorOntarioN9B 3B4Canada Department of Chemistry The University of JordanAmman11942Jordan School of Chemistry Sun Yat-Sen UniversityGuangzhou 510275China Department of Chemistry and Biochemistry Florida State UniversityTallahasseeFlorida 32306-4390USA

The concept of“robust dynamics”describes the incorporation of mechanically interlocked molecules(MIMs)into metal-organic framework(MOF)materials such that large amplitude motions(e.g.,rotation or translation of a macrocycle)can occur inside the free volume pore of the *** aid in the preparation of such materials,reticular synthesis was used herein to design rigid molecular building blocks with predetermined ordered structures starting from the well-known MOF *** linkers were synthesized that have a T-shape,based on a triphenylene tetra-carboxylate strut,and their incorporation into Cu(II)-based MOFs was *** single-crystal structures of three new MOFs,UWCM-12(fof),β-UWCM-13(loz),UWCM-14(lil),with naked T-shaped linkers were determined;β-UWCM-13 is the first reported example of the loz topology.A fourth MOF,UWDM-14(lil)is analogous to UWCM-14(lil)but contains a[2]rotaxane ***-temperature,^(2)H solid-state NMR was used to probe the dynamics of a 24-membered macrocycle threaded onto the MOF skeleton.

关键词： reticular chemistry metal-organic frameworks mechanically interlocked molecules rotaxane

Changes of the Molecular Mobility of Poly(ε-caprolactone) upon Drawing,Studied by Dielectric Relaxation Spectroscopy

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Chinese journal of Polymer Science 2018年第5期36卷 665-674页

作者： Xiao-Yan Yang Shao-Shuai Liu alexander V.Korobko Stephen j.Picken Nicolaas A.M.Besseling Lucky Research Institute China Lucky Group Corporation Department of Chemical Engineering Delft University of Technology 2628 BL Delft and Dutch Polymer Institute(DPI)

Dielectric relaxation spectroscopy（DRS） of poly（ε-caprolactone） with different draw ratios showed that the mobility of polymer chains in the amorphous part decreases as the draw ratio increases. The activation energy of the α process, which corresponds to the dynamic glass transition, increases upon drawing. The enlarged gap between the activation energies of the α process and the β process results in a change of continuity at the crossover between the high temperature a process and the α and β processes. At low drawing ratios the a process connects with the β process, while at the highest drawing ratio in our measurements, the a process is continuous with the αprocess. This is consistent with X-ray diffraction results that indicate that upon drawing the polymer chains in the amorphous part align and densify upon drawing. As the draw ratio increases, the α relaxation broadens and decreases its intensity, indicating an increasing heterogeneity. We observed slope changes in the α traces, when the temperature decreases below that at which τα≈ 1 s. This may indicate the glass transition from the ‘rubbery＇ state to the non-equilibrium glassy state.

关键词： Semicrystalline polymer Dielectric relaxation spectroscopy Molecular mobility

Evolution of stress fields during the supercontinent cycle

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Geodesy and Geodynamics 2022年第4期13卷 363-375页

作者： alexander Bobrov Alexey Baranov Robert Tenzer Schmidt Institute of Physics of the Earth Russian Academy of SciencesMoscowRussia Institute of Earthquake Prediction Theory and Mathematical Geophysics Russian Academy of SciencesMoscowRussia Department of Land Surveying and Geo-Informatics Hong Kong Polytechnic UniversityHong KongChina

We investigate the evolution of stress fields during the supercontinent cycle using the 2D Cartesian geometry model of thermochemical convection with the non-Newtonian rheology in the presence of floating deformable *** the course of the simulation,the supercontinent cycle is implemented several *** number of continents considered in our model as a function of time oscillates around *** lifetime of a supercontinent depends on its *** results suggest that immediately before a supercontinent breakup,the over-lithostatic horizontal stresses in it(referring to the mean value by the computational area)are tensile and can reach-250 *** the same time,a vast area beneath a supercontinent with an upward flow exhibits clearly the over-lithostatic compressive horizontal stresses of 50-100 МРа.The reason for the difference in stresses in the supercontinent and the underlying mantle is a sharp difference in their *** large parts of the mantle,the over-lithostatic horizontal stresses are in the range of±25 MPa,while the horizontal stresses along subduction zones and continental margins are significantly *** the process of continent-to-continent collisions,the compressive stresses can approximately reach 130 MPa,while within the subcontinental mantle,the tensile over-lithostatic stresses are about-50 *** dynamic topography reflects the main features of the su-percontinent cycle and correlates with real *** the breakup and immediately after the disin-tegration of the supercontinent,continents experience maximum *** the supercontinent cycle,topographic heights of continents typically vary within the interval of about±1.5 km,relatively to a mean *** maxima of orogenic formations to about 2-4 km are detected along continent-to-continent collisions as well as when adjacent subduction zones interact with continental margins.

