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Subsequent total joint arthroplasty: Are we learning from the first stage?

World Journal of orthopedics 2024年第3期15卷 230-237页

作者： Christine Jiang Wu Colin Penrose Sean Patrick Ryan Michael Paul Bolognesi Thorsten Markus Seyler Samuel Secord Wellman Department of orthopaedic Surgery Duke University HospitalDurhamNC 27710United States Department of orthopaedic Surgery Midwest Center for Joint ReplacementIndianapolisIN 46241United States

BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource *** degenerative conditions progress in multiple joints,many patients undergo multiple *** To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second *** The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were *** demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second *** metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)*** A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were *** was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 *** THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(P<0.001).THA patients had significantly decreased operative time only when the same sized implant was utilized(P=0.025).The vast majority(93.3%)of patients were discharged to the same type of location following their second ***,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second *** may

关键词： Staged total joint arthroplasty Asynchronous total joint arthroplasty Subsequent total joint arthroplasty Contralateral total joint arthroplasty Perioperative outcomes

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Medial ulnar collateral ligament reconstruction of the elbow in major league baseball players:Where do we stand?

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World Journal of orthopedics 2016年第6期7卷 355-360页

作者： Brandon J Erickson Bernard R Bach Jr Charles A Bush-Joseph Nikhil N Verma Anthony A Romeo midwest ortho-paedics at rush Rush University Medical Center

The ulnar collateral ligament(UCL) is a vital structure to the overhead athlete,especially the baseball *** reasons not completely understood,UCL injurieshave become increasingly more common in major league baseball(MLB) pitchers over the past 10 *** reconstruction(UCLR) is the current gold standard of treatment for these injuries in MLB pitchers who wish to return to sport(RTS) at a high level and who have failed a course of non-operative *** following UCLR in MLB pitchers have been encouraging,with multiple RTS rates now cited at greater than 80%.Unfortunately,with the rising number of UCLR,there has also been a spike in the number of revision UCLR in MLB *** to primary UCLR,the etiology of the increase in revision UCLR,aside from an increase in the number of pitchers who have undergone a primary UCLR,remains *** current literature has attempted to address several questions including those surrounding surgical technique(method of exposure,graft choice,management of the ulnar nerve,concomitant elbow arthroscopy,etc.),post-operative rehabilitation strategies,and timing of RTS following *** some questions have been answered,many remain *** literature surrounding UCLR in MLB pitchers will be reviewed,and future directions regarding this injury in these high level athletes will be discussed.

关键词： Ulnar collateral ligament Ulnar collateral ligament reconstruction Tommy John Major league baseball Pitcher Baseball

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Possible Cortical Spreading Depression Recorded Intraoperatively Following a Generalized Seizure: Illustrative Case

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Neuroscience & Medicine 2024年第3期15卷 119-128页

作者： Greg Schaublin Romina Shirka Nabil Azar Callan Broderick Jayson Neil George R. Lee Kiara Ebinger Real Time Neuromonitoring Associates Nashville USA Real Time Tele-Epilepsy Consultants Nashville USA Seastnan Medical LLC Kansas City USA midwest Neurosurgery Associates Kansas City USA Research Medical Center Kansas City USA

Background: We present a compelling case fitting the phenomenon of cortical spreading depression detected by intraoperative neurophysiological monitoring (IONM) following an intraoperative seizure during a craniotomy for revascularization. Cortical spreading depression (CSD, also called cortical spreading depolarization) is a pathophysiological phenomenon whereby a wave of depolarization is thought to propagate across the cerebral cortex, creating a brief period of relative neuronal inactivity. The relationship between CSD and seizures is unclear, although some literature has made a correlation between seizures and a cortical environment conducive to CSD. Methods: Intraoperative somatosensory evoked potentials (SSEPs) and electroencephalography (EEG) were monitored continuously during the craniotomy procedure utilizing standard montages. Electrophysiological data from pre-ictal, ictal, and post-ictal periods were recorded. Results: During the procedure, intraoperative EEG captured a generalized seizure followed by a stepwise decrease in somatosensory evoked potential cortical amplitudes, compelling for the phenomenon of CSD. The subsequent partial recovery of neuronal function was also captured electrophysiologically. Discussion: While CSD is considered controversial in some aspects, intraoperative neurophysiological monitoring allowed for the unique analysis of a case demonstrating a CSD-like phenomenon. To our knowledge, this is the first published example of this phenomenon in which intraoperative neurophysiological monitoring captured a seizure, along with a stepwise subsequent reduction in SSEP cortical amplitudes not explained by other variables.

