Titanium elastic nails versus spica cast in pediatric femoral shaft fractures:A systematic review and meta-analysis of 1012 patients

Background: There is a general consensus on the management of femoral fractures in children younger than two years and adolescents older than sixteen years. The best treatment for patients younger than sixteen years of age is still debatable. Titanium Elastic Nails (TEN), is widely used with some evidence, nonetheless, we undertook a systematic meta-analysis to assess the efficacy of TEN compared to Spica cast for the management of femoral shaft fracture in children aged between 2 to 16 years old. Methods: A computer literature search of PubMed, Scopus, Web of Science, CINAHL and Cochrane Central was conducted using relevant keywords. We included clinical trials and observational studies that compared TEN versus Spica cast; Records were screened for eligible studies and data were extracted and synthesized using Review Manager version 5.3 for Windows. Our search found 573 unique articles. After screening the abstract and relevant full text, 12 studies with a total of 1012 patients were suitable for the final analysis. Results: In terms terms of union (in weeks), the reported effect sizes favoured the TEN group in two included studies only. Moreover, the overall standardized mean difference in sagittal (SMD -0.48, 95% CI [-0.70 to -0.26], P<0.001) and coronal angulations (SMD -0.66, 95% CI [-1.00 to -0.31], P<0.001) favored TEN fixation in management of femoral fractures younger than 16 years. The reported length of hospital stay was not consistent across studies. The overall risk ratio of malalignment (RR=0.39, 95% CI [0.27 to 0.57], P<0.001) favored the TEN as well as walking independently. Based on our analysis, TEN treatment is superior to traction and hip spica for femoral fractures in patients younger than 16 years old. Conclusion: Based on our analysis we recommend the use of TEN fixation in management of pediatric femoral fractures in patients younger than 16 years

(2E)-3-(3-Benzyl­oxyphen­yl)-1-(2-hydroxy-5-methyl­phen­yl)prop-2-en-1-one

In the mol­ecule of the title compound, C23H20O3, an intra­molecular O—H⋯O hydrogen bond generates an S(6) ring. The central benzene ring makes dihedral angles of 80.17 (8) and 16.99 (7)°, respectively, with the benz­yloxy and hy­droxy­methyl phenyl rings. In the crystal, mol­ecules are linked via inter­molecular C—H⋯O hydrogen bonds to form dimers. The dimers are connected by C—H⋯O hydrogen bonds and C—H⋯π inter­actions to form columns down the b axis

The effect of type of femoral component fixation on mortality and morbidity after hip hemiarthroplasty:A systematic review and meta-analysis

Background: Hip hemiarthroplasty is a well-established treatment of displaced femoral neck fracture, although debate exists over whether cemented or uncemented fixation is superior. Uncemented prostheses have typically been used in younger, healthier patients and cemented prostheses in older patients with less-stable bone. Also, earlier research has suggested that bone cement has cytotoxic effects and may trigger cardiovascular and respiratory adverse events. Questions/Purposes: The aim of this systematic review and meta-analysis was to compare morbidity and mortality rates after cemented and uncemented hemiarthroplasty for the treatment of displaced femoral neck fractures in elderly patients. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven medical databases for randomized clinical trials and observational studies. We compared cemented and uncemented hemiarthroplasty using the Harris Hip Score (HHS), as well as measures of postoperative pain, mortality, and complications. Data were extracted and pooled as risk ratios or standardized mean difference with their corresponding 95% confidence intervals in a meta-analysis model. Results: The meta-analysis included 34 studies (12 randomized trials and 22 observational studies), with a total of 42,411 patients. In the pooled estimate, cemented hemiarthroplasty was associated with less risk of postoperative pain than uncemented hemiarthroplasty. There were no significant differences between groups regarding HHS or rates of postoperative mortality, pulmonary embolism, cardiac arrest, myocardial infarction, acute cardiac arrhythmia, or deep venous thrombosis. Conclusions: While we found that cemented hemiarthroplasty results in less postoperative pain than uncemented hemiarthroplasty in older patients with femoral neck fracture, the lack of significant differences in functional hip scores, mortality, and complications was surprising. Further high-level research is needed

Chertsey Outcome Score for Trauma: Development and validation of a new unifying patient reported outcome measure for orthopaedic trauma

