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Assessing Injection Techniques in the Treatment of Trigger Finger

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Modern Plastic Surgery 2012年第4期2卷 83-86页

作者： john R fowler Lauren Ogrich Perry Evangelista Alyssa A Schaffer Temple University Hospital Department of Orthopaedics Philadelphia USA Temple University School of Medicine Philadelphia USA University of Pennyslvania School of Medicine Philadelphia USA

Background: Trigger finger is characterized by the inability to smoothly flex and extend the digit. Corticosteroids are an accepted non-surgical treatment option and can be delivered via two techniques. While the palmar approach is more commonly used, some have suggested that the mid-axial approach may be less painful for patients and yield higher intrasheath injection rates. The purpose of this study is to compare the accuracy of the palmar and midaxial approaches for delivery of corticosteroids into the flexor tendon sheath using radio-opaque dye in a cadaver model. Methods: A total of 50 injections were performed, 25 via midaxial technique and 25 via palmar technique. A one inch, 25-gauge needle was used to inject 1 mL of Isovue contrast dye into the flexor tendon sheath under live fluoroscopy. The fluoroscopic images were examined after injection to determine intrasheath versus extrasheath delivery of the dye, with visualization of contrast filling the sheath defining a successful injection. Results: The midaxial approach had a success rate of 52% compared to the conventional palmar approach success rate of 36%, p=0.5. The ring finger is the most common location of trigger finger and the rates of success were equal between groups for this digit (80%). Conclusions: Based on our findings, there is no statistical difference in the accuracy of intrasheath injection between the midaxial technique and palmar technique. The midaxial technique can be considered as an alternative to the palmar technique for trigger finger injection.

关键词： Trigger Finger Injection Corticosteroids Palmar and Midaxial Approaches

Integration of VR with BIM to facilitate real-time creation of bill of quantities during the design phase: A proof of concept study

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Frontiers of Engineering Management 2020年第3期7卷 396-403页

作者： Jordan DAVIDSON john fowler Charalampos PANTAZIS Massimo SANNINO Jordan WALKER Moslem SHEIKHKHOSHKAR Farzad Pour RAHIMIAN Department of Architecture University of StrathclydeGlasgowG11XJUK Department of Mechanical and Construction Engineering Faculty of Engineering and EnvironmentNorthumbria UniversityNewcastle NE18STUK

As building practices change,procedures that seemed indispensable at one point can be abandoned for others,one example of which is the bill of quantities(B/Q).Research into the extant literature attributes the declining use of B/Qs to a multitude of reasons,such as its complexity,the potentially long time required to produce it,the growth in popularity of non-traditional procurement systems,and the challenge of using the information within the document in a construction *** these issues in mind,building information modeling(BIM)and virtual reality(VR)are combined and proposed as a potential solution that allows inclusion of the client into the design *** a literature review and precedent study,an experiment was carried out using this new process to simulate a client’s design decisions on window and interior *** choices made by the client using VR automatically updated a B/Q schedule built in Revit and allowed them to have a firm understanding of project *** giving the client more confidence in a pleasing final outcome,the technology also ensured an up-to-date,accurate,and easily understandable B/*** proposed method features great potential savings in cost and time and gives the B/Q a newfound importance in future construction *** research case presented in this paper is a stepping stone in exploring new opportunities offered by VR and BIM and how they could improve the reliability and accuracy of traditional procurement within construction,specifically within the B/Q document.

