Gait analysis and functional outcome in patients after Lisfranc injury treatment

Introduction: Lisfranc injuries involve any bony or ligamentous disruption of the tarsometatarsal joint. Outcome results after treatment are mainly evaluated using patient-reported outcome measures (PROM), physical examination and radiographic findings. Less is known about the kinematics during gait.Methods: Nineteen patients (19 feet) treated for Lisfranc injury were recruited. Patients with conservative treatment and surgical treatment consisting of open reduction and internal fixation (ORIF) or primary arthrodesis were included. PROM, radiographic findings and gait analysis using the Oxford Foot Model (OFM) were analysed. Results were compared with twenty-one healthy subjects (31 feet). Multivariable logistic regression was used to determine factors influencing outcome.Results: Patients treated for Lisfranc injury had a significantly lower walking speed than healthy subjects (P &lt;0.001). There was a significant difference between the two groups regarding the range of motion (ROM) in the sagittal plane (flexion-extension) in the midfoot durieng the push-off phase (p &lt;0.001). The ROM in the sagittal plane was significantly correlated with the AOFAS midfoot score (r2 = 0.56, p = 0.012), FADI (r(2) = 0.47, p = 0.043) and the SF-36-physical impairment score (r(2) = 0.60, p = 0.007) but not with radiographic parameters for quality of reduction. In a multivariable analysis, the best explanatory factors were ROM in the sagittal plane during the push-off phase (beta = 0.707, p = 0.001), stability (beta = 0.423, p = 0.028) and BMI (beta = -0.727 p = &lt;0.001). This prediction model explained 87% of patient satisfaction.Conclusions: This study showed that patients treated for Lisfranc injury had significantly lower walking speed and significantly lower flexion/extension in the midfoot than healthy subjects. The ROM in these patients was significantly correlated with PROM, but not with radiographic quality of reduction. Most important satisfaction predictors were BMI, ROM in the sagittal plane during the push-off phase and fracture stability. (c) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.</p

Leveraging Library Ecology: Growing Beyond Boundaries to Cultivate a Sustainable Knowledge Community Through Team-Based Librarianship

Higher education increasingly challenges libraries to thrive while adapting to fiscal realities, imploring institutions to accomplish more with less, and leverage assets creatively. When competing demands vie for attention, interdisciplinary concepts such as sustainability may be neglected, or simply absent from a library’s mission. A team-based community of librarians can galvanize existing assets wherever they reside within an organization. This approach requires that librarians transcend traditional boundaries to reveal untapped or underutilized expertise. Interdepartmental teams within a library can address topics difficult to assign to one designated specialist, and access the education, interests, or networks possessed by multiple individuals across an organization. A matrix model addressing this concept has been administered at K-State Libraries, and the following paper provides expanded insight into how such concepts have been handled within the organization

Leveraging Library Ecology: Growing Beyond Boundaries to Cultivate a Sustainable Knowledge Community Through Team-Based Librarianship

Higher education increasingly challenges libraries to thrive while adapting to fiscal realities, imploring institutions to accomplish more with less, and leverage assets creatively. When competing demands vie for attention, interdisciplinary concepts such as sustainability may be neglected, or simply absent from a library’s mission. A team-based community of librarians can galvanize existing assets wherever they reside within an organization. This approach requires that librarians transcend traditional boundaries to reveal untapped or underutilized expertise. Interdepartmental teams within a library can address topics difficult to assign to one designated specialist, and access the education, interests, or networks possessed by multiple individuals across an organization. A matrix model addressing this concept has been administered at K-State Libraries, and the following paper provides expanded insight into how such concepts have been handled within the organization

Post-extubation stridor after prolonged intubation in the pediatric intensive care unit (PICU): a prospective observational cohort study

Purpose: Prolonged endotracheal intubation may lead to laryngeal damage, with stridor being the most relevant clinical symptom. Our objective was to determine the incidence of post-extubation stridor and their clinical consequences in children within a tertiary referral center and to identify contributing factors. Methods: 150 children, aged 0–16 years, intubated for more than 24 h were prospectively enrolled until discharge of the hospital. Potential relevant factors, thought to mediate the risk of laryngeal damage, were recorded and analyzed. Results: The median duration of intubation was 4 days, ranging from 1 to 31 days. Stridor following extubation occurred in 28 patients (18.7%); 3 of them required reintubation due t

Prevalence of permanent neonatal hearing impairment: systematic review and Bayesian meta-analysis

