Tuning the pore chemistry of Zr-MOFs for efficient metal ion capture from complex streams.

Metal-organic frameworks (MOFs) have shown promise for adsorptive separations of metal ions. Herein, MOFs based on highly stable Zr(IV) building units were systematically functionalized with targeted metal binding groups. Through competitive adsorption studies, it was shown that the selectivity for different metal ions was directly tunable through functional group chemistry.

Identifying Risk Factors for Complications During Exposure for Anterior Lumbar Interbody Fusion.

Introduction An anterior approach to lumbar interbody fusion is a widely utilized method of access to the lumbar spine. Due to the potential for vascular complications with spine exposure, vascular surgeons are frequently included in the care of these patients as part of a team-based approach. Identifying risk factors for such complications is difficult and not well-defined in the literature. In this investigation, we evaluate the potential risk factors for complications during anterior lumbar inter-body fusion (ALIF). Methods This is a retrospective review of 106 patients who underwent ALIF at a single institution between May 1, 2007, and April 30, 2017. Patients were identified through operating room case logs and Current Procedural Terminology (CPT) codes correlating with ALIF. Vascular surgeons performed all anterior exposures. Patient demographics and data regarding their surgical care and postoperative course were obtained from a review of operative and progress notes in the electronic medical record. Statistical methods employed included a t-test for normally distributed data and the Wilcoxon rank-sum test for non-normally distributed data. Categorical variables were compared using Fisher's exact and chi-square tests. A logistic regression model was applied to predict complications by controlling other significant covariates. Results Of the 106 patients included in this analysis, 16 patients experienced a defined complication, giving an overall complication rate of 15%. Patients with complications were more likely to be of male gender (n=11, P=0.016), with older average age (54.6, P=0.017), with higher estimated blood loss, with higher use of blood products, and with higher use of cell-saver. A venous injury was the most common complication (n=11, 10.4%); ileus and nerve injury were the next most common (n=3, 2.8%). The 30-day mortality was 0%. Male gender demonstrated an odds ratio of 3.78 (P=0 .034) in a logistic regression model after adjusting for age and blood products. Conclusions Overall complication rates were comparable to those in the published literature and male gender was identified as a predictor for risk of complications in those undergoing ALIF. This is the first study to identify male sex as a risk factor for complications following ALIF. The results of this study will hopefully guide future studies in gaining more insight into the predictors of complications in larger series.

Effects, uptake, and translocation of aluminum oxide nanoparticles in lettuce: A comparison study to phytotoxic aluminum ions.

The widespread use of aluminum oxide nanoparticles (Al2O3 NPs) unavoidably causes the release of NPs into the environment, potentially having unforeseen consequences for biological processes. Due to the well-known issue of Al phytoxicity, plant interactions with Al2O3 NPs are cause for concern, but these interactions remain poorly understood. This study investigated the effects of Al2O3 NPs on lettuce (Lactuca sativa L.) to elucidate the similarities and differences in plant growth responses when compared to those of Al ions. Seed germination, root length, biomass production, and uptake of Al and nutrients were measured from hydroponically-grown lettuce with varying concentrations of Al2O3 NPs (0, 0.4, 1, and 2 mg/mL) or AlCl3 (0, 0.04, 0.4, and 1 mg/mL). The Al2O3 NPs treatments had a positive influence on root elongation, whereas AlCl3 significantly reduced emerging root lengths. While 0.4 mg/mL Al2O3 NPs promoted biomass, 1 and 2 mg/mL showed a 10.4% and 17.9% decrease in biomass, respectively, when compared to the control. Similarly, 0.4 and 1 mg/mL AlCl3 reduced biomass to 22.3% and 9.96%, respectively. Both treatments increased Al uptake by roots linearly; however, translocation of Al2O3 NPs into shoots was limited, whereas translocation of AlCl3 increased with increasing treatment concentration. Further, Al2O3 NPs adsorbed on the roots serve as adsorbents for macronutrients, promoting their absorption and uptake in plants, but not micronutrients. Calcium uptake was the most inhibited by AlCl3. A new in vivo imaging technique, with elemental analysis, confirmed that Al2O3 NPs were assimilated as particles, not ions, suggesting that the observed phytotoxicity is not due to Al ions being released from the NPs. Thus, it is concluded that Al2O3 NPs pose less phytoxicity than AlCl3, primarily due to NPs role on stimulated root growth, significant adsorption/aggregation on roots, limited lateral translocation to shoots, and increased uptake of macronutrients.

