Breakage of tibial interlocking nails is a rare complication and is associated with tibial nonunion. The distal part of a broken tibial nail is difficult to extract and can be a real challenge. ...Preoperative planning is important, as the retrieval techniques of broken implants are not routine operations. There are various techniques and instruments described by different authors with none being uniformly successful. Therefore, surgeons should know as many methods as possible to choose the most suitable one. Minimally invasive retrieval techniques should be favored because of their reduced morbidity, while fenestration extraction methods should be used as the second intention. Cannulated intramedullary nails are more prone to benefitting from minimally invasive retrieval techniques than solid ones. This paper reviews and describes the present techniques used to extract the distal part of broken tibial nails, to serve as a quick guide for surgeons who need it.
ABSTRACT This paper aims the identification of the Organization Designation Authorization (ODA) regulatory approaches adopted by the United States, using the Boeing 737 MAX 8 certification process as ...a basis, by revising the ODA’s certification role and what can be enhanced on the ODA program, considering the data from the Federal Aviation Administration (FAA), the U.S. Department of Transportation, AND the Office of Inspector General (OIG), and comparing them to the regulatory basis in Europe and in Brazil. An assessment of undue pressure on ODA Unit members and other aspects, such as conflicting restraints, analysing their consequences and roles for the process’ safety, is presented, as well as a comparison with the independent design assurance system adopted by the other two agencies. Therefore, the discussion around the ODA’s aircraft certification processes highlights the ODA model drawbacks, and what can be learned from other models to improve it, so the industry and the society can fully benefit from this system.
New copper(
i
), copper(
ii
) and zinc(
ii
) azasterol derivatives were prepared using 20-hydrazone-imidazolin-2-yl-5α-pregnan-3β-ol (
H1
) as a ligand. The reactions were carried out under mild ...experimental conditions with different zinc(
ii
) and copper(
ii
) salts to produce Zn(
H1
)
2
(OH)
2
(
1
), Zn(
H1
)
2
Cl
2
(
2
), Zn(
H1
)
3
(NO
3
)NO
3
(
3
), Cu(
H1
)
2
(OH)
2
(
4
), Cu(
H1
)
2
Cl (
5
) and Cu(
H1
)
2
NO
3
(
6
). They were fully characterized by analytical and spectroscopic techniques. The molecular structure of these six metal complexes was also investigated by computational methods (DFT) to get information on the most stable geometry configuration around the metal atoms Zn and Cu. Antifungal activities of
H1
, compounds
1-6
, and itraconazole (ITZ) as positive controls were tested
in vitro
against
S. brasiliensis
. The results showed that the fungus was more susceptible to all metal-azasterol complexes than
H1
. The most efficient metal-azasterol complex was Zn(
H1
)
2
(OH)
2
(
1
), with IC
50
equal to that of itraconazole (0.25 μM). These biological results demonstrated that metal-azasterol complexes are promising molecules in the search and development of new antifungal compounds.
Characterized zinc- and copper-azasterol complexes acting as promising antifungal agents against
Sporothrix brasiliensis
. Metal-drug synergism was effectively applied.
Gastric duplication cysts (GDCs) in adults are exceedingly rare, with only a few documented cases in medical literature. The spectrum of clinical presentations varies widely, ranging from ...asymptomatic to severe symptoms such as hematemesis, vomiting or abdominal pain. Among the less common complications associated with GDCs, segmental portal hypertension is a notable rarity. We present a compelling case report of a patient exhibiting signs of segmental portal hypertension, where ultrasound and echo-endoscopy revealed a sizable gastric duplication cyst as the underlying etiology. Recognizing the scarcity of literature on GDCs in adult patients, we conducted a thorough review to underscore the diagnostic significance of ultrasonography and endoscopic ultrasound (EUS) in accurately identifying these congenital anomalies. This case report and comprehensive literature review emphasize the pivotal role of EUS and abdominal ultrasound in achieving an accurate diagnosis of GDCs. By shedding light on the diagnostic and therapeutic intricacies, we aim to raise awareness among clinicians regarding this rare pathology and the importance of multimodal imaging approaches for optimal patient management.
The study of the genetic markers and identifying new markers involves an increasing number of research projects in the fields of genetics of immunology, biochemical genetics, molecular genetics, ...quantity genetics and the genetic improvement of animals. Some studies on genes frequency determining the red cells specificity and for whey hemoglobin are approached in the present report. In this way, some blood factors, most of them belonging to B system (the most complex system in cattle) have been evidenced. The lowest gene frequency was present in K factor (7%), and highest one in, O1, G’ , W and F1 (100%). In addition to basic importance on knowledge and determination of cattle population genetic structure for studied protein loci, another theme proposed to correlate hemoglobin type with some traits of economical importance: milk yield, fat and protein content, fat and protein yield. Higher performance was recorded by HbA/HbA individuals.
