Enhancing Splinting Confidence through Inter-Residency Education: An Educational Workshop

Introduction. The initial treatment for many orthopaedic injuries is splinting. Unfortunately, formal musculoskeletal training is limited in primary care leading to deficiencies in competency and confidence. Suboptimal splints can result in complications such as skin breakdown, worsening of deformity, and increased pain. Our orthopaedic surgery clinic often cares for patients who initially present to an emergency department or primary care clinic for their orthopaedic injury. Previous studies have shown that a high number of splints are applied improperly in the primary care setting, which could result in in avoidable skin complications and fracture instability. Methods. Orthopaedic surgery residents held a splinting workshop for family medicine residents. The workshop involved didactic and skills portions. Pre- and post-surveys were administered using a 10-point scale to assess confidence in applying three common splints. The data were analyzed using student’s t-test and qualitative feedback. Results. Confidence in applying and molding each splint type improved significantly (p < 0.05). Knowledge in splint construction improved significantly as well (p < 0.05). Subjective feedback was positive. Conclusion. These results showed inter-residency education can increase residents’ confidence in skill-based medical care significantly. The results are encouraging and should facilitate further collaboration between multispecialty residency programs to improve patient care. Further investigation is needed to determine how well skills gained in workshop are retained

Initial stage of plate lifting from a water surface

This study deals with the flow induced by a rigid flat plate of finite length, initially touching a horizontal water surface, when it starts to move upwards with constant acceleration. In the present model, negative hydrodynamic pressures on the lower (wetted) surface of the plate are allowed, and thus, the water follows the plate due to the resulting suction force. The acceleration of the plate and the plate length are such that gravity, surface tension and viscous effects can be neglected during the early stages of the motion. Under these assumptions, the initial two-dimensional, potential flow caused by the plate lifting is obtained by using the small-time expansion of the velocity potential. This small-time solution is not valid close to the plate edges, as it predicts there singular flow velocities and unbounded displacements of the water-free surface. It is shown that close to the plate edges the flow is nonlinear and self-similar to leading order. This nonlinear flow is computed by the boundary-element method combined with a time-marching scheme. The numerical time-dependent solution approaches the self-similar local solution with time

ExoMol line lists – LI. Molecular line lists for lithium hydroxide (LiOH)

New molecular line lists for lithium hydroxide (6Li16O1H and 7Li16O1H isotopologues) covering wavelengths λ > 1 μ m (0–10 000 cm−1 range) are presented. Each line list contains around 300 million transitions between rotation–vibration energy levels with total angular momentum up to J = 95, applicable for temperatures up to T ≈ 3500 K. Line list calculations were based on a previously published, high-level ab initio potential energy surface and a newly computed dipole moment surface of the ground X~1Σ+ electronic state. Lithium-containing molecules are important in a variety of stellar objects and there is potential for LiOH to be observed in the atmospheres of exoplanets. Transit spectra are simulated using the rocky super-Earth 55 Cancri e as an example with two different atmospheric scenarios including LiOH. This work provides the first, comprehensive line lists of LiOH to facilitate its future molecular detection. The OYT7 line lists along with the associated temperature- and pressure-dependent molecular opacities can be downloaded from the ExoMol database at www.exomol.com and the CDS astronomical database

The contribution of diet and genotype to iron status in women:a classical twin study

This is the first published report examining the combined effect of diet and genotype on body iron content using a classical twin study design. The aim of this study was to determine the relative contribution of genetic and environmental factors in determining iron status. The population was comprised of 200 BMI- and age-matched pairs of MZ and DZ healthy twins, characterised for habitual diet and 15 iron-related candidate genetic markers. Variance components analysis demonstrated that the heritability of serum ferritin (SF) and soluble transferrin receptor was 44% and 54% respectively. Measured single nucleotide polymorphisms explained 5% and selected dietary factors 6% of the variance in iron status; there was a negative association between calcium intake and body iron (p = 0.02) and SF (p = 0.04)

Inside-Out Evacuation of Transitional Protoplanetary Disks by the Magneto-Rotational Instability

How do T Tauri disks accrete? The magneto-rotational instability (MRI) supplies one means, but protoplanetary disk gas is typically too poorly ionized to be magnetically active. Here we show that the MRI can, in fact, explain observed accretion rates for the sub-class of T Tauri disks known as transitional systems. Transitional disks are swept clean of dust inside rim radii of ~10 AU. Stellar coronal X-rays ionize material in the disk rim, activating the MRI there. Gas flows from the rim to the star, at a rate limited by the depth to which X-rays ionize the rim wall. The wider the rim, the larger the surface area that the rim wall exposes to X-rays, and the greater the accretion rate. Interior to the rim, the MRI continues to transport gas; the MRI is sustained even at the disk midplane by super-keV X-rays that Compton scatter down from the disk surface. Accretion is therefore steady inside the rim. Blown out by radiation pressure, dust largely fails to accrete with gas. Contrary to what is usually assumed, ambipolar diffusion, not Ohmic dissipation, limits how much gas is MRI-active. We infer values for the transport parameter alpha on the order of 0.01 for GM Aur, TW Hyd, and DM Tau. Because the MRI can only afflict a finite radial column of gas at the rim, disk properties inside the rim are insensitive to those outside. Thus our picture provides one robust setting for planet-disk interaction: a protoplanet interior to the rim will interact with gas whose density, temperature, and transport properties are definite and decoupled from uncertain initial conditions. Our study also supplies half the answer to how disks dissipate: the inner disk drains from the inside out by the MRI, while the outer disk photoevaporates by stellar ultraviolet radiation.Comment: Accepted to Nature Physics June 7, 2007. The manuscript for publication is embargoed per Nature policy. This arxiv.org version contains more technical details and discussion, and is distributed with permission from the editors. 10 pages, 4 figure

Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance.

