Leeds-Genoa Non-Union Index: a clinical tool for asessing the need for early intervention after long bone fracture fixation

Aim of the study The aim of this case–control study was to develop a clinical decision rule to support assessment of the risk of long-bone non-union and plan for appropriate early intervention. Methods Two hundred patients (100 cases and 100 controls) were recruited. Risk factors identified to contribute to the development of non-union were recorded and analysed with a multivariable logistic regression model. Tabulation of the outcome (non-union/union) against each risk factor in turn (univariable analysis) was carried out. Odds ratios and confidence intervals were derived using Wald’s method. A receiver–operator curve was calculated and the area under the curve was computed. Having established the eight most important risk factors, a non-union risk index was developed as the count of the risk factors present in each patient. Results The five risk factors for non-union with greater effect size were post-surgical fracture gap > 4 mm (odds ratio (OR) = 11.97 95% CI (4.27, 33.53)), infection superficial/deep (OR 10.16 (2.44, 42.36)), not optimum mechanical stability (OR 10.06 (3.75, 26.97)), displacement > 75% of shaft width (OR 6.81 (2.21, 20.95)), and site of fracture—tibia (OR 4.33 (1.32, 14.14)). The ROC curve for the non-union index was 0.924, sensitivity 91%, specificity 77%. Conclusions The non-union index derived from counting risk factors predicts union for 0–4 risk factors and non-union for 5–8 risk factors. It can be readily applied and can guide clinicians about the risk of development of long-bone non-union. It can become a powerful aid for assessing fracture fixation outcome and to support early intervention

Femoral non-union above a fused knee: Successful treatment with exchange nailing and intramedullary delivery of bone morphogenetic protein

Bone healing is a complex and well-orchestrated physiological process, in which bone repairs and regenerates regaining its original biomechanical and biochemical properties. It is estimated that 5 to 10% of all fractures are complicated by delayed union or non-union. Progression to non-union is thought to be multifactorial, even though the exact biological sequence remains obscure. Treatment should aim to addressing deficiencies in both the mechanical and biological components, along with eliminating co-factors that could negatively affect the locally induced fracture healing response. We report a case of a 78-year-old patient who presented with a distal femoral non-union above a previously fused knee, which was successfully managed with exchange nailing and intramedullary delivery of recombinant human bone morphogenetic protein-7 (rhBMP-7)

Turning agricultural wastes into biomaterials: Assessing the sustainability of scenarios of circular valorization of corn cob in a life-cycle perspective

Circular economy plays a key role in increasing the sustainability of the agricultural sector, given the countless possibilities of transforming crop residues and recycling precious resources. The maize cultivation process produces a significant amount of residual organic materials, commonly left on the field, as a soil conditioner and source of nutrients even if some parts, such as the cob, play a minor role in these actions. The solutions for the valorization of this remnant depend on economic and environmental factors and the evaluation of the environmental performances of the processes in a life-cycle perspective is important to compare the overall sustainability of the valorization alternatives, maximizing their environmental added value. This work reports the results of Life Cycle Analysis, from cradle-to-gate of corn cob valorized as a raw material in two scenarios: corn cob pellet and corn cob abrasive grits to use as blasting or finishing media. A comparative study has been performed with two products available on the market and with the same functions. The results show that cob-based products have lower impact than those currently used. The work provides indication for evaluating the benefits of turning agricultural wastes in natural-based materials and intends to promote circular economy processes in agriculture production

Behavior and welfare of undocked heavy pigs raised in buildings with different ventilation systems

The present study aimed to evaluate animal welfare of pigs from the same farm, raised with two ventilation systems. The study involved 60 pens of fattening pigs, raised in two buildings: one naturally ventilated (NV) and the other mechanically ventilated (MV). Pigs were assessed on three observation days: at 40 kg (T1), 100 kg (T2), and 160 kg (T3) of live weight. Animal-based measures were used such as qualitative behavioral analysis (QBA), behavioral measures (BMs), and lesion and health measures (LHMs). Housing conditions (HCs) measured at each observation day were the number of pigs per pen, space allowance, temperature, light, and CO2. The association study was performed using a general linear model and analysis of variance. Ventilation effect was analyzed by performing computational fluid dynamics. Results showed that overall pigs raised in the MV were in a more positive affective state. Despite that, with hot temperatures, the higher oc-currence of pig soiling indicated heat stress in pigs and consequent welfare impairment. The higher frequency of pigs showing dog sitting behavior at T2 and T3 suggest welfare worsening in the last phases of fattening. The study concludes that ventilation system influences animal behavior and overall animal welfare, especially during the warmer season

Methodology for sensor calibration in agro-industrial facilities

The rising need of precision in several sectors, agriculture included, brings to the development of new monitoring systems customised for the specific application. These systems often take advantages of probes offered by the market, however, the integration between market probes and home-built systems, requires tests to validate the recorded measurements.This paper provides a methodology to perform a calibration procedure when the probes fail the validation test.The results show the comparison of the measurements collected by investigated sensors and reference sensor coupled with the application of simple correlation methods can bring to an improvement of the sensor precision as far as to pass the validation test