关键词： Supercontinent cycle Floating deformable continents Thermochemical convection Horizontal stresses Dynamic topography

Emergency department management of acute agitation in the reproductive age female and pregnancy

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World journal of Emergency Medicine 2024年第2期15卷 83-90页

作者： Ariella Gartenberg Kayla Levine alexander Petrie Department of Emergency Medicine Jacobi Medical Center and Montefiore Medical CenterNY 10461USA Department of Psychiatry and Behavioral Sciences Albert Einstein College of Medicine and Montefiore Medical CenterNY 10461USA Department of Emergency Medicine Jacobi Medical Center and North Central Bronx HospitalNY 10461USA

BACKGROUND:Agitation is a common presentation within emergent departments(EDs).Agitation during pregnancy should be treated as an obstetric emergency,as the distress may jeopardize both the patient and *** safety of psychotropic medications in the reproductive age female has not been well *** review aimed to explore a summary of general agitation recommendations with an emphasis on ED management of agitation during ***:A literature review was conducted to explore the pathophysiology of acute agitation and devise a preferred treatment plan for ED management of acute agitation in the reproductive age or pregnant ***:While nonpharmacological management is preferred,ED visits for agitation often require medical *** should be selected based on the etiology of agitation and the clinical setting to avoid major adverse *** effects are common in pregnant *** mild to moderate agitation in pregnancy,diphenhydramine is an effective sedating agent with minimal adverse *** moderate to severe agitation,high-potency typical psychotropics are preferred due to their neutral effects on *** has become the most frequently utilized psychotropic for agitation during *** generation psychotropics are often utilized as second-line therapy,including *** and ketamine have demonstrated adverse fetal ***:While randomized control studies cannot be ethically conducted on pregnant patients requiring sedation,animal models and epidemiologic studies have demonstrated the effects of psychotropic medication exposure in *** the fetal risk associated with multiple doses of psychotropic medications remains unknown,weighing the risks and benefits of each agent,while utilizing the lowest effective dose remains critical in the treatment of acute agitation within the EDs.

关键词： Agitation Pregnancy Haloperidol Ketamine Benzodiazepines

Follow the nevus: the cost-utility of monitoring for growth of choroidal nevi

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International journal of Ophthalmology(English edition) 2019年第9期12卷 1456-1464页

作者： alexander S.Barsam Allister Gibbons Andrew j.McClellan j.William Harbour William E.Smiddy Department of Ophthalmology Bascom Palmer Eye InstituteUniversity of Miami Miller School of MedicineFlorida 33136United States Texas Retina Associates Ft.WorthTexas 76104United States

AIM: To develop a model to evaluate the cost-utility of choroidal nevi monitoring recommendations with varying clinical risk ***: A Markov model was created to evaluate the cost-utility in cost per quality-adjusted life-year($/QALY) for monitoring patients with choroidal nevus. This probabilistic model was applied both to a hypothetically monitored and unmonitored group of patients beginning at different ages and with varying clinical risk factors of the nevus. Duration of screening was modeled for the remainder of the patients’ life expectancy. Best available clinical data on the prevalence and incidence of choroidal nevi/melanoma, and relative risk of nevus transformation were combined with the initial and downstream costs of screening, downstream costs of melanoma-related mortality, and QALY saved by monitoring, to estimate the best monitoring regimen. Main outcome measures were average $/QALY saved by consensus recommended monitoring scenarios for the duration of a patient’s remaining life expectancy in comparison with no follow-up, and the cost-utility of modified regimens. RESULTS: The $/QALY of the recommended monitoring scenarios varied substantially based on nevus clinical risk factors, patient age, frequency of follow-up, and objective testing utilized. The $/QALY for the recommended monitoring scenario of a flat nevus without risk factors in a 60-yearold patient was $77 180. The $/QALY for monitoring a nevus with 3 clinical risk factors in a 60-year-old patient was $85 393. The $/QALY values for differently-aged patients were larger, and intermediate degrees of risk factors for nevus growth varied, depending largely upon the specifics of the modeled monitoring ***: The average $/QALY of currently recommended monitoring scenarios fall within economically acceptable standards and could provide insight for formulating appropriate clinical strategies. Cost-utility could be enhanced by targeting higher risk groups and considering l

关键词： cost-utility choroidal nevus choroidal melanoma screening Markov modeling

Engineering osteoarthritic cartilage model through differentiating senescent human mesenchymal stem cells for testing disease-modifying drugs

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Science China(Life Sciences) 2022年第2期65卷 309-327页

