Comparison of Joint Compression and Pull- Out Strength of 6.5-mm Self-Drilling Screws With Headed and Headless in Subtalar Arthrodesis: A Pilot Study

Background: In patients with degenerative osteoarthritis of the subtalar joint, surgical treatment can include subtalar arthrodesis. Notably, mechanical factors such as compression and pull-out strength contribute to successful union, which can be achieved through use of headed or headless cannulate screws. The purpose of this study was to compare the resultant joint compressive force and pull-out strength between use of a headless 6.5-mm self-drilling cannulated compression screw and a more traditional headed 6.5- mm self-drilling cannulated compression screw. Methods: This study used the calcaneus and talus from six paired fresh frozen specimens. The soft tissues were stripped and the joint was separated. Fujifilm Prescale Compression Paper (Minato, Tokyo, Japan) was placed in the subtalar joint, and both the talus and calcaneus were fixed with either traditional headed or a headless cannulated screw. Pull-out strength was measured by fixing the fused subtalar joints to a servohydraulic activator and measuring peak load at failure in distraction. Imaging analysis of the compression paper determined peak compression across the joint. Results: The resultant joint compressive force and pull-out strength were not statistically different between use of headed and headless cannulated compression screws (P = 0.30 and P = 0.67, respectively). Conclusions: In a small sample, use of headless cannulated compression screws offered equivalent joint compression as that of a headed screw in subtalar arthrodesis and showed equivalent resistance to pullout force

Biomechanical Strength and Bulk Comparisons Between the Open-Book Technique and the Pulvertaft Method for Peroneal Tendon Transfer: A Pilot Study

Background: The Pulvertaft method has classically been used for the transfer of various tendon injuries owing to its biomechanical strength; however, this method has been shown to be bulky. We describe the open-book technique, which can offer comparable structural integrity with a decreased bulk. The purpose of this study was to determine whether the openbook technique is biomechanically equivalent to the Pulvertaft method for treating peroneal tendon injuries. Methods: We evaluated five pairs of human cadaveric ankles. Within each pair, one specimen was randomly assigned to either the Pulvertaft or the open-book group. Using sharp dissection, the tendons were severed in a standardized method. Transfer was performed using one of the two randomly assigned techniques. The transferred peroneal tendons were stressed on a mechanical tensioning device until failure. Data were recorded and analysis was performed. Results: There was a statistically significant difference (P \u3c 0.001) between the thickness of the Pulvertaft method (7.6 mm) and open-book technique (5.7 mm). There was also a statistically significant difference in elongation, with the Pulvertaft undergoing more elongation at yield (9.7 mm vs 3.7 mm, respectively; P = 0.04). No statistical difference was detected in elongation at peak (P = 0.52), load at yield (P = 0.9), or peak load (P = 0.69). Conclusions: The open-book technique appears to be a viable biomechanical alternative to the Pulvertaft method for peroneal tendon transfer. The peak load, load at yield, and elongation at peak were biomechanically equivalent. The open-book technique was found to provide a significant decrease in thickness, which could prove advantageous when dealing with anatomical locations

Access to primary care for socio-economically disadvantaged older people in rural areas: a qualitative study

Objective: We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Methods: Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Findings: Older people’s experience can be understood within the context of a patient perceived set of unwritten rules or social contract – an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes Health professionals’ described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Conclusion: Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service

Isolation and growth rates of methanol utilizing rhodospirillaceae.

38 pure culture strains belonging to seven species of the Rhodospirillaceae were isolated from 39 methanol enrichment cultures inoculated with water and mud samples of different habitats. None of the strains exhibited doubling times shorter than 10 h in methanol-bicarbonate media

Effects of protein on fermentation and fiber disappearance in vitro using an equine cecal inoculum

The purpose of this experiment is to determine the effects of varying protein sources on in vitro fermentation characteristics and fiber disappearance utilizing an equine cecal fluid inoculum. Experimental design consisted of a completely randomized design with 4 replications (horse). Treatments consisted of protein source (no protein, casein, whey, soybean meal, plasma, L-lysine, and fishmeal). Cecal fluid was acquired from 4 cecally cannulated horses consuming a diet of smooth bromegrass hay (1.5% BW) and commercial concentrate (0.5% BW). Strain and stratified cecal fluid was mixed with McDougal’s buffer, substrates, and respective treatments and then incubated for 48 hours in a shaking incubator at 39°C. Gas pressure was continuously recorded and terminal concentrations of DM, OM, NDF, ADF, and VFA (acetate, propionate, butyrate, Valerate and Isovalerate) were determined. Compared to the control, casein, soybean meal, whey, plasma, L-lysine, and fishmeal increased (P < 0.05) DM disappearance and acetate production. NDF and ADF disappearance was greater (P < 0.05) for all protein sources when compared to control. Total VFA concentrations increased (P < 0.05) with all protein sources when compared to the control. Results from this experiment demonstrate that fiber disappearance of a low quality can be enhanced via supplemental protein, regardless of source. Similarly, protein increases VFA production which can be attributed to greater microbial activity and/or populations. Protein sources with greater solubility appear to be more effective at improving fiber disappearance and VFA production although this observation was not statistically significant. Future work in vivo is warranted to determine if the same effects would be observed in the equine