Proximal humerus fractures account for approximately 5% of all fractures and they are the third most common fracture seen in the elderly population. Complex fracture patterns, including 3-parts and ...4-parts, have traditionally been amendable to shoulder hemiarthroplasty. However, several limiting factors, including poor patient satisfaction and low functional outcomes have guided further exploration for other treatment options. Reverse shoulder arthroplasty (RSA) has began to expand its traditional indications of rotator cuff arthropathy, massive rotator cuff tears, failed shoulder arthroplasties, and proximal humerus fracture sequelae. Overall, consistently improved functional outcomes are reported in RSA studies, including an increased postoperative range of motion, specifically external rotation. RSA has began to have a clinically significant role in the management of acute, complex proximal humerus fractures. Our video demonstrates the key features associated with positive patient outcomes, concluding with postoperative clinical videos.
To evaluate the effect of technical errors (TEs) on the outcomes after repair of femoral neck fractures in young adults.
Multicenter retrospective clinical study.
26 North American Level 1 Trauma ...Centers.
Skeletally mature patients younger than 50 years of age with 492 femoral neck fractures treated between 2005 and 2017.
Operative repair of femoral neck fracture.
The association between TE (malreduction and deviation from optimal technique) and treatment failure (fixation failure, nonunion, malunion, osteonecrosis, malunion, and revision surgery) were examined using logistic regression analysis.
Overall, a TE was observed in 50% (n = 245/492) of operatively managed femoral neck fractures in young patients. Two or more TEs were observed in 10% of displaced fractures. Treatment failure in displaced fractures occurred in 27% of cases without a TE, 56% of cases with 1 TE, and 86% of cases with 2 or more TEs. TEs were encountered less frequently in treatment of nondisplaced fractures compared with displaced fractures (39% vs. 53%, P < 0.001). Although TE(s) in nondisplaced fractures increased the risk of treatment failure and/or major reconstructive surgery (22% vs. 9%, P < 0.001), they were less frequently associated with treatment failure when compared with displaced fractures with a TE (22% vs. 69% P < 0.001).
TEs were found in half of all femoral neck fractures in young adults undergoing operative repair. Both the occurrence and number of TEs were associated with an increased risk for failure of treatment. Preoperative planning for thoughtful and well-executed reduction and fixation techniques should lead to improved outcomes for young patients with femoral neck fractures. This study should also highlight the need for educational forums to address this subject.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
To evaluate whether augmenting traditional fixation with a femoral neck buttress plate (FNBP) improves clinical outcomes in young adults with high-energy displaced femoral neck fractures.
Multicenter ...retrospective matched cohort comparative clinical study.
Twenty-seven North American Level 1 trauma centers.
Adult patients younger than 55 years who sustained a high-energy (nonpathologic) displaced femoral neck fracture.
Operative reduction and stabilization of a displaced femoral neck fracture with (group 1) and without (group 2) an FNBP.
Complications including failed fixation, nonunion, osteonecrosis, malunion, and need for subsequent major reconstructive surgery (early revision of reduction and/or fixation), proximal femoral osteotomy, or arthroplasty.
Of 478 patients younger than 55 years treated operatively for a displaced femoral neck fracture, 11% (n = 51) had the definitive fixation augmented with an FNBP. One or more forms of treatment failure occurred in 29% (n = 15/51) for group 1 and 49% (209/427) for group 2 ( P < 0.01). When FNBP fixation was used, mini-fragment (2.4/2.7 mm) fixation failed significantly more often than small-fragment (3.5 mm) fixation (42% vs. 5%, P < 0.01). Irrespective of plate size, anterior and anteromedial plates failed significantly more often than direct medial plates (75% and 33% vs. 9%, P < 0.001).
The use of a femoral neck buttress plate to augment traditional fixation in displaced femoral neck fractures is associated with improved clinical outcomes, including lower rates of failed fixation, nonunion, osteonecrosis, and need for secondary reconstructive surgery. The benefits of this technique are optimized when a small-fragment (3.5 mm) plate is applied directly to the medial aspect of the femoral neck, avoiding more anterior positioning .
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Perspectivas del Derecho a la Ciudad en Puebla De la Fuente Morales, Claudia Guadalupe; Méndez Sánchez, Fernando
Política, globalidad y ciudadanía,
12/2021, Volume:
7, Issue:
14
Journal Article
Peer reviewed
Open access
El denominado Derecho a la Ciudad, parte de la premisa de que la población pueda recuperar los espacios urbanos que originalmente les corresponden y hacerlos nuevamente parte de su propia cultura, ...independientemente de los intereses del capitalismo salvaje. Desde el punto de vista de este derecho, se propuso un estudio de la Ciudad de Puebla, analizando su fundación, y la manera en que la población ha sufrido una planificación territorial muy específica, de la cual se desprenden ahora muchos de los problemas de violencia y conflictos sociales que se viven al interior de esta. Se utilizaron los métodos inductivo, histórico y analítico, recurriendo a instrumentos nacionales e internacionales, con especial énfasis en estos últimos. Dentro de las principales conclusiones que se obtuvieron se debe destacar la necesidad de aplicar un protocolo para coadyuvar con el desarrollo del Derecho a la Ciudad en Puebla, que abarque tres aspectos: comunidad, delincuencia y ambiente.
