A 43-year-old female patient with migraines presented with rightsided headaches, jaw and ear pain... more A 43-year-old female patient with migraines presented with rightsided headaches, jaw and ear pain, tongue and uvula deviation, right arm weakness, and dysphagia of solids and liquids resulting in a 7pound weight loss. Neurologic examination included serologic and cerebrospinal fluid evaluation, which ruled out infectious, inflammatory, and paraneoplastic diseases. Magnetic resonance imaging of the brain and computed tomography angiography of the head and neck ruled out cerebrovascular accident and vasculitis. The single abnormality was the distal internal carotid artery (ICA) in the parapharyngeal space (PPS). She was found to have bilateral ICA dissections with pseudoaneurysm (PSA), the left (11 mm in diameter) larger than the right (9 mm in diameter; A). A three-dimensional reconstruction of the computed tomography angiogram was obtained, and this demonstrated right ICA PSA impingement of the roots of cranial nerves IX, X, XI, and XII, symptoms known as the Collet-Sicard syndrome (B/Cover). Our diagnosis for its cause is fibromuscular dysplasia. The patient was treated empirically with prednisone, which worsened her symptoms. Therefore, she underwent placement of a Pipeline embolization device (PED; Medtronic, Minneapolis, Minn) into the right distal ICA (C). This PED stent is a flexible meshlike, bimetallic 48-strand braided construction that provides flow diversion and reduction of flow within aneurysms, which will then thrombose, approved for intracranial aneurysms. She was discharged from the hospital 2 days after this intervention on dual antiplatelet therapy (aspirin and clopidogrel) for 6 months. The patient noticed improvement within the first week of intervention and complete resolution of all symptoms by 1 month. Diagnostic angiography at the 2-month mark demonstrated an excellent result (D). Cranial nerve palsies due to lesions of the ICA are extremely rare. However, when they occur, fibromuscular dysplasia is the most common of the arteriopathies. 1,2 A constellation of symptoms involving the PPS was first described by Frédéric Collet and Jean Sicard in post-traumatic cases as a result of metallic fragments dislodged in the PPS. 3,4 Here, we describe a symptomatic right ICA dissection with PSA treated with the PED system. The use of this stent system From the Section of Vascular and Endovascular Surgery,
Journal of the American Academy of Orthopaedic Surgeons, 2007
Osteonecrosis, also referred to as avascular necrosis, refers to the death of cells within bone c... more Osteonecrosis, also referred to as avascular necrosis, refers to the death of cells within bone caused by a lack of circulation. It has been documented in bones throughout the body. In the foot, osteonecrosis is most commonly seen in the talus, the first and second metatarsals, and the navicular. Although uncommon, osteonecrosis has been documented in almost every bone of the foot and therefore should be considered in the differential diagnosis when evaluating both adult and pediatric foot pain. Osteonecrosis is associated with many foot problems, including fractures of the talar neck and navicular as well as Kohler's disease and Freiberg's disease. Orthopaedists who manage foot disorders will at some point likely be faced with the challenges associated with patients with osteonecrosis of the foot. Because this disease can masquerade as many other pathologies, physicians should be aware of the etiology, presentation, and treatment options for osteonecrosis in the foot.
Journal of the American Academy of Orthopaedic Surgeons, 2008
Lateral epicondylitis, or tennis elbow, is a common cause of elbow pain in the general population... more Lateral epicondylitis, or tennis elbow, is a common cause of elbow pain in the general population. Traditionally, lateral epicondylitis has been attributed to degeneration of the extensor carpi radialis brevis origin, although the underlying collateral ligamentous complex and joint capsule also have been implicated. Nonsurgical treatment, the mainstay of management, involves a myriad of options, including rest, nonsteroidal anti-inflammatory drugs, physical therapy, cortisone, blood and botulinum toxin injections, supportive forearm bracing, and local modalities. For patients with recalcitrant disease, the traditional open débridement technique has been modified by multiple surgeons, with others relying on arthroscopic or even percutaneous procedures. Without a standard protocol (nonsurgical or surgical), surgeons need to keep abreast of established and evolving treatment options to effectively treat patients with lateral epicondylitis.
