Purpose Patient-rated instruments are increasingly used to measure orthopaedic outcomes. However, the clinical relevance of modest score changes on such instruments is often unclear. This study was designed to define the minimal clinically important differences (MCID) of the Disabilities of the Arm, Shoulder, and Hand (DASH), QuickDASH, and Patient Rated Wrist Evaluation (PRWE) for atraumatic conditions of the hand, wrist, and forearm. Methods One hundred two patients undergoing nonoperative treatment for isolated tendonitis, arthritis, or nerve compression syndromes from the forearm to the hand were analyzed prospectively. Patients completed the DASH, Quick DASH (subset of DASH), and PRWE at enrollment, 2 weeks (n=78 used in analysis), and 4 weeks (n=24 used in analysis) after initiating treatment by telephone. Patients reporting clinical improvement each contributed a single data point categorized as no change (n=41), minimal improvement (n=30), or marked improvement (n=31) via a validated anchor-based approach. The minimal clinically important difference was calculated as the mean change score for each outcome measure in the minimal improvement group. Results The MCID (95%CI) for the DASH was 10 (5-15). The MCID for the Quick DASH was 14 (9-20). The MCID was 14 (8-20) for the PRWE. MCID values were significantly different from changes in these outcome measures at times of either no change or marked improvement. MCID values positively correlated with baseline outcome measure scores to a greater degree than final outcome measure scores. Discussion Longitudinal changes on the DASH of 10 points, the Quick DASH of 14 points, and the PRWE of 14 points represent minimal clinically important changes. We recommend application of these MCID values for group-level analysis when conducting research and interpreting data examining groups of patients as opposed to assessing individual patients. These MCID values may provide a basis for sample size calculations for future investigation using these common patient-rated outcome measures. Level of Evidence: Diagnostic III

The mode-locking of a ceramic Nd:yttrium aluminum garnet ͑YAG͒ solid-state laser ͑SSL͒ with solution processed graphene as saturable absorber ͑SA͒ was demonstrated. Transform-limited pulses with duration of 4 ps centered at 1064 nm were generated for a nondispersion compensated Nd:YAG SSL. Z-scan studies revealed that the graphene SA has a saturation intensity of 0.87 M W cm −2 and a normalized modulation depth of 17.4%. Our results illustrate the potential of using graphene as a mode locker for SSLs.

Our results show that synthetic meshes are not inferior to biologic meshes in contaminated AWR. This is important in view of the tremendous cost disparity between these two products and the questionable ability of biologic mesh to offer a durable hernia repair.

We report on solution processed, highly light sensitive thin film transistors (TFTs) based on poly(9,9-dioctylfluorene-co-bithiophene) (F8T2). Transistors without heat treatment showed the highest saturation mobility, while devices annealed at 280°C showed the highest drain current. The latter annealed transistors were found to give highly stable and reproducible performance over many light cycles. Measurements were carried out using an inorganic light emitting diode (LED) light source with a peak wavelength of 465nm and 19nm bandwidth from 0to400μW∕cm2 light intensity on TFTs with an F8T2 film thickness of 30nm. The TFT OFF current was found to increase both with light intensity and gate bias. The bulk photogenerated carrier density was calculated to change from 5×1011to1×1013cm−3 over the measured light intensity range. The TFT saturation mobility did not change with light intensity, remaining constant at 1.2×10−4cm2∕Vs. The TFT ON current instead increased due to a shift in the turn-on voltage VT. This changed from −27to−20V over the measured light intensity range, initially changing rapidly but then saturating at higher intensity values. Contact resistance RC measurements showed large values in the dark. RC rapidly decreases with increasing light intensity, again saturating at higher values. From these results, we propose a phototransistor model in which illumination varies the device performance by effecting injection. By considering this shift in RC as photoassisted barrier lowering which additionally varies the width of the region depleted of carriers between the injecting interface and the channel, it is possible to explain the observed shift in VT as a change in the fraction of the gate bias dropped across the contact capacitance CC. By operating the phototransistor at a value of Vg=−5V (below VT), it was possible to achieve a highly linear response of the photocurrent with light intensity. Alternatively, by operating at a value of Vg=−40V (above VT), it was possible to maximize the photoresponsivity within the measured range. A photoresponsivity of 18.5A∕W at 5μW∕cm2 light intensity was achieved.

Even in experienced hands, complex revisional bariatric surgery should be approached with significant caution, especially given that weight loss is less substantial.

Postoperative patients might consume less than half of the opioid pills they are prescribed. More research is needed to standardize opioid prescriptions for postoperative pain management while reducing opioid diversion.

We report on a diode-pumped passively mode-locked subpicosecond Nd:CLNGG disordered crystal laser for the first time to our knowledge. Owing to the large inhomogeneous broadening and spectrum splitting of the disordered crystal, the Nd:CLNGG laser generated 900 fs mode-locked pulses with a repetition rate of approximately 88 MHz at 1061 nm wavelength. With a single-emitter laser diode pumping, a maximum average output power of 486 mW was achieved with a slope efficiency of 26%. Our experimental results show that the four-level Nd:CLNGG disordered crystal could be an excellent alternative for subpicosecond pulse generation.

A diode-end-pumped dual-wavelength mode-locked laser based on Nd:LuYSiO5 crystal is demonstrated. With a SESAM, simultaneous mode locking at the 1075.8 nm and 1078.1 nm is achieved and the dual-wavelength mode locked pulses have a pulse width of 8.9 ps. Due to frequency beating, ultrahigh repetition rate ultrafast pulses with 997 fs pulse width and 0.59 THz repetition rate are further formed. Under 12.7 W absorbed pump power 1.7 W mode-locked output power was obtained, the slope efficiency of the mode locked laser was 24.3%.