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The Use of the V.A.C. RX-4 for Multiple Soft Tissue Wound Application in the Single Patient: A Case Report

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Surgical Science 2022年第3期13卷 155-163页

作者： Emily R. Kindal Kaitlin J. Larson Luis G. Fernandez sean F. o’keefe Marc R. Matthews Medical Student IV Royal College of Surgeons in Ireland Dublin Ireland Surgical Resident The Arrowhead Surgical Residency Glendale Arizona Department of Surgery University of Texas Health Science Center Tyler USA Trauma Wound Care UT Health East Tyler USA Department of Surgery University of Texas Medical Branch Galveston USA Business Development Manager Saint Paul US University of Arizona & Creighton University Schools of Medicine The Arizona Burn Center Phoenix Arizona

Contact burn injuries account for a considerable proportion of admissions that frequently require debridement. Such debridements of these multiple open wounds might benefit from the application of negative pressure wound therapy (NPWT) for the removal of proinflammatory mediators and to promote granulation tissue with macrostrain and microstrain. Having four or more Vacuum Assist Closure (V.A.C.) Ulta devices connected to the same patient for adequate wound coverage is cumbersome in the management of the patient’s wound care and tethers the patient to the bed. The V.A.C. RX-4 is a multichannel device that can deliver NPWT with a smaller footprint. In addition, the V.A.C. RX-4 has a weight of 16 lbs. versus one V.A.C Ulta which is 7.4 lbs. Therefore, collectively, four V.A.C. Ultas would equal 29.6 lbs. or almost double the weight of a single V.A.C. RX-4. Use of the V.A.C. RX-4 by healthcare providers can mean greater mobility for the patient and easier transport between patient destinations within the hospital. This case report demonstrates the utility of the V.A.C. RX-4 for open and freshly debrided, large soft tissue wounds in a burn patient.

关键词： V.A.C. RX-4 Negative Pressure Wound Therapy Wounds V.A.C. Ulta Footprint Burns

Limb Salvage Using Human Placental Allografts: Adding to the Reconstructive Ladder Paradigm

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Surgical Science 2022年第1期13卷 1-8页

作者： Stephanie Y. ohara Samantha A. Delapena William H. Tettelbach Lora Whooley sean F. o’keefe Marc R. Matthews Valleywise Health Medical Center Creighton University Phoenix AZ USA Western Peak Specialty Hospital Bountiful UT USA MIMEDX Group Inc. Marietta GA USA Department of Anesthesiology School of Medicine Duke University Durham NC USA 3M St. Paul MN USA Arizona Burn Center Department of Surgery Valleywise Health Medical Center Phoenix AZ USA

Human placental allografts are the latest treatment modalities for diabetic ulcers, chronic wounds, limbs, and tendons for healing cascade and promoting granulation tissue coverage. Purion® processed dehydrated human amnion/chorion membrane allografts (dHACM), decellularized human collagen matrix (dHCM), dehydrated umbilical cord (dHUC) and micronized dehydrated human amnion/chorion membrane allografts (mdHACM) have been the newest modality used to salvage injured human extremities with tendon and bone exposure. A 53-year-old male was assaulted and sustained second and third degree burns to both legs. The left extremity had a 9.5% total body surface area (%TBSA) burned. The right extremity had a 5.5% TBSA and three exposed tendons (Achilles/flexor digitorum longus/tibialis anterior), muscles, talar and tibial bones. Bilateral extremity pedal pulses were present, and all toes had less than two second capillary refill. Sensation, motor, and strength were normal. During the 48-day-hospital stay, the patient had eight operations: tangential excisional debridements of necrotic tissue with weekly wound dressing applications of dHACM and dHCM, on both legs. In addition, dHUC was applied over the exposed tendons on weeks 2 - 5. The exposed tendons were injected with mdHACM on weeks 4 and 5. Negative pressure wound therapy was applied at 125 mmHg for

关键词： Limb Salvage Placental Membranes Amnion Chorion Umbilical Cord Allograft Burns Trauma

Blood biomarkers of Alzheimer’s disease:important considerations for use in clinical practice

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Neural Regeneration Research 2025年第1期20卷 205-206页

作者： Sarah Fullam sean o’Dowd Antoinette o’Connor Department of Neurology Tallaght University HospitalDublinIreland Academic Unit of Neurology Trinity College DublinIreland

Introduction:Fluid and positron emission tomography(PET)biomarkers that enable the detection of the hallmark proteins of Alzheimer’s disease(AD)(amyloid and tau)have revolutionized our approach to the diagnosis of *** evolution of AD diagnostic criteria to include biological characterization(Alzheimer’s Association Working Group,2023)provides an appropriate framework to reduce levels of clinico-pathologic mismatch and improve in-vivo diagnostic *** the therapeutic landscape for neurodegenerative disease evolves,it is increasingly incumbent on clinicians to provide timely,and pathologically precise diagnoses for ***,the expensive and invasive nature of these tests limits their scalability.

