A displaced medial tibial plateau fracture with central and lateral impaction, but an intact anterolateral cortical rim, is an uncommon variant of bicondylar tibial plateau fracture that presents a ...number of challenges. Without a lateral metaphyseal fracture line to work through, it is challenging to address central and lateral impaction. Previously published techniques for addressing this fracture pattern describe an intra-articular osteotomy of the lateral plateau to aid visualization and reduction, or use a posterolateral approach to the proximal tibia with or without an osteotomy of the proximal fibula. This study presents a technique which utilizes standard dual incision approaches and does not involve an intra-articular osteotomy of the lateral tibial plateau or a posterolateral approach. A case series was conducted evaluating radiographic and functional outcomes of 8 patients.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Chronic lymphocytic leukaemia (CLL) is a malignancy of the immune B lymphocyte cells and is the most common leukaemia diagnosed in developed countries. In this paper, we report the synthesis and ...antiproliferative effects of a series of (
)-9-(2-nitrovinyl)anthracenes and related nitrostyrene compounds in CLL cell lines and also in Burkitt's lymphoma (BL) cell lines, a rare form of non-Hodgkin's immune B-cell lymphoma. The nitrostyrene scaffold was identified as a lead structure for the development of effective compounds targeting BL and CLL. The series of structurally diverse nitrostyrenes was synthesised via Henry-Knoevenagel condensation reactions. Single-crystal X-ray analysis confirmed the structure of (
)-9-chloro-10-(2-nitrobut-1-en-1-yl)anthracene (
) and the related 4-(anthracen-9-yl)-1
-1,2,3-triazole (
). The (
)-9-(2-nitrovinyl)anthracenes
and
were found to elicit potent antiproliferative effects in both BL cell lines EBV
MUTU-1 (chemosensitive) and EBV
DG-75 (chemoresistant) with >90% inhibition at 10 μM. Selected (
)-9-(2-nitrovinyl)anthracenes demonstrated potent antiproliferative activity in CLL cell lines, with IC
values of 0.17 μM (HG-3) and 1.3 μM (PGA-1) for compound
. The pro-apoptotic effects of the most potent compounds
,
,
,
and
were demonstrated in both CLL cell lines HG-3 and PGA-1. The (
)-nitrostyrene and (
)-9-(2-nitrovinyl)anthracene series of compounds offer potential for further development as novel chemotherapeutics for CLL.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The Taj Mahal-an iconic World Heritage monument built of white marble-has become discolored with time, due, in part, to high levels of particulate matter (PM) soiling its surface (Bergin et al 2015 ...Environ. Sci. Technol. 49 808-812). Such discoloration has required extensive and costly treatment (2015 Two Hundred Sixty Second Report on Effects of Pollution on Taj Parliament of India Rajya Sabha, New Delhi) and despite previous interventions to reduce pollution in its vicinity, the haze and darkening persists (Bergin et al 2015 Environ. Sci. Technol. 49 808-812; 2015 Two Hundred Sixty Second Report on Effects of Pollution on Taj Parliament of India Rajya Sabha, New Delhi). PM responsible for the soiling has been attributed to a variety of sources including industrial emissions, vehicular exhaust and biomass burning, but the contribution of the emissions from the burning of open municipal solid waste (MSW) may also play an important role. A recent source apportionment study of fine particulate matter (PM2.5) at the Taj Mahal showed biomass burning emissions, which would include MSW emissions, accounted for nearly 40% of organic matter (OM)-a component of PM-deposition to its surface (Bergin et al 2015 Environ. Sci. Technol. 49 808-812); dung cake burning, used extensively for cooking in the region, was the suggested culprit and banned within the city limits (2015 Two Hundred Sixty Second Report on Effects of Pollution on Taj Parliament of India Rajya Sabha, New Delhi), although the burning of MSW, a ubiquitous practice in the area (Nagpure et al 2015 Environ. Sci. Technol. 49 12904-12), may play a more important role in local air quality. Using spatially detailed emission estimates and air quality modeling, we find that open MSW burning leads to about 150 ( 130) mg m−2 yr−1 of PM2.5 being deposited to the surface of the Taj Mahal compared to about 12 ( 3.2) mg m−2 yr−1 from dung cake burning. Those two sources, combined, also lead to an estimated 713 (377-1050) premature mortalities in Agra each year, dominated by waste burning in socioeconomically lower status neighborhoods. An effective MSW management strategy would reduce soiling of the Taj Mahal, improve human health, and have additional aesthetic benefits.