关键词： virtual reality bill of quantities BIM Revit real-time synchronisation

Reproductive biology of largehead hairtail(Trichiurus lepturus)in south-eastern Australia

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Aquaculture and Fisheries 2023年第2期8卷 148-158页

作者： Chantelle Clain john Stewart Ashley fowler Sandra Diamond School of Science Western Sydney UniversityLocked Bag 1797PenrithNSW2751Australia NSW Department of Primary Industries Sydney Institute of Marine ScienceChowder Bay RoadMosmanNSW2088Australia

Knowledge of reproductive biology and life-history traits of populations exploited by fisheries is important for their sustainable *** investigated the life-history traits of Trichiurus lepturus(largehead hairtail)in south-eastern Australia;a region of low exploitation for this otherwise heavily exploited circumglobal species,to investigate whether there were differences in the reproductive biology and life-history traits in the south-east Australian population compared with those in other *** also used histological sections to examine male and female gonads at a microscopic *** lepturus in south-eastern Australia had a greater maximum length(193 cm total length(TL)),matured at a larger length(108 cm TL at 50%mature)and had a spawning period(March to September,Austral winter)that was inconsistent with other *** overall sex ratio of 1:0.4 females:males was consistent with a female dominant sex ratio observed in other regions,particularly in larger length ***,females in the current study dominated samples from both estuarine and coastal habitats,as well as during the spawning and non-spawning periods,which is not consistent with the patterns found in other *** in south-eastern Australia may relate to limited fishing pressure,genetic variation,or differences in environmental factors that influence reproductive development,including temperature,trophic resources and habitat.

关键词： Fisheries Length at maturity Histology Spawning period Sex ratio Trichiurus

Treatment of hemorrhoids: A survey of surgical practice in Australia and New Zealand

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World Journal of Clinical Cases 2019年第22期7卷 3742-3750页

作者： George E fowler Javariah Siddiqui Assad Zahid Christopher john Young Department of Colorectal Surgery Royal Devon and Exeter NHS Foundation TrustExeter EX25DWUnited Kingdom Department of Colorectal Surgery Royal Prince Alfred HospitalNewtown 2042NSWAustralia

BACKGROUND Hemorrhoidal disease is the most common anorectal *** can be classified as external or internal,according to their relation to the dentate *** hemorrhoids originate below the dentate line and are managed conservatively unless the patient cannot keep the perianal region clean,or they cause significant *** hemorrhoids originate above the dentate line and can be managed according to the graded degree of prolapse,as described by ***,low-grade internal hemorrhoids are effectively treated conservatively,by non-operative measures,while high-grade internal hemorrhoids warrant procedural *** To determine the application of clinical practice guidelines for the current management of hemorrhoids and colorectal surgeon consensus in Australia and New *** An online survey was distributed to 206 colorectal surgeons in Australia and New Zealand using 17 guideline-based hypothetical clinical *** There were 82 respondents(40%)to 17 guideline-based ***(53%)reached consensus,of which only 1(6%)disagreed with the *** was based on low quality evidence for the management of acutely thrombosed external *** were 8 scenarios which showed community equipoise(47%)and they were equally divided for agreeing or disagreeing with the *** topics were based on low and moderate levels of *** included the initial management of grade I internal hemorrhoids,grade III internal hemorrhoids when initial management had failed and the patient had recognised risks factors for septic complications;and finally,the decision-making when considering patient preferences,including a prompt return to work,or minimal post-operative *** Although there are areas of consensus in the management of hemorrhoids,there are many areas of community equipoise which would benefit from further research.

关键词： Hemorrhoids Clinical practice guidelines Survey Consensus

Modelling Dust Emissions from a Source Using Dust Monitoring and Meteorological Data

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Journal of Environmental Protection 2016年第3期7卷 467-472页

作者： john Bruce Jim Smith Hugh Datson Mike fowler School of Earth and Environmental Sciences University of Portsmouth Portsmouth UK DustScan Ltd Oxford UK