Unstable pelvic fractures in women: implications on obstetric outcome

Purpose Obstetric outcomes in women following pelvic injuries requiring surgical fixation is not thoroughly known. We aimed to evaluate if radiographic measurements (RMs) can be used to provide information on delivery methods outcome after these injuries, and to evaluate if metal work removal is required prior to delivery. Method A retrospective study in a level 1 trauma centre of female patients with pelvic fractures treated operatively, aged 16–45 at the time of injury. Participants completed a questionnaire regarding their obstetric history. RM evaluating pelvic symmetry, displacement, and pelvimetry were conducted on postoperative radiographs and CT scans. Patients who gave birth after the injury were divided to two groups according to the delivery method: vaginal delivery (VD) and caesarean section (CS). These two groups RM were compared. Results Forty-four patients were included, comparison of the RM of patients who delivered by CS (9) and patients who had only VD (11) showed no significant difference between the groups. Two patients underwent a trial of VD who subsequently underwent urgent CS due to prolonged labour, their RM were below the average and their pelvimetry measurements were above the cut-off for CS recommendation. Eleven patients had uncomplicated VD, all had retained sacroiliac screws at the time of delivery and one patient had an anterior pubic plate. Conclusion Postoperative RM did not show an effect on delivery method of women after pelvic fracture fixation. A relatively high number of patients who underwent normal vaginal delivery had retained sacroiliac screws. These findings can form the foundation for larger cohort studies

Epidemiologia dos pacientes com hemorragia digestiva alta atendidos no Hospital Regional de Sobradinho

Objetivo: Estabelecer o perfil clínico e epidemiológico dos pacientes atendidos como urgência no setor de Endoscopia Digestiva do Hospital Regional de Sobradinho com protocole de rastreamento de hemorragia digestiva alta no período janeiro de 2019 a dezembro de 2019.Métodos: Trata-se de um estudo descritivo e exploratório, do tipo transversal. Para tanto, será utilizada uma abordagem quantitativa. Assim, foram analisados os prontuários dos pacientes contidos no Track Care que realizaram endoscopia digestiva alta solicitadas com a hipótese diagnóstica de hemorragia digestiva alta no pedido, no Hospital Regional de Sobradinho entre janeiro e dezembro de 2019.Resultados: Foram registrados 137 casos, a idade média foi de 61,7 anos. Registrada maior ocorrência no sexo masculino (61%). A grande maioria dos pacientes (88%) possuía uma ou mais comorbidades prévias. A mortalidade global foi de 27%.Conclusão: A hemorragia pode trazer um risco à vida e a terapêutica endoscópica é um recurso importante para diagnóstico e tratamento das patologias causadoras do sangramento. São necessários mais estudados para que se tenha mais conhecimento sobre o assunto

Inducing social self‐sorting in organic cages to tune the shape of the internal cavity

Many interesting target guest molecules have low symmetry, yet most methods for synthesising hosts result in highly symmetrical capsules. Methods of generating lower symmetry pores are thus required to maximise the binding affinity in host–guest complexes. Herein, we use mixtures of tetraaldehyde building blocks with cyclohexanediamine to access low-symmetry imine cages. Whether a low-energy cage is isolated can be correctly predicted from the thermodynamic preference observed in computational models. The stability of the observed structures depends on the geometrical match of the aldehyde building blocks. One bent aldehyde stands out as unable to assemble into high-symmetry cages-and the same aldehyde generates low-symmetry socially self-sorted cages when combined with a linear aldehyde. We exploit this finding to synthesise a family of low-symmetry cages containing heteroatoms, illustrating that pores of varying geometries and surface chemistries may be reliably accessed through computational prediction and self-sorting

A Meta-Analysis of the Existing Knowledge of Immunoreactivity against Hepatitis C Virus (HCV)

Approximately 3% of the world population is infected by HCV, which represents a major global health challenge. Almost 400 different scientific reports present immunological data related to T cell and antibody epitopes derived from HCV literature. Analysis of all HCV-related epitope hosted in the Immune Epitope Database (IEDB), a repository of freely accessible immune epitope data, revealed more than 1500 and 1900 distinct T cell and antibody epitopes, respectively. The inventory of all data revealed specific trends in terms of the host and the HCV genotypes from which sequences were derived. Upon further analysis we found that this large number of epitopes reflects overlapping structures, and homologous sequences derived from different HCV isolates. To access and visualize this information we developed a novel strategy that assembles large sets of epitope data, maps them onto reference genomes and displays the frequency of positive responses. Compilation of the HCV immune reactivity from hundreds of different studies, revealed a complex and thorough picture of HCV immune epitope data to date. The results pinpoint areas of more intense reactivity or research activities at the level of antibody, CD4 and CD8 responses for each of the individual HCV proteins. In general, the areas targeted by the different effector immune functions were distinct and antibody reactivity was positively correlated with hydrophilicity, while T cell reactivity correlated with hydrophobicity. At the sequence level, epitopes frequently recognized by both T cell and B cell correlated with low variability, and our analysis thus highlighted areas of potential interest for practical applications. The human reactivity was further analyzed to pinpoint differential patterns of reactivity associated with acute versus chronic infection, to reveal the apparent impact of glycosylation on T cell, but not antibody responses, and to highlight a paucity of studies involved antibody epitopes associated with virus neutralization