Purpose: To report a case of foveal schisis in X-linked retinoschisis treated with ocriplasmin. M... more Purpose: To report a case of foveal schisis in X-linked retinoschisis treated with ocriplasmin. Methods: Case report. Results: A 27-year-old man with X-linked retinoschisis was treated with a single intravitreal injection of ocriplasmin. After injection, a posterior vitreous detachment was induced and the macular schisis cavity resolved at 1 week. Central macular thickness on optical coherence tomography decreased from 731 mm to 185 mm, visual acuity remained unchanged, and there were no adverse events. However, the macular schisis cavity recurred at 1 month. Conclusion: This is the first reported case of using ocriplasmin to treat foveal schisis in X-linked retinoschisis. Although vitreomacular traction was relieved, the schisis cavity recurred shortly after initial closure.
Midfoot arthritis is a common cause of significant pain and disability. Although the medial tarso... more Midfoot arthritis is a common cause of significant pain and disability. Although the medial tarsometatarsal (TMT) joints provide <7°of sagittal plane motion, the more mobile lateral fourth and fifth TMT joints provide balance and accommodation on uneven ground. These small constrained TMT joints also provide stability and translate the forward propulsion motion of the hindfoot and ankle joint to the forefoot metatarsophalangeal joints from heel rise to toe-off. Posttraumatic degeneration is the primary cause of midfoot arthritis, although primary degeneration and inflammatory conditions can also affect this area. The end result is a painful midfoot that can no longer effectively transmit load from the hindfoot to the forefoot. Shoe modifications and orthotic inserts have been the mainstay of nonsurgical management. Successful management of midfoot arthritis with orthoses is predicated on achieving adequate joint stabilization while still allowing function. Surgical intervention typically involves arthrodesis of the medial midfoot. The best treatment of the more mobile lateral column is a subject of debate.
American journal of orthopedics (Belle Mead, N.J.), 2010
Several fracture patterns with resulting bony defects require augmentation with bone graft or oth... more Several fracture patterns with resulting bony defects require augmentation with bone graft or other orthobiologics. Accurate placement of graft may be difficult when the area to be augmented is not readily accessible. In such a case, a quickly modified 3-mL plastic syringe may be a useful and efficient delivery method for accurate placement and impacting of the graft.
versity-A simple curvature-based model is used to study crawling C. elegans in a micro-structured... more versity-A simple curvature-based model is used to study crawling C. elegans in a micro-structured environment of periodic pillars. In our model system, the shape of the worm is described by a simple sinusoidal expression in curvature representation. The gait of the worm is determined by a set of parameters including the amplitude, frequency, and phase of the curvature. The moving worm is subject to the friction with the underlying substrate, and the forces due to interaction of the worm body with pillars. If the friction is isotropic the worm has to interact with the pillars to move forward. We find that only a narrow range of worm gaits leads to efficient propulsion in this case. To investigate how the worm adjusts its gait to the environment microstructure, we implement a simple control system that chooses the right set of parameters based on the past interactions of the worm with its surroundings. Results of our simulations of the worm motion are compared with our experimental observations of C. elegans crawling in an agar environment containing an array of fabricated pillars. 1 We acknowledge financial support by NSF grant CBET 1059745.
By the WestJEM article submission agreement, all authors are required to disclose all affiliation... more By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.
h i g h l i g h t s A reduced reaction mechanism for diesel/syngas RCCI engine combustion was dev... more h i g h l i g h t s A reduced reaction mechanism for diesel/syngas RCCI engine combustion was developed. Chemistry interaction of multi-component fuels was considered in mechanism reduction. Conjugate-alkene and immediate lower level ketohydroperoxides should be retained. Reactions with OH/HO 2 have completing/assisting effects on co-oxidation.
