Excellent Recovery Research Articles

Liver Dysfunction as a Rare Presentation of ICD Lead-Induced Tricuspid Regurgitation: A Case Report

Abstract Background Implanted cardiac devices with right ventricular leads can cause tricuspid regurgitation and subsequent heart failure. In these patients, congestive hepatopathy because of tricuspid regurgitation is well documented, however the presentation of liver dysfunction without overt heart failure is rare. Case Summary We report a case of a 56-year-old man with presumed hypertrophic cardiomyopathy, presenting with jaundice without signs of decompensated heart failure, eight years post implantation of dual chamber implantable cardiac defibrillator (ICD). A workup for abnormal liver function, including a liver biopsy, determined congestive hepatopathy as the cause. Cardiac imaging revealed severe tricuspid regurgitation caused by right ventricular ICD lead causing tricuspid valve malposition. Management included both tricuspid valve replacement and extraction of ICD and there was an excellent recovery. Discussion This is a rare case where severe tricuspid regurgitation and congestive hepatopathy secondary to an ICD lead presented with jaundice in the absence of signs of decompensated heart failure. In patients with an implanted cardiac device presenting with signs of liver dysfunction, congestive hepatopathy secondary to tricuspid regurgitation should be considered.

Dynamic characteristics and transmission efficiency of energy-harvesting shock absorber with low speed and heavy duty capacity

Traditional hydraulic shock absorbers commonly encounter challenges such as cavitation, oil leakage, and the management of energy dissipation. The proposed regenerative shock absorber, which utilizes a ball screw mechanism, offers advantages such as high efficiency and heavy load capacity. This paper focuses on the design, modeling, and testing of a mechatronic shock absorber. Virtual prototype simulation techniques are employed to investigate the dynamic behaviors of the shock absorber. The paper presents a systematic efficiency model of a shock absorber, which is based on the ball screw and gearbox mechanisms. The study comprehensively analyzes the effects of rotation speed, axial load, and structure parameters on transmission efficiency. The results demonstrate that a peak power of 38 W can be achieved with a damping force of only 340 N, and the recovery efficiency can reach up to 28%. The experimental test results validate the effectiveness and reliability of the proposed dynamic and efficiency models. The originality of this study lies in the development of a novel energy-harvesting shock absorber with a ball screw mechanism in series with a gearbox, which shows excellent energy recovery potential and transmission efficiency under low speed and high duty conditions.

HPB SO14 - Surprise Inside: Gallbladder Herniation in a Parastomal Hernia - A Rare Case Report and Management Insight

Abstract Background Parastomal hernias are a common complication of stoma formation, affecting approximately 40% of patients within two years. Gallbladder herniation within a parastomal hernia is a rare phenomenon, with only 18 cases previously reported. Patients are typically elderly females, with the condition attributed to ageing factors such as loss of visceral fat and elastic tissue, liver shrinkage, and the increased length and loss of elasticity of the gallbladder mesentery. These factors contribute to visceroptosis of the gallbladder, increasing its mobility and the risk of herniation. Method We present the case of a 68-year-old female with a four-day history of severe parastomal hernia pain and swelling. She had an emergency left hemicolectomy and transverse colostomy in the right upper quadrant 10 years prior for ischaemic colitis and perforation. Her stoma was functioning well. Vital signs and biochemistry results were normal. On examination her hernia was severely tender but partially reducible. CT revealed a right upper abdominal parastomal hernia containing loops of colon and surprisingly the gallbladder with a long stretched cystic duct. There was no evidence of cholecystitis, bowel obstruction, or compromise within the hernial sac. Results With analgesia, the patient's pain improved, though her hernia remained irreducible. She was discharged after two days of conservative management and referred back to the hospital where she had the initial operation. On enquiry with that hospital it was reported that an elective parastomal hernia repair with completion right colectomy and end ileostomy was performed. The gallbladder was mobilised and reduced back into the peritoneal cavity, and the hernial defect was closed. The patient made an excellent recovery and was discharged home three days after surgery. Conclusion Cholecystic parastomal herniation is a very rare phenomenon and should be considered as a differential in similar cases. Management should be based on clinical presentation, radiological diagnosis, and a multidisciplinary team approach. No standardised classification or approach exists. We propose classifying gallbladder herniations as either being simple (without inflammatory sequelae) or complicated (with cholecystitis, gallbladder torsion, incarceration or perforation). Simple herniations, such as the case presented, can be managed electively with intra-operative reduction of the gallbladder sufficing. Complicated herniations during acute admissions indicate the need for emergency surgical intervention with combined cholecystectomy and parastomal hernia repair.

