Mixed domain coherent link with electrically reconfigurable IMDD and coherent modes for O-band data center applications.

We report the first O-band link with electrically reconfigurable intensity-modulation direct-detection (IMDD) and coherent operation using custom silicon photonic chips packaged with commercial electronic chips. Transmission below the KP4-FEC threshold is shown using commercial 53 Gbaud PAM4 digital signal processing (DSP) for 16QAM (200 Gbps/λ) and PAM4 (100 Gbps/λ). Efficient operation of the packaged full link at 12 and 11.

Carpal Tunnel Surgery: Can Patients Read, Understand, and Act on Online Educational Resources?

Background: Patients often access online resources to educate themselves prior to undergoing elective surgery such as carpal tunnel release (CTR). The purpose of this study was to evaluate available online resources regarding CTR on objective measures of readability (syntax reading grade-level), understandability (ability to convey key messages in a comprehensible manner), and actionability (providing actions the reader may take).

Methods: The study conducted two independent Google searches for "Carpal Tunnel Surgery" and among the top 50 results, analyzed articles aimed at educating patients about CTR.

Buffering Mitigates Chondrocyte Oxidative Stress, Metabolic Dysfunction, and Death Induced by Normal Saline: Formulation of a Novel Arthroscopic Irrigant.

For decades, surgeons have utilized 0.9% normal saline (NS) for joint irrigation to improve visualization during arthroscopic procedures. This continues despite mounting evidence that NS exposure impairs chondrocyte metabolism and compromises articular cartilage function.

Ulnar Variance in Athletes: A Scoping Review.

Context: Ulnar variance (UV) is a measurement of the relative locations of the radius and ulna that may become perturbed in athletic populations. Positive UV can be associated with wrist pathologies often treated conservatively or surgically and may result in interruption of sports participation.

Objective: This scoping review aims to summarize diagnostic measures of UV in athletes, describe its relation to separate wrist conditions, and present treatment strategies for symptomatic UV.

Retrieval of a Lane Plate 82 Years After Implantation: Case Report, Metallurgical Analysis, and Historical Review.

Background: The Lane plate was one of the first widely used bone plates, utilized in the first decades of the twentieth century. Here we present the results of a retrieval analysis on a Lane plate, and a review of the history of these plates. Our patient underwent plating of her femur with a Lane plate in 1938.

Early Versus Delayed Surgery for Midshaft Clavicle Fractures: A Systematic Review.

Background: Orthopaedic surgeons debate the timing of and necessity for surgical intervention when treating displaced midshaft clavicle fractures (MCFs). This systematic review evaluates the available literature regarding functional outcomes, complication rates, nonunion, and reoperation rates between patients undergoing early versus delayed surgical management of MCFs.

Methods: Search strategies were applied in PubMed (Medline), CINAHL (EBSCO), Embase (Elsevier), Sport Discus (EBSCO), and Cochrane Central Register of Controlled Trials (Wiley).

Integrated SOAs enable energy-efficient intra-data center coherent links.

Coherent optical links are becoming increasingly attractive for intra-data center applications as data rates scale. Realizing the era of high-volume short-reach coherent links will require substantial improvements in transceiver cost and power efficiency, necessitating a reassessment of conventional architectures best-suited for longer-reach links and a review of assumptions for shorter-reach implementations. In this work, we analyze the impact of integrated semiconductor optical amplifiers (SOAs) on link performance and power consumption, and describe the optimal design spaces for low-cost and energy-efficient coherent links.

Efficiency Benefits of Live Fluoroscopy in Hand Clinics.

Background: Postoperative imaging protocols for common hand procedures typically consist of 2-3 plain radiographs at defined intervals dependent on the surgery. Radiographs typically verify reduction, hardware position, and/or evaluate for complications, but also generate costs and alterations in clinic flow. We hypothesize the use of mini-fluoroscopic images will provide comparable clinical data with less cost and improved clinic flow.

The Rurality of Lower Extremity Firearm Injuries.

Background: To highlight the unique spectrum of lower extremity firearm injuries seen at a rural, Midwestern level 1 trauma center to provide insight into prevalence, mechanism of injury, and identify modifiable factors that contribute to firearm injuries of the lower extremity. It is our belief that the creation of our database will help future trauma and firearm databases improve documentation and understand the relationship between anatomic location of injury and outcomes.

Methods: A retrospective review of lower extremity firearm injuries from a rural, Midwestern level 1 trauma center was collected from January 2011 to December 2019.

Comparison of Early versus Late Below Knee Amputation After Trauma With Standardized Prosthetic Care.

Background: High energy, lower extremity trauma is associated with longstanding pain and functional limitations. The clinical decision to proceed with early amputation or limb salvage is often controversial. This study was designed to compare differences in complications, costs, and clinical outcomes of below knee amputation (BKA) performed early after injury or after attempted limb salvage in a hospital with standardized prosthetic care following amputation.

Menstrual hormone-induced cyclic thumb CMC instability and degeneration in women: a systematic review.

Background: Relaxin is a hormone which peaks during the luteal phase of the menstrual cycle, and a known collagenolytic promoter that has been shown to avidly bind tissues supporting the trapeziometacarpal (TMC) joint in women. We hypothesize a causal linkage between cyclic binding of relaxin to the supporting tissues of the female TMC joint; and to the earlier onset of more severe TMC osteoarthritis (OA) commonly seen in women.