This paper describes a study into the development of more robust dust emission factors by means of dust and meteorological monitoring. Emission factors for nuisance dusts in the literature are scarce, with estimates of dust output given for many processes in mass per unit area per year. Temporal variations and the extent and conditions in which maximum concentrations occur can therefore be impossible to predict with any accuracy. This investigation aims to improve predic-tions by “back calculating” emission levels based on dust monitoring around known dust sources. Nuisance dust and meteorological monitoring has been undertaken at a sand and gravel quarry in the UK for a consecutive period of two years. Sticky pad directional dust monitors were used to collect dust at eight locations at and around the site with meteorological data collected at an elec-tronic weather station within the site. Air quality modelling software (ADMS) was used to test emission factors from the European Environment Agency (EEA) and the US Environmental Protec-tion Agency (EPA) for emissions from mineral workings. Predictions were compared with the dust monitoring data to assess accuracy, with results showing limited poor correspondence (r2 2 0.89) and similar maximum concentrations (<5% difference). This study has therefore shown that ac-curate site-specific emission rates can be produced in combination with site boundary sticky pad dust monitoring in order to accurately derive estimations elsewhe

关键词： Dust Nuisance Dust Dust Modelling Sticky Pad ADMS

Ankle Arthroscopy,Lateral Ligament Repair and Peroneal Tendon Reefing for Chronic Lateral Ankle Instability:The Triad vs Arthroscopy with Ligament Repair

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Surgical Science 2015年第9期6卷 403-411页

作者： john J.Anderson Loren K.Spencer Zflan fowler Alamogordo Orthopedics AlamogordoNMUSA

Peroneal tendon and retinacular pathology contributes to chronic lateral ankle instability. The “gold standard” surgical treatment for chronic lateral ankle instability has been the Brostrom-Gould procedure with its modifications. An ankle arthroscopy is an adjuvant procedure to address any intra-articular pathology. We review our results of two study groups. The first group underwent an ankle arthroscopy and a Brostrom-Gould procedure. The second group (triad) underwent an ankle arthroscopy, the Brostrom-Gould procedure and excision of low lying peroneal muscle belly with tightening of the inferior peroneal retinaculum. The triad technique was performed on 97 patients and results compared to 71 ankle arthroscopies with the Brostrom-Gould procedure. The patients were contacted at a mean follow-up time of 30 months for postoperative ACFAS scores, VAS scores, and overall satisfaction. Patients were also asked to report incidence of ankle sprain recurrence. The average postoperative ACFAS hindfoot and ankle score was 92 for the triad group and 89 for the arthroscopic debridement and Brostrom-Gould group. The average overall satisfaction was 98% in the triad group and 91% in the scope and Brostrom group. There were 4 (4.3%) recurrences in the triad group and 12 (17.6%) in the Brostrom-Gould with scope group. Each group had a similar incidence of wound healing complications. Peroneal tendon and retinacular pathology contributes to continued ankle instability and pain. We believe that the triad procedure is superior to the Brostrom-Gould procedure.

关键词： Brostrom-Gould Lateral Ankle Instability Triad Procedure

First Metatarsophalangeal Joint Arthrodesis: Comparison of Mesenchymal Stem Cell Allograft versus Autogenous Bone Graft Fusion Rates

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Surgical Science 2013年第5期4卷 263-267页

作者： john Anderson Nathan Jeppesen Myron Hansen Chad Brady Adam Gough Zflan fowler Alamogordo Orthopaedics Alamogordo USA Cactus Foot and Ankle Gilbert USA Gila Regional Medical Center Silver City USA Presbyterian Albuquerque USA Scripps Mercy-Kaiser Hospital San Diego USA

With patients undergoing first time 1st metatarsophalangeal joint arthrodesis using graft material when it was required to fill cystic bone voids, we retrospectively compared the time to fusion (clinical and radiographic), and non-union rate between the patient’s own bone autograft (n = 62) versus a mesenchymal stem cell impregnated allograft group (n = 51). A third control group (n = 52) was included in which an end-to-end arthrodesis was performed and no graft interposition was used or necessary. The non-union rate was 4% (n = 2) in the control group, 5.9% (n = 4) in the autograft group, and 9.5% (n = 5) in the mesenchymal stem cell allograft group. The time for radiographic fusion was 6.46 weeks for the control group, 6.52 weeks for the autograft group, and 6.53 weeks for the mesenchymal stem cell allograft group. The difference in time to clinical and radiographic union and the non-union rate were not found to be statistically significant among all 3 groups. Patient comorbidities and their possible effects on union rates were also analyzed within the populations. Some comorbidities had statistically significantly non-unions within the population, notably smoking (p = 0.024) and Rheumatoid arthritis (p = 0.001), however the populations were fairly small. The use of allogeneic bone graft impregnated with mesenchymal stem cells yields a similar fusion rate as with the use of autologous bone graft harvested from the surrounding area. The allograft impregnated with mesenchymal stem cells is a viable alternative yielding similar results when local autogenous bone graft is not available, not obtainable, or conditions warrant its use.