Abstract 4145899: The Danger of Moderator Band Ectopy: A Case of Premature Ventricular Contraction induced Recurrent Ventricular Fibrillation

Introduction: Premature Ventricular Contractions (PVCs) are often a benign arrhythmia. However, those originating from the Purkinje system can result in fatal arrhythmias. One example is PVCs originating from the moderator band (MB) within the right ventricle (RV) of the heart. We present a case of PVCs originating from the MB triggering idiopathic ventricular fibrillation (VF) and electrical storm. Case: A previously healthy 49-year-old woman was admitted following a witnessed VF cardiac arrest. She had recurrent episodes of VF, initially treated with Amiodarone and Procainamide which failed to suppress the recurrent VF. She received 54 external defibrillations before a transvenous pacer (TVP) was placed to override the PVCs at a pacing rate of 110 bpm. Post-resuscitation ECGs revealed frequent PVCs originating from the RV free wall, potentially from the lateral part of MB (Figure 1). Quinidine was added to suppress the PVCs ultimately allowing removal of the TVP. Transthoracic Echocardiogram revealed normal cardiac function and a prominent MB. A cardiac MRI was performed showing no infiltrative disease or any other abnormalities. The patient underwent sympathectomy and defibrillator placement. Despite recurrent cardiac arrest, she had excellent neurologic recovery and was subsequently discharged on Quinidine. Discussion: MB extends from the septal wall to the base of the anterior papillary muscle in the RV, carrying Purkinje fibers(PF) from the right bundle branch as it exits the septum. Purkinje fibers have been shown to initiate arrhythmias by several mechanisms including enhanced automaticity, triggered activity and re-entry. In the genesis of PVCs, triggered activity is the likely mechanism. This can degenerate into VF in a structurally normal heart, hence the term “idiopathic VF”. Familiarity with this entity and ECG features of MB ectopy leads to timely management and may potentially prevent lethal arrhythmias in symptomatic patients with such PVCs. Further studies are required to fully understand the arrhythmogenic mechanisms and the optimal management approach for MB ectopy.

Quantitative Monitoring of Cyclic Glycine–Proline in Marine Mangrove-Derived Fungal Metabolites

This study developed and validated a robust UPLC-MS/MS method for quantifying cyclic glycine–proline (cGP) in mangrove-derived Penicillium and Aspergillus strains. The method demonstrated excellent linearity, precision, and recovery, with detection limits as low as 4.8 ng/mL. Penicillium pedernalense extract achieved a cGP content of 67.45 ± 1.11 ng/mL, with a corresponding fermentation yield of 29.31 ± 0.61 mg/L. This surpassed Penicillium steckii, which reached a content of 31.71 ± 0.31 ng/mL, with a yield of 8.51 ± 0.15 mg/L. This quantitative approach for metabolite analysis provides a viable method for screening these fungal strains, highlighting their potential for sustainable production of cyclic glycine–proline (cGP).

Contemporary Outcomes of Degenerative Mitral Valve Surgery in a Regional Tertiary Care Center

Objective: As percutaneous mitral valve techniques become more prevalent, it is important to evaluate the contemporary outcomes of surgical mitral valve interventions. This study assessed the current results and procedural trends of mitral valve surgery for degenerative mitral regurgitation (DMR) at a regional tertiary care center. Methods: Data were analyzed from 693 consecutive DMR patients who underwent isolated mitral valve operations, with or without tricuspid valve repair and atrial fibrillation ablation between 2017 and 2024. The outcomes were defined according to MVARC criteria. The study endpoints included successful mitral valve repair, in-hospital results, and operative and long-term mortality. Logistic regression was applied to assess the impact of valve lesions and patient risk factors on the probability of valve repair. Survival was analyzed using Kaplan–Meier methodology. The follow up was 100% complete. Results: Mitral valve repair was performed in 90.9% of cases, with only 0.9% requiring the conversion to replacement due to unsuccessful repair. Posterior leaflet lesions had the highest success rate (93.4%), while anterior leaflet lesions had a lower rate (86.2%), with anterior pathology being a negative predictor of repair (OR 2.57, p = 0.02). The type of lesion (prolapse vs. flail), the commissural involvement, and the increased risk for SAM had no statistically significant impact on valve repair outcome. Less invasive transaxillary access was used in 63.2% of patients, and its adoption increased significantly (from 50.9% to 67.4% p = 0.03) over time, resulting in more frequent fast-track extubation and home discharges. The rate of in-hospital mortality was 0.6%, while the rate of 5-year survival was 95.5%. Conclusions: Contemporary surgical techniques for DMR lead to high repair rates and excellent recovery outcomes. Despite the rise in transcatheter options, our findings confirm that surgery remains the gold standard for most DMR patients.