关键词： Blood Alzheimer diagnosis

Space Rocks-and Dust-Roll into Planetary Science Limelight

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Engineering 2024年第8期39卷 3-6页

作者： sean o’Neill Senior Technology Writer

Space sample retrieval is having a *** 24 September 2023,in a triumph of complex engineering,a US National Aeronau-tics and Space Administration(NASA)mission,oSIRUS-REx(short for origins,spectral interpretation,resource identification,and security-regolith explorer;regolith is the surface layer of uncon-solidated rocks and dust/soil covering bedrock),successfully deliv-ered to Earth a capsule containing the largest sample of asteroid material ever collected,captured from Bennu.

关键词： rock Earth origin

Necrotizing Fasciitis Secondary to Emphysematous Cholecystitis and Cholecystocutaneous Fistula: A Rare Case Report Presentation

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Surgical Science 2023年第5期14卷 388-397页

作者： Alexandra N. Dominianni Samantha A. Delapena Luis G. Fernandez Mostaffa T. Jabassini sean F. o’keefe Rachel L. Villanueva Marc R. Matthews College of Medicine-Phoenix University of Arizona Phoenix AZ USA Creighton University Arizona Health Education Alliance Phoenix AZ USA Department of Surgery Division of Trauma Surgery/Surgical Critical Care The University of Texas Health Science Center Tyler TX USA The University of Texas-Tyler School of Medicine Bill Barrett Endowed Chair in Trauma Surgery Tyler TX USA Trauma Wound Care UT Health East Tyler TX USA Department of Surgery University of Texas Medical Branch Galveston TX USA Adjunct Clinical Professor of Medicine and Nursing University of Texas Arlington TX USA Past Commanding General TXSG Medical Brigade Austin TX USA Surgical Resident Abrazo Health Network General Surgery Residency Glendale AZ USA Area Sales Manager Miach Orthopedics Surgical Acute Account Manager 3M Minneapolis MN USA Clinical Professor of Surgery Banner University of Arizona/University Medical Center Tucson AZ USA

Emphysematous cholecystitis is a rare subtype of acute cholecystitis characterized by the presence of gas in the gallbladder wall secondary to ischemia. Typically, this is a result of cystic artery vascular compromise with a concomitant infection from gas-forming organisms such as Clostridium species, Klebsiella species, or Escherichia coli. The mortality rate of acute emphysematous cholecystitis is 15% - 20% compared with 1.4% in uncomplicated acute cholecystitis. The subsequent development of a cholecystocutaneous fistula, an abnormal connection between the gallbladder and the skin, is also a rare complication of gallbladder disease. We describe a case of a 77-year-old male who presented with right flank necrotizing fasciitis which developed from a cholecystocutaneous fistula secondary to emphysematous cholecystitis. once the necrotic tissues were adequately debrided, the large open wound was treated with negative pressure wound therapy with instillation (NPWT-i) utilizing hypochlorous acid (HoCL). The wound was closed with a split-thickness skin graft.

关键词： Emphysematous Cholecystitis Gangrenous Cholecystitis Cholecystocutaneous Fistula Necrotizing Fasciitis Sepsis

新发射的卫星旨在确保甲烷排放源如实报告排放情况（英文）

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Engineering 2024年第10期 1-3页

作者： sean o'Neill

on 4 March 2024,a new methane-observing satellite,MethaneSAT,was launched atop a SpaceX Falcon 9 rocket and successfully placed in orbit [1].Developed by the New York City,NY,USA-headquartered Environmental Defense Fund (EDF) in partnership with the New Zealand Space Agency and funded by multiple philanthropic donors including the Bezos Earth Fund,the spacecraft promises to greatly improve scientists'ability to pinpoint and monitor methane emissions,particularly those related to the oil and gas industry.

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Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively

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World Journal of orthopedics 2024年第7期15卷 627-634页

作者： Billy Insup Kim Jeffrey o'Donnell Colleen M Wixted Thorsten Markus Seyler William A Jiranek Michael Paul Bolognesi sean Patrick Ryan Department of orthopedic Surgery Hospital for Special SurgeryNew YorkNY 10021United States Department of orthopedic Surgery New York UniversityNew YorkNY 10003United States Department of orthopedic Surgery Duke University HospitalDurhamNC 27560United States

BACKGRoUND Tobacco use is a well-documented modifiable risk factor for perioperative *** To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)*** A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of *** patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients *** our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to *** cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete *** who were able to maintain cessation postoperatively had improved Patient-Reported outcomes Measurement Information System(PRoMIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(***)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision *** We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years *** undergoing TJA who were able to remain abstinent had improved PRoMIS-10 mental health scores and *** *** perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