关键词： Metatarsophalangeal Joint Bone Autograft Mesenchymal Stem Cell

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利用双处理器延长电池使用寿命

今日电子 2008年第10期 54-57页

作者： john Dixon Zack Albus Adrian Valenzuela JB fowler TI公司

向着更低功耗、更高性能的电池供电型系统发展的趋势毋庸置疑。对于电池电源而言，消费者希望便携式电子产品能够以“更低电量执行更多功能”，同时，众多工业产品也开始转而采用电池供电。

关键词：电池供电使用寿命双处理器便携式电子产品电池电源工业产品低功耗多功能

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硫、氮化合物源-汇关系的非线性特征

AMBIO－人类环境杂志 2005年第1期34卷 41-46页

作者： David fowler Jennifer Muller Rognvald I.Smith john Neil Cape Jan Willem Erisman 吕超群 Centrefor Ecology and Hydrology Bush EstateMidlothian EH26 0QBUK. Energy research Centre of the Nethetlands (ECN) P.O. Box 1 1755 ZGPetten The Netherlands.

大气污染物排放和沉降的时空关系引起了科研工作者和政策制订者的极大关注。事实上,这二者间的关系可能由于其基础过程随时间或空间发生改变而呈现非线性特征。非线性特征也可能来源于排放或沉降数据的误差,细致审察不同数据源及其关系... 详细信息

大气污染物排放和沉降的时空关系引起了科研工作者和政策制订者的极大关注。事实上,这二者间的关系可能由于其基础过程随时间或空间发生改变而呈现非线性特征。非线性特征也可能来源于排放或沉降数据的误差,细致审察不同数据源及其关系可以改善这种不足。欧洲硫、氮化合物源汇关系的非线性特征已经在英国的测量数据中得到了证实。硫的干沉降过程受周围NH_3浓度的强烈影响,所以SO_2浓度下降和SO_2/NH_3比值下降都会引起沉降速率的极大提高。实地研究证据包括欧洲3个国家的3种不同地被类型上的测量。这些为我们提供了对非线性特征成因的机械解释。由于海运排放的影响,也导致显著非线性存在于硫沉降领域。这种效应在西海岸地区表现得非常明显,在一个阶段陆源的硫排放减少了50%,但降水中的SO_4^(2-)浓度并没有显著下降。海运影响的主要地带是英国西南部沿海地区,海运来源占当地硫沉降的很大部分,而在其它地区这种影响就难于观测到了。对空间上分散的排放气体以及它们随时间的变化做详尽的定量化可以消除源-汇数据中表现上的非线性特征。英国氮氧化物的排放和沉降过程也为其源-汇关系的非线性特征提供了大量证据。1987～2001年,排放的NO_3^-减少了45%,但降雨中沉降下来的NO_3^-浓度却几乎没有降低。数据表明氮氧化物的平均传输距离显著降低,而其平均氧化速率很可能提高了。但是,由硫排放的变化以及硫排放减少对主要氧化剂竞争的减轻所引起的气溶胶化学变化的净效应还没有区分开来。目前仍缺乏对这种非线性特征成因的定量解释,因而其影响被认为是重要的不确定因子,阻碍了欧洲制定进一步的草案来控制酸化作用、富营养化作用和光化学氧化剂。

关键词：非线性特征氮化合物硫沉降大气污染物排放 SO2浓度物源沉降过程 SO4^2- 测量数据