关键词： Cortical Spreading Depression Electroencephalography Intraoperative Neurophysiological Monitoring Seizure

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Improved hearing in noise using new signal processing algorithms with the Cochlear^(TM) Nucleus~ 6 sound processor

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Journal of Otology 2015年第2期10卷 51-56页

作者： Jan Gilden Kristen Lewis Ginger Grant Jillian Crosson Houston Ear Research Foundation midwest Ear Institute Cochlear Americas

Objective： To demonstrate the performance benefit of the Automatic Scene Classifier （SCAN） algorithm available in the Nucleus 6 （CP900 series） sound processor over the default processing algorithms of the previous generation Nucleus 5 （CP810） and Freedom HybridTM sound processors. Methods： Eighty-two cochlear implant recipients （40 Nucleus 5 processor users and 42 Freedom Hybrid processor users） listened to and repeated AzBio sentences in noise with their current processor and with the Nucleus 6 processor. Results： The SCAN algorithm when enabled yielded statistically significant non-inferior and superior performance when compared to the Nucleus 5 and Freedom Hybrid sound processors programmed with ASC ＋ ADRO. Conclusion： The results of these studies demonstrate the superior performance and clinical utility of the SCAN algorithm in the Nucleus 6 processor over the Nucleus 5 and Freedom Hybrid processors.

关键词： Cochlear implant Speech perception Nucleus 6 Automatic scene classifier (SCAN) SmartSound iQ

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Sorption and desorption behavior of residual antidepressants and caffeine in freshwater sediment and sewage sludge

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International Journal of Sediment Research 2022年第3期37卷 346-354页

作者： Ismael Laurindo Costa Junior Christiane Schinneider Machado Adelmo Lowe Pletsch Yohandra Reyes Torres Department of Chemistry Federal University of Technology-Paraná (UTFPR) Department of Chemistry State University of Midwest (UNICENTRO)

The use of antidepressants is widespread in modern times. Thus, they present a potential risk for ecosystems due to occurrence in domestic sewage containing unaltered metabolites and structures, even after the treatment plants have processed the sewage. The current research investigated the sorption and desorption of antidepressants(citalopram, venlafaxine, fluoxetine, sertraline, and amitriptyline) and caffeine from freshwater sediment and sewage sludge. The samples of freshwater sediment were collected in a river spring in an area with few anthropogenic sources of pollution and samples of sewage sludge were taken from stabilization ponds of a sewage treatment. The matrices were mainly composed of organic fractions, sediment of humic nature, and aliphatic biomolecules in sludges. The presence of silt and clay in the sediment proved to be important for the sorption process when compared to the flocs and colloidal structure of the sludge. The kinetic study indicated pseudo-first order behavior. The Freundlich isotherm was satisfactorily used in the interpretation of sorption and desorption for all analytes and matrices. The high percentages obtained for desorption suggest analyte mobility, which is more intense in the sludge than in the sediment since each matrix has a different composition. It can be considered that the information obtained here reinforces the ecotoxicological concern with respect to pharmacological residues in the environment, as processes of retention by sorption in the sludge and the sediment have been confirmed, as well as the preferential partition of some analytes by the aqueous phase.

关键词： Emerging pollutants Drugs Persistence Partition Mobility Sorption

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Geochemistry and petrogenesis of Rajahmundry trap basalts of Krishna-Godavari Basin,India

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Geoscience Frontiers 2015年第3期6卷 437-451页

作者： C.Manikyamba Sohini Ganguly M.Santosh Abhishek Saha G.Lakshminarayana CSIR-National Geophysical Research Institute Department of Geology University of Calcutta School of Earth Sciences and Resources China University of Geosciences midwest Group Banjara Hills