2014 IEEE Petroleum and Chemical Industry Technical Conference (PCIC), 2014
IEEE Industry ApplIcAtIons MAgAzInE • july|Aug 2016 • www.IEEE.org/IAs n engineering team at a la... more IEEE Industry ApplIcAtIons MAgAzInE • july|Aug 2016 • www.IEEE.org/IAs n engineering team at a large oil and gas company was tasked to address the alarming trend of increasing capital expenditures required to manage its two main challenges: the obsolescence and aging of electrical equipment in over 1,000 electrical substations. it was forecasted that nearly US$1 billion will be required over the next ten years to replace the obsolete electrical equipment. reliability and cost efficiency in power systems operation equate to zero incidents and unplanned outages as a result of A
We present a computationally efficient method for analyzing H&E stained digital pathology slides ... more We present a computationally efficient method for analyzing H&E stained digital pathology slides with the objective of discriminating diagnostically relevant vs. irrelevant regions. Such technology is useful for several applications: (1) It can speed up computer aided diagnosis (CAD) for histopathology based cancer detection and grading by an order of magnitude through a triage-like preprocessing and pruning. (2) It can improve the response time for an interactive digital pathology workstation (which is usually dealing with several GByte digital pathology slides), e.g., through controlling adaptive compression or prioritization algorithms. (3) It can support the detection and grading workflow for expert pathologists in a semi-automated diagnosis, hereby increasing throughput and accuracy. At the core of the presented method is the statistical characterization of tissue components that are indicative for the pathologist's decision about malignancy vs. benignity, such as, nuclei, tubules, cytoplasm, etc. In order to allow for effective yet computationally efficient processing, we propose visual descriptors that capture the distribution of color intensities observed for nuclei and cytoplasm. Discrimination between statistics of relevant vs. irrelevant regions is learned from annotated data, and inference is performed via linear classification. We validate the proposed method both qualitatively and quantitatively. Experiments show a cross validation error rate of 1.4%. We further show that the proposed method can prune ≈90% of the area of pathological slides while maintaining 100% of all relevant information, which allows for a speedup of a factor of 10 for CAD systems.
Retrospective review. The purpose of this study was to assess the preoperative neurologic risk in... more Retrospective review. The purpose of this study was to assess the preoperative neurologic risk in a consecutive series of spinal deformity patients undergoing correction surgery at one institution. During spinal deformity correction surgery, neurologic monitoring techniques are commonly applied to reduce the risk of neurologic deficits. While previous studies have demonstrated risk factors for neurologic changes in the setting of spinal surgery, these involved long time spans and heterogeneous patient populations. Of 301 cases performed over 1 year, 281 cases were monitorable. Patients were grouped according to diagnosis: neuromuscular (NM) scoliosis, Sagittal Plane deformity, and Scoliosis. Demographic and surgical data were collected for neurologically monitorable patients. Coronal and sagittal parameters were measured using digital images of radiographs. Neurologic status was measured with somatosensory-evoked potentials and/or motor-evoked potentials. Primary NM scoliosis cases had the highest incidence of neurologic monitoring changes (NMC) (10%) while revision sagittal plane deformity had the second highest (9.8%). Sensitivity and specificity were both 100%. Overall incidence of neurologic deficit was 1.1%. Of the 13 NMCs patients, 3 patients had persistent neurologic deficit. Majority of NMCs occurred before deformity correction. In patients with NM scoliosis, NMCs increased with hybrid constructs with wires (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). In patients with scoliosis, NMCs increased with increased body mass index, estimated blood loss, operative time, and postoperative coronal thoracolumbar curve magnitude (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.04). In patients with primarily sagittal plane deformity, NMCs increased with preoperative proximal curve, postoperative proximal and thoracolumbar curves, and postoperative kyphosis and lordosis (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.04). Primary NM scoliosis and revision sagittal plane deformities appear to carry greatest incidence of NMCs during surgical intervention. Most observed NMCs did not result in a permanent neurologic deficit. Neuromonitoring should be assessed throughout the entire surgical procedure. This study may aid surgeons and patients to better assess neurologic risks related to spinal deformity surgery.
