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Nature Communications Jun 2024Light-weight, high-strength, aluminum (Al) alloys have widespread industrial applications. However, most commercially available high-strength Al alloys, like AA 7075,...
Light-weight, high-strength, aluminum (Al) alloys have widespread industrial applications. However, most commercially available high-strength Al alloys, like AA 7075, are not suitable for additive manufacturing due to their high susceptibility to solidification cracking. In this work, a custom Al alloy AlTiFeCoNi is fabricated by selective laser melting. Heterogeneous nanoscale medium-entropy intermetallic lamella form in the as-printed Al alloy. Macroscale compression tests reveal a combination of high strength, over 700 MPa, and prominent plastic deformability. Micropillar compression tests display significant back stress in all regions, and certain regions have flow stresses exceeding 900 MPa. Post-deformation analyses reveal that, in addition to abundant dislocation activities in Al matrix, complex dislocation structures and stacking faults form in monoclinic AlCo type brittle intermetallics. This study shows that proper introduction of heterogeneous microstructures and nanoscale medium entropy intermetallics offer an alternative solution to the design of ultrastrong, deformable Al alloys via additive manufacturing.
PubMed: 38879562
DOI: 10.1038/s41467-024-48693-4 -
BMC Musculoskeletal Disorders Jun 2024Traumatic proximal tibiofibular fracture and dislocation (PTFD) have been rarely studied and are easily missed in clinical practice. PTFD is considered a marker of...
BACKGROUND
Traumatic proximal tibiofibular fracture and dislocation (PTFD) have been rarely studied and are easily missed in clinical practice. PTFD is considered a marker of severely traumatized knees. The purpose of this study was to retrospectively analyze the incidence and impact of PTFD in traumatized knees with vascular injury.
METHODS
Patients with knee trauma and vascular injury were included from January 2022 to October 2023. X-rays and CT scans of included patients were retrospectively analyzed to determine the presence of PTFD. Patients were further divided into PTFD group and non-PTFD group for further comparative analysis.
RESULTS
A total of 27 patients (28 limbs) were included. Incidence of PTFD was 39.3% (11/28) in traumatic knee with vascular injury, including 8 anterolateral dislocations and 3 posteromedial dislocations. PTFD group had significantly more limbs with open injuries compared with non-PTFD group (10/11 VS 7/17, p<0.05). Amputation rate of PTFD group was as high as 40% (4/10), compared to 23.5% (4/17) in non-PTFD group. However, the difference between two groups was not statistically significant (p>0.05).
CONCLUSIONS
PTFD was easily overlooked or missed. In traumatized knees with vascular injury, incidence of PTFD was high. The presence of PTFD might indicate severe knee trauma and the possibility of open injury. Although there was no significant difference compared with non-PTFD group, PTFD group had a relatively high amputation rate of 40%.
Topics: Humans; Male; Female; Retrospective Studies; Adult; Middle Aged; Tibial Fractures; Knee Dislocation; Fibula; Incidence; Young Adult; Tomography, X-Ray Computed; Vascular System Injuries; Amputation, Surgical; Aged; Knee Injuries; Adolescent
PubMed: 38879480
DOI: 10.1186/s12891-024-07577-w -
Journal of Orthopaedic Surgery and... Jun 2024Postoperative pulmonary complications (PPCs) are among the most severe complications following total hip arthroplasty revision (THAR), imposing significant burdens on...
BACKGROUND
Postoperative pulmonary complications (PPCs) are among the most severe complications following total hip arthroplasty revision (THAR), imposing significant burdens on individuals and society. This study examined the prevalence and risk factors of PPCs following THAR using the NIS database, identifying specific pulmonary complications (SPCs) and their associated risks, including pneumonia, acute respiratory failure (ARF), and pulmonary embolism (PE).
METHODS
The National Inpatient Sample (NIS) database was used for this cross-sectional study. The analysis included patients undergoing THAR based on NIS from 2010 to 2019. Available data include demographic data, diagnostic and procedure codes, total charges, length of stay (LOS), hospital information, insurance information, and discharges.
RESULTS
From the NIS database, a total of 112,735 THAR patients in total were extracted. After THAR surgery, there was a 2.62% overall incidence of PPCs. Patients with PPCs after THAR demonstrated increased LOS, total charges, usage of Medicare, and in-hospital mortality. The following variables have been determined as potential risk factors for PPCs: advanced age, pulmonary circulation disorders, fluid and electrolyte disorders, weight loss, congestive heart failure, metastatic cancer, other neurological disorders (encephalopathy, cerebral edema, multiple sclerosis etc.), coagulopathy, paralysis, chronic pulmonary disease, renal failure, acute heart failure, deep vein thrombosis, acute myocardial infarction, peripheral vascular disease, stroke, continuous trauma ventilation, cardiac arrest, blood transfusion, dislocation of joint, and hemorrhage.
