No Wound Healing Complications or Recurrences Were Seen and a High Level of Satisfaction Was Reported in Patients Who Underwent Endoscopic Olecranon Bursectomy for Recalcitrant Olecranon Bursitis.

Purpose: To determine the outcomes of endoscopic olecranon bursectomy for the treatment of recalcitrant olecranon bursitis in one surgeon's practice. Methods: A retrospective analysis was conducted on all patients who underwent an endoscopic olecranon bursectomy for the treatment of recalcitrant olecranon bursitis between January 2018 and May 2021 at one surgeon's practice. Demographic variables as well as causes for olecranon bursitis such as aseptic, septic, and gouty tophi were recorded. In addition, any complications such as infection, recurrence, wound failure, or hospitalizations were documented, with wound dehiscence, recurrence of bursitis, and return to the operating room being the primary outcome measures. During the final phone encounter before finalizing this project, patients were queried to obtain the patient-reported form of the American Shoulder and Elbow Surgeons Elbow Questionnaire, quick Disabilities of the Arm Shoulder and Hand score, and the Single Assessment Numeric Evaluation score. Results: Our study included 28 patients (23 male and 5 female) with an average age of 68 years (ranging from 33-86 years), all of whom had follow-up. The average follow-up was 24.7 months (range 3-42 months). There were 15 cases (54%) of aseptic bursitis, 13 cases (46%) of septic bursitis, and 7 cases (25%) that contained gouty tophi (5 aseptic and 2 septic). Of the 28 patients, 4 experienced complications. These all occurred within 3 months of surgery. One necessitated hospitalization and intravenous antibiotics, 2 were minor infections treated with oral antibiotics, and one was swelling treated successfully with in-office aspiration. Overall, 24 (86%) patients reported no issues at all related to the surgery. There were no instances of recurrence, wound failure, or secondary operations. Of the 20 (71.4%) patients who were reached for patient-reported form of the American Shoulder and Elbow Surgeons Elbow Questionnaire, quick Disabilities of the Arm Shoulder and Hand score, and Single Assessment Numeric Evaluation scores, all 20 patients reported no residual pain or difficulties with daily tasks. Average satisfaction with the procedure was 9.9 of 10 and, on average, patients reported that their elbow functionality was 96% with 100% representing completely normal. Conclusions: In this population, patients who underwent endoscopic olecranon bursectomy experienced no recurrences or wound-healing complications necessitating return to the operating room. In addition, patients reported high function and satisfaction after the procedure. Level of Evidence: Level IV, therapeutic case series.

Minimum 5-Year Outcomes After Primary Segmental Labral Reconstruction for Irreparable Labral Tears in the Hip With Hamstring Grafts: With a Subanalysis Comparing Autograft Versus Allograft.

BACKGROUND: Comparable short-term outcomes have been obtained using hamstring allografts versus autografts after primary segmental labral reconstruction (SLR). Midterm results have not yet been determined. PURPOSE: (1) To evaluate minimum 5-year patient-reported outcome (PRO) scores in patients who underwent primary SLR with hamstring grafts in the setting of femoroacetabular impingement syndrome (FAIS) and irreparable labral tears and (2) to compare the outcomes of hamstring autografts versus allografts in a subanalysis using propensity-matched groups. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Prospectively collected data were retrospectively reviewed for patients who underwent primary hip arthroscopy between September 2010 and November 2015. Patients were included if they underwent SLR using hamstring autografts or allografts and had preoperative and minimum 5-year PROs. The exclusion criteria were previous ipsilateral hip surgery or conditions, dysplasia, or Tönnis grade >1. Patients with autograft SLR were propensity matched 1 to 1 based on age, sex, and body mass index (BMI) to patients who underwent SLR using hamstring allografts. The minimal clinically important difference (MCID) and the Patient Acceptable Symptom State (PASS) were calculated. RESULTS: Overall, 48 patients (N = hips 48) were eligible to be included in this study, and 41 patients (n = 41 hips [85.4%]) had a minimum 5-year follow-up reporting significant improvements in all PROs. Within the entire cohort, 9.8% required a secondary arthroscopy, with a mean time of 19 ± 1.8 months, and survivorship was 82.9%. Of the 41 included patients, 15 underwent an SLR with a hamstring autograft and were matched to 15 patients with labral reconstruction using a hamstring allograft. Groups were similar for sex (P > .999), age (P = .775), and BMI (P = .486). The mean follow-up times were 80.8 ± 25.5 and 66.1 ± 8.3 months (P = .223) for the autograft and allograft groups, respectively. Baseline PROs, preoperative radiographic measurements, surgical findings, and intraoperative procedures were similar. The groups achieved significant and comparable improvements for all PROs (P < .0001), satisfaction (P = .187), and the rate of achieving the MCID and the PASS. However, a tendency for higher postoperative PROs favoring allograft reconstruction was found. CONCLUSION: At a minimum 5-year follow-up, patients who underwent primary arthroscopic SLR in the context of FAIS and irreparable labra, with either autograft or allograft hamstring tendons, reported significant improvements and comparable postoperative scores for all PROs, patient satisfaction, MCID, and PASS.