Under the auspices of the Protein Analysis Working Group (PAWG) of the Comité Consultatif pour la Quantité de Matière (CCQM) a key comparison, CCQM-K115.b, was coordinated by the Bureau International ...des Poids et Mesures (BIPM) and the Chinese National Institute of Metrology (NIM). Seven Metrology Institutes or Designated Institutes and the BIPM participated. Participants were required to assign the mass fraction of oxytocin (OXT) present as the main component in the comparison sample for CCQM-K115.b. The comparison samples were prepared from synthetic OXT purchased from a commercial supplier and used as provided without further treatment or purification.
OXT was selected to be representative of the performance of a laboratory's measurement capability for the purity assignment of chemically synthesized peptides of known sequence, with one cross-link and up to 5 kDa. It was anticipated to provide an analytical measurement challenge representative for the value-assignment of compounds of broadly similar structural characteristics.
The majority of participants used amino acid analysis (PICAA) or quantitative nuclear magnetic resonance (PICqNMR) spectroscopy with a correction for structurally-related peptide impurities approach as the amount of material that has been provided to each participant (25 mg) is insufficient to perform a full mass balance based characterization of the material by a participating laboratory. The coordinators, both the BIPM and the NIM, were the laboratories to use the mass balance approach as they had more material available.
It was decided to propose KCRVs for both the OXT mass fraction and the mass fraction of the peptide related impurities as indispensable contributor regardless of the use of PICAA, PICqNMR or mass balance to determine the OXT purity. This allowed participants to demonstrate the efficacy of their implementation of the approaches used to determine the OXT mass fraction. In particular, it allows participants to demonstrate the efficacy of their implementation of peptide related impurity identification and quantification.
More detailed studies on the identification/quantification of peptide related impurities and the hydrolysis efficiency revealed that the integrity of the impurity profile of the related peptide impurities obtained by the participant is crucial for the impact on accuracy of the OXT mass fraction assignment.
The assessment of the mass fraction of peptide impurities is based on the assumption that only the Largest Consistent Subset (LCS) of results is taken for the calculation of the KCRV
PepImp
by use of the weighted mean. The KCRV
PepImp
of 31.6 mg/g is associated with a small corresponding expanded uncertainty of ±1.4 mg/g (k =2) providing a more realistic basis of evaluation for the capabilities of the participants to identify/quantify peptide related impurities. Inspection of the degree of equivalence plots for the mass fraction of peptide impurities and additional information obtained from the peptide related impurity profile indicates that in many cases the major related peptide impurities have been identified and quantified.
The approach selected to obtain a KCRV
OXT
for the mass fraction of OXT is based on random-effects meta-analysis (DerSimonian-Laird (DSL) variance-weighted mean). The DSLmean takes into account the uncertainties of the results while introducing sufficient excess variance to allow for their observed dispersion resulting in a larger expanded uncertainty U(KCRV
OXT
). The KCRV
OXT
for CCQM-K115.b is 787.2 mg/g with a corresponding expanded uncertainty of the KCRV
OXT
of ±12.9 mg/g. All OXT mass fraction results except the result of NMIM are in agreement with the KCRV
OXT
. It should be pointed out that the mass balance approaches show smaller uncertainties than PICAA or PICqNMR approaches. Mass balance approaches seem to produce slightly higher OXT mass fractions while PICAA approaches deliver slightly lower OXT mass fractions.
Main text
To reach the main text of this paper, click on
Final Report
. Note that this text is that which appears in Appendix B of the BIPM key comparison database
kcdb.bipm.org/
.
The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Objective There is limited knowledge on the onset of comorbidities in congenital adrenal hyperplasia (CAH) during childhood. We aimed to establish the health status of children with CAH in the UK. ...Design and methods This cross-sectional multicentre study involved 14 tertiary endocrine UK units, recruiting 101 patients aged 8–18 years with classic 21-hydroxylase deficiency and 83 controls. We analysed demographic, clinical and metabolic data, as well as psychological questionnaires (Strengths and Difficulties (SDQ), Paediatric Quality of Life (PedsQL)). Results Patient height SDS in relation to mid-parental height decreased with age, indicating the discrepancy between height achieved and genetic potential height. Bone age was advanced in 40.5% patients, with a mean difference from the chronological age of 1.8 (±2.3) years. Patients were more frequently overweight (27%) or obese (22%) compared to controls (10.8% and 10.8%, respectively, P < 0.001). No consistent relationship between glucocorticoid dose and anthropometric measurements or hormonal biomarkers was detected. A small number of patients had raised total cholesterol (3.0%), low HDL (3.0%), raised LDL (7.0%) and triglycerides (5.0%). SDQ scores were within the ‘high’ and ‘very high’ categories of concern for 16.3% of patients. ‘School functioning’ was the lowest PedsQL scoring dimension with a median (interquartile range) of 70 (55–80), followed by ‘emotional functioning’ with a median of 75 (65–85). Conclusions Our results show an increased prevalence of problems with growth and weight gain in CAH children and suggest reduced quality of life. This highlights the urgent need to optimise management and monitoring strategies to improve long-term health outcomes.
