EXAMINING MORTALITY RATES FOLLOWING PERIPROSTHETIC FEMUR FRACTURES IN PATIENTS UNDERGOING PRIMARY AND REVISION TOTAL HIP ARTHROPLASTY: RETROSPECTIVE COHORT RESEARCH

Introduction Following total knee and hip arthroplasty (TKA and THA), periprosthetic fractures (PPF) have risen. The study evaluated morbidity and mortality after PPF surgery for the knee and hip.  Methods A level-1 trauma center examined 248 patients, throughout two years. These patients were included retrospectively. Mortality was taken into consideration as the main event in Fine and Gray's model when assessing risk factors for postoperative morbidity. Cox regression models, both univariate and multivariate, were used to identify death risk variables.  Result The mean age was 77 years; 77.40% were female with PPF of the hip (n = 194) and knee (n = 54). Out of all the fracture types in Vancouver, B2 (n = 78; 42.4%) was the most common, followed by B1 (n = 46; 25.00%). Form I fractures (n=28; 51.9%) were the most common form of Lewis-Rorabeck fracture in the PPF of the knee. Complication rates for PPF of the knee and hip were 44.0% and 29.9%, respectively. Six patients experienced early and late problems, 50 had early complications, and 38 had late implant-related complications that required surgery.  Conclusion Younger patients and those undergoing ORIF have higher postoperative morbidity from implant issues. Accounting for mortality prevents underestimating complications. The retrospective study at a level 1 trauma hospital shows that, with careful planning, surgeries longer than two days do not harm patient outcomes.  Recommendation An earlier study found that for patients with native hip fractures or periprosthetic fractures, surgery is still advised 24 to 48 hours after admission

A COHORT STUDY COMPARING SHOULDER PRIMARY ADHESIVE CAPSULITIS TREATMENT WITH ARTHROSCOPIC CAPSULAR RELEASE, SUBACROMIAL DECOMPRESSION, ROTATOR INTERVAL RELEASE AND MANIPULATION UNDER GENERAL ANESTHESIA

Background In 90% of cases, adhesive capsulitis is manageable using conservative management strategies but it requires optimum surgical intervention if it is not cured with conservative strategies. This study aims to compare the combination of arthroscopic capsular release and rotator interval release and manipulation under general anesthesia.  Method A total of 120 patients who did not respond to conservative management strategies were included in this study. They were divided into two groups: 60 patients underwent manipulation under general anesthesia (GA) alone, and the other 60 patients received a combination of arthroscopic capsular release, rotator interval release, and manipulation under GA. Visual Analog Scale (VAS) and the Oxford Shoulder Score (OSS)were recorded before surgery and at follow-ups after one week, one month, three months, and six months.  Results Both VAS and OSS declined significantly in both groups. For the manipulation under the GA group, the OSS decreased from 49.8±3.3 to 30±4.4 after six months, while the combination group saw a reduction from 50.1±4.4 to 17.4±3.0 after six months. Similarly, the VAS decreased from 6.65±0.93 to 1.47±0.8 in the manipulation group, and from 7.6±1.0 to 0.29±0.47 in the combination group after six months. The combination procedure showed significantly better outcomes in terms of both pain reduction and improved shoulder function (p<0.001).  Conclusion The combination of arthroscopic capsular release, rotator interval release, and manipulation under general anesthesia provides significantly better outcomes than manipulation under general anesthesia alone for adhesive capsulitis, as evidenced by improvements in VAS and OSS over six months.  Recommendation Symptoms and stages of adhesive capsulitis should be taken into consideration while selecting the best possible conservative management strategy and surgical intervention

A PROSPECTIVE STUDY EXAMINING THE CLINICAL AND FUNCTIONAL OUTCOMES OF ADULTS WITH PROXIMAL HUMERUS FRACTURES TREATED USING A LOCKING COMPRESSION PLATE (LCP): A COHORT STUDY.