Objective: To investigate the variance in reported prevalence rates of permanent neonatal hearing impairment (HI) worldwide. Design: A systematic review and meta-analysis was performed on reported prevalence rates of sensorineural and permanent conductive or mixed HI worse than 40 dB in neonates, detected as a result of a screening programme or audiometric study. Study sample: For meta-analysis, 35 articles were selected, 25 from high-income countries and 10 from middle-income countries according to the world bank classification system. Results: The prevalence rate of permanent uni- and bilateral HI worse than 40 dB in neonates varied from 1 to 6 per 1000, the overall prevalence was 2.21 per 1000 [1.71, 2.8]. In NICU populations the prevalence rate was higher with a larger fraction of bilateral cases. Although not significant, prevalence rates were slightly higher in Asia compared to Europe and the number of infants lost to follow-up appeared higher in countries with lower gross national income. Conclusion: Substantial variations exist in prevalence rates of neonatal permanent HI across countries and regions. There is a strong need for more data from low-income countries to identify demographic factors that account for this variability in reported prevalence rates. Reporting these data in a uniform way is advocated

Recurrent patterns of DNA copy number alterations in tumors reflect metabolic selection pressures.

Copy number alteration (CNA) profiling of human tumors has revealed recurrent patterns of DNA amplifications and deletions across diverse cancer types. These patterns are suggestive of conserved selection pressures during tumor evolution but cannot be fully explained by known oncogenes and tumor suppressor genes. Using a pan-cancer analysis of CNA data from patient tumors and experimental systems, here we show that principal component analysis-defined CNA signatures are predictive of glycolytic phenotypes, including 18F-fluorodeoxy-glucose (FDG) avidity of patient tumors, and increased proliferation. The primary CNA signature is enriched for p53 mutations and is associated with glycolysis through coordinate amplification of glycolytic genes and other cancer-linked metabolic enzymes. A pan-cancer and cross-species comparison of CNAs highlighted 26 consistently altered DNA regions, containing 11 enzymes in the glycolysis pathway in addition to known cancer-driving genes. Furthermore, exogenous expression of hexokinase and enolase enzymes in an experimental immortalization system altered the subsequent copy number status of the corresponding endogenous loci, supporting the hypothesis that these metabolic genes act as drivers within the conserved CNA amplification regions. Taken together, these results demonstrate that metabolic stress acts as a selective pressure underlying the recurrent CNAs observed in human tumors, and further cast genomic instability as an enabling event in tumorigenesis and metabolic evolution

Constraint Programming for LNG Ship Scheduling and Inventory Management

Abstract We propose a constraint programming approach for the optimization of inventory routing in the liquefied natural gas industry. We present two constraint programming models that rely on a disjunctive scheduling representation of the problem. We also propose an iterative search heuristic to generate good feasible solutions for these models. Computational results on a set of largescale test instances demonstrate that our approach can find better solutions than existing approaches based on mixed integer programming, while being 4 to 10 times faster on average

Narrative-based computational modelling of the Gp130/JAK/STAT signalling pathway.

BACKGROUND: Appropriately formulated quantitative computational models can support researchers in understanding the dynamic behaviour of biological pathways and support hypothesis formulation and selection by "in silico" experimentation. An obstacle to widespread adoption of this approach is the requirement to formulate a biological pathway as machine executable computer code. We have recently proposed a novel, biologically intuitive, narrative-style modelling language for biologists to formulate the pathway which is then automatically translated into an executable format and is, thus, usable for analysis via existing simulation techniques. RESULTS: Here we use a high-level narrative language in designing a computational model of the gp130/JAK/STAT signalling pathway and show that the model reproduces the dynamic behaviour of the pathway derived by biological observation. We then "experiment" on the model by simulation and sensitivity analysis to define those parameters which dominate the dynamic behaviour of the pathway. The model predicts that nuclear compartmentalisation and phosphorylation status of STAT are key determinants of the pathway and that alternative mechanisms of signal attenuation exert their influence on different timescales. CONCLUSION: The described narrative model of the gp130/JAK/STAT pathway represents an interesting case study showing how, by using this approach, researchers can model biological systems without explicitly dealing with formal notations and mathematical expressions (typically used for biochemical modelling), nevertheless being able to obtain simulation and analysis results. We present the model and the sensitivity analysis results we have obtained, that allow us to identify the parameters which are most sensitive to perturbations. The results, which are shown to be in agreement with existing mathematical models of the gp130/JAK/STAT pathway, serve us as a form of validation of the model and of the approach itself