Magnon-phonon hybridization in 2D antiferromagnet MnPSe3.

Magnetic excitations in van der Waals (vdW) materials, especially in the two-dimensional (2D) limit, are an exciting research topic from both the fundamental and applied perspectives. Using temperature-dependent, magneto-Raman spectroscopy, we identify the hybridization of two-magnon excitations with two phonons in manganese phosphorus triselenide (MnPSe3), a magnetic vdW material that hosts in-plane antiferromagnetism. Results from first-principles calculations of the phonon and magnon spectra further support our identification. The Raman spectra's rich temperature dependence through the magnetic transition displays an avoided crossing behavior in the phonons' frequency and a concurrent decrease in their lifetimes. We construct a model based on the interaction between a discrete level and a continuum that reproduces these observations. Our results imply a strong hybridization between each phonon and a two-magnon continuum. This work demonstrates that the magnon-phonon interactions can be observed directly in Raman scattering and provides deep insight into these interactions in 2D magnetic materials.

Distinct magneto-Raman signatures of spin-flip phase transitions in CrI3.

The discovery of 2-dimensional (2D) materials, such as CrI3, that retain magnetic ordering at monolayer thickness has resulted in a surge of both pure and applied research in 2D magnetism. Here, we report a magneto-Raman spectroscopy study on multilayered CrI3, focusing on two additional features in the spectra that appear below the magnetic ordering temperature and were previously assigned to high frequency magnons. Instead, we conclude these modes are actually zone-folded phonons. We observe a striking evolution of the Raman spectra with increasing magnetic field applied perpendicular to the atomic layers in which clear, sudden changes in intensities of the modes are attributed to the interlayer ordering changing from antiferromagnetic to ferromagnetic at a critical magnetic field. Our work highlights the sensitivity of the Raman modes to weak interlayer spin ordering in CrI3.

Quasi-Two-Dimensional Magnon Identification in Antiferromagnetic FePS3via Magneto-Raman Spectroscopy.

Recently it was discovered that van der Waals-bonded magnetic materials retain long range magnetic ordering down to a single layer, opening many avenues in fundamental physics and potential applications of these fascinating materials. One such material is FePS3, a large spin (S=2) Mott insulator where the Fe atoms form a honeycomb lattice. In the bulk, FePS3 has been shown to be a quasi-two-dimensional-Ising antiferromagnet, with additional features in the Raman spectra emerging below the Néel temperature (TN) of approximately 120 K. Using magneto-Raman spectroscopy as an optical probe of magnetic structure, we show that one of these Raman-active modes in the magnetically ordered state is actually a magnon with a frequency of ≈3.7 THz (122 cm-1). Contrary to previous work, which interpreted this feature as a phonon, our Raman data shows the expected frequency shifting and splitting of the magnon as a function of temperature and magnetic field, respectively, where we determine the g-factor to be ≈2. In addition, the symmetry behavior of the magnon is studied by polarization-dependent Raman spectroscopy and explained using the magnetic point group of FePS3.

Phonon origin and lattice evolution in charge density wave states.

Metallic transition metal dichalcogenides, such as tantalum diselenide (TaSe2), display quantum correlated phenomena of superconductivity and charge density waves (CDW) at low temperatures. Here, the photophysics of 2H-TaSe2 during CDW transitions is revealed by combining temperature-dependent, low-frequency Raman spectroscopy and density functional theory (DFT). The spectra contain amplitude, phase, and zone-folded modes that are assigned to specific phonons and lattice restructuring predicted by DFT calculations with superb agreement. The non-invasive and efficient optical methodology detailed here demonstrates an essential link between atomic-scale and microscopic quantum phenomena.

