Volar locking plate fixation via open reduction and internal fixation is an increasingly accepted method for managing displaced distal radius fractures. Volar plating offers biomechanically stable ...fixation, allows early rehabilitation, and enables fixation of comminuted or osteopenic bone. The literature reporting complications of volar plate fixation is limited primarily to case reports and small case series. The surgeon must be mindful of potential soft-tissue, neurovascular, and osseous complications, such as extensor tendon and flexor tendon injury, flexor pollicis rupture, carpal tunnel syndrome, complex regional pain syndrome, and loss of reduction, as well as hardware failure. Increased awareness of potential complications may lead to more prompt recognition and treatment when they do arise.
A strong temperature dependence of oxygen K-edge x-ray absorption fine structure features was observed for supercooled and normal liquid water droplets prepared from the breakup of a liquid microjet. ...Analysis of the data over the temperature range 251 to 288 kelvin (-22° to + 15°C) yields a value of 1.5 ± 0.5 kilocalories per mole for the average thermal energy required to effect an observable rearrangement between the fully coordinated ("ice-like") and distorted ("broken-donor") local hydrogen-bonding configurations responsible for the pre-edge and post-edge features, respectively. This energy equals the latent heat of melting of ice with hexagonal symmetry (ice Ih) and is consistent with the distribution of hydrogen bond strengths obtained for the "overstructured" ST2 model of water.
While mechanical thrombectomy for large-vessel occlusions is now an evidence-based treatment, its efficacy and safety in minor stroke syndromes (NIHSS ≤ 5) is not proved. We identified, in our ...prospective data base, 378 patients with minor strokes in the anterior circulation; 54 (14.2%) of these had proved large-vessel occlusions. Eight of 54 (14.8%) were immediately treated with mechanical thrombectomy, 6/54 (11.1%) after early neurologic deterioration, and the rest were treated with standard thrombolysis only. Rates of successful recanalization were similar between the 2 mechanical thrombectomy groups (75% versus 100%). Rates of excellent outcome (modified Rankin Scale 0-1) were higher in patients with immediate thrombectomy (75%) compared with patients with delayed thrombectomy (33.3%) and thrombolysis only (55%). No symptomatic intracranial hemorrhage occurred in either group. These descriptive data are encouraging, and further analysis of large registries or even randomized controlled trials in this patient subgroup should be performed.
We evaluated the frequency of moderate and severe adverse events following coadministration of seasonal influenza vaccine (SIV) versus placebo with COVID-19 vaccines among adults to support practice ...guidelines.
FluVID is a participant-blinded, phase IV, randomised control trial. On the same day as the participant's scheduled COVID-19 vaccine, participants were randomised to receive SIV or saline placebo; those assigned placebo at visit one then received SIV a week later, and vice versa. Self-reported adverse events were collected daily for seven days following each visit. The primary endpoint was any solicited adverse event of at least moderate severity occurring up to seven days following receipt of SIV or placebo. This was modelled using a Bayesian logistic regression model. Analyses were performed by COVID-19 vaccine type and dose number.
Overall, 248 participants were enrolled; of these, 195 had received BNT162b2 and 53 had received mRNA1273 COVID-19 vaccines according to national guidelines. After randomisation, 119 were assigned to receive SIV and 129 were assigned to receive placebo at visit one. Adverse events were most frequently reported as mild (grade 1) in nature. Among 142 BNT162b2 booster dose one and 43 BNT162b2 booster dose two recipients, the posterior median risk difference for moderate/severe adverse events following SIV versus placebo was 13% (95% credible interval CrI -0.03 to 0.27) and 13% (95%CrI -0.37 to 0.12), respectively. Among 18 mRNA1273 booster dose one and 35 mRNA1273 booster dose two recipients, the posterior median risk difference of moderate/severe adverse events following influenza vaccine versus placebo was 6% (95%CrI -0.29 to 0.41) and -4% (95%CrI -0.30 to 0.23), respectively.
Adverse events following SIV and COVID-19 co-administration were generally mild and occurred with similar frequency to events following COVID-19 vaccine alone. We found no evidence to justify routine separation of SIV and COVID-19 vaccine doses.
ACTRN12621001063808.
Mammalian milk or colostrum contains up to 10% of carbohydrate, of which free lactose usually constitutes more than 80%. Lactose is synthesized within lactating mammary glands from uridine ...diphosphate galactose (UDP-Gal) and glucose by a transgalactosylation catalysed by a complex of β4-galactosyltransferase and α-lactalbumin (α-LA). α-LA is believed to have evolved from C-type lysozyme. Mammalian milk or colostrum usually contains a variety of oligosaccharides in addition to free lactose. Each oligosaccharide has a lactose unit at its reducing end; this unit acts as a precursor that is essential for its biosynthesis. It is generally believed that milk oligosaccharides act as prebiotics and also as receptor analogues that act as anti-infection factors. We propose the following hypothesis. The proto-lacteal secretions of the primitive mammary glands of the common ancestor of mammals contained fat and protein including lysozyme, but no lactose or oligosaccharides because of the absence of α-LA. When α-LA first appeared as a result of its evolution from lysozyme, its content within the lactating mammary glands was low and lactose was therefore synthesized at a slow rate. Because of the presence of glycosyltransferases, almost all of the nascent lactose was utilized for the biosynthesis of oligosaccharides. The predominant saccharides in the proto-lacteal secretions or primitive milk produced by this common ancestor were therefore oligosaccharides rather than free lactose. Subsequent to this initial period, the oligosaccharides began to serve as anti-infection factors. They were then recruited as a significant energy source for the neonate, which was achieved by an increase in the synthesis of α-LA. This produced a concomitant increase in the concentration of lactose in the milk, and lactose therefore became an important energy source for most eutherians, whereas oligosaccharides continued to serve mainly as anti-microbial agents. Lactose, in addition, began to act as an osmoregulatory molecule, controlling the milk volume. Studies on the chemical structures of the milk oligosaccharides of a variety of mammalian species suggest that human milk or colostrum is unique in that oligosaccharides containing lacto-N-biose I (LNB) (Gal(β1 → 3)GlcNAc, type I) predominate over those containing N-acetyllactosamine (Gal(β1 → 4)GlcNAc, type II), whereas in other species only type II oligosaccharides are found or else they predominate over type I oligosaccharides. It can be hypothesized that this feature may have a selective advantage in that it may promote the growth of beneficial colonic bacteria, Bifidobacteria, in the human infant colon.
