Purpose Unstable, dorsal, intra-articular, fracture-dislocations of the proximal interphalangeal (PIP) joint can be difficult to treat and often lead to long-term pain, stiffness, and functional ...deficit. We present the outcomes of patients sustaining such injuries that were treated by a novel dynamic external fixator. This fixator uses a system of K-wires and rubber bands that maintains a concentrically reduced PIP joint while allowing for early motion. Methods Fourteen patients with unstable, dorsal fracture-dislocation injuries of the PIP joint were treated between September 2001 and January 2006. Eight were available for follow-up evaluation at an average of 26 months. We measured PIP range of motion and grip strength, and assessed pain on a visual analog scale. Demographic information about the original injury was recorded. New radiographs were obtained to assess joint congruency and the presence of arthritis or articular step-off deformity. Results In the 8 patients available for follow-up evaluation, the average motion of the affected PIP joint was from 1° (range 0° to 5°) to 89° (range 75° to 110°). Grip strength was 92% (range 71% to 110%) of the unaffected hand. The average score on the visual analog pain scale was 0.6 (range 0–1.5). There were few complications. Radiographs at follow-up evaluation showed a concentric reduction in all joints, but with evidence of a small step-off deformity or arthritis in 5 patients. Conclusions The dynamic external fixator studied is an effective method of treating unstable, dorsal fracture-dislocation injuries. Outcomes compared favorably with those of other similar devices studied in the literature. Type of study/level of evidence Therapeutic IV.
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GEOZS, NUK, OILJ, SBCE, UL
Summary Background We did a phase 3 study in previous non-responders with chronic hepatitis C virus (HCV) genotype 1 infection and compensated liver disease that related to the standard of care for ...these patients at the time this study was initiated. We investigated whether simeprevir is non-inferior in terms of efficacy to telaprevir, each in combination with peginterferon alfa-2a and ribavirin. Methods We did this randomised, double-blind, phase 3 trial at 169 investigational sites in 24 countries. We enrolled adults (≥18 years) with chronic HCV genotype 1 infection, compensated liver disease, and plasma HCV RNA higher than 10 000 IU/mL who were null or partial responders during at least one previous course of peginterferon alfa-2a and ribavirin treatment. We randomly assigned (1:1) patients (stratified by HCV genotype 1 subtype 1a plus other/1b and previous treatment response partial or null) to receive simeprevir (150 mg once a day) plus telaprevir placebo (three times a day 7–9 h apart) or telaprevir (750 mg three times a day) plus simeprevir placebo (once a day) in combination with peginterferon alfa-2a and ribavirin for 12 weeks followed by 36 weeks of peginterferon alfa-2a and ribavirin alone. The primary efficacy endpoint was sustained virological response 12 weeks after end of treatment (SVR12) in the intention-to-treat and the per-protocol population. We compared groups with the Cochran-Mantel-Haenszel test. We established a non-inferiority margin of 12%. Adverse events were reported descriptively. This trial is registered with ClinicalTrials.gov , number NCT01485991. Findings Patient screening began on Jan 19, 2012, and the last visit was on April 7, 2014. We included 763 patients (472 previous null responders 62%). Simeprevir and peginterferon alfa-2a and ribavirin was non-inferior to telaprevir and peginterferon alfa-2a and ribavirin for SVR12 (54% 203/379 vs 55% 210/384; difference −1·1%, 95% CI −7·8 to 5·5; p=0·0007). SVR12 was achieved in 70% (101/145) versus 68% (100/146) of previous partial responders and 44% (102/234) versus 46% (110/238) of previous null responders with simeprevir and peginterferon alfa-2a and ribavirin and telaprevir and peginterferon alfa-2a and ribavirin treatment, respectively. We recorded differences between treatment groups in simeprevir or telaprevir-related adverse events (69% 261/379 in the simeprevir group vs 86% 330/384 in the telaprevir group), serious adverse events (2% 8/379 vs 9% 33/384), and adverse events leading to simeprevir or telaprevir discontinuation (2% 7/379 vs 8% 32/384). Interpretation Simeprevir once a day with peginterferon alfa-2a and ribavirin was well tolerated in HCV genotype 1-infected previous non-responders and was non-inferior to telaprevir, thus providing an alternative treatment in areas of the world where all-oral HCV regimens are not available or accessible. Funding Janssen.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The goal was to evaluate how perceptual thresholds are related to electrode impedance, electrode size, the distance of electrodes from the retinal surface, and retinal thickness in six subjects blind ...as a result of retinitis pigmentosa, who received epiretinal prostheses implanted monocularly as part of a U.S. Food and Drug Administration (FDA)-approved clinical trial.
The implant consisted of an extraocular unit containing electronics for wireless data, power recovery, and generation of stimulus current, and an intraocular unit containing 16 platinum stimulating electrodes (260- or 520-microm diameter) arranged in a 4 x 4 pattern. The electrode array was held onto the retina by a small tack. Stimulation was controlled by a computer-based external system that allowed independent control over each electrode. Perceptual thresholds (the current necessary to see a percept on 79% of trials) and impedance were measured for each electrode on a biweekly basis. The distance of electrodes from the retinal surface and retinal thickness were measured by optical coherence tomography on a less regular basis.
Stimulation thresholds for detecting phosphenes correlated with the distance of the electrodes from the retinal surface, but not with electrode size, electrode impedance, or retinal thickness.
Maintaining close proximity between the electrode array and the retinal surface is critical in developing a successful retinal implant. With the development of chronic electrode arrays that are stable and flush on the retinal surface, it is likely that the influence of other factors such as electrode size, retinal degeneration, and subject age will become more apparent. (ClinicalTrials.gov number, NCT00279500.).
Introduction: The purpose of this secondary analysis was to examine the relationship among perceived infrastructure, perceived business climate, perceived workforce, and business growth. The research ...question was: What is the relationship among perceived infrastructure, perceived business climate, perceived workforce, and business growth? Methods: The study utilized a quantitative approach for a secondary analysis of the Pennsylvania Department of Community and Economic Development (DCED) Business Retention and Expansion Program (BREP). Four variables were included: perceived infrastructure, perceived business climate, perceived workforce, and business growth. The sample consisted of 1,802 companies from northeastern Pennsylvania. Data from July 1, 2004 to February 28, 2007 was selected. Spearman's rho was used to test the hypotheses, and logistic regression analysis was also used to determine if perceived infrastructure, perceived business climate, or perceived workforce predict business growth. Results: For the relationship between perceived infrastructure and business growth, an extremely weak correlation that was not significant was found (r (1289) = .045, p > .05); for the relationship between perceived business climate and business growth, a weak positive correlation was found (r (1289) = .115, p < .001), indicating a significant relationship between the two variables; for the relationship between perceived workforce and business growth, an extremely weak correlation that was not significant was found (r (1289) = −.010, p > .05). Conclusion: To gain a competitive advantage in the global economic development competition, a reframed quantitative analysis of the northeastern Pennsylvania's assets, especially its workforce, infrastructure, and business climate must be conducted to gain a better understanding of the community's assets and growth potential.
With the long-term goal of restoring functional vision in patients with retinal degenerative diseases, the eyes of blind human subjects were implanted chronically with epiretinal prostheses ...consisting of two-dimensional electrode arrays that directly stimulated cells of the neural retina.
Psychophysical techniques were used to measure the brightness of electrically generated percepts on single electrodes using a variety of electrical stimulation patterns.
It was possible to predict the sensitivity of the human visual system to a wide variety of retinal electrical stimulation patterns using a simple and biologically plausible model.
This is the first study to demonstrate that, on the single-electrode level, retinal electrical stimulation in humans can produce visual qualia that are predictable using a quantitative model, a prerequisite for a successful retinal prosthesis. (ClinicalTrials.gov number, NCT00279500.).
Abstract
We present the discovery that ASASSN-14ko is a periodically flaring active galactic nucleus at the center of the galaxy ESO 253-G003. At the time of its discovery by the All-Sky Automated ...Survey for Supernovae (ASAS-SN), it was classified as a supernova close to the nucleus. The subsequent 6 yr of
V
- and
g
-band ASAS-SN observations revealed that ASASSN-14ko has nuclear flares occurring at regular intervals. The 17 observed outbursts show evidence of a decreasing period over time, with a mean period of
P
0
= 114.2 ± 0.4 days and a period derivative of
. The most recent outburst in 2020 May, which took place as predicted, exhibited spectroscopic changes during the rise and had a UV bright, blackbody spectral energy distribution similar to tidal disruption events (TDEs). The X-ray flux decreased by a factor of 4 at the beginning of the outburst and then returned to its quiescent flux after ∼8 days. The Transiting Exoplanet Survey Satellite observed an outburst during Sectors 4–6, revealing a rise time of 5.60 ± 0.05 days in the optical and a decline that is best fit with an exponential model. We discuss several possible scenarios to explain ASASSN-14ko’s periodic outbursts, but currently favor a repeated partial TDE. The next outbursts should peak in the optical on UT 2020 September 7.4±1.1 and UT 2020 December 26.5±1.4.
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