  Background Proximal humerus fractures (PHF) are common, particularly among the elderly, and can significantly impact functional outcomes. The introduction of locking compression plates (LCP) has enhanced the management of these complex fractures by providing stable fixation. The study assessed the clinical and functional results of locking compression plate treatment for PHF in adult patients.  Methods Included were 150 patients who had closed proximal humerus fractures that were categorized as 2-, 3-, or 4-part fractures according to NEER guidelines. Using a deltopectoral technique, patients received open reduction and internal fixation with LCP. The Constant-Murley scoring system was used to estimate clinical and functional outcomes, such as pain, daily living activities, range of motion (ROM), and muscle power. There were follow-ups at two weeks, six weeks, three months, six months, and a year. The statistical analysis was carried out with SPSS 23.0.  Results The study included participants with a mean age of 38.6 years, 56.7% males​. Significant improvements were observed in all outcome measures. Pain scores decreased from a preoperative mean of 12.5 to 2.1 at one year. Activities of daily living scores improved from 10.3 to 20.0. ROM increased from 22.3 degrees to 80.2 degrees, and muscle power improved from 14.7 to 24.3. Complications were noted in 12% of cases, including infection, hardware failure, nonunion, and subacromial impingement. Statistical analysis confirmed these improvements were highly significant (p < 0.001).  Conclusion Locking compression plates effectively improves clinical and functional outcomes for proximal humerus fractures. The significant reduction in pain and enhancement in ROM and muscle power support the use of LCPs in managing these complex fractures.  Recommendations Further studies should focus on long-term outcomes and strategies to minimize complications associated with LCPs. Additionally, patient selection criteria and individualized treatment protocols should be optimized based on specific fracture patterns and patient characteristics

A study of impact of stress: examinations on menstrual cycle among medical students

Background: Premenstrual Syndrome (PMS), a common problem among adolescent girls, is associated with various physical, mental and behavioral symptoms that lead to social and occupational impairment. Stress has also been hypothesized to be an important etiologic factor. Examination stress may also be responsible for affecting the premenstrual symptoms. The objectives of this study was to study the impact of exam stress on the menstrual cycle and the relationship of perceived stress with the severity of premenstrual symptoms. Methods: This was a cross-sectional observational study conducted among female medical students of final MBBS, who were candidate of upcoming exams. They were assessed on semi structured socio-demographic and menstrual history proforma, ACOG guidelines, DSM-5 criteria, Perceived Stress Scale (PSS) and Premenstrual Symptom Screening Tool (PSST).Results: As per ACOG guidelines, 66% participants had PMS and 6% participants had PMDD according to DSM-5 criteria. On PSST total 88% participants had premenstrual symptoms and out of them 58% had mild/no PMS while 30% had moderate to severe PMS. 5% participants also fulfilled criteria for PMDD on PSST. Stress was found to be mild in 26% and moderate in 74% participants on PSS. PMS was found in 93.75% participants who had painful menstruation (dysmenorrhea) and this association was statistically significant. Data wise 73.1% participants having mild stress had PMS, while 93.2% participants having moderate stress, had PMS and this association was found to be statistically significant.  Surprisingly not a single participant consulted to any health care provider for their menstruation related problems.Conclusions: Premenstrual Syndrome is common in adolescent girls and exam stress is an important etiological factor. PMS/PMDD was found significantly higher in participants who had dysmenorrhea and moderate stress. A positive and highly significant correlation was also found between the severity of stress and severity of premenstrual symptoms

Penalized Orthogonal Iteration for Sparse Estimation of Generalized Eigenvalue Problem

We propose a new algorithm for sparse estimation of eigenvectors in generalized eigenvalue problems (GEP). The GEP arises in a number of modern data-analytic situations and statistical methods, including principal component analysis (PCA), multiclass linear discriminant analysis (LDA), canonical correlation analysis (CCA), sufficient dimension reduction (SDR) and invariant co-ordinate selection. We propose to modify the standard generalized orthogonal iteration with a sparsity-inducing penalty for the eigenvectors. To achieve this goal, we generalize the equation-solving step of orthogonal iteration to a penalized convex optimization problem. The resulting algorithm, called penalized orthogonal iteration, provides accurate estimation of the true eigenspace, when it is sparse. Also proposed is a computationally more efficient alternative, which works well for PCA and LDA problems. Numerical studies reveal that the proposed algorithms are competitive, and that our tuning procedure works well. We demonstrate applications of the proposed algorithm to obtain sparse estimates for PCA, multiclass LDA, CCA and SDR. Supplementary materials are available online

