Mid-term functional outcome after the internal fixation of distal radius fractures

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate. Methods 180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation = 10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand (DASH) and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union. Results The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%). Conclusion This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention.Peer Reviewe

Simulation of carbon fibre composites in an industrial microwave

The ability of microwave radiation to penetrate and interact directly with materials has led to its extensive use in food and drug industries, and more recently in composites manufacturing. Microwave heating of composites allows rapid heat transfer throughout the material thickness with reduced thermal gradients and processing times as well as energy efficiency. Design of microwave systems to process composite parts with various geometries and sizes demands improved understanding of electromagnetic energy distribution and factors influencing it. Finite-element (FE) models can be efficient design tools in such cases, as physical experimentation can be impractical. In this study, a fully-coupled FE model of a carbon fibre composite in an industrial microwave environment is developed using COMSOL Multiphysics®. The effects of the heating process parameters including the number of active magnetrons, specimen thickness and the variation in the frequency of radiation on the electromagnetic field distribution are studied. The FE model showed that a substantial difference in the electromagnetic field distribution exists for the frequencies above 1 GHz compared to the lower frequencies in the microwave regime, resulting in non-uniform heating

Evidence for complete and partial surface renewal at an air-water interface

A wind-wave flume is used to determine the extent to which the thermal boundary layer (TBL) at a wind-forced air-water interface is completely renewed from below. We measure skin temperature, Tskin, radiometrically, temperature immediately below the TBL, Tsubskin, using a temperature profiler, and net heat flux using the gradient flux technique. The Tskin probability density function, p(Tskin), and surface renewal time scale, τ, were measured using passive and active infrared imaging techniques, respectively. We find that the mean percentile rank of Tsubskin in p(Tskin) is 99.90, implying that complete surface renewal occurs. This result suggests an alternative to radiometric measurement of Tskin through the simple combination of an infrared camera and an in situ temperature sensor. Comparison of the temperature difference across the TBL to the expected cooling implies that a significant portion of events only partially renew the TBL. This result should impact efforts to improve air-sea transfer models

Global tropospheric ozone modelling:quantifying errors due to grid resolution.

Ozone production in global chemical models is dependent on model resolution because ozone chemistry is inherently nonlinear, the timescales for chemical production are short, and precursors are artificially distributed over the spatial scale of the model grid. In this study we examine the sensitivity of ozone, its precursors, and its production to resolution by running a global chemical transport model at four different resolutions between T21 (5.6° × 5.6°) and T106 (1.1° × 1.1°) and by quantifying the errors in regional and global budgets. The sensitivity to vertical mixing through the parameterization of boundary layer turbulence is also examined. We find less ozone production in the boundary layer at higher resolution, consistent with slower chemical production in polluted emission regions and greater export of precursors. Agreement with ozonesonde and aircraft measurements made during the NASA TRACE-P campaign over the western Pacific in spring 2001 is consistently better at higher resolution. We demonstrate that the numerical errors in transport processes on a given resolution converge geometrically for a tracer at successively higher resolutions. The convergence in ozone production on progressing from T21 to T42, T63, and T106 resolution is likewise monotonic but indicates that there are still large errors at 120 km scales, suggesting that T106 resolution is too coarse to resolve regional ozone production. Diagnosing the ozone production and precursor transport that follow a short pulse of emissions over east Asia in springtime allows us to quantify the impacts of resolution on both regional and global ozone. Production close to continental emission regions is overestimated by 27% at T21 resolution, by 13% at T42 resolution, and by 5% at T106 resolution. However, subsequent ozone production in the free troposphere is not greatly affected. We find that the export of short-lived precursors such as NO x by convection is overestimated at coarse resolution

Gene expression drives the evolution of dominance.

Dominance is a fundamental concept in molecular genetics and has implications for understanding patterns of genetic variation, evolution, and complex traits. However, despite its importance, the degree of dominance in natural populations is poorly quantified. Here, we leverage multiple mating systems in natural populations of Arabidopsis to co-estimate the distribution of fitness effects and dominance coefficients of new amino acid changing mutations. We find that more deleterious mutations are more likely to be recessive than less deleterious mutations. Further, this pattern holds across gene categories, but varies with the connectivity and expression patterns of genes. Our work argues that dominance arises as a consequence of the functional importance of genes and their optimal expression levels

3D Finite Element Modelling of Cutting Forces in Drilling Fibre Metal Laminates and Experimental Hole Quality Analysis