Resonance Raman signature of intertube excitons in compositionally-defined carbon nanotube bundles.

Electronic interactions in low-dimensional nanomaterial heterostructures can lead to novel optical responses arising from exciton delocalization over the constituent materials. Similar phenomena have been suggested to arise between closely interacting semiconducting carbon nanotubes of identical structure. Such behavior in carbon nanotubes has potential to generate new exciton physics, impact exciton transport mechanisms in nanotube networks, and place nanotubes as one-dimensional models for such behaviors in systems of higher dimensionality. Here we use resonance Raman spectroscopy to probe intertube interactions in (6,5) chirality-enriched bundles. Raman excitation profiles for the radial breathing mode and G-mode display a previously unobserved sharp resonance feature. We show the feature is evidence for creation of intertube excitons and is identified as a Fano resonance arising from the interaction between intratube and intertube excitons. The universality of the model suggests that similar Raman excitation profile features may be observed for interlayer exciton resonances in 2D multilayered systems.

Intricate Resonant Raman Response in Anisotropic ReS2.

The strong in-plane anisotropy of rhenium disulfide (ReS2) offers an additional physical parameter that can be tuned for advanced applications such as logic circuits, thin-film polarizers, and polarization-sensitive photodetectors. ReS2 also presents advantages for optoelectronics, as it is both a direct-gap semiconductor for few-layer thicknesses (unlike MoS2 or WS2) and stable in air (unlike black phosphorus). Raman spectroscopy is one of the most powerful characterization techniques to nondestructively and sensitively probe the fundamental photophysics of a 2D material. Here, we perform a thorough study of the resonant Raman response of the 18 first-order phonons in ReS2 at various layer thicknesses and crystal orientations. Remarkably, we discover that, as opposed to a general increase in intensity of all of the Raman modes at excitonic transitions, each of the 18 modes behave differently relative to each other as a function of laser excitation, layer thickness, and orientation in a manner that highlights the importance of electron-phonon coupling in ReS2. In addition, we correct an unrecognized error in the calculation of the optical interference enhancement of the Raman signal of transition metal dichalcogenides on SiO2/Si substrates that has propagated through various reports. For ReS2, this correction is critical to properly assessing the resonant Raman behavior. We also implemented a perturbation approach to calculate frequency-dependent Raman intensities based on first-principles and demonstrate that, despite the neglect of excitonic effects, useful trends in the Raman intensities of monolayer and bulk ReS2 at different laser energies can be accurately captured. Finally, the phonon dispersion calculated from first-principles is used to address the possible origins of unexplained peaks observed in the Raman spectra, such as infrared-active modes, defects, and second-order processes.

Intensity Ratio of Resonant Raman Modes for (n,m) Enriched Semiconducting Carbon Nanotubes.

Relative intensities of resonant Raman spectral features, specifically the radial breathing mode (RBM) and G modes, of 11, chirality-enriched, single-wall carbon nanotube (SWCNT) species were established under second-order optical transition excitation. The results demonstrate an under-recognized complexity in the evaluation of Raman spectra for the assignment of (n,m) population distributions. Strong chiral angle and mod dependencies affect the intensity ratio of the RBM to G modes and can result in misleading interpretations. Furthermore, we report five additional (n,m) values for the chirality-dependent G(+) and G(-) Raman peak positions and intensity ratios; thereby extending the available data to cover more of the smaller diameter regime by including the (5,4) second-order, resonance Raman spectra. Together, the Raman spectral library is demonstrated to be sufficient for decoupling G peaks from multiple species via a spectral fitting process, and enables fundamental characterization even in mixed chiral population samples.

Isolation of >1 nm Diameter Single-Wall Carbon Nanotube Species Using Aqueous Two-Phase Extraction.

In this contribution we demonstrate the effective separation of single-wall carbon nanotube (SWCNT) species with diameters larger than 1 nm through multistage aqueous two-phase extraction (ATPE), including isolation at the near-monochiral species level up to at least the diameter range of SWCNTs synthesized by electric arc synthesis (1.3-1.6 nm). We also demonstrate that refined species are readily obtained from both the metallic and semiconducting subpopulations of SWCNTs and that this methodology is effective for multiple SWCNT raw materials. Using these data, we report an empirical function for the necessary surfactant concentrations in the ATPE method for separating different SWCNTs into either the lower or upper phase as a function of SWCNT diameter. This empirical correlation enables predictive separation design and identifies a subset of SWCNTs that behave unusually as compared to other species. These results not only dramatically increase the range of SWCNT diameters to which species selective separation can be achieved but also demonstrate that aqueous two-phase separations can be designed across experimentally accessible ranges of surfactant concentrations to controllably separate SWCNT populations of very small (∼0.62 nm) to very large diameters (>1.7 nm). Together, the results reported here indicate that total separation of all SWCNT species is likely feasible by the ATPE method, especially given future development of multistage automated extraction techniques.