U2AF65 adapts to diverse pre-mRNA splice sites through conformational selection of specific and promiscuous RNA recognition motifs

Degenerate splice site sequences mark the intron boundaries of pre-mRNA transcripts in multicellular eukaryotes. The essential pre-mRNA splicing factor U2AF(65) is faced with the paradoxical tasks of accurately targeting polypyrimidine (Py) tracts preceding 3\u27 splice sites while adapting to both cytidine and uridine nucleotides with nearly equivalent frequencies. To understand how U2AF(65) recognizes degenerate Py tracts, we determined six crystal structures of human U2AF(65) bound to cytidine-containing Py tracts. As deoxy-ribose backbones were required for co-crystallization with these Py tracts, we also determined two baseline structures of U2AF(65) bound to the deoxy-uridine counterparts and compared the original, RNA-bound structure. Local structural changes suggest that the N-terminal RNA recognition motif 1 (RRM1) is more promiscuous for cytosine-containing Py tracts than the C-terminal RRM2. These structural differences between the RRMs were reinforced by the specificities of wild-type and site-directed mutant U2AF(65) for region-dependent cytosine- and uracil-containing RNA sites. Small-angle X-ray scattering analyses further demonstrated that Py tract variations select distinct inter-RRM spacings from a pre-existing ensemble of U2AF(65) conformations. Our results highlight both local and global conformational selection as a means for universal 3\u27 splice site recognition by U2AF(65)

Somatic Mutational Landscape of Splicing Factor Genes and Their Functional Consequences across 33 Cancer Types

Hotspot mutations in splicing factor genes have been recently reported at high frequency in hematological malignancies, suggesting the importance of RNA splicing in cancer. We analyzed whole-exome sequencing data across 33 tumor types in The Cancer Genome Atlas (TCGA), and we identified 119 splicing factor genes with significant non-silent mutation patterns, including mutation over-representation, recurrent loss of function (tumor suppressor-like), or hotspot mutation profile (oncogene-like). Furthermore, RNA sequencing analysis revealed altered splicing events associated with selected splicing factor mutations. In addition, we were able to identify common gene pathway profiles associated with the presence of these mutations. Our analysis suggests that somatic alteration of genes involved in the RNA-splicing process is common in cancer and may represent an underappreciated hallmark of tumorigenesis

Retina-simulating phantom for optical coherence tomography.

Optical coherence tomography (OCT) is a rapidly growing imaging modality, particularly in the field of ophthalmology. Accurate early diagnosis of diseases requires consistent and validated imaging performance. In contrast to more well-established medical imaging modalities, no standardized test methods currently exist for OCT quality assurance. We developed a retinal phantom which mimics the thickness and near-infrared optical properties of each anatomical retinal layer as well as the surface topography of the foveal pit. The fabrication process involves layer-by-layer spin coating of nanoparticle-embedded silicone films followed by laser micro-etching to modify the surface topography. The thickness of each layer and dimensions of the foveal pit are measured with high precision. The phantom is embedded into a commercially available, water-filled model eye to simulate ocular dispersion and emmetropic refraction, and for ease of use with clinical OCT systems. The phantom was imaged with research and clinical OCT systems to assess image quality and software accuracy. Our results indicate that this phantom may serve as a useful tool to evaluate and standardize OCT performance

Siyasi komiserler yeni başbakanı ayaklarına kadar getirttiler:Ali Rıza Paşa İngiliz yardımını talep etti

Taha Toros Arşivi, Dosya Adı: Milli Mücadele İstiklal Harbi GazetesiUnutma İstanbul projesi İstanbul Kalkınma Ajansı'nın 2016 yılı "Yenilikçi ve Yaratıcı İstanbul Mali Destek Programı" kapsamında desteklenmiştir. Proje No: TR10/16/YNY/010