Retrospective analysis of treatment decisions and clinical outcome of Lisfranc injuries: operative vs. conservative treatment

Purpose: Lisfranc injuries are rare and often pose a challenge for surgeons, particularly in initially missed or neglected cases. The evidence on which subtypes of Lisfranc injuries are suitable for conservative treatment or should undergo surgery is low. The aim of this study was to retrospectively analyze treatment decisions of Lisfranc injuries and the clinical outcome of these patients within the last ten years. Methods: All patients treated due to a Lisfranc injury in a German level I trauma centre from January 2011 until December 2020 were included in this study. Radiologic images and medical data from the patient files were analyzed concerning the classification of injury, specific radiologic variables, such as the Buehren criteria, patient baseline characteristics, and patient outcome reported with the Foot Function Index (FFI). Results: Ninety-nine patients were included in this study (conservative = 20, operative = 79). The overall clinical outcome assessed by the FFI was good (FFI sum 23.93, SD 24.93); patients that were identified as suitable for conservative treatment did not show inferior functional results. Qualitative radiological factors like the grade of displacement and the trauma mechanism were more strongly associated with the decision for surgical treatment than quantitative radiologic factors such as the distance from the first to the second metatarsal bone. Conclusion: If the indication for conservative or operative treatment of Lisfranc injuries is determined correctly, the clinical outcome can be comparable. These decisions should be based on several factors including quantitative and qualitative radiologic criteria, as well as the trauma mechanism

Long-term risk of adverse outcomes according to atrial fibrillation type

Sustained forms of atrial fibrillation (AF) may be associated with a higher risk of adverse outcomes, but few if any long-term studies took into account changes of AF type and co-morbidities over time. We prospectively followed 3843 AF patients and collected information on AF type and co-morbidities during yearly follow-ups. The primary outcome was a composite of stroke or systemic embolism (SE). Secondary outcomes included myocardial infarction, hospitalization for congestive heart failure (CHF), bleeding and all-cause mortality. Multivariable adjusted Cox proportional hazards models with time-varying covariates were used to compare hazard ratios (HR) according to AF type. At baseline 1895 (49%), 1046 (27%) and 902 (24%) patients had paroxysmal, persistent and permanent AF and 3234 (84%) were anticoagulated. After a median (IQR) follow-up of 3.0 (1.9; 4.2) years, the incidence of stroke/SE was 1.0 per 100 patient-years. The incidence of myocardial infarction, CHF, bleeding and all-cause mortality was 0.7, 3.0, 2.9 and 2.7 per 100 patient-years, respectively. The multivariable adjusted (a) HRs (95% confidence interval) for stroke/SE were 1.13 (0.69; 1.85) and 1.27 (0.83; 1.95) for time-updated persistent and permanent AF, respectively. The corresponding aHRs were 1.23 (0.89, 1.69) and 1.45 (1.12; 1.87) for all-cause mortality, 1.34 (1.00; 1.80) and 1.30 (1.01; 1.67) for CHF, 0.91 (0.48; 1.72) and 0.95 (0.56; 1.59) for myocardial infarction, and 0.89 (0.70; 1.14) and 1.00 (0.81; 1.24) for bleeding. In this large prospective cohort of AF patients, time-updated AF type was not associated with incident stroke/SE

Talent management as a management fashion in HRD: towards a research agenda

HRD practitioners have long shown concerns about the status and legitimacy of the occupation, and, arguably, this has not been unconnected to the range of titles HRD has been given over the years. Has there been an element of ‘management fashion’ about this, or have they reflected some real change at the level of practice? This paper considers whether ‘talent management’ (TM), as a recentlyemerged area of interest for HRD, can be argued to display features of a management fashion. On the basis of a review of three main perspectives, we conclude that it is too early to say with regard to two of them, given TM’s recent emergence and the paucity of empirical material, but that TM displays features of institutionalism in TM talk in the business and professional literature. A research agenda, based primarily on institutional theory, is developed and a number of research questions outlined

Near infra-red dyes based on Pyrene Aza-BODIPYs

Pyrene substituted donor-acceptor type NIR aza-BODIPYs were designed and synthesized. The 1,7-positions of aza-BODIPY core were substituted by pyrene moieties and 3,5-positions were substituted with phenyl/2-thienyl or anisyl groups in the aza-BODIPYs. The effect of substituents on their photophysical and electrochemical properties was studied; also computational studies were carried out for the target aza-BODIPYs. These near infrared dyes displayed the lowest energy absorption maxima in the range of 670-738 nm; whereas their emission maxima were centered on ?764 nm. The absorption and emission spectra of aza-BODIPYs were significantly red shifted (72-94 nm) as compared to the parent tetra-phenylaza-BODIPY. Fluorescence studies suggested effective energy transfer (up to 65%) from donor groups to the aza-BODIPY core in all the compounds. TD-DFT studies indicated significant electronic interactions between energy donor groups and aza-BODIPY core in all the aza-BODIPYs. The values of HOMO-LUMO gap (?E) calculated from cyclic voltammetry data were comparable with those obtained from DFT studies.by Iti- Gupta, Naresh Balsukuri, Praseetha E. Kesavan and Nayan Jyoti Borua