Application of nucleophilic substitution reaction for sensitive determination of heptaminol hydrochloride in pharmaceuticals

A straightforward and sensitive spectrofluorimetric approach was established for the determination of heptaminol hydrochloride (HTM-HCl) based on the derivatization of the drug through its reaction with 5-dimethylaminonaphthalene-1-sulfonyl chloride (Dansyl chloride). The reagent underwent a nucleophilic substitution of its chlorine atom with HTM to give N-(5-dimethylaminonaphthalene-1-sulfonyl)-6-amino-2-methylheptan-2-ol. The highly luminescent derivative was extracted using methylene chloride and subjected to analysis at an excitation wavelength of 345 nm and an emission wavelength of 490 nm. The chemical reaction occurred within an aqueous environment buffered with a 0.1 M borate buffer solution adjusted to pH 10.5. Experimental findings indicate that the proposed method displays sensitivity and linearity across a concentration range from 0.03 to 2 µg mL− 1. The method achieves lower detection and quantification limits of 0.016 and 0.048 µg mL− 1, respectively. The analytical validation of this method followed the guidelines outlined by the International Council of Harmonization (ICH). This approach was applied effectively for quantifying the medication in both tablet and oral drops formulations available on the market, demonstrating excellent recovery of 98.95 ± 0.45 for tablets and 99.37 ± 0.24 for oral drops with no interference from excipients.

Dynamic Non-Covalent Bonds Powering Enhanced Temporary Shape Retention Temperature and Mechanical Robustness in Shape Memory Polyurethane.

Shape memory polyurethane (SMPU) with excellent mechanical properties holds significant application value in engineering. However, achieving high strength and toughness typically relies on hydrogen bonding for energy dissipation, which limits the application of such PUs due to their deformation temperature being below room temperature. Here, we introduce a rigid long-chain polyamide acid with a rich aromatic structure as a chain extender, combined with metal coordination, to develop a shape memory polyurethane with a phase transition temperature of 50 °C and outstanding mechanical performance. The presence of rigid segments of polyamic acid (PAA) and -COOH not only increases the rigidity of the polyurethane chains but also promotes the formation of hydrogen bonds and π-π conjugation, leading to physical cross-linking points and significant microphase separation, resulting in superior mechanical properties for PU-PAA. The dynamic bonding characteristics impart self-healing and solvent recyclability to PU-PAA. The coordination interactions enhance the cross-linking points, enabling PU-PAA-Eu to exhibit excellent shape fixation and recovery rates, as well as fluorescence properties. Additionally, due to the presence of -COOH, PU-PAA demonstrates remarkable adhesion to various metals. This work provides a strategy toward the development of high performance SMPU and holds promising potential for applications such as anticounterfeit coatings.

Healable, Recyclable, and Ultra-Tough Waterborne Polyurethane Elastomer Achieved through High-Density Hydrogen Bonding Cross-Linking Strategy.

With the increasing popularity of elastomers in industry and daily life, their high performance and functionality have attracted widespread attention. However, it is a great challenge for them to possess both high mechanical properties and excellent healing and recovery capabilities due to the limitations of the preparation methods and the intrinsic microstructure of the elastomers. In this study, a strategy of ice-controlled interfacial stepwise cross-linking was proposed to prepare the waterborne polyurethane-based elastomers with ultrahigh-density hydrogen bonding interaction achieved by enhancing the utilization rate of phenol hydroxyl groups of tannic acid to the maximum extent. The elastomers have incredible mechanical properties, including ultrahigh toughness of 1.03 GJ m-3 (which represents the highest level among polyurethane elastomers prepared through common processing techniques to date), extremely high true fracture stress of ∼1.9 GPa, world-record fracture energy of 520 kJ m-2, and exciting multiple functional characteristics, such as highly efficient self-healing ability of 10 min, high resistance to physical damage and chemical corrosion, broad temperature and frequency damping effects, good shape memory effect, and excellent melt-processing recyclability and solvent recyclability. These robust multifunctional elastomers represent considerable potential in various fields, from defense and military industry and civil transportation to precision manufacturing, etc.

Effect of various culinary treatments on the glycoalkaloid content of potato peel

Potatoes are one of the most consumed foods worldwide. During germination, glycoalkaloids (GAs) with potential bioactive properties are produced, which, at high concentrations, may have adverse health effects. Potato peels, a byproduct generated in large quantities but increasingly used in contemporary cuisine, contain significant levels of these GAs. This paper examines GA levels in potato peels after various culinary treatments (boiling, steaming, baking, air frying, conventional deep frying, and double frying) to provide new data and ensure food safety. An optimized extraction method using ultrasound-assisted extraction (UAE) was employed, followed by purification with mesostructured SBA-15 silica functionalized with octadecylsilane (C18) chains as sorbent in solid-phase extraction, prior to HPLC-DAD determination of α-solanine and α-chaconine levels in the samples. The method was validated, obtaining excellent recovery values (88 – 96 %) and low detection and quantification limits (0.3 and 1 mg/L, respectively). Upon application of the validated analytical method to the samples culinarily treated using the most common cooking techniques (boiling, steaming, baking, air frying, conventional deep frying, and double frying) at various times and temperatures, the obtained results demonstrated significant reductions (between 52 % and 84 %) in GAs content in the treated potato peels, compared to fresh samples. Statically significant degradation of these compounds was observed through baking at elevated times and temperatures (74 – 84 %), as well as both conventional deep frying and double frying (76 – 83 %).

Two Erigeron species comparison based on their ingredient profile by UPLC-PDA-QTOF-MS/MS and discriminant analysis.

Erigeron breviscapus (EB) and Erigeron multiradiatus (EM) are the two species of the genus Erigeron (Asteraceae) with extremely close genetic relationships. They were used as the same "meiduoluomi" for the treatment of plague and epidemics in traditional Tibetan medicine. But in traditional Chinese medicine, only EB is used for treatment of cerebrovascular obstruction, hemiplegia due to stroke, coronary artery obstruction, chest congestion, and angina pectoris. These two Erigeron species show different effects in different traditional medicine systems. Therefore, analyzing the chemical compositions of two species will not only enhance comprehension of their medicinal properties but also foster the advancement and exploration of novel applications. However, to date, there has been no comprehensive and detailed investigation comparing the constituents of EB and EM. A methodology for rapid identification of chemical profiles from two Erigeron species was devised through the integration of ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UHPLC-QTOF-MS/MS) and multivariate statistical analysis. Additionally, a UHPLC-photo-diode array (PDA) method was established to precisely quantify of 11 components. A total of 58 constituents comprising flavonoids, phenolic acids, saponin, and long chain fatty acids were elucidated. Thirteen compounds were identified as potential differentiators in chemical profiles among the two Erigeron species. For quantitative assessment, 11 bioactive compounds were simultaneously quantified across 49 batches of Erigeron species samples utilizing UHPLC-PDA with wavelengths of 325, 254, and 266 nm. The method demonstrated excellent precision, linearity, accuracy, repeatability, stability, and recovery. The findings from this study will serve as a reference for quality control, functional activity exploration, and improved clinical application based on the ingredient profiles of the two species. Furthermore, this inaugural investigation into the ingredient profiles of these two species will enhance the potential and optimal utilization of both EB and EM resources.