作者： Ning Wang Yuchen He Silvia Liu Meagan j.Makarcyzk Guanghua Lei alexander Chang Peter G alexander Tingjun Hao Anne-Marie Padget Nuria de Pedro Tsapekos Menelaos Hang Lin Department of Orthopaedic Surgery University of Pittsburgh School of MedicinePittsburgh PA 15219USA Department of Orthopedic Surgery Xiangya HospitalCentral South UniversityChangsha 410008China Department of Pathology University of Pittsburgh School of MedicinePittsburgh PA 15219USA Department of Bioengineering University of Pittsburgh Swanson School of EngineeringPittsburgh PA 15219USA Department of Bioinformatics University of Pittsburgh School of MedicinePittsburgh PA 15219USA McGowan Institute for Regenerative Medicine University of Pittsburgh School of MedicinePittsburgh PA 15219USA Department of Biology University of Pittsburgh Dietrich School of Arts and SciencePittsburgh PA 15219USA Department of Research B2B Life Length SLMadrid 28010Spain Xiangya Third Hospital Central South UniversityChangsha 410013China

Significant cellular senescence has been observed in cartilage harvested from patients with osteoarthritis(OA).In this study,we aim to develop a senescence-relevant OA-like cartilage model for developing disease-modifying OA drugs(DMOADs).Spe-cifically,human bone marrow-derived mesenchymal stromal cells(MSCs)were expanded in vitro up to passage 10(P10-MSCs).Following their senescent phenotype formation,P10-MSCs were subjected to pellet culture in chondrogenic *** from qRT-PCR,histology,and immunostaining indicated that cartilage generated from P10-MSCs displayed both senescent and OA-like phenotypes without using other OA-inducing agents,when compared to that from normal passage 4(P4)-***,the same gene expression differences observed between P4-MSCs and P10-MSC-derived cartilage tissues were also observed between the preserved and damaged OA cartilage regions taken from human samples,as demonstrated by RNA sequencing data and other analysis ***,the utility of this senescence-initiated OA-like cartilage model in drug development was assessed by testing several potential DMOADs and *** results suggest that pre-existing cellular senescence can induce the generation of OA-like changes in *** P4-and P10-MSCs derived cartilage models also represent a novel platform for predicting the efficacy and toxicity of potential DMOADs on both preserved and damaged cartilage in humans.

关键词： osteoarthritis MSC senescence cartilage tissue engineering disease-modifying OA drug senolytic

Efficacy of infliximab in acute severe ulcerative colitis:A single-centre experience

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World journal of Gastroenterology 2013年第7期19卷 1091-1097页

作者： Stephen j Halpin P john Hamlin Daniel P Gree Lisa Warren alexander C Ford Leeds Gastroenterology Institute St.James's University HospitalLeedsWest Yorkshire LS9 7TFUnited Kingdom Leeds Gastroenterology Institute St.James's University HospitalLeedsWest Yorkshire LS9 7TFUnited Kingdom r Leeds Institute of Molecular Medicine University of LeedsLeedsWest Yorkshire LS9 7TFUnited Kingdom

AIM:To suggest infliximab(IFX) is effective for acute severe ulcerative colitis,from real-life clinical ***:All patients receiving IFX for the treatment of acute severe ulcerative colitis in a single centre were *** were extracted from clinical records in order to assess response to IFX *** primary endpoint was colectomy-free survival,and secondary outcomes included glucocorticosteroid-free remission and safety,which was evaluated by recording deaths and adverse *** and clinical characteristics of those who underwent colectomy and those who were colectomy-free,both at discharge from their index admission,and during follow-up after an initial response to IFX were ***:Forty-four patients(16 females,mean age 36 years) received IFX between May 2006 and january 2012 for acute severe ulcerative *** median duration of follow-up post-first infusion was 396 d(interquartile range = 173-828 d).There were 21(47.7%) patients with 2 years of follow-up post-first infusion of ***,35(79.5%) responded to IFX,avoiding colectomy during their index admission,29(65.9%) were colectomyfree at last point of follow-up(median follow-up 396 d),and 25(56.8%) were in glucocorticosteroid-free remission at end of *** was one death from post-operative sepsis,20 d after a single IFX *** rates were generally lower among those "bridging" to *** 18 patients "bridged" to thiopurine therapy,17(94.4%) were colectomyfree,and 15(83.3%) were in glucocorticosteroid-free remission at study *** predictors of response were ***:IFX is effective for acute severe ulcerative colitis in real-life clinical ***-thirds of patients avoided colectomy,and more than 50% were in glucocorticosteroid-free remission.

关键词： Ulcerative colitis Severe Azathioprine Infliximab Remission