National trends in total hip arthroplasty for traumatic hip fractures:An analysis of a nationwide all-payer database

BACKGROUND Hemiarthroplasty(HA)has traditionally been the treatment of choice for elderly patients with displaced femoral neck fractures.Ideal treatment for younger,ambulatory patients is not as clear.Total hip arthroplasty(THA)has been increasingly utilized in this population however the factors associated with undergoing HA or THA have not been fully elucidated.AIM To examine what patient characteristics are associated with undergoing THA or HA.To determine if outcomes differ between the groups.METHODS We queried the Nationwide Inpatient Sample(NIS)for patients that underwent HA or THA for a femoral neck fracture between 2005 and 2014.The NIS comprises a large representative sample of inpatient hospitalizations in the United States.International Classifications of Disease,Ninth Edition(ICD-9)codes were used to identify patients in our sample.Demographic variables,hospital characteristics,payer status,medical comorbidities and mortality rates were compared between the two procedures.Multivariate logistic regression analysis was then performed to identify independent risk factors of treatment utilized.RESULTS Of the total 502060 patients who were treated for femoral neck fracture,51568(10.3%)underwent THA and the incidence of THA rose from 8.3%to 13.7%.Private insurance accounted for a higher percentage of THA than hemiarthroplasty.THA increased most in urban teaching hospitals relative to urban non-teaching hospitals.Mean length of stay(LOS)was longer for HA.The mean charges were less for HA,however charges decreased steadily for both groups.HA had a higher mortality rate,however,after adjusting for age and comorbidities HA was not an independent risk factor for mortality.Interestingly,private insurance was an independent predictor for treatment with THA.CONLUSION There has been an increase in the use of THA for the treatment of femoral neck fractures in the United States,most notably in urban hospitals.HA and THA are decreasing in total charges and LOS.

Monocyte chemoattractant protein-1 level in serum of patients with acute spinal cord injury

Objective: To detect the concentration of monocyte chemoattractant protein-1 (MCP-1) in the serum of patients with incomplete spinal cord injury and evaluate its relation with the pathologic classification of the spinal cord injury.Methods: MCP-1 concentration in the serum of patients with incomplete spinal cord injury (iSCI), single spine compression and healthy subjects were detected by ELISA, respectively in the present study and the magnetic resonance imaging data of these patients were studied at the same time on a blind base.Results: Serum level of MCP-1 in iSCI patients was 428 pg/ml±11 pg/ml by ELISA, which was higher than both that of the patients with single spine compression and of controls, with the concentration of 184 pg/ml±21 pg/ml and 124 pg/ml±15 pg/ml, respectively. There was significant difference between any two groups (P< 0.01). iSCI patients with normal MRI showed a lower serum level of MCP-1 as 312 pg/ml±30 pg/ml. Pathological classification of spinal cord edema and hematoma corresponded to 390 pg/ml±16 pg/ml and 508 pg/ml± 24 pg/ml in the concentration of MCP-1.Conclusions: MCP-1 may induce secondary inflammatory response by recruiting inflammatory cells to the injury site and thus affect the prognosis of spinal cord injury.

Multimaterial additive manufacturing manipulator for fabricating magnetoelectric pressure sensors

The simultaneous placement of different types of materials including polymers,ceramics,and metals,in their desired positions could be adopted to manufacture end-use devices/apparatuses with diverse functionalities and significantly reduce the fabrication cost and time.However,existing additive manufacturing(AM)approaches can only treat one material species at a time due to their intrinsic working mechanisms.Here we develop an AM manipulator for manufacturing a wide variety of material species,including polymers,ceramics,and metals,through a multifilament transport strategy assisted by laser power.The six-jaw manipulator contains three pairs of filament delivering/cutting systems for transporting diverse materials and a beam of tunable laser as the thermal source.The whole apparatus is integrated into a robotic manipulator to create a multifreedom manufacturing platform.With this innovation,products with multiple material species and desired complex geometries can be fabricated on demand.Furthermore,we synthesize a multimaterial(polymer/ceramic/metal)printed magnetoelectric pressure sensor that can convert applied mechanical forces to electricity and maintain efficiency even after undergoing 10000 cycles of pressure/recovery.With this multimaterial filament transport and laser manufacturing strategy,our AM manipulator exhibits promising application in the advanced manufacturing of embedded electronics,sensors,soft robotics,and customizable medical devices.