Fenestrated endovascular aneurysm repair with concomitant horseshoe kidney.

Horseshoe kidney (HSK) is a rare anatomic anomaly that poses surgical challenges in the setting of abdominal aortic aneurysm repair. An endovascular approach is safer for patients yet carries technical challenge because of variable renal vasculature. We present the case of a patient with an infrarenal abdominal aortic aneurysm and concomitant HSK who underwent successful repair with a custom fenestrated endograft with preservation of a midaortic renal artery. Complex endovascular aneurysm repair options for HSK include chimneys and fenestrated stent grafts. We suggest that the availability of custom fenestrated grafts and ongoing skill enhancement among vascular surgeons may make this approach more favorable.

Hybrid approach to complex vascular injury secondary to blast induced scapulothoracic dissociation.

Scapulothoracic dissociation is a rare but devastating injury complex involving high velocity blunt trauma to the osseous, muscular, neurologic, and vascular structures of the shoulder girdle. Often seen following a motor vehicle or motorcycle accident, this injury complex presents with vascular trauma in over 80% of cases. We present a unique case of scapulothoracic dissociation secondary to a self-inflicted shotgun wound to the shoulder, not previously reported in the literature. The patient presented in hemorrhagic shock, with an open wound to the chest, and a flaccid, pulseless left upper extremity. Imaging was consistent with subclavian artery transection with thrombosis. He underwent successful upper extremity revascularization with a hybrid approach including open wound exploration and endovascular repair of the subclavian artery. Furthermore, we review the diagnosis and treatment of scapulothoracic dissociation and discuss the safety of emerging hybrid vascular techniques in the management of subclavian and axillary vessel trauma.

Non-operative management of isolated spontaneous superior mesenteric artery dissection.

Isolated spontaneous superior mesenteric artery (SMA) dissection is a rare differential for patients presenting with abdominal pain. Due to limited cases reported, management strategies have been poorly defined. We present the case of a 49-year-old male with history of hypertension and ischemic colitis, presenting with abdominal pain. CT imaging demonstrated a thrombosed dissection of the SMA extending into second and third order braches. He was managed conservatively with therapeutic anticoagulation. His symptoms improved and upon discharge he was transitioned to aspirin and warfarin. Repeat CT imaging continued to show the dissection with resolution of the SMA thrombus. Spontaneous SMA dissection is exceedingly rare with no universally agreed upon standard of care for treatment. Operative intervention should be reserved for failed conservative management or vascular compromise. Understanding the current treatment options helps ensure a favorable patient outcome.

Popliteal artery entrapment syndrome presenting as acute limb ischemia in pregnancy.

Popliteal artery entrapment syndrome typically causes calf claudication in young active adults. Acute limb ischemia from popliteal artery thrombosis, embolization, or aneurysmal degeneration is less common. Chronic compression, histologic changes, and predisposing factors, such as vigorous exercise or hypercoagulability, play a role in these cases. We present the case of a 32-year-old pregnant woman with acute limb ischemia found to have popliteal artery thrombosis as a result of popliteal artery entrapment syndrome. Although many imaging modalities are available, pregnancy creates a unique situation in which consideration of irradiation and exposure to contrast material is important in diagnosis and treatment.

Progression of malrotation into volvulus in an adult after appendectomy.

Among the pediatric population malrotation is the most common cause of volvulus. This paper describes a case of adult malrotation, which progressed to volvulus shortly after appendectomy. It also reviews clinical presentations and diagnostic tools, discusses the recommended management, and considerations when addressing of this rare malady.