Notes

Blend of revised carbapenem inactivation technique (mCIM) along with EDTA-CIM (eCIM) pertaining to phenotypic recognition involving carbapenemase-producing Enterobacteriaceae.
Executive function entails the core components of response inhibition, working memory and cognitive flexibility. An accumulating literature has shown that a single bout of exercise improves the response inhibition and working memory components of executive function; however, limited work has examined a putative exercise-related improvement to cognitive flexibility. To address this limitation, Experiment 1 entailed a 20-min session of moderate intensity aerobic exercise (via cycle ergometer), and pre- and post-exercise cognitive flexibility was examined via a task-switching paradigm involving alternating pro- and antisaccades (AABB A = prosaccade, B = antisaccade). In Experiment 2, participants sat on the cycle ergometer without exercising (i.e., rest break) and the same AABB paradigm was examined pre- and post-break. We used an AABB pro- and antisaccade paradigm because previous work has shown that a prosaccade preceded by an antisaccade exhibits a reliable-and large magnitude-increase in reaction time, whereas the converse switch does not (i.e., the unidirectional prosaccade switch-cost). Experiment 1 showed a unidirectional prosaccade switch-cost pre-exercise (p = .012)-but not post-exercise (p = .30), and a two one-sided t test indicated that the latter comparison was within an equivalence boundary (p  less then  .01). In contrast, Experiment 2 revealed a unidirectional prosaccade switch-cost at pre- and post-break assessments (ps  less then  .01). Accordingly, our results indicate that a single bout of exercise improves cognitive flexibility and provides convergent evidence that exercise improves global components of executive function.We consider the effects of a pressure gradient on the spontaneous flow of an active nematic liquid crystal in a channel, subject to planar anchoring and no-slip conditions on the boundaries of the channel. We employ a model based on the Ericksen-Leslie theory of nematics, with an additional active stress accounting for the activity of the fluid. By directly solving the flow equation, we consider an asymptotic solution for the director angle equation for large activity parameter values and predict the possible values of the director angle in the bulk of the channel. Through a numerical solution of the full nonlinear equations, we examine the effects of pressure on the branches of stable and unstable equilibria, some of which are disconnected from the no-flow state. In the absence of a pressure gradient, solutions are either symmetric or antisymmetric about the channel midpoint; these symmetries are changed by the pressure gradient. Considering the activity-pressure state space allows us to predict qualitatively the extent of each solution type and to show, for large enough pressure gradients, that a branch of non-trivial director angle solutions exists for all activity values.
This study examined osteotomy union and heterotopic ossification (HO) after performing digastric trochanteric osteotomies during open reduction and internal fixation (ORIF) of acetabular and combined femoral head fractures. Femoral head osteonecrosis and trochanteric screw removal were secondarily assessed.

Twenty-six patients treated at a Level I trauma center, from years 2003 to 2019, who received a digastric trochanteric osteotomy during acetabular and combined femoral head fracture ORIF through a posterior surgical approach were retrospectively identified. Osteotomies were fixed with two 3.5mm cortical lag screws. Rates of osteotomy union, HO, femoral head osteonecrosis, and trochanteric screw removal were determined.

All osteotomies went onto union without displacement or failure of fixation. Only three (12%) patients developed severe HO (modified-Brooker class III-IV). There were no instances of femoral head osteonecrosis and only one (7%) patient required trochanteric screw removal.

The digastric trochanteric osteotomy heals reliably with low rates of severe HO, femoral head osteonecrosis, and screw removal for soft-tissue irritation. A review of the literature is presented and found comparable findings.
The digastric trochanteric osteotomy heals reliably with low rates of severe HO, femoral head osteonecrosis, and screw removal for soft-tissue irritation. A review of the literature is presented and found comparable findings.
Approximately, 50 persons per 100,000 per year sustain a tibial fracture. There is, however, a lack of large cohort studies that describe the treatment and re-operation frequencies of tibial fractures. The aim of this study was to describe the treatment and re-operation rates of tibial fractures in all segments of the tibia.

Data related to all patients aged 16 and above treated for tibial fractures (ICD-10 S82.10-31) at Sahlgrenska University Hospital in 2011-2015 were extracted from the Swedish Fracture Register. To make sure all re-operations were included in the study, the operation planning system was checked for all patients included in the study.

The study comprised 1371 tibial fractures - 712 proximal, 417 diaphyseal and 242 distal tibial fractures. Among the proximal and distal tibial fractures, plate fixation was the most commonly used surgical method, whereas among tibial shaft fractures, an intramedullary nail was the most commonly used surgical method. Almost 30% (29.8%) of all surgically treated tibial fractures underwent re-operation. Among proximal tibial fractures, 24.0% underwent re-operation; tibial shaft fractures 37.0% and distal tibial fractures 26.8%. Re-operations due to infection were more or less equally common in all segments (3.9-5.4%).

This study describes the treatment and re-operation rates after tibial fractures in a cohort of 1371 tibial fractures at Sahlgrenska University Hospital during a period of 5years. The study shows an overall re-operation rate of 29.8% for fractures in all segments of the tibia.
This study describes the treatment and re-operation rates after tibial fractures in a cohort of 1371 tibial fractures at Sahlgrenska University Hospital during a period of 5 years. The study shows an overall re-operation rate of 29.8% for fractures in all segments of the tibia.
Analyze the diagnostic performance of suction drainage fluid culture for acute surgical site infection, which has not been specifically reported in spine surgery patients.