The Rajahmundry Trap Basalts （RTB） are erupted through fault-controlled fissures in the Krishna-Godavari Basin （K-G Basin） of Godavari Triple Junction, occurring as a unique outcrop sandwiched between Cretaceous and Tertiary sediments along the east coast of India. Detailed geochemical studies have revealed that RTB are mid-Ti （1.74-1.92） to high-Ti （2.04-2.81） basalts with a distinct quartz tholeiitic parentage. MgO （6.2-13.12 wt.%）, Mg# （29-50） and Zr （109-202 ppm） suggest that these basalts evolved by fractional crystallization during the ascent of the parent magma along deep-seated fractures. Mod- erate to high fractionation of HREE, as indicated by （Gd/Yb）N ratios （1.71-2.31） of RTB, suggest their generation through 3-5% melting of a Fe-rich mantle corresponding to the stability fields of spinel and garnet peridotite at depths of 60-100 km. Low K2O/P2O5 （0.26-1.26）, high TiO2/P2O5 （6.74-16.79）, La/Nb （0.89-1.45）, Nb/Th 〉 8 （8.35-13）, negative anomalies at Rb reflect minimum contamination by granitic continental crust. （Nb/La）PM ratios （0.66-1.1） of RTB are attributed to endogenic contamination resulted through recycling of subducted oceanic slab into the mantle. Pronounced Ba enrichment with relative depletion in Rb indicates assimilation of Infra- and Inter-trappean sediments of estuarine to shallow marine character. Geochemical compositions such as A1203/TiO2 （3.88-6.83）, medium to high TiO2 （1.74 -2.81 wt.%）, positive Nb anomalies and LREE enrichment of these RTB attest to their mantle plume origin and indicate the generation of parent magma from a plume-related enriched mantle source with EM 1 signature. Ba/Th （46-247）, Ba/La （3.96-28.51） and Th/Nb （0.08-0.13） ratios suggest that the source enrichment process was marked by recycling of subduction-processed oceanic crust and lithospheric components into the mantle. Zr/Hf （37-41） and Zr/Ba （0.51-3.24） indicate involvement of an asthenospheric mantle source. The Rajahmundry basalts show affinity towards FOZO （

关键词： Rajahmundry Trap Basalts (RTB) Fault-controlled fissures Fractional crystallization Enriched mantle source Plume-lithosphere interaction

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Desialylated Platelet Clearance in the Liver is a Novel Mechanism of Systemic Immunosuppression

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Research 2024年第3期2023卷 35-50页

作者： June Li Danielle Karakas Feng Xue Yingyu Chen Guangheng Zhu Yeni H.Yucel Sonya A.MacParland Haibo Zhang John W.Semple John Freedman Qizhen Shi Heyu Ni Department of Laboratory Medicine and Pathobiology University of TorontoTorontoONCanada Toronto Platelet Immunobiology Group TorontoONCanada Keenan Research Centre for Biomedical Science of St.Michael's Hospital TorontoONCanada Canadian Blood Services Centre for Innovation TorontoONCanada Departments of Pediatrics Medical College of WisconsinMilwaukeeWIUSA Blood Research Institute Versiti WisconsinMilwaukeeWIUSA Departments of Ophthalmology and Vision Sciences Medicine University of TorontoTorontoONCanada Faculty of Engineering and Architectural Science Ryerson UniversityTorontoONCanada Multi-Organ Transplant Program Toronto General Hospital Research InstituteTorontoONCanada Department of Immunology University of TorontoTorontoONCanada Critical Care Medicine Department ofAnesthesiology and PainUniversity of TorontoTorontoONCanada Department of Physiology University of TorontoTorontoONCanada Department of Pharmacology University of TorontoTorontoONCanada. Division of Hematology and Transfusion Medicine Lund UniversityLundSweden clinical Immunology and Transfusion Medicine Ofice of Medical ServicesRegion SkaneLundSweden Department of Medicine University of TorontoTorontoONCanada Children's Research Institute Children's WisconsinWauwatosaWIUSA midwest Athletes Against Childhood Cancer Fund Research Center MilwaukeeWIUSA.

Platelets are small, versatile blood cells that are critical for hemostasis/thrombosis. Local platelet accumulation is a known contributor to proinflammation in various disease states. However, the anti-inflammatory/immunosuppressive potential of platelets has been poorly explored. Here, we uncovered, unexpectedly, desialylated platelets (dPLTs) down-regulated immune responses against both platelet-associated and -independent antigen challenges. Utilizing multispectral photoacoustic tomography, we tracked dPLT trafficking to gut vasculature and an exclusive Kupffer cell-mediated dPLT clearance in the liver, a process that we identified to be synergistically dependent on platelet glycoprotein Ibα and hepatic Ashwell–Morell receptor. Mechanistically, Kupffer cell clearance of dPLT potentiated a systemic immunosuppressive state with increased anti-inflammatory cytokines and circulating CD4+ regulatory T cells, abolishable by Kupffer cell depletion. Last, in a clinically relevant model of hemophilia A, presensitization with dPLT attenuated anti-factor VIII antibody production after factor VIII ( infusion. As platelet desialylation commonly occurs in daily-aged and activated platelets, these findings open new avenues toward understanding immune homeostasis and potentiate the therapeutic potential of dPLT and engineered dPLT transfusions in controlling autoimmune and alloimmune diseases.

