Medial Head of the Gastrocnemius Tenotomy Through a Posteromedial Approach Significantly Improves Surgical Accessibility of the Tibial Plateau.

Objectives: Compare accessible area of the posterior tibial plateau through a modified posteromedial (PM) approach before and after tenotomy of the medial head gastrocnemius. We report the outcomes of 8 patients who underwent gastrocnemius tenotomy during PM approach.

Methods: A modified PM approach was performed on 10 cadaveric legs, and the surgically accessible area was outlined.

Barely fluorescent molecules. II. Twin-discharge jet laser-induced fluorescence spectroscopy of HSnBr and DSnBr.

HSnBr and DSnBr have been detected for the first time by a combination of laser-induced fluorescence (LIF), fluorescence hole-burning, and wavelength resolved emission spectroscopies. The transient molecules were produced in a twin-discharge jet using separate precursor streams of SnH/SnD and HBr/DBr, both diluted in high pressure argon. The ÃA″-X̃A' spectrum of HSnBr only consists of the 0 and 2 cold bands that show clearly resolved subband structure with fluorescence lifetimes varying from 526 to 162 ns.

Data associated with a tellurium absorption atlas 19,000 - 24,000 cm.

Transmittance and absorbance data in the form of a spectral atlas have been obtained from Fourier transform spectra recorded on a commercial (Bomem DA3) instrument, operated with an external white light source injected through the instrument's `emission' port. The sample was a sealed, evacuated cell containing a small quantity of Te. This cell was placed in a ceramic furnace maintained close to 620 °C, with tellurium vapor pressures 8-11 Torr.

Patient-Reported Outcomes After Lateral Process Talus Fracture.

Objectives: To evaluate functional outcome after lateral process talus fracture using patient-reported instruments and identify injury characteristics that portend a worse prognosis.

Design: Retrospective case series.

Setting: Level 1 academic trauma center.

Convergent Total Synthesis of Yaku'amide A.

Total synthesis of the anticancer peptide natural product yaku'amide A is reported. Its β-tert-hydroxy amino acids were prepared by regioselective aminohydroxylation involving a chiral mesyloxycarbamate reagent. Stereospecific construction of the E- and Z-ΔIle residues was accomplished through a one-pot reaction featuring anti dehydration, azide reduction, and O→N acyl transfer.

Estimating the effect of focused donor registration efforts on the number of organ donors.

Waiting times for organs in the United States are long and vary widely across regions. Donor registration can increase the number of potential donors, but its effect on the actual number of organ transplants depends upon several factors. First among these factors is that deceased donor organ donation requires both that death occur in a way making recovery possible and that authorization to recover organs is obtained.

Patient Outcomes After Transolecranon Fracture-Dislocation.

Introduction: There are few small case series that discuss patient outcomes after a transolecranon fracture-dislocation, and they suggest that patients have reasonable function after injury. The purpose of this study was to describe the injury pattern and clinical outcomes of transolecranon fracture-dislocations.

Methods: After Institutional Review Board approval, transolecranon fracture-dislocations treated at two academic level 1 trauma centers between 2005 and 2018 were retrospectively reviewed.

Reconciliation of Differences in Apparent Diffusion Coefficients Measured for Self-Exchange Electron Transfer between Molecules Anchored to Mesoporous Titanium Dioxide Thin Films.

Redox-active sites present at large concentrations as part of a solid support or dissolved as molecules in fluid solutions undergo reversible self-exchange electron-transfer reactions. These processes can be monitored using a variety of techniques. Chronoamperometry and cyclic voltammetry are common techniques used to interrogate this behavior for molecules bound to mesoporous thin films of wide-bandgap semiconductors and insulators.

Shear Bond Comparison between 4 Bioceramic Materials and Dual-cure Composite Resin.

Introduction: Bioceramic materials have shown biologic and physical properties favorable for regenerative treatment. A key to treatment success is an adequate restoration to prevent microleakage; however, research is limited regarding the bond strength between restorative and bioceramic materials used in regenerative procedures. This study compared the bond strength between 4 bioceramic materials and a dual-cure composite resin.

Insights into base-free OsO-catalyzed aminohydroxylations employing chiral ligands.

Attempts to perform the OsO-catalyzed enantioselective base-free aminohydroxylation of β,β-disubstituted enoates are described. Low yields and racemic products were obtained in the presence of standard chiral ligands, suggesting the occurrence of a "Second Cycle" process due to slow hydrolysis of the amino alcohol product from the Os metal center. Support for this hypothesis was provided by the slightly improved enantioselectivity (60:40 er) obtained with an amino alcohol ligand.

Interacting circadian and homeostatic processes with opportunity cost: A mathematical model of sleep with application to two mammalian species.

This paper introduces a new model of sleep for mammals. It extends the classic 'two-process' model of sleep to account for differences in external circumstances. We apply this model to previously-collected data on elephants and sloths, comparing sleep patterns in the wild with sleep patterns in captivity.

Femoropopliteal In-stent Restenosis Repair: Midterm Outcomes After Paclitaxel Eluting Balloon Use (PLAISIR Trial).

Objective: The aim was to assess 18 month outcomes of the paclitaxel eluting balloon (PEB) in patients with femoropopliteal (FP) in-stent restenosis (ISR).

Methods: In a national prospective and multicentre cohort study, symptomatic patients with femoropopliteal in-stent restenosis were included from January 2012 to June 2013. Patients were treated by paclitaxel eluting balloon angioplasty (In Pact Admiral, Medtronic, Santa Rosa, CA, USA).

Selective access to E- and Z-ΔIle-containing peptides via a stereospecific E2 dehydration and an O → N acyl transfer.

