Challenges in managing pubic ramus fractures Routine Computed Tomography for all pubic ramus fractures- Is there a role?

Posterior pelvic ring injury (PPRI) can be often overlooked if solely based on plain radiographs. There is paucity of literature correlating between pubic ramus fracture and concomitant PPRI in elderly patients

Major and trace element and multiple sulfur isotope composition of sulfides from the Paleoproterozoic Surda copper deposit, Singhbhum Shear Zone, India: Implications for the mineralization processes

The present study combines major and trace element composition, and sulfur (S) isotope data of pyrite and chacopyrite from the Surda copper sulfide deposit in the Singhbhum Shear Zone, the most important copper and uranium producing belt (Singhbhum Cu-U Belt) in India. Three textural and compositional types of both pyrite and chalcopyrite were distinguished; unzoned to partially zoned Pyrite IA with high Co (up to 54900 ppm) and low Ni content is earliest, followed by oscillatory zoned Pyrite IB with high As (up to 25600 ppm) and Co (up to 46800 ppm), bothoccurring in pyrite I + chalcopyrite I + pyrrhotite + magnetite + apatite vein; Cobaltite-type substitution (Fe1-xCox)(S1-xAsx)2 is suggested for Pyrite IB. Gold occurs in Pyrite I as minor “invisible” gold and as electrum inclusions. It also occurs along with Cu, Mn, Ni, Hg, Ag, Pb, Sb, Zn, Ce, Y, U, and Th in micro-fractures that transgress the primary zoning pattern defined by As, Co, and Ni in Pyrite IB. The early inclusion-rich chalcopyrite generation (Chalcopyrite I) contains high concentration of Zn and Se, and minor to trace amounts of Co, Ni, Hg, Pb, Sb, Te, and Bi, appeared in between Pyrite I and II.Low Co, high Ni (up to 37700 ppm) content Pyrite II, and inclusion-free Chalcopyrite II enriched in Co, Ni, Hg, Bi, Mn, Ag, Sb, V, and Pb are cogenetic, and occurring in pyrite II + pyrrhotite + pentlandite + chalcopyrite II ± violarite vein. Low Co and Ni containing Pyrite III + Chalcopyrite III occur mainly as disseminated grains. The relative timing of formation of Pyrite II + Chalcopyrite II with PyriteIII + Chalcopyrite III remains uncertain. Pyrite + chalcopyrite textures indicate that all pyrite + chalcopyrite formed at some time prior to the end of deformation and metamorphism. Both in situ and mineral separates of all pyrite types and associated chalcopyrite yield a narrow range of positive δ34S values (between +3.8 to +6.9 ‰) suggesting sulfur being derived from a similar source. Consistent positive δ34S values and other circumstantial evidence indicate that most sulfur was derived from seawater sulfate or modified seawater (brine/evaporite). Δ33S values revealed mass dependent fractionation (MDF) signature. It is proposed that incorporation of MDF sulfur of the mineralization event in Paleoproterozoic Singhbhum Cu-U Belt took place after the great oxidation event. The high Se concentrations (260 to 400 ppm) and ∑Se/∑S ratios for both Pyrite I and II from Surda deposit (4.4 to 5.7 x10-4) suggest a low temperature of the Cu–rich ores (250°-350°C), and precipitation from a metalliferous fluid with a high ∑Se/∑S ratio (10-4 to 10-3) consistent with igneous input of these elements

Is organic food becoming less safe? A longitudinal analysis of conventional and organic product recalls

Organic products are often portrayed as a healthy alternative—grown in a sustainable way, often locally and subject to external certification scrutiny. However, recent high-profile cases of contaminated organic food have raised questions about the risks associated with organic produce: is organic produce becoming less safe and more risky? The context for this investigation is in the realm of food product recalls. Based on 2010–2017 panel data from the US on food product recalls (with 2721 observations), this paper compares the volume of recalls (adjusted for the growth of sales) between conventional and organic food. This paper further addresses two food-related risks: design risk (a risk that is present in the development of food; such as the use of unapproved ingredients or the omission of some ingredients on the food label) and process risk (a risk within the supply chain, such as the contamination of food products with salmonella or E. coli). Further comparison is drawn based on food product type (here the paper distinguishes between processed and unprocessed food). The paper demonstrates that organic products are becoming less safe and that organic products are recalled at a higher rate. In comparison to conventional produce, organic produce is more prone to process risk and far less to design risk. Similar conclusions are reached even when the organic produce is analysed from a product type perspective

Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries

, and maternal health service utilization in developing countries. are significantly associated with utilization of maternal health services. The odds of having a skilled attendant at delivery for women in the poorest wealth quintile are 94% lower than that for women in the highest wealth quintile and almost 5 times higher for women with complete primary education relative to those less educated. The likelihood of using modern contraception and attending four or more antenatal care visits are 2.01 and 2.89 times, respectively, higher for women with complete primary education than for those less educated. Women with the highest empowerment score are between 1.31 and 1.82 times more likely than those with a null empowerment score to use modern contraception, attend four or more antenatal care visits and have a skilled attendant at birth.Efforts to expand maternal health service utilization can be accelerated by parallel investments in programs aimed at poverty eradication (MDG 1), universal primary education (MDG 2), and women's empowerment (MDG 3)

A decade of inequality in maternity care: antenatal care, professional attendance at delivery, and caesarean section in Bangladesh (1991–2004)

<p>Abstract</p> <p>Background</p> <p>Bangladesh is committed to the fifth Millennium Development Goal (MDG-5) target of reducing its maternal mortality ratio by three-quarters between 1990 and 2015. Since the early 1990s, Bangladesh has followed a strategy of improving access to facilities equipped and staffed to provide emergency obstetric care (EmOC).</p> <p>Methods</p> <p>We used data from four Demographic and Health Surveys conducted between 1993 and 2004 to examine trends in the proportions of live births preceded by antenatal consultation, attended by a health professional, and delivered by caesarean section, according to key socio-demographic characteristics.</p> <p>Results</p> <p>Utilization of antenatal care increased substantially, from 24% in 1991 to 60% in 2004. Despite a relatively greater increase in rural than urban areas, utilization remained much lower among the poorest rural women without formal education (18%) compared with the richest urban women with secondary or higher education (99%). Professional attendance at delivery increased by 50% (from 9% to 14%, more rapidly in rural than urban areas), and caesarean sections trebled (from 2% to 6%), but these indicators remained low even by developing country standards. Within these trends there were huge inequalities; 86% of live births among the richest urban women with secondary or higher education were attended by a health professional, and 35% were delivered by caesarean section, compared with 2% and 0.1% respectively of live births among the poorest rural women without formal education. The trend in professional attendance was entirely confounded by socioeconomic and demographic changes, but education of the woman and her husband remained important determinants of utilization of obstetric services.</p> <p>Conclusion</p> <p>Despite commendable progress in improving uptake of antenatal care, and in equipping health facilities to provide emergency obstetric care, the very low utilization of these facilities, especially by poor women, is a major impediment to meeting MDG-5 in Bangladesh.</p

Dynamics of a Quantum Phase Transition and Relaxation to a Steady State

We review recent theoretical work on two closely related issues: excitation of an isolated quantum condensed matter system driven adiabatically across a continuous quantum phase transition or a gapless phase, and apparent relaxation of an excited system after a sudden quench of a parameter in its Hamiltonian. Accordingly the review is divided into two parts. The first part revolves around a quantum version of the Kibble-Zurek mechanism including also phenomena that go beyond this simple paradigm. What they have in common is that excitation of a gapless many-body system scales with a power of the driving rate. The second part attempts a systematic presentation of recent results and conjectures on apparent relaxation of a pure state of an isolated quantum many-body system after its excitation by a sudden quench. This research is motivated in part by recent experimental developments in the physics of ultracold atoms with potential applications in the adiabatic quantum state preparation and quantum computation.Comment: 117 pages; review accepted in Advances in Physic

Varicellovirus UL49.5 Proteins Differentially Affect the Function of the Transporter Associated with Antigen Processing, TAP