Machining Glass fibre aluminium reinforced epoxy (GLARE) is cumbersome due to distinctively different mechanical and thermal properties of its constituents, which makes it challenging to achieve damage-free holes with the acceptable surface quality. The proposed work focuses on the study of the machinability of thin (~2.5 mm) GLARE laminate. Drilling trials were conducted to analyse the effect of feed rate and spindle speed on the cutting forces and hole quality. The resulting hole quality metrics (surface roughness, hole size, circularity error, burr formation and delamination) were assessed using surface profilometry and optical scanning techniques. A three dimensional (3D) finite-element (FE) model of drilling GLARE laminate was also developed using ABAQUS/Explicit to help understand the mechanism of drilling GLARE. The homogenised ply-level response of GLARE laminate was considered in the FE model to predict cutting forces in the drilling process

Concise Reporting of Benign Endometrial Biopsies is an Acceptable Alternative to Descriptive Reporting

In the United Kingdom, endometrial biopsy reports traditionally consist of a morphologic description followed by a conclusion. Recently published consensus guidelines for reporting benign endometrial biopsies advocate the use of standardized terminology. In this project we aimed to assess the acceptability and benefits of this simplified "diagnosis only" format for reporting non-neoplastic endometrial biopsies. Two consultants reported consecutive endometrial biopsies using 1 of 3 possible formats: (i) diagnosis only, (ii) diagnosis plus an accompanying comment, and (iii) the traditional descriptive format. Service users were asked to provide feedback on this approach via an anonymized online survey. The reproducibility of this system was assessed on a set of 53 endometrial biopsies among consultants and senior histopathology trainees. Of 370 consecutive benign endometrial biopsies, 245 (66%) were reported as diagnosis only, 101 (27%) as diagnosis plus a brief comment, and 24 (7%) as diagnosis following a morphologic description. Of the 43 survey respondents (28 gynecologists, 11 pathologists, and 4 clinical nurse specialists), 40 (93%) preferred a diagnosis only, with 3 (7%) being against/uncertain about a diagnosis only report. Among 3 histopathology consultants and 4 senior trainees there was majority agreement on the reporting format in 53/53 (100%) and 52/53 (98%) biopsies. In summary, we found that reporting benign specimens within standardized, well-understood diagnostic categories is an acceptable alternative to traditional descriptive reporting, with the latter reserved for the minority of cases that do not fit into specific categories. This revised approach has the potential to improve reporting uniformity and reproducibility

Long-term results of diaphragmatic plication in adults with unilateral diaphragm paralysis

<p>Abstract</p> <p>Background</p> <p>In this study we aimed to evaluate the long-term outcome of diaphragmatic plication for symptomatic unilateral diaphragm paralysis.</p> <p>Methods</p> <p>Thirteen patients who underwent unilateral diaphragmatic plication (2 patients had right, 11 left plication) between January 2003 and December 2006 were evaluated. One patient died postoperatively due to sepsis. The remaining 12 patients [9 males, 3 females; mean age 60 (36-66) years] were reevaluated with chest radiography, flouroscopy or ultrasonography, pulmonary function tests, computed tomography (CT) or magnetic resonance imaging (MRI), and the MRC/ATS dyspnea score at an average of 5.4 (4-7) years after diaphragmatic plication.</p> <p>Results</p> <p>The etiology of paralysis was trauma (9 patients), cardiac by pass surgery (3 patients), and idiopathic (1 patient). The principle symptom was progressive dyspnea with a mean duration of 32.9 (22-60) months before surgery. All patients had an elevated hemidiaphragm and paradoxical movement radiologically prior to surgery. There were partial atelectasis and reccurent infection of the lower lobe in the affected side on CT in 9 patients. Atelectasis was completely improved in 9 patients after plication. Preoperative spirometry showed a clear restrictive pattern. Mean preoperative FVC was 56.7 ± 11.6% and FEV1 65.3 ± 8.7%. FVC and FEV1 improved by 43.6 ± 30.6% (p < 0.001) and 27.3 ± 10.9% (p < 0.001) at late follow-up. MRC/ATS dyspnea scores improved 3 points in 11 patients and 1 point in 1 patient at long-term (p < 0.0001). Eight patients had returned to work at 3 months after surgery.</p> <p>Conclusions</p> <p>Diaphragmatic plication for unilateral diaphragm paralysis decreases lung compression, ensures remission of symptoms, and improves quality of life in long-term period.</p