INTRODUCTION: 2018 World Health Organization (WHO) guidelines for the treatment of isoniazid (H)-resistant (Hr) tuberculosis recommend a four-drug regimen: rifampicin (R), ethambutol (E), pyrazinamide (Z) and levofloxacin (Lfx), with or without H ([H]RZE-Lfx). This is used once Hr is known, such that patients complete 6 months of Lfx (≥6[H]RZE-6Lfx). This cohort study assessed the impact of fluoroquinolones (Fq) on treatment effectiveness, accounting for Hr mutations and degree of phenotypic resistance. METHODS: This was a retrospective cohort study of 626 Hr tuberculosis patients notified in London, 2009-2013. Regimens were described and logistic regression undertaken of the association between regimen and negative regimen-specific outcomes (broadly, death due to tuberculosis, treatment failure or disease recurrence). RESULTS: Of 594 individuals with regimen information, 330 (55.6%) were treated with (H)RfZE (Rf=rifamycins) and 211 (35.5%) with (H)RfZE-Fq. The median overall treatment period was 11.9 months and median Z duration 2.1 months. In a univariable logistic regression model comparing (H)RfZE with and without Fqs, there was no difference in the odds of a negative regimen-specific outcome (baseline (H)RfZE, cluster-specific odds ratio 1.05 (95% CI 0.60-1.82), p=0.87; cluster NHS trust). Results varied minimally in a multivariable model. This odds ratio dropped (0.57, 95% CI 0.14-2.28) when Hr genotype was included, but this analysis lacked power (p=0.42). CONCLUSIONS: In a high-income setting, we found a 12-month (H)RfZE regimen with a short Z duration to be similarly effective for Hr tuberculosis with or without a Fq. This regimen may result in fewer adverse events than the WHO recommendations

Editorial: Wheat biofortification to alleviate global malnutrition

According to the latest FAO report on the state of food security and nutrition in the world (1), more than 720 million people faced hunger, and around 3 billion people did not have access to a healthy diet. All these problematics, exacerbated by the current COVID-19 crisis, led to an increase in the number of people affected by the so-called hidden hunger, caused by an inadequate intake of essential micronutrients (MNs) such as iron (Fe), zinc (Zn), selenium (Se) and provitamin A. Biofortification, intended as the improvement of the nutritional quality of food crops through either conventional breeding, agronomic practices ormodern biotechnologies, represents a sustainable, costeffective and long-term approach to alleviate micronutrient-deficiency. Staple crops are typically the major target of most biofortification studies, given their central role in human diet. Wheat, specifically, contributes to around 20% of the total energy and protein intake and to around 30% of the Fe and Zn intake worldwide. However, the current level of MNs present in most wheat-derived food products is not enough to meet the minimum daily intake, especially in the poorest regions of the world. For these reasons, continuing to work on wheat biofortification is fundamental to ensure the production of nutritious and sustainable food and to contribute to the reduction of MNs deficiency

Testing superabsorbent polymer (SAP) sorption properties prior to implementation in concrete: results of a RILEM Round-Robin Test

This article presents the results of a round-robin test performed by 13 international research groups in the framework of the activities of the RILEM Technical Committee 260 RSC "Recommendations for use of superabsorbent polymers in concrete construction''. Two commercially available superabsorbent polymers (SAP) with different chemical compositions and gradings were tested in terms of their kinetics of absorption in different media; demineralized water, cement filtrate solution with a particular cement distributed to every participant and a local cement chosen by the participant. Two absorption test methods were considered; the tea-bag method and the filtration method. The absorption capacity was evaluated as a function of time. The results showed correspondence in behaviour of the SAPs among all participants, but also between the two test methods, even though high scatter was observed at early minutes of testing after immersion. The tea-bag method proved to be more practical in terms of time dependent study, whereby the filtration method showed less variation in the absorption capacity after 24 h. However, absorption followed by intrinsic, ionmediated desorption of a specific SAP sample in the course of time was not detected by the filtration method. This SAP-specific characteristic was only displayed by the tea-bag method. This demonstrates the practical applicability of both test methods, each one having their own strengths and weaknesses at distinct testing times

OPV strains circulation in HIV infected infants after National Immunisation Days in Bangui, Central African Republic

<p>Abstract</p> <p>Background</p> <p>Humans are the only host of polioviruses, thus the prospects of global polio eradication look reasonable. However, individuals with immunodeficiencies were shown to excrete vaccine derived poliovirus for long periods of time which led to reluctance to prolong the vaccination campaign for fear of this end result. Therefore, we aimed to assess the duration of excretion of poliovirus after the 2001 National Immunization Days according to Human immunodeficiency virus status.</p> <p>Findings</p> <p>Fifty three children were enrolled. Sequential stool samples were collected in between National Immunisation Days rounds and then every month during one year. Children were classified into 2 groups: no immunodepression (n = 38), immunodepression (n = 15) according to CD4+ lymphocytes cells count. Thirteen poliovirus strains were isolated from 11 children: 5 Human immunodeficiency virus positive and 6 Human immunodeficiency virus negative. None of the children excreted poliovirus for more than 4 weeks. The restriction fragment length polymorphism analysis showed that all strains were of Sabin origin including a unique Polio Sabine Vaccine types 2 and 3 (S2/S3) recombinant.</p> <p>Conclusions</p> <p>From these findings we assume that Human immunodeficiency virus positive children are not a high risk population for long term poliovirus excretion. More powerful studies are needed to confirm our findings.</p