Trace-level quantification of NDMA in levosulpuride active pharmaceutical ingredient and tablet formulation Using UFLC-MS/MS

Nitrosamine impurities identified in several pharmaceuticals during recent times has raised concerns leading to product recalls worldwide and necessitating sensitive liquid and gas chromatographic methods for trace level detection of nitrosamine impurities. This study developed and validated a ultra-fast liquid chromatography-tandem mass spectrometry (UFLC-MS/MS) method for the quantification of NDMA in Levosulpuride drug substance and tablet formulation. Current method utilizes a triple quadrupole analyzer, atmospheric pressure chemical ionization (APCI) ionization source and multiple reaction monitoring (MRM) scan mode for the analysis. Chromatographic separation was achieved on a Gemini NX-C18 column (150 × 4.6 mm, 3 µm) maintained at 40 °C. The mobile phase consisted of a binary gradient of solvent A (0.1 % formic acid in water) and solvent B (methanol), with a total run time of 18 minutes. Current method achieved excellent linearity, recovery, precision, and sensitivity. Greenness of the developed method was evaluated using the GAPI, AGREE, and AES metrics. Current method is sensitive and selective for NDMA in levosulpuride drug substance and tablet formulations and can be employed for routine quality control analysis in pharmaceutical industry.

Sustainable synthesis of PVA@ZnO:Ga3+ nanocomposite films for UV shielding, food preservation, shape memory and anti-counterfeiting applications

Herein, we successfully fabricated transparent and highly flexible polyvinyl alcohol@ZnO:Ga3+ (PVA@ZnO:Ga3+) nanocomposites (NCs) films by simple solution casting method. Upon excitation at 266 nm, both the ZnO:Ga3+ nanoparticles (NPs) and the PVA@ZnO:Ga3+ NCs exhibit a prominent peak at 385 nm and a broad peak around 550 nm. The optimized PVA@ZnO:Ga3+ NCs demonstrated the most effective ultra violet (UV) blockage across the UV-A (99.99 %), UV-B (100 %) and UV-C (100 %) and high energy blue light HEBL (94.63 %). However, PVA alone absorbed <25 % of the light in all UV regions. Packaging of fresh cherry fruit with PVA@ZnO:Ga3+ (0.1 wt%) NCs enhanced the shelf-life up-to 15 days of storage under room temperature. These innovative NCs packaging films could provide a green, environment-friendly and antimicrobial system to combat the shorter shelf life of cherry fruit. The optimized NCs exhibited excellent shape recovery under pH conditions of 1, 7 and 13 and at a temperature of 70 °C, returning to its original shape within 120, 150, 160 and 6 sec, respectively. This emphasizes the NCs remarkable water-induced shape memory ability. Further, PVA@ZnO:Ga3+ NCs security ink offers strong anti-counterfeiting (AC) properties with UV luminescence and stability against UV exposure, aging and temperature effect. It adheres well to various substrates, ensuring long-term durability and resistance to replication. Overall, the results clearly show that ZnO:Ga3+ NPs hold great promise for applications in AC technology, UV blocking and the food packaging industry, thanks to their low cost, biocompatibility, flexibility and transparency.

Rubber-assisted and modulated epoxy topological network for developing fatigue-resistant, high-strain-cycle high performance shape memory polymer composites

High performance shape memory polymer (HPSMP) has a wide range of application such as smart device, smart mold. In this study, we designed a rigid-flexible shape memory epoxy with flexible chain segment as the main chain and rigid benzene ring as the side group. Meanwhile, carboxyl-terminated nitrile butadiene rubber (CTBN) was accessed into the epoxy main chain as a fatigue-resistant functional filler. The results showed that the flexible backbone plays a major role in improving the ductility. The superior fatigue-resistant shape memory cycling performance was synergistically achieved by modulating the epoxy topological network through altering the disulfide cross-linker prompted by CTBN, and the materials exhibited good high and low-temperature resistant mechanical properties. Comparatively, it is found that disulfide bonding can significantly improve the tensile property and thermal stability for epoxy. The synergistic effect between the elastic chain segments in CTBN and the flexible backbone achieves excellent shape recovery ratio. Therefore, the rational structural design provides an effective way to develop HPSMP, which can expand the application areas for HPSMP.

