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Static load to failure for BP1, BP3, and BP2 were 240 ± 5 N, 398 ± 9 N, and 420 ± 3 N, respectively ( p   less then  0.05). BP1 was the only plate series that failed during dynamic testing; all other plates achieved 100,000 cycles. Failure mode was a fracture occurring through the central screw hole of BP1. Finite element analysis demonstrated the effects of central screw holes on stress, strain, and plastic deformation under loading. Conclusion  Unused screw holes are the mechanical weak points; plates designed without these central screw holes are expected to survive greater load values. The threshold for clinical importance will need to be determined by future studies.Objectives  The purpose of this study was to find out if carpal instability played a role in the etiology of ganglion cysts. NBQX Materials and Methods  Dynamic wrist radiographs of 33 patients with and without a ganglion cyst of the wrist were compared. The control group consisted of patients who had dynamic radiographs of both wrists after a traumatic event in one wrist. Measurements were performed on the contralateral uninjured side. Radiological parameters that may indicate carpal instability included width of the scapholunate gap, scapholunate, radiolunate, and lunocapitate angles, and ulnar translocation. Results  No statistically significant difference was found between the two groups except for lunocapitate angle which was higher in wrists with ganglion cysts. However, mean lunocapitate angle was still within the normal range. Conclusions  It could be concluded that in this study we did not see a difference between scapholunate gap and radiocarpal angles with the presence or absence of a ganglion cyst.Background  Excision of the pisiform is an infrequently used option for pisotriquetral joint dysfunction when nonoperative treatment is ineffective. This study reviews the patient-reported outcomes of patients treated with pisiformectomy, and furthermore focuses on the complications and the need for and time to revision procedure. Materials and Methods  Medical records of 57 patients were manually reviewed and assessed for complications, rate of unplanned reoperations, and type of reoperations. Thirty-seven patients (65%) completed patient-rated outcomes surveys at a median of 10 years after their procedure. Results  The complication rate was 13% ( n  = 7). Ulnar nerve symptoms were noted in three patients. No reoperations were performed after the pisiform excision. Out of the 16 patients who had preoperative symptoms of ulnar nerve compression at the wrist, 10 patients reported that their symptoms had completely resolved after the surgery. The median Quick Disability of Arm, Shoulder and Hand (QuickDASH) score after surgery was 4.5 (2.3-16), median score for pain 0 (interquartile range [IQR] 0-2), and median score for overall satisfaction 10 (IQR 8-10). Conclusions  Pisiformectomy is a surgery used sparingly in cases with refractory pain associated with arthrosis of the pisotriquetral joint or enthesopathy of the flexor carpi ulnaris/pisiform interface. When utilized in this fashion, patients report limited disability on patient-rated outcome measures, low pain scores, and high satisfaction at mid- to late follow-up.Background  Scaphoid fractures are relatively uncommon in children, especially below the age of 10 due to the ossification of the scaphoid bone, which starts around 4 to 6 years of age and continues until 13 to 15 years of age, where pediatric scaphoid fractures peak. This makes the diagnoses challenging in this age group. Methods  The primary aim of this study was to analyze prospectively collected data in managing scaphoid fractures. All cases in children up to the age of 10 years, treated in a tertiary pediatric hand and upper limb from January 2014 to June 2018 were included. Parameters studied were patient demographics, clinical presentation, mechanism of injury, investigations, type of fracture, associated injuries, treatment offered, outcomes and complications. The secondary aim was to review the literature due to the limited knowledge about these fractures in these low age groups. Results  A total of 23 patients with documented scaphoid fractures in children up to the age of 10 years were found. Final diagnosis in all these patients was done with magnetic resonance imaging (MRI). The mean age was 9.8 years, with female preponderance. Scaphoid waist was the most common location. Five patients had associated fractures of the capitate and one patient had associated second metacarpal base fracture. All patients were managed nonoperatively. The average time of immobilization was 6.6 weeks (range 4-10 weeks). A majority of patients had minor symptoms after the fracture, most likely due to the immobilization time. Conclusion  Scaphoid fractures are rare in the pediatric population up to the age of 10. MRI is most often needed to confirm diagnosis. Nonoperative management of most scaphoid fractures in this age group is safe and feasible with no significant long-term morbidity. Surgical management of scaphoid fractures might be required in very selected cases. Level of Evidence  This is a Level IV study.

Alzheimer’s Disease (AD) is a neurodegenerative complex brain disease that represents a public health concern. AD is considered the fifth leading cause of death in Americans who are older than 65 years which prioritizes the importance of understanding the etiology of AD in its early stages before the onset of symptoms. This study attempted to further understand Alzheimer’s disease (AD) etiology by investigating the dysregulated genes using gene expression data from multiple brain regions.

A linear mixed-effects model for differential gene expression analysis was used in a sample of 15 AD and 30 control subjects, each with data from four different brain regions, in order to deal with the hierarchical multilevel data. Post-hoc Gene Ontology and pathway enrichment analyses provided insights on the biological implications in AD progression. Supervised machine learning algorithms were used to assess the discriminative power of the top 10 candidate genes in distinguishing between the two groups.

Enrichment analyses revealed biological processes and pathways that are related to structural constituents and organization of the axons and synapses.