Objective: Few studies exist that have examined the spectrum and natural long‐term course of eating disturbance in the community. We examine the lifetime prevalence and long‐term course of anorexia ...nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in an adult female twin population.
Method: Female twins (n = 1002) from the Australian Twin Registry, aged 28–39 years, were assessed using the Eating Disorder Examination, revised to yield lifetime diagnostic information. For women with lifetime eating disorders, the assessment occurred, on average, 14.52 years (SD = 5.65) after onset of their disorder.
Results: In accordance with other community studies, we found a 1.9% lifetime prevalence of AN, with an additional 2.4% who met the criteria for ‘partial AN’ (absence of amenorrhea). Criteria for BN were met by 2.9% of the women, an additional 2.9% of women met criteria for binge eating disorder, while 5.3% met criteria for purging disorder unaccompanied by binge eating (EDNOS‐p). Eleven (7%) of the women with lifetime eating disorders had a current eating disorder. Each diagnostic group continued to be differentiated by current eating pathology from women without lifetime eating disorders. Although approximately 75% of the women had a good outcome, less than 50% of each diagnostic group was asymptomatic.
Conclusions: Eating disorders tend to improve over time often reaching subdiagnostic levels of severity, but only a minority of sufferers becomes asymptomatic. The DSM‐IV diagnosis EDNOS needs to be considered in studies of the prevalence and course of eating disorders.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Context.
The composition of planets may be largely determined by the chemical processing and accretion of icy pebbles in protoplanetary disks. Recent observations of protoplanetary disks hint at ...wide-spread depletion of gaseous carbon. The missing volatile carbon is likely frozen in CO and/or CO
2
ice on grains and locked into the disk through pebble trapping in pressure bumps or planetesimals.
Aims.
We aim to measure the total elemental C/H ratio in the outer region of seven disks, four of which have been previously shown to be depleted of carbon gas interior to 0.1 AU through near-infrared spectroscopy.
Methods.
We present the results of the first successful Atacama Compact Array (ACA) C
I
J
= 1−0 mini-survey of seven protoplanetary disks. Using tailored azimuthally symmetric Dust And LInes thermo-chemical disk models, supported by the C
I
J
= 1−0 and resolved CO isotopologue data, we determine the system-averaged elemental volatile carbon abundance in the outer disk of three sources.
Results.
Six out of the seven sources are detected in C
I
J
= 1−0 with ACA, four of which show a distinct disk component. Based on the modeling we find severe cold gaseous carbon depletion by a factor of 157
+17
-15
in the outer disk of DL Tau and moderate depletion in the outer disks of DR Tau and DO Tau, by factors of 5
+2
-1
and 17
+3
-2
, respectively. The carbon abundance is in general expected to be higher in the inner disk if carbon-rich ices drift on large grains toward the star. Combining the outer and inner disk carbon abundances, we demonstrate definitive evidence for radial drift in the disk of DL Tau, where the existence of multiple dust rings points to either short-lived or leaky dust traps. We find dust locking in the compact, smooth disks of DO Tau and DR Tau, which hints at unresolved dust substructure. Comparing our results with the inner and outer disk carbon depletion around stars of different ages and luminosities, we identify an observational evolutionary trend in gaseous carbon depletion that is consistent with dynamical models of CO depletion processes.
Conclusions.
The transport efficiency of solids in protoplanetary disks can significantly differ from what we expect based on the current resolved substructure in the continuum observations. This has important implications for our understanding of the impact of radial drift and pebble accretion on planetary compositions.
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FMFMET, NUK, UL, UM, UPUK
496.
Obesity, Orthopaedics, and Outcomes Mihalko, William M; Bergin, Patrick F; Kelly, Frank B ...