Comparison of anterior spinal fusion and posterior cervical foraminotomy for cervical spondylotic radiculopathy in terms of postoperative recovery of upper-limb motor deficits

This study compared postoperative motor recovery between anterior spinal fusion (ASF) and posterior cervical foraminotomy (PCF) in patients with cervical spondylotic radiculopathy (CSR) who had motor deficits. From a database maintained by surgeons across 27 institutions, 227 patients undergoing primary ASF or PCF for CSR without myelopathy were evaluated. Among these, 106 patients with upper-limb motor deficits (manual muscle testing [MMT] grade 0–3) were observed for at least 12 months post-surgery. Data on preoperative and postoperative MMT grades were collected at 3, 6, and 12 months after surgery and at the final follow-up. The recovery of motor function was compared between the ASF and PCF groups using Kaplan–Meier curves and Cox regression analysis. While the overall excellent recovery rates (MMT grade ≥ 2) at the final follow-up were similar between the ASF and PCF group (74 % vs. 86 %, p = 0.15), the PCF group showed significantly faster motor recovery at 3, 6, and 12 months postoperatively, with recovery rates of 43 %, 63 %, and 82 %, respectively, compared to 18 %, 46 %, and 54 % in the ASF group (HR = 1.62, p = 0.031). These findings suggest that PCF may offer a quicker recovery of motor function and could be a more suitable surgical procedure than ASF for patients with CSR and motor deficits.

The impact of early cranioplasty on neurological function, stress response, and cognitive function in traumatic brain injury.

To analyze the efficacy of early cranioplasty in patients with traumatic brain injury and its impact on neurological function, stress response, and cognitive function. A total of 90 patients with traumatic brain injury admitted to the hospital from January 2021 to March 2024 were included in the study. The patients were divided into an observation group (45 cases) and a control group (45 cases) based on the timing of their cranioplasty. The control group underwent cranioplasty 3 to 6 months post-trauma, while the observation group received cranioplasty within 3 months post-trauma. Neurological function was assessed using the National Institutes of Health Stroke Scale. Cognitive function was evaluated using the Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination. Blood samples were collected to measure and compare serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha between the 2 groups. The observation group demonstrated a higher rate of excellent recovery compared to the control group (95.56% vs 80.00%), with significantly lower National Institutes of Health Stroke Scale scores ([11.18 ± 2.35] vs [14.74 ± 3.61], P < .05). Posttreatment scores for Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination were significantly higher in the observation group compared to the control group ([59.26 ± 6.12] vs [47.86 ± 5.27], [25.02 ± 4.61] vs [22.74 ± 5.13], [103.52 ± 10.63] vs [88.76 ± 7.39], P < .05). Serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha were significantly lower in the observation group ([22.76 ± 4.15] ng/mL vs [25.38 ± 5.27] ng/mL, [66.29 ± 4.91] nmol/L vs [78.24 ± 6.08] nmol/L, [3.36 ± 1.02] ng/mL vs [4.91 ± 0.98] ng/mL, P < .05). The total incidence of postoperative complications was significantly lower in the observation group (8.70% vs 26.09%, P < .05). Early cranioplasty is beneficial for the postoperative recovery of patients with traumatic brain injury. It improves neurological function, enhances cognitive function, and reduces stress response, while also significantly lowering the incidence of postoperative complications.

Mechanical Behaviors of Orthogonal Spiral Metal Skeleton–Polyurethane Elastomer Composites under Complex Loading Modes

Herein, a novel material design strategy is proposed: an interpenetrating composite composed of a woven orthogonal spiral metal skeleton and polyurethane (PU) elastomer. This interpenetrating composite combines rigidity and flexibility, exhibiting excellent elasticity and deformation recovery. The deformation behavior and mechanical properties of the composites under various loading conditions are investigated through experiments and numerical simulations. Different degrees of warping behaviors occur in composites with various structural parameters under uniaxial tension. Alternating rotations and double spiral arrangements can significantly limit the warping phenomenon, with a maximum reduction of 78%. The bending load capacity is regularly increased by increasing the wire diameter and decreasing the pitch. Increasing the number of loaded spiral wires enhances the bending load capacity of the composites. Uniaxial compression tests demonstrate that the composites have excellent load‐carrying capacity and strain recovery, with compressive strength 1.5 times that of pure PU. Cyclic compression tests further illustrate the excellent energy consumption capacity and stability of the composites. Overall, the introduction of orthogonal spiral skeletons into the composites demonstrates the potential to achieve enhanced load‐carrying capacity and large strain recovery simultaneously.

Simultaneous Quantification of Carboxylate Enantiomers in Multiple Human Matrices with the Hydrazide-Assisted Ultrahigh-Performance Liquid Chromatography Coupled with Tandem Mass Spectrometry.