Gum arabic glycoprotein (GAGP) is a large molecular weight, hydroxyproline-rich arabinogalactan-p... more Gum arabic glycoprotein (GAGP) is a large molecular weight, hydroxyproline-rich arabinogalactan-protein (AGP) component of gum arabic. GAGP has a simple, highly biased amino acid composition indicating a repetitive polypeptide backbone.
GFR (Beta ϩ0.47, pϽ0.01) and age (Beta-0.44, pϽ0.01), but not type of urinary diversion, were ind... more GFR (Beta ϩ0.47, pϽ0.01) and age (Beta-0.44, pϽ0.01), but not type of urinary diversion, were independently associated with 3-year renal function. CONCLUSIONS: In bladder cancer patients undergoing radical cystectomy, T-Pouch orthotopic urinary diversion did not mitigate a reduction in renal function. Baseline GFR and age were independent predictors of 3-year renal function. Extended follow-up of trial subjects is ongoing.
Proteosomal degradation of proteins is one of the major mechanisms of intracellular protein turno... more Proteosomal degradation of proteins is one of the major mechanisms of intracellular protein turnover. Failure of the proteosome to degrade misfolded protein is implicated in the accumulation of α‐synuclein in Parkinson’s disease (PD). Heme oxygenase‐1 (HO‐1), an enzyme that converts heme to free iron, carbon monoxide (CO) and biliverdin (bilirubin precursor) is expressed in response to various stressors. HO‐1 is up‐regulated in PD‐ and Alzheimer’s disease‐affected neural tissues. In this study, we found that HO‐1 over‐expression engenders dose‐dependent decreases in α‐synuclein protein levels in human neuroblastoma M17 cells. When over‐expression of HO‐1 was silenced in HO‐1 transfected cells, level of α‐synuclein was restored. Likewise, treatment of HO‐1 over‐expressing cells with the HO‐1 inhibitor, tin mesoporphyrin, the iron chelator deferoxamine or antagonist of CO‐dependent cGMP activation, methylene blue, mitigated the HO‐1‐induced reduction in α‐synuclein levels. Furthermore...
A 43-year-old female patient with migraines presented with rightsided headaches, jaw and ear pain... more A 43-year-old female patient with migraines presented with rightsided headaches, jaw and ear pain, tongue and uvula deviation, right arm weakness, and dysphagia of solids and liquids resulting in a 7pound weight loss. Neurologic examination included serologic and cerebrospinal fluid evaluation, which ruled out infectious, inflammatory, and paraneoplastic diseases. Magnetic resonance imaging of the brain and computed tomography angiography of the head and neck ruled out cerebrovascular accident and vasculitis. The single abnormality was the distal internal carotid artery (ICA) in the parapharyngeal space (PPS). She was found to have bilateral ICA dissections with pseudoaneurysm (PSA), the left (11 mm in diameter) larger than the right (9 mm in diameter; A). A three-dimensional reconstruction of the computed tomography angiogram was obtained, and this demonstrated right ICA PSA impingement of the roots of cranial nerves IX, X, XI, and XII, symptoms known as the Collet-Sicard syndrome (B/Cover). Our diagnosis for its cause is fibromuscular dysplasia. The patient was treated empirically with prednisone, which worsened her symptoms. Therefore, she underwent placement of a Pipeline embolization device (PED; Medtronic, Minneapolis, Minn) into the right distal ICA (C). This PED stent is a flexible meshlike, bimetallic 48-strand braided construction that provides flow diversion and reduction of flow within aneurysms, which will then thrombose, approved for intracranial aneurysms. She was discharged from the hospital 2 days after this intervention on dual antiplatelet therapy (aspirin and clopidogrel) for 6 months. The patient noticed improvement within the first week of intervention and complete resolution of all symptoms by 1 month. Diagnostic angiography at the 2-month mark demonstrated an excellent result (D). Cranial nerve palsies due to lesions of the ICA are extremely rare. However, when they occur, fibromuscular dysplasia is the most common of the arteriopathies. 1,2 A constellation of symptoms involving the PPS was first described by Frédéric Collet and Jean Sicard in post-traumatic cases as a result of metallic fragments dislodged in the PPS. 3,4 Here, we describe a symptomatic right ICA dissection with PSA treated with the PED system. The use of this stent system From the Section of Vascular and Endovascular Surgery,
Journal of the American Academy of Orthopaedic Surgeons, 2007
Osteonecrosis, also referred to as avascular necrosis, refers to the death of cells within bone c... more Osteonecrosis, also referred to as avascular necrosis, refers to the death of cells within bone caused by a lack of circulation. It has been documented in bones throughout the body. In the foot, osteonecrosis is most commonly seen in the talus, the first and second metatarsals, and the navicular. Although uncommon, osteonecrosis has been documented in almost every bone of the foot and therefore should be considered in the differential diagnosis when evaluating both adult and pediatric foot pain. Osteonecrosis is associated with many foot problems, including fractures of the talar neck and navicular as well as Kohler&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease and Freiberg&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease. Orthopaedists who manage foot disorders will at some point likely be faced with the challenges associated with patients with osteonecrosis of the foot. Because this disease can masquerade as many other pathologies, physicians should be aware of the etiology, presentation, and treatment options for osteonecrosis in the foot.