Journal of the American Academy of Orthopaedic Surgeons,
2014-November, 2014-Nov, 2014-11-00, 20141101, Volume:
22, Issue:
11
Journal Article
Peer reviewed
Obesity, one of the most common health conditions, affects an ever-increasing percentage of orthopaedic patients. Obesity is also associated with other medical conditions, including diabetes, ...cardiovascular disease, pulmonary disease, metabolic syndrome, and obstructive sleep apnea. These comorbidities require specific preoperative and postoperative measures to improve outcomes in this patient population. Patients who are obese are at risk for increased perioperative complications; however, orthopaedic procedures may still offer notable pain relief and improved quality of life.
The current management of acute type A aortic dissection (ATAD) repair does not consider the safe duration of cardiac ischaemia as an operative strategy. We aimed to evaluate whether the duration of ...cardiac ischaemia during ATAD repair can predict operative mortality and to determine the optimum cardiac ischaemia time that is associated with better outcomes.
This was a retrospective observational study. Patients who underwent ATAD repair from 2003 to 2020 were identified from our hospital records.
Three hundred and sixty three (363) ATAD patients met eligibility criteria. The median patient age was 61 years, 221 (61%) patients were male. Duration of cardiac ischaemia was associated with operative mortality (Odds ratio OR =1.01; p<0.0005). Its optimal cut-off point was equal to or above 149.5 minutes (95% CI: 126.2–172.8). In patients with a shorter period (less than 150 mins) of cardiac ischaemia, a valve-sparing root repair was used more often (OR=2.5; 95% CI: 1.6–3.9; p<0.001). Procedures that had the longer period of cardiac ischaemia included the Bentall procedure (OR=10.9; 95% CI: 4.9–27.4; p<0.001), descending thoracic aorta replacement (OR=4.3; 95% CI: 1.007–18.7; p=0.049) and concomitant cardiac surgery (OR=4.7; 95% CI: 2–11.1; p<0.001). Operations associated with shorter cardiac ischaemia were associated with lower in-hospital mortality and better long-term survival.
This study determined that the duration of cardiac ischaemia in ATAD repair is linked to operative mortality. Further studies are required to confirm that ATAD patients with surgical repair involving less than 150 minutes of cardiac ischaemic time have lower in-hospital mortality and better long-term survival.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
498.
The Reply Doroghazi, Robert M.; Bergin, Samuel W.
The American journal of medicine,
08/2018, Volume:
131, Issue:
8
Journal Article
Background
The impact of regulatory approvals of new therapies for castration‐resistant prostate cancer (CRPC) in Australia is unclear.
Aims
To determine if changes in novel therapy access in ...Australia affected how clinicians initially managed men with newly diagnosed CRPC.
Methods
Data from patients diagnosed with CRPC from 2013 to 2016 across three Australian hospitals were retrospectively collected. Baseline clinicopathological factors and initial management decision at the time of CRPC development (early treatment (ET) vs deferred treatment (DT)) were recorded. Categorical variables between cohorts were compared by Chi‐squared analysis. Cox regression analysis was performed to assess the impact of CRPC diagnosis year on time to commencing life‐prolonging systemic treatment (TTT).
Results
Our study identified 137 CRPC patients, with 126 (92%) patients receiving life‐prolonging systemic treatment. The median age was 73 years. The initial management decision was DT in 71 (52%) patients and ET in 66 (48%) patients. There was a significant shift from DT to ET during the study period (2013–2014: DT 61% vs ET 33%; 2015–2016: DT 39% vs ET 67%; P = 0.004), with a rise in novel androgen receptor signalling inhibitor use and simultaneous reduction in first‐generation antiandrogen use at CRPC development. Each successive CRPC diagnosis year was associated with shorter TTT on univariate analysis (HR: 1.5, 95% CI: 1.3–1.7, P < 0.001).
Conclusion
Over time, clinicians are favouring earlier introduction of life‐prolonging systemic treatment at the development of CRPC. This trend is largely driven by substantial uptake of novel androgen receptor signalling inhibitors as the preferred initial treatment for CRPC patients.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Skin antisepsis with iodine povacrylex resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in patients with closed limb fractures but not in those with open ...fractures.
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