The diphenylurea 4,4′-dinitrocarbanilide (DNC) is the residue of concern left in edible tissues of broilers fed diets containing the anticoccidial nicarbazin. When chicken meat is submitted to ...thermal processing, p-nitroaniline (p-NA) is expected from DNC degradation. This work aimed at evaluating whether thermal processing of DNC-containing chicken meat induces p-NA appearance. First, a hydrolysis assay was performed in aqueous solutions at 100 °C in different pH, confirming that DNC cleavage yields p-NA. Then a novel LC-MS/MS method was used to detect traces of this aromatic amine in DNC-containing chicken breast fillets subjected to cooking methods. Our evidence showed p-NA occurrence in such chicken meat samples, which corroborated results from hydrolysis assay. The p-NA appearance in fillets was rather discrete during boiling treatment, but its concentration became pronounced over time for grilling, frying, and roasting, achieving respectively 326.3, 640.0, and 456.9 μg/kg. As far as we are concerned, no other research identified degradation products from DNC residue in heat-processed chicken fillets. Therefore, this study leads to additional approaches to assess impacts on food safety.
Main text
Under the auspices of the Protein Analysis Working Group (PAWG) of the Comité Consultatif pour la Quantité de Matière (CCQM) a key comparison, CCQM-K115.c, was coordinated by the Bureau ...International des Poids et Mesures (BIPM), the Health Sciences Authority (HSA) of Singapore and the Chinese National Institute of Metrology (NIM). Nine Metrology Institutes or Designated Institutes and the BIPM participated. Participants were required to assign the mass fraction of the glycated hexapeptide of HbA1c (GE) present as the main component in the comparison sample for CCQM-K115.c. The comparison samples were prepared by HSA/BIPM from synthetic GE purchased from a commercial supplier and used as provided without further treatment or purification.
GE was selected to be representative of the performance of a laboratory's measurement capability for the purity assignment of chemically synthesized peptides of known sequence, without cross-links, up to 5 kDa and modification (mono-glycation). It was anticipated to provide an analytical measurement challenge representative for the value-assignment of compounds of broadly similar structural characteristics.
The majority of participants used amino acid analysis (PICAA) or quantitative nuclear magnetic resonance (PICqNMR) spectroscopy with a correction for structurally-related peptide impurities approach as the amount of material that has been provided to each participant (25 mg) is insufficient to perform a full mass balance based characterization of the material by a participating laboratory. The coordinators, the BIPM, the HSA and the NIM, were the laboratories to use the mass balance approach as they had more material available.
It was decided to propose KCRVs for both the GE mass fraction and the mass fraction of the peptide-related impurities as indispensable contributor regardless of the use of PICAA, PICqNMR or mass balance to determine the GE purity. This allowed participants to demonstrate the efficacy of their implementation of the approaches used to determine the GE mass fraction. In particular, it allows participants to demonstrate the efficacy of their implementation of peptide-related impurity identification and quantification.
More detailed studies on the identification/quantification of peptide-related impurities revealed that the integrity of the impurity profile of the related peptide impurities obtained by the participant is crucial for the impact on accuracy of the GE mass fraction assignment.
The assessment of the mass fraction of peptide impurities is based on the assumption that that all results are directly taken for the calculation of the KCRVPepImp by use of random-effects meta-analysis (DerSimonian-Laird (DSL) variance-weighted mean). The KCRVPepImp of 45.4 mg/g is associated with a corresponding expanded uncertainty of 9.5 mg/g (k =2.26) providing a more realistic basis of evaluation for the capabilities of the participants to identify/quantify peptide-related impurities. Inspection of the degree of equivalence plots for the mass fraction of peptide impurities and additional information obtained from the peptide-related impurity profile indicates that in most cases the major related peptide impurities have been identified and quantified.
The approach selected to obtain a KCRVGE for the mass fraction of GE is based on the DerSimonian-Laird (DSL) variance-weighted mean. The DSL mean takes into account the uncertainties of the results while introducing sufficient excess variance to allow for their observed dispersion resulting in a larger expanded uncertainty U(KCRVGE). The KCRVGE for CCQM-K115.c is 628 mg/g with a corresponding expanded uncertainty of the KCRVGE of 27 mg/g (k =2.26). All GE mass fraction results are in agreement with the KCRVGE.
To reach the main text of this paper, click on
Final Report
. Note that this text is that which appears in Appendix B of the BIPM key comparison database
https://www.bipm.org/kcdb/
.
The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
O presente trabalho discute o posicionamento da Organização para a Unidade Africana em relação a Israel e à Questão Palestina, fundamentando em suas resoluções e naquelas da Organização das Nações ...Unidas. Busca-se traçar a aproximação de pan-arabismo e pan-africanismo e a evolução dos debates sobre o Oriente Médio no seio da OUA e compreender o que a teria levado a se solidarizar com a Questão Palestina e a considera-la, em 1975, literalmente uma causa africana. O recorte analisado é balizado pela ocupação dos territórios árabes por Israel, que marcou uma virada nas relações da África com esse país, e pela aprovação da resolução 3379 da Assembleia Geral da ONU, em 1975, apoiada amplamente pelos membros africanos, que considerou o sionismo uma forma de racismo.
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