Purpose: Lately there is an increasing tendency of using Patient Reported Outcome Measures (PROMs) as a final indicator of the outcome of many surgical treatments in orthopaedics and in other medical specialties. Currently there are many outcome scores in orthopaedics and most of them are site specific. In the contrary there is a lack of trauma specific outcome scores. Methods: We have designed a new PROM especially for orthopaedic trauma patients, in order to measure in what extent the patients manage to return to their pre-injury state. This score uses as baseline the pre-injury status of the patient and has the aim to determine the percentage of rehabilitation after treatment for any injury. Results: A total of 60 Chertsey Outcome Score for Trauma (COST) questionnaires were gathered in our outpatients department. The participants were 57% male (aged 46.81 years ± 18.5 years) and the questionnaires collected at mean 10 months post-injury. A Cronbach's Alpha value of 0.89 was identified for the whole construct. The three dimensions of the scale had good internal consistency as well (Cronbach's Alpha test values 0.74, 0.84 and 0.81 for symptoms, function and mental status respectively). Strong/moderate correlation (Spearman's Rho test 0.43–0.65) was observed between the respective physical/mental dimensions of the COST and SF-12v2 questionnaires. Conclusion: There is a need among the orthopaedic trauma society for a specific PROM of trauma. COST is a useful and easy to use tool for every trauma surgeon

Advanced Estimation of Brain Age Using Pre-trained 2D Convolutional Neural Networks on a Public Dataset

This work introduces a brand-new approach to be employed for correctly assessing healthy person’s brain aging, masking what constitutes the most serious challenge in the fight against age-related cognitive decline. An approach is serviced by 2D CNNs, a simpler technology to state-of-the-art 3D model, to yield close to accurate forecast. Our algorithm improves telling in two respects. By virtue of this, we will utilize well-known ImageNet-pre-trained classifiers to suggest initial brain age predictions. This process sets the tone of the core of our business model in terms of dependability and reliability. Next, we improve the networks’ performance through progressively expanding their capacity via fine-tuning on pre-segmentation tasks using the neuroimaging datasets which are openly available. This stage increases the predictive accuracy in addition to ensuring that there is transparency and flexibility because it utilizes open datasets. Our research's strength is that it encompasses all techniques and fields necessary for brain age estimation and adopts justifiable evaluation metrics. As a result, this conduct adds to the literature. Our study not only points out deficiencies in private datasets but reels out the validity of our approach by using the public data instead to give the results another direction of accessibility and reproducibility

(2E)-1-(2-Hydroxy-5-methylphenyl)-3-(4-methoxyphenyl)prop-2-en-1-one

In the title compound, C17H16O3, the dihedral angle between the aromatic rings is 4.59&amp;#8197;(7)&amp;#176; and an intramolecular O&amp;#8212;H...O hydrogen bond generates an S(6) ring. In the crystal, adjacent molecules are linked by C&amp;#8212;H...O hydrogen bonds, leading to the formation of [001] supramolecular chains. Weak C&amp;#8212;H...&amp;#960; interactions consolidate the packing

The Evaluation Effect of Copper Fibre Diameter on Enhancing Compressive Strength of Pure Gypsum

The sustainability and impact of copper fibres on pure gypsum is the primary purpose of this study to investigate a combination of two kinds of copper fibres obtained from environmental waste (damaged electrical wires). The copper fibres are dividings into a fixed length of 10 mm, but with two different diameters: the first is 0.83 mm and the second is 0.63 mm, where the ratio of width to height (L/D) is 12 and 15.9, respectively, with a volume ratio Vf = 0.4 %, the ratios 0.5 and 0.6 represent the Water to Gypsum ratio (W/G) individually. Each W/G ratio has two types of mixtures which organize according to diameter. The first considers a reference mixture without copper fibres (CF), and the other is a copper fibres (CF) mixture. This work found that the compressive strength increased from adding the copper fibres to a mixture of pure gypsum. Furthermore, this increase is apparent in pure gypsum compressive strength when raising the aspect ratio because of reducing the copper fibres’ diameters. In another way, increasing ratio of W/G in the case of existing copper fibres or none may reduce a compressive strength of mixtures. Therefore, when the ratio of (W/G) drops, the significance of copper fibres may become more apparent