Tendonitis and Tendon Rupture in Low-Profile Dorsal versus Volar Plating for Distal Radius Fractures: A Systematic Review and Meta-Analysis

INTRODUCTION: Dorsal plating of distal radius fractures has been associated with high rates of hardware removal, tendonitis, and tendon rupture. Much of this research was performed using 2.5mm thick distal radius plating, whereas modern dorsal plates are thinner (1.2mm-1.5mm). We examine whether modern plates have higher rates of complications than volar plates. METHODS: We search Ovid MEDLINE, Web of Science, and EMBASE for literature describing tendon complications associated with plating of distal radius fractures. Inclusion criteria included any comparison between volar and dorsal plating and report of tendon complication. Exclusion criteria included: failure to specify low-profile dorsal plates; lack of volar plating comparison arm; no reporting of tendon complications. All studies were assessed for quality using MINOR’s criteria. RESULTS: All 5 included studies were retrospective cohorts, totaling 806 subjects; 584 received volar plates and 222 received dorsal plates. Minimum average follow-up was 5 months. Of the volar plate group, 2% had symptoms consistent with tendonitis, 1% experienced a tendon rupture, and 4% underwent hardware removal. In the dorsal group, 6% had tendonitis, 1% had tendon ruptures, and 11% underwent hardware removal. Meta-analysis showed no significant difference in rates of tendonitis (4 studies, Z=0.79, P=0.43) or tendon rupture (5 studies, Z=0.59, P=0.56). DISCUSSION: To our knowledge, this review provides the largest comparison of modern dorsal and volar distal radius plates to date. Our results do not demonstrate increased risk of tendon complications in patients who underwent dorsal plating. This study sets a precedent for more routine use of dorsal plating

Finite Element Analysis and Machine Learning Guided Design of Carbon Fiber Organosheet-based Battery Enclosures for Crashworthiness

Carbon fiber composite can be a potential candidate for replacing metal-based battery enclosures of current electric vehicles (E.V.s) owing to its better strength-to-weight ratio and corrosion resistance. However, the strength of carbon fiber-based structures depends on several parameters that should be carefully chosen. In this work, we implemented high throughput finite element analysis (FEA) based thermoforming simulation to virtually manufacture the battery enclosure using different design and processing parameters. Subsequently, we performed virtual crash simulations to mimic a side pole crash to evaluate the crashworthiness of the battery enclosures. This high throughput crash simulation dataset was utilized to build predictive models to understand the crashworthiness of an unknown set. Our machine learning (ML) models showed excellent performance (R2 > 0.97) in predicting the crashworthiness metrics, i.e., crush load efficiency, absorbed energy, intrusion, and maximum deceleration during a crash. We believe that this FEA-ML work framework will be helpful in down select process parameters for carbon fiber-based component design and can be transferrable to other manufacturing technologies

Development and Validation of a Novel Decision Aid for WALANT Hand Surgeries: Investigating Patient Preferences

INTRODUCTION: This study aims to develop a novel decision aid packet (DAP) for hand surgery patients deciding between Wide-Awake-Local-Anesthesia-No-Tourniquet (WALANT) and traditional anesthesia. METHODS: Development: The DAP was developed following International Patient Decision Aid Standards. Validation: Alpha Testing Seven hand surgeons experienced in WALANT and traditional surgeries belonging to the WALANT Research Consortium in the U.S. commented on the DAP through three rounds of editing utilizing the Delphi method. Seven patient advocates provided readability feedback. Beta Testing Orthopedic hand surgery patients were assigned to the control or experimental group. The experimental group was given the DAP pre-surgery. Both groups completed a validated regret scale at follow-up. A paired t-test was conducted to analyze the difference between average scores on the regret scale and pre- and post-DAP knowledge tests (p RESULTS: The experimental group (n=58) demonstrated a 145% increase (p DISCUSSION: Increased knowledge test scores following the DAP suggest that patients are better informed after DAP usage. Low decisional conflict scores suggest that the DAP increases patients’ confidence. Lower average regret scale scores among the experimental group indicate a relationship between DAP administration and reduced post-surgical regret. The greater patient preference for WALANT following DAP usage, alongside the lower postoperative regret, elucidates a general preference in informed patients towards the WALANT modality

Current research into brain barriers and the delivery of therapeutics for neurological diseases: a report on CNS barrier congress London, UK, 2017.

This is a report on the CNS barrier congress held in London, UK, March 22-23rd 2017 and sponsored by Kisaco Research Ltd. The two 1-day sessions were chaired by John Greenwood and Margareta Hammarlund-Udenaes, respectively, and each session ended with a discussion led by the chair. Speakers consisted of invited academic researchers studying the brain barriers in relation to neurological diseases and industry researchers studying new methods to deliver therapeutics to treat neurological diseases. We include here brief reports from the speakers

Impact of natural killer cells on outcomes after allogeneic hematopoietic stem cell transplantation: A systematic review and meta-analysis.