Journal of the American Academy of Orthopaedic Surgeons, 2008
Lateral epicondylitis, or tennis elbow, is a common cause of elbow pain in the general population... more Lateral epicondylitis, or tennis elbow, is a common cause of elbow pain in the general population. Traditionally, lateral epicondylitis has been attributed to degeneration of the extensor carpi radialis brevis origin, although the underlying collateral ligamentous complex and joint capsule also have been implicated. Nonsurgical treatment, the mainstay of management, involves a myriad of options, including rest, nonsteroidal anti-inflammatory drugs, physical therapy, cortisone, blood and botulinum toxin injections, supportive forearm bracing, and local modalities. For patients with recalcitrant disease, the traditional open débridement technique has been modified by multiple surgeons, with others relying on arthroscopic or even percutaneous procedures. Without a standard protocol (nonsurgical or surgical), surgeons need to keep abreast of established and evolving treatment options to effectively treat patients with lateral epicondylitis.
Purpose: To report a case of foveal schisis in X-linked retinoschisis treated with ocriplasmin. M... more Purpose: To report a case of foveal schisis in X-linked retinoschisis treated with ocriplasmin. Methods: Case report. Results: A 27-year-old man with X-linked retinoschisis was treated with a single intravitreal injection of ocriplasmin. After injection, a posterior vitreous detachment was induced and the macular schisis cavity resolved at 1 week. Central macular thickness on optical coherence tomography decreased from 731 mm to 185 mm, visual acuity remained unchanged, and there were no adverse events. However, the macular schisis cavity recurred at 1 month. Conclusion: This is the first reported case of using ocriplasmin to treat foveal schisis in X-linked retinoschisis. Although vitreomacular traction was relieved, the schisis cavity recurred shortly after initial closure.
Midfoot arthritis is a common cause of significant pain and disability. Although the medial tarso... more Midfoot arthritis is a common cause of significant pain and disability. Although the medial tarsometatarsal (TMT) joints provide <7°of sagittal plane motion, the more mobile lateral fourth and fifth TMT joints provide balance and accommodation on uneven ground. These small constrained TMT joints also provide stability and translate the forward propulsion motion of the hindfoot and ankle joint to the forefoot metatarsophalangeal joints from heel rise to toe-off. Posttraumatic degeneration is the primary cause of midfoot arthritis, although primary degeneration and inflammatory conditions can also affect this area. The end result is a painful midfoot that can no longer effectively transmit load from the hindfoot to the forefoot. Shoe modifications and orthotic inserts have been the mainstay of nonsurgical management. Successful management of midfoot arthritis with orthoses is predicated on achieving adequate joint stabilization while still allowing function. Surgical intervention typically involves arthrodesis of the medial midfoot. The best treatment of the more mobile lateral column is a subject of debate.
