Bladder incarceration following anterior external fixation of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation

Anterior pelvic ring disruptions are often associated with injuries to the genitourinary structures with the potential for considerable resultant morbidity. Herniation of the bladder into the symphyseal region after injury with subsequent entrapment upon reduction of the symphyseal diastasis has seldom been reported in the literature. We report such a case involving bladder herniation and subsequent entrapment after attempted closed reduction with anterior pelvic external fixation immediately treated with open reduction and internal fixation along with a review of the literature

Students as Producers: The Postgraduate Teaching Assistant Pilot Project

This paper reports on a pilot project in which two postgraduate students were supported to function in the role of teaching assistants (TAs) as part of their learning experience. The project embraced the notion of students as producers rather than consumers. Using a reflective approach, this case study was jointly written by TAs and their teaching staff. It incorporates feedback from other students collected through an anonymous module feedback survey, which was analysed by attribution to themes. The role of TAs benefitted others students, staff, and the TAs; the project is a strong affirmation of the principle of treating students as producers. The impact of the role on both the students undertaking the TA role and the tutors was profound, and student experience was enhanced as a result. TAs can assist in bridging student-teacher communication gaps and support students’ learning through sharing their knowledge by creating resources. This article is written from the perspectives of both the TAs and the tutors

Predicting the outcome of conservative treatment with physiotherapy in adults with shoulder pain associated with partial-thickness rotator cuff tears – a prognostic model development study

Model coefficient statistics (DOCX 21 kb

Cooperation and virulence in acute Pseudomonas aeruginosa infections

BACKGROUND: Efficient host exploitation by parasites is frequently likely to depend on cooperative behaviour. Under these conditions, mixed-strain infections are predicted to show lower virulence (host mortality) than are single-clone infections, due to competition favouring non-contributing social 'cheats' whose presence will reduce within-host growth. We tested this hypothesis using the cooperative production of iron-scavenging siderophores by the pathogenic bacterium Pseudomonas aeruginosa in an insect host. RESULTS: We found that infection by siderophore-producing bacteria (cooperators) results in more rapid host death than does infection by non-producers (cheats), and that mixtures of both result in intermediate levels of virulence. Within-host bacterial growth rates exhibited the same pattern. Crucially, cheats were more successful in mixed infections compared with single-clone infections, while the opposite was true of cooperators. CONCLUSION: These data demonstrate that mixed clone infections can favour the evolution of social cheats, and thus decrease virulence when parasite growth is dependent on cooperative behaviours

Enhancements in nocturnal surface ozone at urban sites in the UK

Analysis of diurnal patterns of surface ozone (O3) at multiple urban sites in the UK shows the occurrence of prominent nocturnal enhancements during the winter months (November–March). Whilst nocturnal surface ozone (NSO) enhancement events have been observed at other locations, this is the first time that such features have been demonstrated to occur in the UK and the second location globally. The observed NSO enhancement events in the UK were found to be so prevalent that they are clearly discernible in monthly diurnal cycles averaged over several years of data. Long-term (2000–2010) analysis of hourly surface ozone data from 18 urban background stations shows a bimodal diurnal variation during the winter months with a secondary nighttime peak around 0300 hours along with the primary daytime peak. For all but one site, the daily maxima NSO concentrations during the winter months exceeded 60 μg/m3 on >20 % of the nights. The highest NSO value recorded was 118 μg/m3. During the months of November, December, and January, the monthly averaged O3 concentrations observed at night (0300 h) even exceeded those observed in the daytime (1300 h). The analysis also shows that these NSO enhancements can last for several hours and were regional in scale, extending across several stations simultaneously. Interestingly, the urban sites in the north of the UK exhibited higher NSO than the sites in the south of the UK, despite their daily maxima being similar. In part, this seems to be related to the sites in the north typically having lower concentrations of nitrogen oxides

Africa’s response to the COVID-19 pandemic : A review of the nature of the virus, impacts and implications for preparedness

Background: COVID-19 continues to wreak havoc in different countries across the world, claiming thousands of lives, increasing morbidity and disrupting lifestyles. The global scientific community is in urgent need of relevant evidence, to understand the challenges and knowledge gaps, as well as the opportunities to contain the spread of the virus. Considering the unique socio-economic, demographic, political, ecological and climatic contexts in Africa, the responses which may prove to be successful in other regions may not be appropriate on the continent. This paper aims to provide insight for scientists, policy makers and international agencies to contain the virus and to mitigate its impact at all levels. Methods: The Affiliates of the African Academy of Sciences (AAS), came together to synthesize the current evidence, identify the challenges and opportunities to enhance the understanding of the disease. We assess the potential impact of this pandemic and the unique challenges of the disease on African nations. We examine the state of Africa’s preparedness and make recommendations for steps needed to win the war against this pandemic and combat potential resurgence. Results: We identified gaps and opportunities among cross-cutting issueswhich must be addressed or harnessed in this pandemic. Factors such as the nature of the virus and the opportunities for drug targeting, point of care diagnostics, health surveillance systems, food security, mental health, xenophobia and gender-based violence, shelter for the homeless, water and sanitation, telecommunications challenges, domestic regional coordination and financing. Conclusion: Based on our synthesis of the current evidence, while there are plans for preparedness in several African countries, there are significant limitations. A multi-sectoral efforts from the science, education, medical, technology, communication, business, and industry sectors, as well as local communities, must work collaboratively to assist countries in order to win this fight

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo