Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%-19%. This ...study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60-101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality.
In this paper, we introduce the
(
k
,
s
)
-fractional integral and differential operators involving
k
-Mittag-Leffler function
E
k
,
ρ
,
β
δ
(
z
)
as its kernel. Also, we establish various properties ...of these operators. Further, we consider a number of certain consequences of the main results.
Leiomyosarcomas (LMS) are common soft tissue tumors in the body. Primary orbital and conjunctival LMS are, however, rare. Herein, we describe the diverse clinical presentations, histopathological ...features, and management outcomes of three cases of primary LMS of the conjunctiva and one case of primary orbital LMS. The first patient was a 40-year-old female with primary orbital LMS who developed recurrence following wide local excision. The remaining three cases were primary conjunctival LMS. All four patients underwent orbital exenteration and were disease-free at a mean follow-up period of 18.64 months. LMS is known for local recurrences and metastasis. Complete surgical excision and prompt adjuvant radiotherapy can improve the prognosis.
In this paper, we aim to determine some results of the generalized Bessel–Maitland function in the field of fractional calculus. Here, some relations of the generalized Bessel–Maitland functions and ...the Mittag-Leffler functions are considered. We develop Saigo and Riemann–Liouville fractional integral operators by using the generalized Bessel–Maitland function, and results can be seen in the form of Fox–Wright functions. We establish a new operator Zν,η,ρ,γ,w,a+μ,ξ,m,σϕ and its inverse operator Dν,η,ρ,γ,w,a+μ,ξ,m,σϕ, involving the generalized Bessel–Maitland function as its kernel, and also discuss its convergence and boundedness. Moreover, the Riemann–Liouville operator and the integral transform (Laplace) of the new operator have been developed.
The management of the infrapatellar fat pad (IPFP) during total knee arthroplasty (TKA) is the subject of ongoing debate. In part 2 of this two part series the authors aimed to investigate if ...resection of the IPFP affects clinical outcomes.
A systematic search of CENTRAL Cochrane library, Medline, Embase and Web-of-science databases for the past 10 years was performed. Studies of patients undergoing primary TKA comparing outcomes between IPFP resection and preservation were included. The meta-analysis was performed with Review Manager 5.3.
Seven studies, involving 2815 patients (3312 knees) were included in the systematic review, of which two were RCTs. Outcome measures included patellar tendon length (PTL), post-operative pain, Knee Society Scores (KSS) and Functional Scores. Meta-analysis identified a trend toward shortening of the patellar tendon with IPFP resection. Resection correlated with a lower incidence of post-operative pain at one to two months, however at three to six months pain scores were higher in this group. No statistical difference was found in KSS and Functional Scores.
There is wide variation in practice with regard to the IPFP in TKA. The available literature with regard to resection or preservation of the IPFP is not conclusive.
There is no clear consensus in the literature on the resection or preservation of the IPFP indicating a clear need for high quality studies in the future to provide meaningful answers.
Summary
Background
The study of patients with bleeding problems is a powerful approach in determining the function and regulation of important proteins in human platelets. We have identified a ...patient with a chronic bleeding disorder expressing a homozygous P2RY12 mutation, predicting an arginine to cysteine (R122C) substitution in the G‐protein‐coupled P2Y12 receptor. This mutation is found within the DRY motif, which is a highly conserved region in G‐protein‐coupled receptors (GPCRs) that is speculated to play a critical role in regulating receptor conformational states.
Objectives
To determine the functional consequences of the R122C substitution for P2Y12 function.
Patient/methods
We performed a detailed phenotypic analysis of an index case and affected family members. An analysis of the variant R122C P2Y12 stably expressed in cells was also performed.
Results
ADP‐stimulated platelet aggregation was reduced as a result of a significant impairment of P2Y12 activity in the patient and family members. Cell surface R122C P2Y12 expression was reduced both in cell lines and in platelets; in cell lines, this was as a consequence of agonist‐independent internalization followed by subsequent receptor trafficking to lysosomes. Strikingly, members of this family also showed reduced thrombin‐induced platelet activation, owing to an intronic polymorphism in the F2R gene, which encodes protease‐activated receptor 1 (PAR‐1), that has been shown to be associated with reduced PAR‐1 receptor activity.
Conclusions
Our study is the first to demonstrate a patient with deficits in two stimulatory GPCR pathways that regulate platelet activity, further indicating that bleeding disorders constitute a complex trait.
The main objective of this paper is to study the effect of phase numbers in the dual rotor Brushless DC (BLDC) motor for its application in Electric Vehicles (EVs). The performance of two novel 5-, ...and 7-phase dual rotor BLDC motors is compared against the standard 3-phase dual rotor BLDC motor. The proposed motors combine the positive characteristics of multiphase BLDC motor and the dual rotor BLDC motor thus achieving better fault tolerance capability, high power density, and less per phase stator current. Finite Element Method (FEM) was used to design the 3-, 5-, and 7-phase dual-rotor BLDC motors. The design parameters and operating conditions are kept the same for a fair comparison. The stator current and torque performance of the proposed motors were obtained with FEM simulation and were compared with the standard 3-phase dual rotor BLDC motor. It is possible to use low power rating power electronics switches for the proposed motor. The simulation results also validate low torque ripples and high-power density in the proposed motors. Finally, the fault analysis of the designed motors shows that the fault tolerance capability increases as the phase number increases.
Irrigated rice is a luxurious consumer of water. Dry-seeded rice culture is an option that saves water, but may entail loss in crop yield implying a trade-off of productivity and water conservation. ...This study evaluates the water balance and productivity response of dry-seeded rice to management interventions using ORYZA2000 model. The database was generated from field studies involving combinations of planting dates and irrigation regimes. The performance of the model in simulating phenology, biomass, water use and yield was reasonable within the experimental conditions. The normalized root mean square of deviation (RMSD
n
) for simulated and measured harvest-time biomass and grain yield was 12 and 16%, while RMSD
n
for progressive soil water content and water use was less than 10%. Scenario analysis using historical weather data showed that rice planted on June 16 had minimum variance in potential yield (5.4%) compared to earlier (June 1) or later (July 1) planting. The evapotranspiration (ET)-based water productivity (WP
ET
) was greater for June 16 and July 1 than June 1 planting. Loss of yield and WP
ET
with reduction in irrigation frequency were least on June 16 rice implying this as optimal planting time of rice in the study region.
The management of the infrapatellar fat pad (IPFP) during total knee arthroplasty (TKA) is the subject of ongoing debate. In part 1 of this two-part series, we present an overview of current practice ...regarding the management of the IPFP in elective TKA among surgeons in the UK.
A web-based survey was offered to 269 delegates of the BASK 2017 annual conference.
The survey showed a large variation in practice. Of the 173 responders, 86.7% were consultants; 62.4% partially resected the IPFP; 23.1% totally resected the IPFP, and 9.8% preserved it. Forty percent felt that resection made a difference. Only 23% stated that they were aware of guidelines/evidence.
There is wide variation in practice with regard to the IPFP in TKA. The available literature with regard to resection or preservation of the IPFP is not conclusive.
There are no definitive guidelines available for the management of the IPFP in TKA resulting in a wide variation in practice amongst surgeons.
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