American journal of orthopedics (Belle Mead, N.J.), 2010
Several fracture patterns with resulting bony defects require augmentation with bone graft or oth... more Several fracture patterns with resulting bony defects require augmentation with bone graft or other orthobiologics. Accurate placement of graft may be difficult when the area to be augmented is not readily accessible. In such a case, a quickly modified 3-mL plastic syringe may be a useful and efficient delivery method for accurate placement and impacting of the graft.
versity-A simple curvature-based model is used to study crawling C. elegans in a micro-structured... more versity-A simple curvature-based model is used to study crawling C. elegans in a micro-structured environment of periodic pillars. In our model system, the shape of the worm is described by a simple sinusoidal expression in curvature representation. The gait of the worm is determined by a set of parameters including the amplitude, frequency, and phase of the curvature. The moving worm is subject to the friction with the underlying substrate, and the forces due to interaction of the worm body with pillars. If the friction is isotropic the worm has to interact with the pillars to move forward. We find that only a narrow range of worm gaits leads to efficient propulsion in this case. To investigate how the worm adjusts its gait to the environment microstructure, we implement a simple control system that chooses the right set of parameters based on the past interactions of the worm with its surroundings. Results of our simulations of the worm motion are compared with our experimental observations of C. elegans crawling in an agar environment containing an array of fabricated pillars. 1 We acknowledge financial support by NSF grant CBET 1059745.
By the WestJEM article submission agreement, all authors are required to disclose all affiliation... more By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.
h i g h l i g h t s A reduced reaction mechanism for diesel/syngas RCCI engine combustion was dev... more h i g h l i g h t s A reduced reaction mechanism for diesel/syngas RCCI engine combustion was developed. Chemistry interaction of multi-component fuels was considered in mechanism reduction. Conjugate-alkene and immediate lower level ketohydroperoxides should be retained. Reactions with OH/HO 2 have completing/assisting effects on co-oxidation.
2014 IEEE Petroleum and Chemical Industry Technical Conference (PCIC), 2014
IEEE Industry ApplIcAtIons MAgAzInE • july|Aug 2016 • www.IEEE.org/IAs n engineering team at a la... more IEEE Industry ApplIcAtIons MAgAzInE • july|Aug 2016 • www.IEEE.org/IAs n engineering team at a large oil and gas company was tasked to address the alarming trend of increasing capital expenditures required to manage its two main challenges: the obsolescence and aging of electrical equipment in over 1,000 electrical substations. it was forecasted that nearly US$1 billion will be required over the next ten years to replace the obsolete electrical equipment. reliability and cost efficiency in power systems operation equate to zero incidents and unplanned outages as a result of A
We present a computationally efficient method for analyzing H&E stained digital pathology slides ... more We present a computationally efficient method for analyzing H&E stained digital pathology slides with the objective of discriminating diagnostically relevant vs. irrelevant regions. Such technology is useful for several applications: (1) It can speed up computer aided diagnosis (CAD) for histopathology based cancer detection and grading by an order of magnitude through a triage-like preprocessing and pruning. (2) It can improve the response time for an interactive digital pathology workstation (which is usually dealing with several GByte digital pathology slides), e.g., through controlling adaptive compression or prioritization algorithms. (3) It can support the detection and grading workflow for expert pathologists in a semi-automated diagnosis, hereby increasing throughput and accuracy. At the core of the presented method is the statistical characterization of tissue components that are indicative for the pathologist's decision about malignancy vs. benignity, such as, nuclei, tubules, cytoplasm, etc. In order to allow for effective yet computationally efficient processing, we propose visual descriptors that capture the distribution of color intensities observed for nuclei and cytoplasm. Discrimination between statistics of relevant vs. irrelevant regions is learned from annotated data, and inference is performed via linear classification. We validate the proposed method both qualitatively and quantitatively. Experiments show a cross validation error rate of 1.4%. We further show that the proposed method can prune ≈90% of the area of pathological slides while maintaining 100% of all relevant information, which allows for a speedup of a factor of 10 for CAD systems.