Oxygen K-edge X-ray absorption spectra (XAS) of aqueous chloride solutions have been measured for Li+, Na+, K+, NH4 +, C(NH2)3 +, Mg2+, and Ca2+ at 2 and 4 M cation concentrations. Marked changes in ...the liquid water XAS are observed upon addition of the various monovalent cation chlorides that are nearly independent of the identity of the cation. This indicates that interactions with the dissolved monovalent cations do not significantly perturb the unoccupied molecular orbitals of water molecules in the vicinity of the cations and that water−chloride interactions are primarily responsible for the observed spectral changes. In contrast, the addition of the divalent cations engenders changes unique from the case of the monovalent cations, as well as from each other. Density functional theory calculations suggest that the ion-specific spectral variations arise primarily from direct electronic perturbation of the unoccupied orbitals due to the presence of the ions, probably as a result of differences in charge transfer from the water molecules onto the divalent cations.
Health literacy is known to influence health. Findings on the unequal distribution of health literacy among less well-educated young people are presented. The influence of socio-demographic factors ...and the consequences of a low level of health literacy with regard to health-related behaviour are discussed.
Data from a survey on the health literacy of young people with a lower level of education, older people and migrants (n = 1,000) were used. Health literacy was measured using the instruments of the European Health Literacy Survey (HLS-EU-Q47).
The results demonstrate a lower level of health literacy among young people with less education and especially among young migrants. Explanations for a lower level of health literacy among young people with less well-educated young people were parents' educational background and parents' wealth. Migration-related factors had no influence on young people. Further correlations between health literacy and health behaviour were explored.
It is concluded that health literacy is linked to health behaviour and that unequal distributions of health literacy among young people may increase health inequalities.
Zusammenfassung
Ziel
Ziel des vorliegenden Beitrages ist es, die ungleiche Verteilung von Gesundheitskompetenz in der Bevölkerung zu verdeutlichen und Ursachen und Folgen niedriger ...Gesundheitskompetenz bei bildungsfernen Jugendlichen zu analysieren.
Material und Methoden
Datengrundlage ist eine an den European-Health-Literacy-Survey anschließende vertiefende Erhebung in Nordrhein-Westfalen, in der die Gesundheitskompetenz von bildungsfernen Jugendlichen, älteren Menschen und von Menschen mit Migrationshintergrund im Mittelpunkt stand (
n
= 1000).
Ergebnisse
Die Ergebnisse zeigen, dass bildungsferne Jugendliche im Durchschnitt eine deutlich niedrigere Gesundheitskompetenz haben als die Allgemeinbevölkerung. Liegt ein Migrationshintergrund vor, steigt das Risiko für eine niedrige Gesundheitskompetenz noch einmal deutlich. Eine Analyse sozio-ökonomischer Einflussfaktoren deutet darauf hin, dass die Gesundheitskompetenz der befragten bildungsfernen Jugendlichen weniger vom Migrationshintergrund als von der Bildung der Eltern und dem Wohlstand der Herkunftsfamilie abhängt. Gefragt wird weiter nach Zusammenhängen zwischen der Gesundheitskompetenz und gesundheitsbezogenen Verhaltensweisen. Für die Annahme, dass die Gesundheitskompetenz das Ernährungs- und Bewegungsverhalten sowie den Unfallschutz beeinflusst, finden sich Belege; der Alkohol- und Tabakkonsum scheint dagegen kaum mit der Gesundheitskompetenz zusammenzuhängen.
Diskussion und Schlussfolgerung
Insgesamt spiegelt sich in der Höhe der Gesundheitskompetenz bildungsferner Jugendlicher die Ungleichverteilung von Bildung und ökonomischen Ressourcen wider. Die Autorinnen des Beitrags leiten daraus die Schlussfolgerung ab, dass Unterschiede in der Gesundheitskompetenz ein wichtiger Erklärungsfaktor dafür sein könnten, wie aus sozialer Ungleichheit gesundheitliche Ungleichheit entsteht.
Measurements of the oxygen K-edge X-ray absorption spectrum (XAS) of aqueous sodium halide solutions demonstrate that ions significantly perturb the electronic structure of adjacent water molecules. ...The addition of halide salts to water engenders an increase in the preedge intensity and a decrease in the postedge intensity of the XAS, analogous to those observed when increasing the temperature of pure water. The main-edge feature exhibits unique behavior and becomes more intense when salt is added. Density functional theory calculations of the XAS indicate that the observed red shift of the water transitions as a function of salt concentration arises from a strong, direct perturbation of the unoccupied molecular orbitals on water by anions, and does not require significant distortion of the hydrogen bond network beyond the first solvation shell. This contrasts the temperature-dependent spectral variations, which result primarily from intensity changes of specific transitions due to geometric rearrangement of the hydrogen bond network.
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