Abstract Study Design Prospective cohort randomized controlled trial. Purpose of the Study Is either a home exercise (HE) program or traditional physical therapy (PT) more effective in the ...postoperative management of metacarpal fractures? Methods Sixty patients suffering from nonthumb metacarpal fractures who received mobilization-stable open reduction and internal fixation were included. All patients were prospectively randomized into either the PT group or the HE group. Follow-up examinations at 2, 6 and 12 weeks postoperatively. Results After 2 weeks, the range of motion (ROM) in both groups was still severely reduced. Twelve weeks after surgery the ROM improved to 245° (PT) and 256° (HE). Grip strength after 6 weeks was 68% (PT) and 71% (HE) when compared to the non-injured hand, improving to 91% (PT) and 93% (HE) after 12 weeks. Conclusion Study results show that both HE program and traditional PT are effective in the postoperative management of metacarpal fractures. Level of Evidence II.
Activity concentrations of naturally occurring radioactive material (238U, 232Th, 40K) and 137Cs were determined in surface soil samples collected from four sites at latitude 33°56' South and at an ...average altitude of 1650 masl in the Andes Cordillera, Chile. The handling of samples and the gamma spectroscopic analyses followed the recommended international protocols for this type of work. The presence of 137Cs due to fallout remains from atomic blasts produced in the Pacific atolls in the seventies was detected only in three sites analyzed in the current study. The activity concentration of this anthropogenic radionuclide showed significant uctuations ranging from below minimum detection activity to 21.32 Bq/kg. The ranges of activity concentrations of 238U, 232Th, 40K were found to be around 15-30, 22-30 and 411-611 Bq/kg respectively. The weighted mean activities concentrations of NORM radionuclides are within those reported from literature and were then used to calculate the radiological hazard indices. Values of external absorbed dose rate (D), the annual outdoor effective dose (AEDE), the radium equivalent activity (Raeq), and the external radiation hazard (Hex) index are within the accepted international ranges. These results point out that the radiation hazard due to NORM radionuclides found in soil samples from the sites studied in this work is not significant.
To decrease surgical site infections after appendectomy for acute appendicitis, preoperative broad-spectrum antibiotics are often used in clinical practice. However, this treatment strategy has come ...under scrutiny because of increasing rates of antibiotic-resistant infections.
The aim of this multisite quality improvement project was to decrease the treatment of uncomplicated acute appendicitis with piperacillin-tazobactam without increasing the rate of surgical site infections. Our quality improvement intervention had 2 distinct components: (1) updating electronic health record orders to encourage preoperative administration of narrow-spectrum antibiotics and (2) educating surgeons and emergency department clinicians about selecting appropriate antibiotic therapy for acute appendicitis. Patient demographics, clinical characteristics, and outcomes were compared 6 months before and after implementation of the quality improvement intervention.
A total of 352 laparoscopic appendectomies were performed during the 6-month preintervention period, and 369 were performed during the 6-month postintervention period. The preintervention period and postintervention period groups had similar baseline demographics, vital signs, and laboratory test values. The rate of preoperative piperacillin-tazobactam administration significantly decreased after the intervention (51.4% preintervention period vs 20.1% postintervention period, P < .001). The rate of surgical site infections was similar in both groups (superficial surgical site infections = 1.4% preintervention period vs 0.8% postintervention period, P = .50; deep surgical site infections = 1.1% preintervention period vs 0.0% postintervention period, P = .06; and organ space surgical site infections = 3.1% preintervention period vs 3.0% postintervention period, P > .99). Rates of 30-day readmission, reoperation, and Clostridioides difficile infection also did not differ between groups.
Our quality improvement intervention successfully decreased piperacillin-tazobactam administration without increasing the rate of surgical site infections in patients with acute appendicitis.
The human genome, human endogenous retroviruses (HERV), of which HERV-K113 and HERV-K115 are the only known full-length proviruses that are insertionally polymorphic. Although a handful of previously ...published papers have documented their prevalence in the global population; to date, there has been no report on their prevalence in the United States population. Here, we studied the geographic distribution of K113 and K115 among 156 HIV-1+ subjects from the United States, including African Americans, Hispanics, and Caucasians. In the individuals studied, we found higher insertion frequencies of K113 (21%) and K115 (35%) in African Americans compared with Caucasians (K113 9% and K115 6%) within the United States. We also report the presence of three single nucleotide polymorphism sites in the K113 5′ long terminal repeats (LTRs) and four in the K115 5′ LTR that together constituted four haplotypes for K113 and five haplotypes for K115. HERV insertion times can be estimated from the sequence differences between the 5′ and 3′ LTR of each insertion, but this dating method cannot be used with HERV-K115. We developed a method to estimate insertion times by applying coalescent inference to 5′ LTR sequences within our study population and validated this approach using an independent estimate derived from the genetic distance between K113 5′ and 3′ LTR sequences. Using our method, we estimated the insertion dates of K113 and K115 to be a minimum of 800,000 and 1.1 million years ago, respectively. Both these insertion dates predate the emergence of anatomically modern Homo sapiens.
