Tibial torus and toddler's fractures misdiagnosed as transient synovitis: a case series

<p>Abstract</p> <p>Introduction</p> <p>The high incidence of transient synovitis in early childhood makes it the first suspected pathology in a limping child. Trauma, which has long been regarded as a causative factor for transient synovitis, may be underestimated in a non-cooperative toddler.</p> <p>After excluding most serious conditions, such as septic arthritis, a speculative diagnosis of transient synovitis can be made, and this can easily mask a subtle musculoskeletal injury.</p> <p>Case presentations</p> <p>We report the cases of three Caucasian patients (two boys, aged 20-months- and three-years-old, and one girl, aged two-years-old), with tibial torus and toddler's fractures which were late-diagnosed due to an initial misdiagnosis of transient synovitis of the hip.</p> <p>Conclusion</p> <p>In a non-cooperative child musculoskeletal trauma can be mistaken as a simple causative factor for transient synovitis of the hip and this can easily prevent further investigation for a possible subtle musculoskeletal injury of the lower extremities.</p> <p>Our experience with the presented cases suggests the need to be more vigilant in the differential diagnosis of transient synovitis in young children.</p

Improving performance and stability in quantum dot-sensitized solar cell through single layer graphene/Cu2S nanocomposite counter electrode

In this work, we presented an effective nanocomposite to modify the Cu2S film by employing single layer graphene (SLG) frameworks via chemical vapor deposition, and utilized this nanocomposite as counter electrode (CE) with CdSe/ZnS core/shell quantum dots for highly stable and efficient quantum dot-sensitized solar cell (QDSSC). Furthermore, Cu2S film is directly synthesized on SLG framework by electrodeposition method. Using this nanocomposite as CE, we have achieved the high efficiency as high as 3.93% with fill factor of 0.63, which is higher than those with bare Cu2S CE (3.40% and 0.57). This remarkable performance is attributed to the surface area enhancement by creating nanoflower-shape, the reduction of charge transfer resistance, improvement of catalytic stability, and the surface smoothness as well as good adhesion. More importantly, no visible color change and detachment from surface for the Cu2S@SLG nanocomposite was observed, demonstrating that the SLG framework is critical role in shielding the Cu2S structure from sulphur ions into electrolyte, and increasing the adhesion of the Cu2S structure on surface, thus preventing its degradation. Consequently, the Cu2S@SLG nanocomposite can be utilized as an effective agent to boost up the performance of QDSSCs. © 2019 Elsevier Lt

Chatter suppression techniques in metal cutting

The self-excited vibration, called chatter, is one of the main limitations in metal removal processes. Chatter may spoil the surface of the part and can also cause large reduction in the life of the different components of the machine tool including the cutting tool itself. During the last 60 years, several techniques have been proposed to suppress chatter. This keynote paper presents a critical review of the different chatter suppression techniques. Process solutions with design and control approaches are compiled to provide a complete view of the available methods to stabilize the cutting process. The evolution of each technique is described remarking the most important milestones in research and the corresponding industrial application. The selection of the most appropriate technique for each specific chatter problem is also discussed considering various aspects of machining processes

Virtual process systems for part machining operations

This paper presents an overview of recent developments in simulating machining and grinding processes along the NC tool path in virtual environments. The evaluations of cutter-part-geometry intersection algorithms are reviewed, and are used to predict cutting forces, torque, power, and the possibility of having chatter and other machining process states along the tool path. The trajectory generation of CNC systems is included in predicting the effective feeds. The NC program is automatically optimized by respecting the physical limits of the machine tool and cutting operation. Samples of industrial turning, milling and grinding applications are presented. The paper concludes with the present and future challenges to achieving a more accurate and efficient virtual machining process simulation and optimization system

Rapamycin Improves Vascular Remodelling in a Controlled Rat Model of Monocrotaline-Induced Pulmonary Hypertension

Background: Pulmonary arterial hypertension (PAH) is a serious disease characterized by the progressive elevation of the pulmonary arterial resistance, leading to the right ventricular failure and death. Objective: To evaluate the effect of rapamycin (RAPA), a potent cell-cycle inhibitor, on exercise capacity, right ventricular hypertrophy and pulmonary vascular remodelling on rats. Methods: A total of 39 nine-week-old male Wistar rats (160-240 g) were divided into three groups: the control (n = 10), PAH control (n = 15) and PAH-RAPA (n = 14) groups. On the 1st day, 60 mg/kg monocrotaline was injected intraperitoneally to induce PAH in the PAH control group and PAH-RAPA groups. On the 21st day, 3 mg/kg/day RAPA was started orally, and the animals were followed for 35 days. On the 35th day, the exercise capacity of the rats was analysed through a modified forced swimming test. After measuring their right ventricular systolic pressure using an open-chest method, their hearts and lungs were excised and analysed histopathologically for right ventricular hypertrophy and pulmonary vascular remodelling. Results: Rapamycin treatment provided limited and insignificant improvements in exercise capacity, right ventricular systolic pressure and right ventricular hypertrophy of the rats. However, there was significant recovery in the rats' pulmonary artery muscular layer thickness with the RAPA treatment (p 0.16); however, a significant recovery was noted in terms of the rats 'median life span (p < 0.006). Conclusion: Pulmonary artificial hypertension is a progressive disease that is not curable with current therapies. Rapamycin may have the potential to reverse vascular remodelling and prolong life expectancy in cases ofpulmonary hypertension

Venous Thromboembolism Risk and Thromboprophylaxis Among Hospitalized Patients: Data From the Turkish Arm of the ENDORSE Study

Objectives: To evaluate venous thromboembolism (VTE) risk and use of thromboprophylaxis in the acute care hospital setting. Methods: A total of 1701 patients hospitalized for acute or exacerbated chronic medical illnesses or elective major surgery at 11 different hospitals across Turkey were included in the study. Patients at risk and VTE prophylaxis application were retrospectively identified based on medical charts. Results: According to the American College of Chest Physicians (ACCP) criteria, overall 35.6% (606 of 1701) of the patients were identified to be at VTE risk. Venous thromboembolism-risk was observed in 64.9% of surgical and 23.8% of medical patients, the latter being lower than global Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting (ENDORSE) study results; while prophylaxis was prescribed in 39.0% and 38.5% of them, respectively. Contraindication to anticoagulant prophylaxis was observed in 8.7% of medical and 8.8% of surgical patients. Conclusions: VTE remains a risk factor among patients hospitalized across Turkey, since identification as well as prophylaxis of patients at VTE risk seems to be neglected