Background: Natural killer (NK) cells play a vital role in early immune reconstitution following allogeneic hematopoietic stem cell transplantation (HSCT). Methods: A literature search was performed on PubMed, Cochrane, and Clinical trials.gov through April 20, 2022. We included 21 studies reporting data on the impact of NK cells on outcomes after HSCT. Data was extracted following the PRISMA guidelines. Pooled analysis was done using the meta-package (Schwarzer et al.). Proportions with 95% confidence intervals (CI) were computed. Results: We included 1785 patients from 21 studies investigating the impact of NK cell reconstitution post-HSCT (8 studies/1455 patients), stem cell graft NK cell content (4 studies/185 patients), therapeutic NK cell infusions post-HSCT (5 studies/74 patients), and pre-emptive/prophylactic NK cell infusions post-HSCT (4 studies/77 patients). Higher NK cell reconstitution was associated with a better 2-year overall survival (OS) (high: 77%, 95%CI 0.73-0.82 vs low: 55%, 95%CI 0.37-0.72; n=899), however, pooled analysis for relapse rate (RR) or graft versus host disease (GVHD) could not be performed due to insufficient data. Higher graft NK cell content demonstrated a trend towards a better pooled OS (high: 65.2%, 95%CI 0.47-0.81 vs low: 46.5%, 95%CI 0.24-0.70; n=157), lower RR (high: 16.9%, 95%CI 0.10-0.25 vs low: 33%, 95%CI 0.04-0.72; n=157), and lower acute GVHD incidence (high: 27.6%, 95%CI 0.20-0.36 vs low: 49.7%, 95%CI 0.26-0.74; n=157). Therapeutic NK or cytokine-induced killer (CIK) cell infusions for hematologic relapse post-HSCT reported an overall response rate (ORR) and complete response (CR) of 48.9% and 11% with CIK cell infusions and 82.8% and 44.8% with NK cell infusions, respectively. RR, acute GVHD, and chronic GVHD were observed in 55.6% and 51.7%, 34.5% and 20%, and 20.7% and 11.1% of patients with CIK and NK cell infusions, respectively. Pre-emptive donor-derived NK cell infusions to prevent relapse post-HSCT had promising outcomes with 1-year OS of 69%, CR rate of 42%, ORR of 77%, RR of 28%, and acute and chronic GVHD rates of 24.9% and 3.7%, respectively. Conclusion: NK cells have a favorable impact on outcomes after HSCT. The optimal use of NK cell infusions post-HSCT may be in a pre-emptive fashion to prevent disease relapse

Tumour brain: pre‐treatment cognitive and affective disorders caused by peripheral cancers

People that develop extracranial cancers often display co-morbid neurological disorders, such as anxiety, depression and cognitive impairment, even before commencement of chemotherapy. This suggests bidirectional crosstalk between non-CNS tumours and the brain, which can regulate peripheral tumour growth. However, the reciprocal neurological effects of tumour progression on brain homeostasis are not well understood. Here, we review brain regions involved in regulating peripheral tumour development and how they, in turn, are adversely affected by advancing tumour burden. Tumour-induced activation of the immune system, blood–brain barrier breakdown and chronic neuroinflammation can lead to circadian rhythm dysfunction, sleep disturbances, aberrant glucocorticoid production, decreased hippocampal neurogenesis and dysregulation of neural network activity, resulting in depression and memory impairments. Given that cancer-related cognitive impairment diminishes patient quality of life, reduces adherence to chemotherapy and worsens cancer prognosis, it is essential that more research is focused at understanding how peripheral tumours affect brain homeostasis

KDM1A microenvironment, its oncogenic potential, and therapeutic significance

The lysine-specific histone demethylase 1A (KDM1A) was the first demethylase to challenge the concept of the irreversible nature of methylation marks. KDM1A, containing a flavin adenine dinucleotide (FAD)-dependent amine oxidase domain, demethylates histone 3 lysine 4 and histone 3 lysine 9 (H3K4me1/2 and H3K9me1/2). It has emerged as an epigenetic developmental regulator and was shown to be involved in carcinogenesis. The functional diversity of KDM1A originates from its complex structure and interactions with transcription factors, promoters, enhancers, oncoproteins, and tumor-associated genes (tumor suppressors and activators). In this review, we discuss the microenvironment of KDM1A in cancer progression that enables this protein to activate or repress target gene expression, thus making it an important epigenetic modifier that regulates the growth and differentiation potential of cells. A detailed analysis of the mechanisms underlying the interactions between KDM1A and the associated complexes will help to improve our understanding of epigenetic regulation, which may enable the discovery of more effective anticancer drugs

View-Specific Assessment of L2 Spoken English

The growing demand for learning English as a second language has increased interest in automatic approaches for assessing and improving spoken language proficiency. A significant challenge in this field is to provide interpretable scores and informative feedback to learners through individual viewpoints of learners’ proficiency, as opposed to holistic scores. Thus far, holistic scoring remains commonly applied in large-scale commercial tests. As a result, an issue with more detailed evaluation is that human graders are generally trained to provide holistic scores. This paper investigates whether view-specific systems can be trained when only holistic scores are available. To enable this process, view-specific networks are defined where both their inputs and structure are adapted to focus on specific facets of proficiency. It is shown that it is possible to train such systems on holistic scores, such that they provide view-specific scores at evaluation time. View-specific networks are designed in this way for pronunciation, rhythm, text, use of parts of speech and grammatical accuracy. The relationships between the predictions of each system are investigated on the spoken part of the Linguaskill proficiency test. It is shown that the view-specific predictions are complementary in nature and capture different information about proficiency.Cambridge University Press and Assessmen