Methods: A systematic literature review was performed per PRISMA guidelines, qualitatively and quantitatively assessing papers regarding relaxin-TMC joint stability interactions.

Objective evaluation of chondrocyte density & cloning after joint injury using convolutional neural networks.

Variations in chondrocyte density and organization in cartilage histology sections are associated with osteoarthritis progression. Rapid, accurate quantification of these two features can facilitate the evaluation of cartilage health and advance the understanding of their significance. The goal of this work was to adapt deep-learning-based methods to detect articular chondrocytes and chondrocyte clones from safranin-O-stained cartilage to evaluate chondrocyte cellularity and organization.

Migrating Progenitor Cells Derived From Injured Cartilage Surface Respond to Damage-Associated Molecular Patterns.

Objective: To delineate the response of migrating chondrogenic progenitor cells (CPCs) that arose from the surface of mechanically injured articular cartilage to proinflammatory damage-associated-molecular-patterns (DAMPs).

Design: Bovine CPCs and non-CPC chondrocytes isolated from either impacted or scratched articular cartilage were studied. Those 2 types of cells were treated with mitochondrial DAMPs (MTDs; 10 nM fMLF and 10 µg/mL CpG DNA), or 10 nM HMGB1, or 10 ng/mL IL-1b for 24 hours.

The Rurality of Upper Extremity Firearm Injuries.

Background: To highlight the unique spectrum of hand and upper extremity firearm injuries seen at a rural, Midwestern level 1 trauma center and identify modifiable factors that contribute to firearm injuries of the hand and upper extremity.

Methods: A retrospective review of upper extremity firearm injuries from a rural, Midwestern level 1 trauma center was collected from January 2002 to December 2019. Data acquired included injury description, demographics, injury mechanism/description/location, firearm used, toxicology, and information regarding hospitalization.

Inclusion of Olecranon Osteotomy With the Posterior Approach for Fixation of Distal Humerus Fractures (OTA/AO 13) Does Not Increase Surgical Complications.

Objectives: To determine if inclusion of an olecranon osteotomy to the posterior paratricipital approach for operative fixation of distal humerus fractures significantly affects surgical complication rates (OTA/AO 13).

Design: Retrospective comparative cohort study.

Setting: Level 1 trauma center.

One-day Acceptance and Commitment Therapy workshop for preventing persistent post-surgical pain and dysfunction in at-risk veterans: A randomized controlled trial protocol.

Objective: Persistent post-surgical pain is common among patients undergoing surgery, is detrimental to patients' quality of life, and can precipitate long-term opioid use. The purpose of this randomized controlled trial is to assess the effects of a behavioral intervention offered prior to surgery for patients at risk for poor post-surgical outcomes, including persistent pain and impaired functioning.

Methods: Described herein is an ongoing randomized, patient- and assessor-blind, attention-controlled multisite clinical trial.

Sarcopenia is Associated with Nonunion of Open Tibia and Ankle Fractures.

Background: Sarcopenia is a clinical syndrome of diminished muscle mass and function associated with disability, poor surgical outcomes, and mortality. Open fractures of the tibia and ankle have a high risk for complications including nonunion and surgical site infection (SSI). The purpose of this study is to determine if sarcopenia is associated with SSI and nonunion in individuals that sustain open fractures of the tibia and ankle.

Heart Rate Variability as an Index of Resilience.

Introduction: Resilience is the ability to maintain or quickly return to a stable physical and psychological equilibrium despite experiencing stressful events. Flexibility of the autonomic nervous system is particularly important for adaptive stress responses and may contribute to individual differences in resilience. Power spectrum analysis of heart rate variability (HRV) allows measurement of sympathovagal balance, which helps to evaluate autonomic flexibility.

Hypermethylation of FOXA1 and allelic loss of PTEN drive squamous differentiation and promote heterogeneity in bladder cancer.

Intratumoral heterogeneity in bladder cancer is a barrier to accurate molecular sub-classification and treatment efficacy. However, individual cellular and mechanistic contributions to tumor heterogeneity are controversial. We examined potential mechanisms of FOXA1 and PTEN inactivation in bladder cancer and their contribution to tumor heterogeneity.

Supermicrosurgery in fingertip defects-split tibial flap of the second toe to reconstruct multiple fingertip defects: A case report.

Background: Injuries to multiple fingertips pose a significant treatment dilemma. Numerous reconstructive options exist, all with the ultimate goal of restoring function and sensibility to the injured fingertips.

Case Summary: A 24-year-old male suffered injury to multiple fingertips of the right hand, resulting in exposed distal phalanges of the middle, ring, and small fingers.

Characterization of Histone Deacetylase Expression Within In Vitro and In Vivo Bladder Cancer Model Systems.

Epigenetic aberrations are prominent in bladder cancer (BC) and contribute to disease pathogenesis. We characterized histone deacetylase (HDAC) expression, a family of deacetylation enzymes, in both in vitro and in vivo BC model systems and analyzed expression data from The Cancer Genome Atlas (TCGA). Quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting analysis was used to determine the expression status of Class I and II HDACs in ten human BC cell lines, while qRT-PCR was used to determine HDAC expression in 24 human tumor specimens.