Isolation of specific small-diameter single-wall carbon nanotube species via aqueous two-phase extraction.

Aqueous two-phase extraction is demonstrated to enable isolation of single semiconducting and metallic single-wall carbon nanotube species from a synthetic mixture. The separation is rapid and robust, with remarkable tunability via modification of the surfactant environment set for the separation.

Thermal conductivity of monolayer molybdenum disulfide obtained from temperature-dependent Raman spectroscopy.

Atomically thin molybdenum disulfide (MoS2) offers potential for advanced devices and an alternative to graphene due to its unique electronic and optical properties. The temperature-dependent Raman spectra of exfoliated, monolayer MoS2 in the range of 100-320 K are reported and analyzed. The linear temperature coefficients of the in-plane E2g 1 and the out-of-plane A1g modes for both suspended and substrate-supported monolayer MoS2 are measured. These data, when combined with the first-order coefficients from laser power-dependent studies, enable the thermal conductivity to be extracted. The resulting thermal conductivity κ = (34.5(4) W/mK at room temperature agrees well with the first principles lattice dynamics simulations. However, this value is significantly lower than that of graphene. The results from this work provide important input for the design of MoS2-based devices where thermal management is critical.

Oversedation in postoperative patients requiring ventilator support greater than 48 hours: a 4-year National Surgical Quality Improvement Program-driven project.

Prolonged mechanical ventilation of postoperative patients can contribute to an increase in morbidity. Every effort should be made to wean patients from the ventilator after surgery. Oversedation may prevent successful extubation. Cases identified by the National Surgical Quality Improvement Program (NSQIP) for Huntington Hospital were reviewed. Oversedation, days on the ventilator, type and duration of sedation, and cost were studied. Data were collected from the NSQIP database and patient charts. Oversedation was determined by the Richmond Agitation Sedation Score (RASS) of each patient. The hospital pharmacy provided data on propofol. Forty-three (35%) patients were oversedated. Propofol was used in 111 (90%) cases with an average use of 4.8 days. Propofol was used greater than 48 hours in 77 (62%) cases. After identifying inconsistent nurse documentation of sedation, corrective actions helped decrease oversedation, average number of days on the ventilator, number of days on propofol, hospital expenditure on propofol, and number of patients on the ventilator greater than 48 hours. Oversedation contributed to prolonged mechanical ventilation. Standardization of RASS and physician sedation order sheets contributed to improving our NSQIP rating. Sedation use decreased and fewer patients spent less time on the ventilator. NSQIP is an effective tool to identify issues with quality in surgical patients.

Analyzing surfactant structures on length and chirality resolved (6,5) single-wall carbon nanotubes by analytical ultracentrifugation.

The structure and density of the bound interfacial surfactant layer and associated hydration shell were investigated using analytical ultracentrifugation for length and chirality purified (6,5) single-wall carbon nanotubes (SWCNTs) in three different bile salt surfactant solutions. The differences in the chemical structures of the surfactants significantly affect the size and density of the bound surfactant layers. As probed by exchange of a common parent nanotube population into sodium deoxycholate, sodium cholate, or sodium taurodeoxycholate solutions, the anhydrous density of the nanotubes was least for the sodium taurodeoxycholate surfactant, and the absolute sedimentation velocities greatest for the sodium cholate and sodium taurodeoxycholate surfactants. These results suggest that the thickest interfacial layer is formed by the deoxycholate, and that the taurodeoxycholate packs more densely than either sodium cholate or deoxycholate. These structural differences correlate well to an observed 25% increase in fluorescence intensity relative to the cholate surfactant for deoxycholate and taurodeoxycholate dispersed SWCNTs displaying equivalent absorbance spectra. Separate sedimentation velocity experiments including the density modifying agent iodixanol were used to establish the buoyant density of the (6,5) SWCNT in each of the bile salt surfactants; from the difference in the buoyant and anhydrous densities, the largest hydrated diameter is observed for sodium deoxycholate. Understanding the effects of dispersant choice and the methodology for measurement of the interfacial density and hydrated diameter is critical for rationally advancing separation strategies and applications of nanotubes.