关键词： Smoking cessation Total joint arthroplasty outcomes Tobacco use Postoperative abstinence

Gas-propelled nanomotors alleviate colitis through the regulation of intestinal immunoenvironment-hematopexis-microbiota circuits

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Acta Pharmaceutica Sinica B 2024年第6期14卷 2732-2747页

作者： Bo Xiao Yuqi Liang Ga Liu Lingshuang Wang Zhan Zhang Libin Qiu Haiting Xu sean Carr Xiaoxiao Shi Rui LReis Subhas CKundu Zhenghua Zhu Department of Gastroenterology the First Affiliated Hospital of Nanchang UniversityNanchang 330006China College of Sericulture Textileand Biomass SciencesSouthwest UniversityChongqing 400715China Department of Neurology School of MedicineEmory UniversityAtlantaGA 30322USA Atlanta Veterans Affairs Medical Center DecaturGA 30033USA Department of Surgery School of MedicineEmory UniversityAtlantaGA 30322USA Bs Research Group I3Bs—Research Institute on BiomaterialsBiodegradables and BiomimeticsUniversity of MinhoHeadquarters of the European Institute of Excellence on Tissue Engineering and Regenerative MedicineAveParkBarcoGuimaraes 4805-017Portugal

The progression of ulcerative colitis(UC)is associated with immunologic derangement,intestinal hemorrhage,and microbiota *** traditional medications mainly focus on mitigating inflammation,it remains challenging to address multiple ***,a versatile gas-propelled nanomotor was constructed by mild fusion of post-ultrasonic Cao_(2) nanospheres with Cu_(2)o *** resulting Cao_(2)–Cu_(2)o possessed a desirable diameter(291.3 nm)and a uniform size *** could be efficiently internalized by colonic epithelial cells and macrophages,scavenge intracellular reactive oxygen/nitrogen species,and alleviate immune reactions by pro-polarizing macrophages to the anti-inflammatory M2 *** nanomotor was found to penetrate through the mucus barrier and accumulate in the colitis mucosa due to the driving force of the generated oxygen *** administration of Cao_(2)–Cu_(2)o could stanch the bleeding,repair the disrupted colonic epithelial layer,and reduce the inflammatory responses through its interaction with the genes relevant to blood coagulation,anti-oxidation,wound healing,and ***,it restored intestinal microbiota balance by elevating the proportions of beneficial bacteria(e.g.,odoribacter and Bifidobacterium)and decreasing the abundances of harmful bacteria(e.g.,Prevotellaceae and Helicobacter).our gas-driven Cao_(2)–Cu_(2)o offers a promising therapeutic platform for robust treatment of UC via the rectal route.

关键词： Nanomotor Anti-inflammation Blood coagulation Immune regulation Hematopexis Microbiota rebalance Ulcerative colitis Rectal administration

Tube feeding,the microbiota,and Clostridium diff icile infection

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World Journal of Gastroenterology 2010年第2期16卷 139-142页

作者： Stephen JD o'keefe Division of Gastroenterology University of Pittsburgh

Clostridium difficile (C. difficile) is now the leading cause of nosocomial diarrhea in the USA, accounting for 30% of patients with antibiotic-associated diarrhea, 70% of those with antibiotic-associated colitis, and most cases of pseudomembranous colitis. The organism has evolved over the last 8 years to become more virulent and resistant to antimicrobials (NAP1/027 strain) causing a more severe form of the disease that has increased mortality and healthcare costs. While it is generally accepted that the problem results from the overuse of antibiotics, and in particular second and third generation cephalosporins, fluoroquinolones and macrolides, recent studies suggest that acid suppres-sion with proton pump inhibitors (PPIs) may be equally culpable. A further common, but less recognized, etiological factor is the prolonged use of elemental diets. Such diets are totally absorbed within the small intestine and therefore deprive the colonic microbiota of their source of nutrition, namely dietary fiber, fructose oligosaccharides, and resistant starch. The resultant suppression of colonic fermentation leads to suppression of the "good" bacteria, such as butyrate-producers (butyrate being essential for colonic mucosal health), and bifidobacteria and the creation of a "permissive" environment for C. difficile colonization and subsequent infection. Based on this analysis, the best chance of suppressing the emerging C. difficile epidemic is to adopt a 3-pronged attack consisting of (1) avoidance of the use of prophylactic antibiotics, (2) the avoidance of prophylactic PPIs, and (3) the conversion of elemental diet feeding to a diet containing adequate indigestible carbohydrate after the first week of critical illness. In this review, we highlight the rising worldwide incidence of C. difficile associated diarrhea and the role played by non-residue diets in destabilizing the colonic microbiota.

关键词： Clostridium difficile Elemental diets Enteral nutrition Microbiota