Hyperon production in the threshold region was studied in the reaction pp→K+Λp using the time-of-flight spectrometer COSY-TOF. Exclusive data, covering the full phase-space, were taken at the three ...different beam momenta of pbeam=2.95, 3.20 and 3.30 GeV/c, corresponding to excess energies of ε=204, 285 and 316 MeV, respectively. Total cross-sections were deduced for the three beam momenta to be 23.9±0.8±2.0 μb, 28.4±1.3±2.2 μb and 35.0±1.3±3.0 μb. Differential observables including Dalitz plots were obtained. The analysis of the Dalitz plots reveals a strong influence of the N(1650)-resonance at pbeam=2.95 GeV/c, whereas for the higher momenta an increasing relative contribution of the N(1710)- and/or of the N(1720)-resonance was observed. In addition, the pΛ-final-state interaction turned out to have a significant influence on the Dalitz plot distribution.
Purpose To determine whether the grip of a healthy subject's hand shows certain universal characteristics. To accomplish this, we examined the complex interactions of the fingers during gripping of ...different-size cylindrical objects. Methods A total of 48 subjects (11 women, 37 men) performed 5 cylinder grips with different object sizes. The 14 joint angular profiles of the 5 digits were measured dynamically with a Technische Universität Berlin sensor glove. Results Frequently, initial movement was detected before the actual grip. This movement consisted of passive flexion of the fingers the moment the hand rose from the table, followed by active extension of the fingers before gripping the object. Along with the type of joint, the size of the object gripped influenced the frequency of these initial movements (p<.001). During actual grip, the proximal interphalangeal joints' flexion was significantly greater than the flexion of the metacarpophalangeal and distal interphalangeal joints (p<.001). The mean flexion of the proximal interphalangeal joints was 43°, that of the metacarpophalangeal joints was 28°, and that of the distal interphalangeal joints was 26°. Apart from these findings, the larger the flexion angle was, the more time tended to be needed to fulfil the motion. Conclusions The results show that there is a universal motion pattern with the cylinder grip in healthy individuals concerning the range of movement of the finger joints. However, to fully understand the cylinder grip in healthy individuals, our next step will be to analyze the dynamics of the cylinder grip as well. For that purpose, we examine the dynamic interactions between the fingers—that is, their chronological sequence during the cylinder grip.
A well defined, congruently melting stoichiometric system, KSb5S8 (see Figure), with a wide optical energy gap that undergoes rapid reversible crystal–glass transformation is described. The ...activation energy of crystallization Ec was calculated to be ∼ 167 kJ mol–1. The kinetic parameters and energy bandgaps of KSb5S8 suggest a new inexpensive phase‐change material for possible ultra high density data storage applications.
Hyperon production in the threshold region was studied in the reaction pp→K+Λp using the time-of-flight spectrometer COSY-TOF. Exclusive data, covering the full phase-space, were taken at three ...different beam momenta pbeam=2.59, 2.68 and 2.85 GeV/c (corresponding to excess energies of ɛ=85, 115 and 171 MeV). Total cross-sections were deduced to be 7.4±0.5 μb, 8.6±0.6 μb and 16.5±0.4 μb, respectively. Differential observables including Dalitz plots were obtained. From the investigation of the Dalitz plot at pbeam=2.85 GeV/c a dominant contribution of the N∗(1650)-resonance to the reaction mechanism was found. In addition the pΛ-final-state interaction turned out to have a significant influence on the Dalitz plot distribution even 171 MeV above threshold.
Collection of PM2.5 particles was carried out in Antarctica in the summer periods of years 2006 and 2007 using solar panels to operate the sampling unit. The unit was installed 2.5 km from the B. ...O'Higgins Chilean base to avoid possible air contamination from oil or gas burning electric power stations. The aerosols were analyzed by XRF identifying twenty elements between Na and Sr. Results showed the presence of elements of typical Earth crust and seawater origins. In addition, considerable amounts of non-sea sulfur together with traces of Pb and Se from probable long distant anthropogenic activities were observed.
Buck Creek metatroctolites preserve evidence of three stages in the geologic history of the region: a relict igneous stage; a high-pressure, granulite-facies metamorphic stage; and a hydrous ...alteration stage. During high-pressure granulite facies metamorphism, adjacent olivine and plagioclase reacted to produce complex coronitic textures. Relict olivine is surrounded by radial, columnar orthopyroxene, and plagioclase is rimmed by fine-grained symplectite composed of separate grains of clinopyroxene/spinel, tschermakitic amphibole/spinel symplectite and minor clinopyroxene/sapphirine symplectite. Examination of textural relationships in back-scattered electron images and X-ray element maps of the symplectites demonstrates that amphibole/spinel and clinopyroxene/spinel symplectites grew simultaneously at high temperature to replace plagioclase in these rocks. Clinopyroxene/sapphirine symplectite grew in the latest stages of plagioclase replacement in some samples. A successful model for the main corona-forming reaction in sample BC7, 1.00 Pl+1.72 Ol+0.17 H2O = 0.59 Di+0.17 Amp+0.68 Spl+0.79 Opx, results only if amphibole is included. The model predicts relative volumes of product clinopyroxene, amphibole and spinel that are generally consistent with the proportions in imaged symplectites. Proportions of clinopyroxene- and amphibole-hosted symplectite appear to have been governed by local mass-balance of Na and Al in plagioclase and/or availability of H2O. The most successful model for formation of the inner clinopyroxene/sapphirine corona, 1.00 Pl+1.47 Ol+0.17 H2O = 0.59 Di+0.17 Amp+0.30 Spr (10 ox.)+0.57 Opx, also includes amphibole, which is present in association with clinopyroxene/sapphirine symplectite. Sufficient H2O for formation of symplectic amphibole must have been present in the intergranular fluid of relict igneous troctolites or have infiltrated during metamorphism at high P-T conditions.
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