Separation of empty and water-filled single-wall carbon nanotubes.

The separation of empty and water-filled laser ablation and electric arc synthesized nanotubes is reported. Centrifugation of these large-diameter nanotubes dispersed with sodium deoxycholate using specific conditions produces isolated bands of empty and water-filled nanotubes without significant diameter selection. This separation is shown to be consistent across multiple nanotube populations dispersed from different source soots. Detailed spectroscopic characterization of the resulting empty and filled fractions reveals that water filling leads to systematic changes to the optical and vibrational properties. Furthermore, sequential separation of the resolved fractions using cosurfactants and density gradient ultracentrifugation reveals that water filling strongly influences the optimal conditions for metallic and semiconducting separation.

Carbon nanotubes: measuring dispersion and length.

Advanced technological uses of single-walled carbon nanotubes (SWCNTs) rely on the production of single length and chirality populations that are currently only available through liquid-phase post processing. The foundation of all of these processing steps is the attainment of individualized nanotube dispersions in solution. An understanding of the colloidal properties of the dispersed SWCNTs can then be used to design appropriate conditions for separations. In many instances nanotube size, particularly length, is especially active in determining the properties achievable in a given population, and, thus, there is a critical need for measurement technologies for both length distribution and effective separation techniques. In this Progress Report, the current state of the art for measuring dispersion and length populations, including separations, is documented, and examples are used to demonstrate the desirability of addressing these parameters.

Multimodal, nanoscale, hyperspectral imaging demonstrated on heterostructures of quantum dots and DNA-wrapped single-wall carbon nanotubes.

A multimodality imaging technique integrating atomic force, polarized Raman, and fluorescence lifetime microscopies, together with 2D autocorrelation image analysis is applied to the study of a mesoscopic heterostructure of nanoscale materials. This approach enables simultaneous measurement of fluorescence emission and Raman shifts from a quantum dot (QD)-single-wall carbon nanotube (SWCNT) complex. Nanoscale physical and optoelectronic characteristics are observed including local QD concentrations, orientation-dependent polarization anisotropy of the SWCNT Raman intensities, and charge transfer from photoexcited QDs to covalently conjugated SWCNTs. Our measurement approach bridges the properties observed in bulk and single nanotube studies. This methodology provides fundamental understanding of the charge and energy transfer between nanoscale materials in an assembly.

Centrifugal length separation of carbon nanotubes.

Separation of single-wall carbon nanotubes (SWCNTs) by length via centrifugation in a high density medium, and the characterization of both the separated fractions and the centrifugation process are presented. Significant quantities of the separated SWCNTs ranging in average length from <50 nm to approximately 2 microm were produced, with the distribution width being coupled to the rate of the separation. Less rapid separation is shown to produce narrower distributions; these length fractions, produced using sodium deoxycholate dispersed SWCNTs, were characterized by UV-visible-near-infrared absorption and fluorescence spectroscopy, dynamic light scattering, Raman scattering, and atomic force microscopy. Several parameters of the separation were additionally explored: SWCNT concentration, added salt concentration, liquid density, rotor speed, surfactant concentration, and the processing temperature. The centrifugation technique is shown to support 10 mg per day scale processing and is applicable to all of the major SWCNT production methods. The cost per unit of the centrifugation-based separation is also demonstrated to be significantly less than size exclusion chromatography-based separations.

Length-dependent optical effects in single-wall carbon nanotubes.

Among the novel chemical and physical attributes of single-wall carbon nanotubes (SWCNTs), the optical properties are perhaps the most compelling. Although much is known about how such characteristics depend on nanotube chirality and diameter, relatively little is known about how the optical response depends on length, the next most obvious and fundamental nanotube trait. We show here that the intrinsic optical response of single-wall carbon nanotubes exhibits a strong dependence on nanotube length, and we offer a simple explanation that relates this behavior to the localization of a bound exciton along the length of a nanotube. The results presented here suggest that, for a given volume fraction, the longest nanotubes display significantly enhanced absorption, near-infrared fluorescence, and Raman scattering, which has important practical implications for potential applications that seek to exploit the unique optical characteristics of SWCNTs.