A concise synthesis of peptides that contain E- or Z-dehydroisoleucine (ΔIle) residues is reported. The key reaction is an unusual anti dehydration of β-tert-hydroxy amino acid derivatives that is mediated by the Martin sulfurane. A subsequent tandem Staudinger reduction-O → N acyl transfer process forges an amide bond to the ΔIle residue with minimal E/Z alkene isomerization.

The Distributional Effects of Health Reform Limits on Flexible Spending Accounts.

Flexible spending accounts (FSAs) are a widely used arrangement that allow employees to pay for qualified out-of-pocket health expenses with pre-tax dollars. The tax preference given to FSAs has been controversial and recent health care law (Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act) limits the tax exclusion to an inflation-adjusted value of $2,500 (2013 $s). The limit is estimated to increase federal payroll and income tax receipts by $13 billion between 2013 and 2019.

[Stenting in superficial femoral artery and usCRP: Multicentric study SAFE in 255 patients].

Objective: To evaluate mid-term primary patency of the femoral artery stenting in correlation with usCRP level and characteristics of the population, morphological aspect of the lesions and interventional techniques.

Methods: Patients were prospectively included in a multicenter study (18 centers in France) after stenting (SMART, Cordis Johnson & Johnson, Issy-les-Moulineaux, France) of the superficial femoral artery (SFA). Inclusion and exclusion criteria were based on recommendations and every day practice of the centers.

Antimicrobial susceptibility of monoculture biofilms of a clinical isolate of Enterococcus faecalis.

The purpose of this study was to create a monoculture biofilm of a clinical isolate of Enterococcus faecalis and to determine susceptibility against four antimicrobial irrigants. Biofilms were subjected to 1-, 3-, and 5-minute exposures to one of the following irrigants: 6% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate (CHX) or one of two new products, <6% NaOCl with surface modifiers (Chlor-XTRA) or 2% CHX with surface modifiers (CHX-Plus) (Vista Dental Products, Racine, WI). It was hypothesized that NaOCl and CHX would be equally effective and that addition of surface modifiers would improve bactericidal activity of the respective irrigants compared to the original formulations.

Value of cutting balloon angioplasty for limb salvage in patients with obstruction of popliteal and distal arteries.

Popliteal-to-distal bypass is still the gold standard for limb salvage. However, some patients, especially elderly or diabetic patients, are not eligible for such treatment; and problems may arise, including poor healing of distal surgical wounds, delayed resumption of ambulation, and prolonged hospitalization. This prospective multicenter study carried out on an intent-to-treat basis includes 53 extremities in 48 patients presenting critical ischemia due to infrageniculate arterial lesions with no proximal lesions.

Ankle replacement versus arthrodesis: a comparative gait analysis study.

Background: The improving survivorship of ankle replacements is making this an increasingly popular option in the treatment of ankle arthritis, rather than the established option of ankle fusion. The potential benefits of restoring movement, improving gait and protecting adjacent joints are persuasive arguments in favor of replacing rather than fusing the ankle joint.

Methods: Gait analysis was performed before and after ankle arthroplasty on 12 patients, and compared to 12 patients with a successful ankle arthrodesis and to a healthy control group of 12 people.

Insurance choice and tax-preferred health savings accounts.

We develop an infinite horizon utility maximization model of the interaction between insurance choice and tax-preferred health savings accounts. The model can be used to examine a wide range of policy options, including flexible spending accounts, health savings accounts, and health reimbursement accounts. We also develop a 2-period model to simulate various implications of the model.

[About two big buttocks: an erysipelas with lymphoedema after pelvis surgery].

We report the case of a 58-year-old man with erysipelas of both buttocks secondary to lymphoedema after pelvis surgery for prostatic cancer and multiple vascular interventions for iliofemoral thrombosis. The diagnosis was based on clinical examination and lymphoscintigraphy. This location of lymphoedema, limited to the buttocks, is uncommon; lower limbs are usually affected.

Symptoms plus family history trump size in thoracic aortic aneurysm.

A 43-year-old woman presented with chest pain of unclear cause. The patient's mother and brother had suffered aortic dissection. Echocardiography had shown mild dilatation of the ascending aorta at 4.

Correction of phase distortion in spatial heterodyne spectroscopy.

The detailed analysis of measured interferograms generally requires phase correction. Phase-shift correction methods are commonly used and well documented for conventional Fourier-transform spectroscopy. However, measured interferograms can show additional phase errors, depending on the optical path difference and signal frequency, which we call phase distortion.

The effect of endodontic solutions on resorcinol-formalin paste in teeth.

This study determined if any of six endodontic solutions would have a softening effect on resorcinol-formalin paste in extracted teeth, and if there were any differences in the solvent action between these solutions. Forty-nine single-rooted extracted teeth were decoronated 2 mm coronal to the CEJ, and the roots sectioned apically to a standard length of 15 mm. Canals were prepared to a 12 mm WL and a uniform size with a #7 Parapost drill.

Robust monolithic ultraviolet interferometer for the SHIMMER instrument on STPSat-1.

We describe the design, fabrication, and testing of a monolithic interferometer consisting entirely of optically contacted fused-silica optical elements that are assembled, adjusted, and permanently bonded in place. The interferometer is part of a spatial heterodyne spectrometer (SHS) [SHIMMER (Spatial Heterodyne Imager for Mesospheric Radicals)] that will be used for near-ultraviolet high-spectral-resolution limb imaging of OH solar resonance fluorescence from low Earth orbit aboard the satellite STPSat-1 scheduled for launch in 2006. The stability of the monolith coupled with the relaxed tolerances on optical quality and alignment inherent to SHS make this new instrument extremely robust and especially attractive for applications in harsh environments.