Cytotoxic T-lymphocytes play an important role in the protection against viral infections, which they detect through the recognition of virus-derived peptides, presented in the context of MHC class I molecules at the surface of the infected cell. The transporter associated with antigen processing (TAP) plays an essential role in MHC class I–restricted antigen presentation, as TAP imports peptides into the ER, where peptide loading of MHC class I molecules takes place. In this study, the UL49.5 proteins of the varicelloviruses bovine herpesvirus 1 (BHV-1), pseudorabies virus (PRV), and equine herpesvirus 1 and 4 (EHV-1 and EHV-4) are characterized as members of a novel class of viral immune evasion proteins. These UL49.5 proteins interfere with MHC class I antigen presentation by blocking the supply of antigenic peptides through inhibition of TAP. BHV-1, PRV, and EHV-1 recombinant viruses lacking UL49.5 no longer interfere with peptide transport. Combined with the observation that the individually expressed UL49.5 proteins block TAP as well, these data indicate that UL49.5 is the viral factor that is both necessary and sufficient to abolish TAP function during productive infection by these viruses. The mechanisms through which the UL49.5 proteins of BHV-1, PRV, EHV-1, and EHV-4 block TAP exhibit surprising diversity. BHV-1 UL49.5 targets TAP for proteasomal degradation, whereas EHV-1 and EHV-4 UL49.5 interfere with the binding of ATP to TAP. In contrast, TAP stability and ATP recruitment are not affected by PRV UL49.5, although it has the capacity to arrest the peptide transporter in a translocation-incompetent state, a property shared with the BHV-1 and EHV-1 UL49.5. Taken together, these results classify the UL49.5 gene products of BHV-1, PRV, EHV-1, and EHV-4 as members of a novel family of viral immune evasion proteins, inhibiting TAP through a variety of mechanisms

Immunohistochemical analysis of oxidative stress and DNA repair proteins in normal mammary and breast cancer tissues

<p>Abstract</p> <p>Background</p> <p>During the course of normal cellular metabolism, oxygen is consumed and reactive oxygen species (ROS) are produced. If not effectively dissipated, ROS can accumulate and damage resident proteins, lipids, and DNA. Enzymes involved in redox regulation and DNA repair dissipate ROS and repair the resulting damage in order to preserve a functional cellular environment. Because increased ROS accumulation and/or unrepaired DNA damage can lead to initiation and progression of cancer and we had identified a number of oxidative stress and DNA repair proteins that influence estrogen responsiveness of MCF-7 breast cancer cells, it seemed possible that these proteins might be differentially expressed in normal mammary tissue, benign hyperplasia (BH), ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC).</p> <p>Methods</p> <p>Immunohistochemistry was used to examine the expression of a number of oxidative stress proteins, DNA repair proteins, and damage markers in 60 human mammary tissues which were classified as BH, DCIS or IBC. The relative mean intensity was determined for each tissue section and ANOVA was used to detect statistical differences in the relative expression of BH, DCIS and IBC compared to normal mammary tissue.</p> <p>Results</p> <p>We found that a number of these proteins were overexpressed and that the cellular localization was altered in human breast cancer tissue.</p> <p>Conclusions</p> <p>Our studies suggest that oxidative stress and DNA repair proteins not only protect normal cells from the damaging effects of ROS, but may also promote survival of mammary tumor cells.</p

Centralization of Esophageal Cancer Surgery: Does It Improve Clinical Outcome?

Background: The volume-outcome relationship for complex surgical procedures has been extensively studied. Most studies are based on administrative data and use in-hospital mortality as the sole outcome measure. It is still unknown if concentration of these procedures leads to improvement of clinical outcome. The aim of our study was to audit the process and effect of centralizing oesophageal resections for cancer by using detailed clinical data. Methods: From January 1990 until December 2004, 555 esophagectomies for cancer were performed in 11 hospitals in the region of the Comprehensive Cancer Center West (CCCW); 342 patients were operated on before and 213 patients after the introduction of a centralization project. In this project patients were referred to the hospitals which showed superior outcomes in a regional audit. In this audit patient, tumor, and operative details as well as clinical outcome were compared between hospitals. The outcome of both cohorts, patients operated on before and after the start of the project, were evaluated. Results: Despite the more severe comorbidity of the patient group, outcome improved after centralizing esophageal resections. Along with a reduction in postoperative morbidity and length of stay, mortality fell from 12% to 4% and survival improved significantly (P = 0.001). The hospitals with the highest procedural volume showed the biggest improvement in outcome. Conclusion: Volume is an important determinant of quality of care in esophageal cancer surgery. Referral of patients with esophageal cancer to surgical units with adequate experience and superior outcomes (outcome-based referral) improves quality of care