CONCLUSIONS
Our study revealed a 2.62% incidence of PPCs, with pneumonia, ARF, and PE accounting for 1.24%, 1.31%, and 0.41%, respectively. A multitude of risk factors for PPCs were identified, underscoring the importance of preoperative optimization to mitigate PPCs and enhance postoperative outcomes.
Topics: Humans; Arthroplasty, Replacement, Hip; Risk Factors; Postoperative Complications; Male; Female; Retrospective Studies; Incidence; Aged; Middle Aged; Cross-Sectional Studies; Databases, Factual; Pulmonary Embolism; Reoperation; Length of Stay; Lung Diseases; United States; Pneumonia; Adult; Aged, 80 and over; Respiratory Insufficiency; Inpatients
PubMed: 38877587
DOI: 10.1186/s13018-024-04836-3 -
Nature Communications Jun 2024Low-cost thermoelectric materials with simultaneous high performance and superior plasticity at room temperature are urgently demanded due to the lack of ever-lasting...
Low-cost thermoelectric materials with simultaneous high performance and superior plasticity at room temperature are urgently demanded due to the lack of ever-lasting power supply for flexible electronics. However, the inherent brittleness in conventional thermoelectric semiconductors and the inferior thermoelectric performance in plastic organics/inorganics severely limit such applications. Here, we report low-cost inorganic polycrystalline MgSbBiTe, which demonstrates a remarkable combination of large strain (~ 43%) and high figure of merit zT (~ 0.72) at room temperature, surpassing both brittle Bi(Te,Se) (strain ≤ 5%) and plastic Ag(Te,Se,S) and organics (zT ≤ 0.4). By revealing the inherent high plasticity in MgSb and MgBi, capable of sustaining over 30% compressive strain in polycrystalline form, and the remarkable deformability of single-crystalline MgBi under bending, cutting, and twisting, we optimize the Bi contents in MgSbBi (x = 0 to 1) to simultaneously boost its room-temperature thermoelectric performance and plasticity. The exceptional plasticity of MgSbBi is further revealed to be brought by the presence of a dense dislocation network and the persistent Mg-Sb/Bi bonds during slipping. Leveraging its high plasticity and strength, polycrystalline MgSbBi can be easily processed into micro-scale dimensions. As a result, we successfully fabricate both in-plane and out-of-plane flexible MgSbBi thermoelectric modules, demonstrating promising power density. The inherent remarkable plasticity and high thermoelectric performance of MgSbBi hold the potential for significant advancements in flexible electronics and also inspire further exploration of plastic inorganic semiconductors.
PubMed: 38876994
DOI: 10.1038/s41467-024-49440-5 -
Cureus May 2024Atypical fractures are gaining attention as a severe potential side effect of long-term treatment with bone-modifying agents (e.g., bisphosphonate and denosumab) for...
Atypical fractures are gaining attention as a severe potential side effect of long-term treatment with bone-modifying agents (e.g., bisphosphonate and denosumab) for osteoporosis. Most atypical fractures occur in weight-bearing bones; the femur is the most frequent site. Atypical fractures occurring in non-weight-bearing bones are extremely rare. We describe an atypical fracture of the scapular spine in a 92-year-old Japanese woman with osteoporosis who had been treated with minodronate for ~7 years. Although the dislocation of the fracture site remained after conservative treatment, there was no obstacle to her daily life.
PubMed: 38872707
DOI: 10.7759/cureus.60237 -
Injury Epidemiology Jun 2024Hand injuries constitute up to 30% of the total cases treated in emergency departments. Over time, demographic changes, especially an aging population, and shifts in...
INTRODUCTION
Hand injuries constitute up to 30% of the total cases treated in emergency departments. Over time, demographic changes, especially an aging population, and shifts in workplace safety regulations and healthcare policies have significantly impacted the landscape of hand trauma. This study aims to identify and analyze these evolving trends over nearly two decades.
METHODS
In this retrospective, cross-sectional study, we investigated patients who were admitted to the high-volume regional hand trauma center of a university hospital between January 2007 and December 2022. We analyzed trends in patients' demographics and annual alterations of injuries. For the comparative analysis, patients were divided into two groups based on the time of presentation: the early cohort (2007-2014) and the current cohort (2015-2022).
RESULTS
A total of 14,414 patients were admitted to our emergency department within the study period. A significant annual increase in patient age was identified (R = 0.254, p = 0.047). The number of presentations increased annually by an average of 2% (p < 0.001). The incidence of the following hand injuries significantly increased: sprains/strains (+ 70.51%, p = 0.004), superficial lacerations (+ 53.99%, p < 0.001), joint dislocations (+ 51.28%, p < 0.001), fractures (carpal: + 49.25%, p = 0.003; noncarpal: + 39.18%, p < 0.001), deep lacerations (+ 37.16%, p < 0.001) and burns and corrosions (+ 29.45%, p < 0.001). However, rates of amputations decreased significantly (- 22.09%, p = 0.04).
CONCLUSIONS
A consistent and significant annual increase in both the total number of injuries and the average age of patients was identified. An aging population may increase injury rates and comorbidities, stressing healthcare resources. Our study underscores the need to adapt healthcare structures and reimbursement policies, especially for outpatient hand injury care.
PubMed: 38872185
DOI: 10.1186/s40621-024-00510-8 -
JBJS Case Connector Apr 2024A 14-year-old adolescent boy with SCN1B mutation experienced frequent seizures and recurrent elbow dislocation, occurring up to 30 times per day. Following failed...
CASE
A 14-year-old adolescent boy with SCN1B mutation experienced frequent seizures and recurrent elbow dislocation, occurring up to 30 times per day. Following failed conservative treatment, the decision was made to surgically repair the lateral collateral ligament complex and stabilize the elbow with the internal joint stabilizer (IJS). At more than 3 years postoperatively, the patient has not had a dislocation event and will retain the device for the foreseeable future to maintain predictable elbow stability.
CONCLUSION
Although there is scant evidence supporting the use of the IJS in pediatric cases, the current case supports its use in pediatric elbow instability.
Topics: Humans; Adolescent; Male; Joint Dislocations; Elbow Joint; Joint Instability; Elbow Injuries; Recurrence
PubMed: 38870329
DOI: 10.2106/JBJS.CC.24.00074 -
Spine Surgery and Related Research May 2024Studies describing the relationship between the hip and spine have reported that corrective spinal surgery for adult spinal deformity (ASD) affects the orientation of...
INTRODUCTION
Studies describing the relationship between the hip and spine have reported that corrective spinal surgery for adult spinal deformity (ASD) affects the orientation of the acetabulum. However, the extent to which spinal correction in ASD affects acetabular anteversion in the standing position is unclear, especially after total hip arthroplasty, for which dislocation is a concern. The purpose of this study was to evaluate changes in anterior acetabular coverage in the upright position due to extensive correction surgery for ASD.
METHODS
Thirty-six consecutive patients who had undergone spinal corrective surgery from the thoracolumbar region to the pelvis were enrolled and evaluated. The ventral-central-acetabular (VCA) angle and anterior acetabular head index (AAHI) were measured with a false-profile view to evaluate the relationship between acetabular anteversion in the standing position and spinopelvic parameters before and after surgery. The spinopelvic parameters measured included thoracic kyphosis, pelvic incidence, pelvic tilt (PT), sacral slope, lumbar lordosis (LL), sagittal vertical axis, and global tilt.
RESULTS
The VCA angle and AAHI were significantly increased after spinal deformity correction (p<0.001). The changes in LL and PT were correlated with the VCA angle (LL: right, ρ=0.56; left, ρ=0.55, p<0.001; PT: right, ρ=-0.59; left, ρ=-0.64, p<0.001) and AAHI (LL: right, ρ=0.51; left, ρ=0.58, p<0.01; PT: right, ρ=-0.52; left, ρ=-0.59, p<0.01), respectively. Linear regression analysis revealed that a 10° increase in LL results in 1.4°-1.9° and 1.6%-2% increases in the VCA angle and AAHI, respectively.
CONCLUSIONS
Surgical correction for ASD significantly affects sagittal spinopelvic parameters, resulting in increased acetabular anteversion. The anterior coverage of the acetabulum in the postoperative standing position could be predicted with the intraoperatively measured LL, and evaluation using a false-profile was considered useful for treating ASD, particularly in patients after total hip arthroplasty.
PubMed: 38868798
DOI: 10.22603/ssrr.2023-0273 -
Deutsches Arzteblatt International Apr 2024
Topics: Humans; Hip Dislocation; Child; Male
PubMed: 38867550
DOI: 10.3238/arztebl.m2023.0058