This was a retrospective single-center observational study including data from 363 patients who underwent aseptic instrumented spine surgery between 2015 and 2017. A suction drain was inserted in all cases. Data analyzed were patient age, gender, ASA score, indication for surgery (degenerative disease, tumor, trauma), spine level (cervical, thoracic, lumbar), procedure performed and spine level, operative time, body temperature, postoperative C-reactive protein time-curve, clinical aspect of surgical scar, bacteriology results of suction drainage fluid, and in case of revision surgery, lavage fluid. Major criteria for periprosthetic infection proposed by the Musculoskeletal Infection Society (MSIS) were accepted as the gold standard for the diagnosis of acute surgical site infection.

The overall rate of surgical site infection was 6.9% (5.76% for 1- or 2-level fusion, 5.81% for 3- or 4-level fusion, and 15.6% for 5-level fusion and above). The suction drain was withdrawn on the second postoperative day in 44.1% of cases and the third day in 39.1%. The sensitivity of suction drainage fluid culture for the diagnosis of surgical site infection was 20% [95%CI 6.8-40.7%] with a 96.2% [95%CI 93.2-97.9] specificity.

The diagnostic performance of suction drainage fluid culture after aseptic instrumented spine surgery for acute surgical site infection is insufficient to warrant its use in routine practice.
The diagnostic performance of suction drainage fluid culture after aseptic instrumented spine surgery for acute surgical site infection is insufficient to warrant its use in routine practice.Electronic Health Records (EHRs) are at the heart of reforms aimed at improving the efficiency and quality of healthcare services provided to citizens. Although there is still some skepticism, open source (OS) EHR is a growing phenomenon in health informatics. Given the widespread adoption of OS software (OSS) in several domains, including operating systems, and enterprise systems, the repeated shortfalls faced by healthcare organizations with dominant proprietary EHRs create an opportunity for other alternatives, such as OSS to demonstrate their abilities in addressing these well-documented problems, including inflexibility, high costs, and low interoperability. However, scholars have expressed extensive concerns about the sustainability of OS EHR. Recognizing that OSS project sustainability relies on their governance arrangements, this case study reports on the evolution of the governance and sustainability of a Japanese OS EHR project and provides rich insights to other open source EHR initiative stakeholders, including physicians, developers, researchers, and policy-makers.A new fluorescence turn-on sensing platform has been developed applicable for sensitive profiling of multiple chemical and biological analytes, using azobenzene-quantum dot as a new stimuli-responsive optical nanoprobe. An azobenzene-carrying compound bis [4, 4'-(dithiophenyl azo)-1, 3-benzenediamine] (DTPABDA) is for the first time reported to be used for conjugation with CdSe/ZnS core/shell quantum dots (QDs) via the ligand exchange reaction. Due to the photo-induced electron-transfer (PET) effect, the electron-withdrawing azobenzene groups of DTPABDA can significantly cause the photoluminescence (PL) of QDs quenched. The QDs' PL can be subsequently reignited by the removal of azo moiety cleavable through three types of specific reactions the dithionite reduction, hypochlorite oxidation, and azoreductase enzymatic catalysis, respectively. By monitoring of reaction-induced recovery of FL signals at 560 nm with an excitation of 450 nm, such azobenzene-QDs conjugates served as a new nanoprobe enabling the fluorescence turn-on sensing of dithionite, hypochlorite, and azoreductase with high sensitivity, broad linear range, and good selectivity. The successful detection of target analytes in real samples reveals the potential of our method in practical applications, such as biosensing, environmental and industrial monitoring. Graphical abstract A new stimuli-responsive fluorescence probe is reported for the sensitive detection of sodium dithionite, hypochlorite, and azoreductase. The probe consists of QDs with an azobenzene-carrying compound as a ligand. The fluorescence of QDs could be quenched by the azo group and subsequently recovered via the removal of azo group by these three compounds, resulting in the "turn-on" sensing of these compounds with high sensitivity, broad linear range, and good selectivity. The successful detection of azoreductase in serum samples reveals the practical use of this method.
The liver hanging maneuver (LHM) was described by Belghiti et al. to facilitate liver resection and is done classically by creating a space between the caudate lobe and the inferior vena cava starting on the edge of caudate lobe and extending cranially, in a para-caval fashion, towards the space between the right and middle hepatic veins. LHM facilitates liver transection, guides anatomical resections, decreases blood loss, facilitates harvesting of the liver graft in live donors, and also has oncological advantages.

We describe a new approach named "up-to-down" to perform LHM in open and laparoscopic liver resections. This approach was mainly used in obese patients, in laparoscopic liver resections and in cases of failure of the classic approach. The advantages/disadvantages, complications, and different modalities of LHM are also summarized.

The peritoneal layer between the liver capsule and the infrahepatic vena cava is opened, and a short blind dissection is initiated on the right anterolateral aspect of the inferior vena cava to the left of the hepatic vein of segment VI.
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