El presente artículo se enmarca en el desarrollo que ha tenido la seguridad social en México hasta el nacimiento del Instituto Mexicano del Seguro Social (IMSS); en el primer apartado se muestra el ...entramado histórico y surgimiento de dicha Institución, como la principal encargada de la aplicación adecuada de la seguridad social; posteriormente, se analiza el contrato colectivo de trabajo (CCT), como uno de los grandes logros alcanzados por la lucha social de los trabajadores; en específico, se estudia el CCT celebrado entre el IMSS y el Sindicato de Trabajadores del Seguro Social (SNTSS), los cambios que ha sufrido y las posiciones que han tenido los trabajadores al respecto, a raíz de las reformas en materia laboral que se han implementado en México.
Birds from at least a dozen orders engage in dustbathing, including Galliformes. Dustbathing is generally considered a behavioural need for poultry. It involves a precise and orderly sequence of ...movements repeated over time. The most characteristic movement involves tossing the dust with the wings and undulating the body beneath the dust shower. Thus, repetitive changes in body position during dustbathing could be automatically detected through data processing of body‐mounted accelerometer recordings. The approach was tested in 13 adult male Japanese quail (Coturnix japonica) fitted with a body mounted triaxial accelerometer. Behaviour was video‐recorded for at least 6 h. Observations showed that when the animal lies on its left‐ or right‐side during dustbathing, the lateral (swaying) component of the acceleration vector adopts values of +1 or −1, respectively. Analysis shows that the bird repeats these shifts in body position every 25–60 s. The wavelet analysis (i.e. complex Morlet continuous wavelet transform (CWT)) detected this oscillatory behaviour within the time series as higher power values. This characteristic was used to automate the detection of dustbathing events, for which a threshold value for the maximum power value estimated was established for the corresponding range of scales between 25 and 60 s. The overall general accuracy of this classification method for dustbathing detection was 80%, with individual variations falling within the range of 66%–100%. Finally, an example of the potential of this method in the study of temporal dynamics, such as daily rhythms of dustbathing, is provided. Our results show that combining accelerometry and wavelet analysis could be useful for the assessment of intra‐ and inter‐individual variability in dustbathing dynamics over long‐term studies, even within large complex environments, such as natural habitats or breeding facilities. Moreover, this approach could open doors for future in‐depth studies exploring the relationship between dustbathing and poultry welfare.
Dustbathing can be automatically detected from body mounted accelerometer recordings, with events appearing in the lateral swaying component of the acceleration vector (black line in plot) as repetitive cycles of side‐to‐side movements (see photographs). This cyclic nature appears as large positive power spectrum coefficient (PSC) estimated using a wavelet analysis (red line in plot). Thus, as shown in flowchart, by estimating an appropriate PSC threshold, classification of dustbathing events can be achieved with an accuracy of ~80%.
Cell functions and behavior are regulated not only by soluble (biochemical) signals but also by biophysical and mechanical cues within the cells' microenvironment. Thanks to the dynamical and complex ...cell machinery, cells are genuine and effective mechanotransducers translating mechanical stimuli into biochemical signals, which eventually alter multiple aspects of their own homeostasis. Given the dominant and classic biochemical-based views to explain biological processes, it could be challenging to elucidate the key role that mechanical parameters such as vibration, frequency, and force play in biology. Gaining a better understanding of how mechanical stimuli (and their mechanical parameters associated) affect biological outcomes relies partially on the availability of experimental tools that may allow researchers to alter mechanically the cell's microenvironment and observe cell responses. Here, we introduce a new device to study in vitro responses of cells to dynamic mechanical stimulation using a piezoelectric membrane. Using this device, we can flexibly change the parameters of the dynamic mechanical stimulation (frequency, amplitude, and duration of the stimuli), which increases the possibility to study the cell behavior under different mechanical excitations. We report on the design and implementation of such device and the characterization of its dynamic mechanical properties. By using this device, we have performed a preliminary study on the effect of dynamic mechanical stimulation in a cell monolayer of an epidermal cell line (HaCaT) studying the effects of 1 Hz and 80 Hz excitation frequencies (in the dynamic stimuli) on HaCaT cell migration, proliferation, and morphology. Our preliminary results indicate that the response of HaCaT is dependent on the frequency of stimulation. The device is economic, easily replicated in other laboratories and can support research for a better understanding of mechanisms mediating cellular mechanotransduction.
(Stein) (Diptera: Anthomyiidae) is a pest of crucifers, such as broccoli, radish, cauliflower, turnip and cabbage. It has been recently described in Mexico as a significant emerging pest of broccoli. ...Due the lack of knowledge of this pest, the present study aimed to determine its life cycle, female sexual maturation, copulation, oviposition behavior and adult longevity. The identity of the fly in Mexico was confirmed genetically by sequencing the cytochrome oxidase subunit 1 gene (
). The mean development time of
was 32-33 days on radish at 24 °C under laboratory conditions. Females became sexually mature 1-2 days after emergence, and the highest incidence of matings was recorded on the second day (60%). Under choice conditions,
females preferred to oviposit on radish plants, rather than broccoli plants, possibly due to the use of radish for rearing the laboratory colony. Oviposition and the mean number of eggs laid varied among the broccoli varieties, with the highest oviposition observed on the Tlaloc variety. Repeated attempts to rear the laboratory colony on broccoli plants failed. Radish-reared insects of both sexes lived longer when individualized in the adult stage (14.5-22.5 days) than when adult flies were maintained in groups (10-11 days). This study contributes to the understanding of
biology and provides information that can be used to establish future control strategies against this pest.
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