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fragility of statistically significant findings from randomized clinical trials of surgical treatment of humeral shaft fractures:A systematic review

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World Journal of Orthopedics 2022年第9期13卷 825-836页

作者： Stephen Craig Morris Anirudh K Gowd Avinesh Agarwalla Wesley P Phipatanakul Nirav H Amin Joseph N Liu Department of Orthopaedic Surgery Loma Linda UniversityLoma LindaCA 92354United States Department of Orthopaedic Surgery Wake Forest University Baptist Medical CenterWinston-SalemNC 27157United States Department of Orthopaedic Surgery Westchester Medical CenterValhallaNY 10595United States Department of Orthopaedic Surgery Premier Orthopaedic and Trauma SpecialistsPomonaCA 91767United States Department of Orthopedic Surgery USC Epstein Family Center for Sports MedicineLos AngelesCA 90089United States

BACKGROUND Despite recent meta-analyses of randomized controlled trials(RCTs),there remains no consensus regarding the preferred surgical treatment for humeral shaft *** fragility index(FI)is an emerging tool used to evaluate the robustness of RCTs by quantifying the number of participants in a study group that would need to switch outcomes in order to reverse the study *** To investigate the fragility index of randomized control trials assessing outcomes of operative fixation in proximal humerus *** We completed a systematic review of RCTs evaluating the surgical treatment of humeral shaft *** criteria included:articles published in English;patients randomized and allotted in 1:1 ratio to 2 parallel arms;and dichotomous outcome *** FI was calculated for total complications,each complication individually,and secondary surgeries using the Fisher exact test,as previously *** Fifteen RCTs were included in the analysis comparing open reduction plate osteosynthesis with dynamic compression plate or locking compression plate,intramedullary nail,and minimally invasive plate *** median FI was 0 for all parameters *** individual outcomes,the FI was 0 for 81/91(89%)of *** FI exceeded the number lost to follow up in only 2/91(2%)*** The FI shows that data from RCTs regarding operative treatment of humeral shaft fractures are fragile and does not demonstrate superiority of any particular surgical technique.

关键词： Humerus fracture Open reduction internal fixation Intramedullary nail fragility index Complications fragility index

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Glass formation,thermal and mechanical properties of ZrCuAlNi bulk metallic glasses

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Transactions of Nonferrous Metals Society of China 2018年第6期28卷 1157-1165页

作者： C.E.BORJA I.A.FIGUEROA O.LOZADA-FLORES M.ESTRADA G.A.LARA-RODRIGUEZ J.A.VERDUZCO Instituto de Investigacion en Metalurgia y Materiales Universidad Michoacana de San Nicolfis de Hidalgo (UMSNH)Fco. J. Mujica S/N Col. Felicitas del Rio C.P. 58030 Morelia Mich. Mexico Instituto de Investigaciones en Materiales Universidad Nacional Autonoma de Mdxico (UNAM) Circuito Exterior S/N Cd. Universitaria C.P. 04510 Cd. Mx. Mexico

The glass forming ability, thermal and mechanical properties of some Zr Cu Al Ni bulk metallic glasses were analyzed. The compositions of the alloys were theoretically determined with the dense packing and kinetic fragility index models. Cylindrical and conical ingots were produced by copper mould suction-casting under Ar atmosphere. The conical ingots were characterized by means of X-ray diffraction in order to determine the glassy structure. It was found that both alloys have a critical glassy diameter, Dc, of 3 mm. Thermal behaviours were investigated by differential scanning calorimetry at heating rates of 0.5, 0.67 and 0.83 K/s. The gamma parameter γ, supercooled liquid region ΔTx, and reduced glass transition temperature Trg, of the experimentally obtained glasses indicated high glass forming ability. The glassy compositions showed a fragility index of ~40 GPa. The compression test of the investigated alloys was carried out at a strain rate of 0.016 s^-1, obtaining a elastic modulus of ~83 GPa, total deformation of ~5%, yield strength of 1.6 GPa and hardness of 4 GPa. It was concluded that the use of the dense packing and kinetic fragility index models helped to predict glass-forming compositions in the family alloy investigated.

关键词： bulk metallic glass glass formation ability fragility index packing efficiency suction casting

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