关键词： Platelet transfusion homeostasis

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Participation of large-scale wind power generation in power system frequency regulation

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Chinese Science Bulletin 2013年第36期58卷 4557-4565页

作者： SUN HaiShun LIU Ju WEN JinYu CHENG ShiJie LUO Cheng YAO LiangZhong State Key Laboratory of Advanced Electromagnetic Engineering and Technology School of Electrical and Electronic EngineeringHuazhong University of Science and Technology midwest Independent Transmission System Operator Inc. China Electric Power Research Institute

The initiative participation of wind power generators in power system frequency regulation is an inevitable demand to ensure power system safe operation with large-scale wind power ***,it is principally difficult for conventional wind turbines to participate in power system frequency *** this reason,solution to this problem is becoming a hot topic in the current *** paper systematically reviews the relevant research progresses in the control strategies and the capability assessment of using wind power generators in the power system frequency regulation,including the comparing among the emulating inertia control,the droop control,the rotor speed control,the pitch angle control and the coordinated ***,future research in this area is pointed out in the paper.

关键词：风力发电机电力系统频率调节控制策略风力涡轮机安全运行惯性控制转速控制

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Dairy sheep production research at the University of Wisconsin-Madison,USA-a review

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Journal of Animal Science and Biotechnology 2014年第2期5卷 127-138页

作者： David L Thomas Yves M Berger Brett C McKusick Claire M Mikolayunas University of Wisconsin-Madison Department of Animal Sciences Spooner Agricultural Research Station Current address:Merial Ltd midwest Organic Services Association ViroquaWisconsinUSA

Commercial milking of sheep is a new agricultural industry in the United States starting approximately 30 yr ago. The industry is still small, but it is growing. The majority of the sheep milk is used in the production of specialty cheeses. The United States is the major importer of sheep milk cheeses with 50 to 60% of annual world exports coming to the United States during the past 20 yr. Therefore, there is considerable growth potential for the industry in the United States. The only dairy sheep research flock in North America is located at the Spooner Agricultural Research Station of the University of Wisconsin-Madison. The research program started in 1993 and has been multifaceted; dealing with several areas important to commercial dairy sheep farmers. The East Friesian and Lacaune dairy breeds were compared and introduced to the industry through the research program. Both dairy breeds produced significantly more milk than traditional meat-wool breeds found in the U.S., but the two breeds differed in their production traits. East Friesian-cross ewes produced more lambs and slightly more milk than Lacaune-cross ewes whereas Lacaune-cross ewes produced milk with a higher percentage of fat and protein than East Friesian-cross ewes. Lactation physiology studies have shown that ewes with active corpora lutea have increased milk yields, oxytocin release during milking is required to obtain normal fat percentages in the milk, large udder cisterns of dairy ewes can allow for increased milking intervals, and short daylengths during late pregnancy results in increased milk yield. In the nutrition area, legume-grass pastures and forages with a higher percentage of legume will result in increased milk production. Grazing ewes respond to additional supplementation with increased milk yield, but it is important to match the supplement to the quality of the grazing. Ewes on high quality legume-grass pastures that are high in rumen degradable protein respond with increased milk

关键词： Dairy sheep East Friesian Grazing Lacaune Lactation physiology Nitrogen efficiency RDP RUP Supplementation

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Recalcitrant paradoxical pustular psoriasis induced by infliximab:Two case reports

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World Journal of Clinical Cases 2021年第15期9卷 3655-3661页

作者： Ping Xia Yan-Hong Li Zhong Liu Xu Zhang Qian Jiang Xiao-Yong Zhou Wei Su Department of Dermatology The First Hospital of WuhanWuhan 430022Hubei ProvinceChina Department of Dermatology Midwest Center for Dermatology and Cosmetic SurgeryClinton TownshipMI 48038United States

BACKGROUND Paradoxical psoriasis induced by tumor necrosis factor alpha antagonists is a rare side effect of those drugs and has similarities with and differences from classical psoriasis in clinical and pathological *** severe paradoxical psoriasis is challenging because the reported cases are rare,with treatment experience being only *** SUMMARY We report 2 cases of paradoxical psoriasis caused by *** cases manifested with a significant number of pustular lesions and had protracted and complicated clinical *** case 1,secukinumab alone could not control the eruptions,but colchicine supplementation markedly decreased disease *** case 2 miscellaneous medications were administered,including the systemic drug acitretin,the immunosuppressive drug cyclosporine,and the biologic agent ***,multiple applications of those medications failed to prevent new lesions from *** cases showed moderate-to-high antinuclear antibody *** Based on these cases,moderate-to-high anti-nuclear antibody titer seems to be a risk factor for paradoxical *** addition,extensive pustular presentation may be a negative prognostic indicator and may portend a protracted clinical course refractory to therapy.

关键词： Pustular psoriasis Paradoxical Infliximab Secukinumab Ustekinumab Antinuclear antibody Case report

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