Retrospective review. The purpose of this study was to assess the preoperative neurologic risk in... more Retrospective review. The purpose of this study was to assess the preoperative neurologic risk in a consecutive series of spinal deformity patients undergoing correction surgery at one institution. During spinal deformity correction surgery, neurologic monitoring techniques are commonly applied to reduce the risk of neurologic deficits. While previous studies have demonstrated risk factors for neurologic changes in the setting of spinal surgery, these involved long time spans and heterogeneous patient populations. Of 301 cases performed over 1 year, 281 cases were monitorable. Patients were grouped according to diagnosis: neuromuscular (NM) scoliosis, Sagittal Plane deformity, and Scoliosis. Demographic and surgical data were collected for neurologically monitorable patients. Coronal and sagittal parameters were measured using digital images of radiographs. Neurologic status was measured with somatosensory-evoked potentials and/or motor-evoked potentials. Primary NM scoliosis cases had the highest incidence of neurologic monitoring changes (NMC) (10%) while revision sagittal plane deformity had the second highest (9.8%). Sensitivity and specificity were both 100%. Overall incidence of neurologic deficit was 1.1%. Of the 13 NMCs patients, 3 patients had persistent neurologic deficit. Majority of NMCs occurred before deformity correction. In patients with NM scoliosis, NMCs increased with hybrid constructs with wires (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). In patients with scoliosis, NMCs increased with increased body mass index, estimated blood loss, operative time, and postoperative coronal thoracolumbar curve magnitude (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.04). In patients with primarily sagittal plane deformity, NMCs increased with preoperative proximal curve, postoperative proximal and thoracolumbar curves, and postoperative kyphosis and lordosis (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.04). Primary NM scoliosis and revision sagittal plane deformities appear to carry greatest incidence of NMCs during surgical intervention. Most observed NMCs did not result in a permanent neurologic deficit. Neuromonitoring should be assessed throughout the entire surgical procedure. This study may aid surgeons and patients to better assess neurologic risks related to spinal deformity surgery.
Gum arabic glycoprotein (GAGP) is a large molecular weight, hydroxyproline-rich arabinogalactan-p... more Gum arabic glycoprotein (GAGP) is a large molecular weight, hydroxyproline-rich arabinogalactan-protein (AGP) component of gum arabic. GAGP has a simple, highly biased amino acid composition indicating a repetitive polypeptide backbone.
GFR (Beta ϩ0.47, pϽ0.01) and age (Beta-0.44, pϽ0.01), but not type of urinary diversion, were ind... more GFR (Beta ϩ0.47, pϽ0.01) and age (Beta-0.44, pϽ0.01), but not type of urinary diversion, were independently associated with 3-year renal function. CONCLUSIONS: In bladder cancer patients undergoing radical cystectomy, T-Pouch orthotopic urinary diversion did not mitigate a reduction in renal function. Baseline GFR and age were independent predictors of 3-year renal function. Extended follow-up of trial subjects is ongoing.
Proteosomal degradation of proteins is one of the major mechanisms of intracellular protein turno... more Proteosomal degradation of proteins is one of the major mechanisms of intracellular protein turnover. Failure of the proteosome to degrade misfolded protein is implicated in the accumulation of α‐synuclein in Parkinson’s disease (PD). Heme oxygenase‐1 (HO‐1), an enzyme that converts heme to free iron, carbon monoxide (CO) and biliverdin (bilirubin precursor) is expressed in response to various stressors. HO‐1 is up‐regulated in PD‐ and Alzheimer’s disease‐affected neural tissues. In this study, we found that HO‐1 over‐expression engenders dose‐dependent decreases in α‐synuclein protein levels in human neuroblastoma M17 cells. When over‐expression of HO‐1 was silenced in HO‐1 transfected cells, level of α‐synuclein was restored. Likewise, treatment of HO‐1 over‐expressing cells with the HO‐1 inhibitor, tin mesoporphyrin, the iron chelator deferoxamine or antagonist of CO‐dependent cGMP activation, methylene blue, mitigated the HO‐1‐induced reduction in α‐synuclein levels. Furthermore...
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