Many chiral carboxylic acids with α-amino, α-hydroxyl, and α-methyl groups are concurrently present in mammals establishing unique molecular phenotypes and multiple biological functions, especially host-microbiota symbiotic interactions. Their chirality-resolved simultaneous quantification is essential to reveal the biochemical details of physiology and pathophysiology, though challenging with their low abundances in some biological matrices and difficulty in enantiomer resolution. Here, we developed a method of the chirality-resolved metabolomics with sensitivity-enhanced quantitation via probe-promotion (Met-SeqPro) for analyzing these chiral carboxylic acids. We designed and synthesized a hydrazide-based novel chiral probe, (S)-benzoyl-proline-hydrazide (SBPH), to convert carboxylic acids into amide diastereomers to enhance their retention and chiral resolution on common C18 columns. Using the d5-SBPH-labeled enantiomers as internal standards, we then developed an optimized ultrahigh-performance liquid chromatography with tandem mass spectrometry (UHPLC-MS/MS) method for simultaneous quantification of 60 enantiomers of 30 chiral carboxylic acids in one run. This enantiomer-resolved method showed excellent sensitivity (LOD < 4 fmol-on-column), linearity (R2 > 0.992), precision (CV < 15%), accuracy (|RE| < 20%), and recovery (80-120%) in multiple biological matrices. With the method, we then quantified 60 chiral carboxylic acids in human urine, plasma, feces, and A549 cells to define their metabolomic phenotypes. This provides basic data for human phenomics and a promising tool for investigating the mammal-microbiome symbiotic interactions.

Return to Sport After Conservative Management of Midshaft Clavicle Fractures in Professional Jockeys.

This study explores the functional recovery and rates return to play (RTP) of professional jockeys following midshaft clavicle fractures, which have been managed conservatively. The high incidence of these fractures in horse racing underscores the importance of evaluating nonsurgical recovery paths for effective RTP. We used a retrospective cohort study to assess treatment outcomes. The research is set in the professional horse racing scene of Ireland. Sixteen professional Irish jockeys with conservatively managed midshaft clavicular fractures were examined. Jockeys who underwent surgery or were inactive at injury time were excluded. The study involved no direct interventions. Recovery was assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score and Patient-Reported Outcome Measures, alongside racing records to track RTP. The all-male cohort had an average age of 27 years. Results showed an average 67.1-day absence from racing, with 94% returning to preinjury competition levels. Complications were minimal, and patient outcomes were positive, as indicated by a mean QuickDASH score of 2.58, suggesting minimal residual disability. Findings highlight the success of conservative management for midshaft clavicle fractures in professional jockeys, enabling them to return to prior competitive levels with few complications and excellent functional recovery.

Quality by Design Approach Driven Development and Validation of Reverse Phase‐High‐Performance Liquid Chromatography Methodology for Dual Quantification of Aspirin and Rivaroxaban

ABSTRACTClinical trials have shown that combining a modest dose of Rivaroxaban (RIV) with Aspirin (ASP) is more effective than ASP alone in reducing cardiovascular mortality, myocardial infarction, and stroke. A high‐performance liquid chromatography method developed using Quality by Design (QbD) effectively estimates ASP and RIV for routine pharmaceutical analysis. The Plackett‐Burman design assessed key factors including organic phase volume, mobile phase pH, flow rate, temperature, and injection volume using an Ishikawa fish‐bone diagram for risk assessment. These parameters were then optimized via Box‐Behnken design in 15 trials. The method meets the International Council For Harmonization standards with a mobile phase ratio of 45:55 (v/v) acetonitrile: buffer (pH 3, adjusted with orthophosphoric acid), a flow rate of 1 mL/min, a column temperature of 30°C, and an injection volume of 20 µL. A Phenomenex Luna C18 column (250 × 4.6 mm, 5 µm particle size) with detection at 251 nm ultra‐violet wavelength. The retention times of 4.54 min for ASP and 5.81 min for RIV were obtained. Validation confirmed linear ranges: 40–200 µg/mL for ASP and 2–10 µg/mL for RIV, with excellent recovery rates (ASP: 99.30%–101.9%; RIV: 98.52%–101.84%). Developed using QbD principles, the method proved specific, accurate, precise, sensitive, and robust for routine quality control of both compounds in pharmaceutical formulations.