Isolated displaced non-union of a triquetral body fracture: a case report

<p>Abstract</p> <p>Introduction</p> <p>Fractures of the body of the triquetral bone are the second most common carpal fractures, and these fractures can be missed on plain X-ray. Although non-union of triquetral body fractures is very rare, such cases are associated with considerable morbidity and reduction in functional activity.</p> <p>Case presentation</p> <p>We report the case of a 29-year-old Caucasian British man who sustained an isolated displaced triquetral body fracture that resulted in non-union, who was treated surgically. We describe an original operative management for this debilitating injury. An open reduction and internal fixation using double headed compression screws was performed, without bone grafting, and with early immobilization of the wrist.</p> <p>Conclusions</p> <p>We propose this novel approach and advocate early clinical suspicion of triquetral body fractures in patients with a history of fall on an outstretched hand and ulnar sided wrist pain. We recommend evaluation using computed tomography or magnetic resonance imaging scanning.</p

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

Understanding the drivers for spread of SARS-CoV-2 in higher education settings is important to limit transmission between students, and onward spread into at-risk populations. In this study, we prospectively sequenced 482 SARS-CoV-2 isolates derived from asymptomatic student screening and symptomatic testing of students and staff at the University of Cambridge from 5 October to 6 December 2020. We performed a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. After a limited number of viral introductions into the university, the majority of student cases were linked to a single genetic cluster, likely dispersed across the university following social gatherings at a venue outside the university. We identified considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and dramatically reduced following a national lockdown. We observed that transmission clusters were largely segregated within the university or within the community. This study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

COMPARISON OF WASTE DUE TO IRRADIATED STEELS IN THE ESFR AND DEMO

For either nuclear fusion or generation IV fission reactors to be viable as a commercial energy source the decommissioning and waste disposal solutions must be considered during the design. A multi-step simulation process combining Monte Carlo Neutron Transport simulations with inventory simulations have been performed to estimate the activation of steels in key reactor components of the European Sodium-cooled fast Reactor (ESFR). Waste classifications based on UK waste disposal regulations have been applied to the key components to estimate the expected masses of low level and intermediate level waste. The use of reduced activation steels, EUROFER and F82H, in reactor components external to the core results in a factor of 10 reduction in the percentage of waste classified as Intermediate Level Waste (ILW). Waste estimates are compared to existing waste estimates for the European Demonstration fusion reactor (DEMO). The ESFR has a lower percentage of ILW per total reactor mass due to irradiated steels compared to DEMO. However, there is no Higher Activity Waste (HAW) associated with DEMO, compared with arisings from the ESFR spent fission fuel

Catecholamine modulatory effects of nepicastat (RS-25560-197), a novel, potent and selective inhibitor of dopamine-β-hydroxylase

1. Inhibitory modulation of sympathetic nerve function may have a favourable impact on the progression of congestive heart failure. Nepicastat is a novel inhibitor of dopamine-β-hydroxylase, the enzyme which catalyses the conversion of dopamine to noradrenaline in sympathetic nerves. The in vitro pharmacology and in vivo catecholamine modulatory effects of nepicastat were investigated in the present study. 2. Nepicastat produced concentration-dependent inhibition of bovine (IC(50)=8.5±0.8 nM) and human (IC(50)=9.0±0.8  nM)dopamine-β-hydroxylase. The corresponding R-enantiomer (RS-25560-198) was approximately 2–3 fold less potent than nepicastat. Nepicastat had negligible affinity (>10 μM) for twelve other enzymes and thirteen neurotransmitter receptors. 3. Administration of nepicastat to spontaneously hypertensive rats (SHRs) (three consecutive doses of either 3, 10, 30 or 100 mg kg(−1), p.o.; 12 h apart) or beagle dogs (0.05, 0.5, 1.5 or 5 mg kg(−1), p.o.; b.i.d., for 5 days) produced dose-dependent decreases in noradrenaline content, increases in dopamine content and increases in dopamine/noradrenaline ratio in the artery (mesenteric or renal), left ventricle and cerebral cortex. At the highest dose studied, the decreases in tissue noradrenaline were 47%, 35% and 42% (in SHRs) and 88%, 91% and 96% (in dogs) in the artery, left ventricle and cerebral cortex, respectively. When tested at 30 mg kg(−1), p.o., in SHRs, nepicastat produced significantly greater changes in noradrenaline and dopamine content, as compared to the R-enantiomer (RS-25560-198), in the mesenteric artery and left ventricle. 4. Administration of nepicastat (2 mg kg(−1), b.i.d, p.o.) to beagle dogs for 15 days produced significant decreases in plasma concentrations of noradrenaline and increases in plasma concentrations of dopamine and dopamine/noradrenaline ratio. The peak reduction (52%) in plasma concentration of noradrenaline and the peak increase (646%) in plasma concentration of dopamine were observed on day-6 and day-7 of dosing, respectively. 5. The findings of this study suggest that nepicastat is a potent, selective and orally active inhibitor of dopamine-β-hydroxylase which produces gradual modulation of the sympathetic nervous system by inhibiting the biosynthesis of noradrenaline. This drug may, therefore, be of value in the treatment of cardiovascular disorders associated with over-activation of the sympathetic nervous system, such as congestive heart failure

Criminal thinking and self-control among drug users in court mandated treatment

This article aims to explore the relationship between self-control and criminal thinking in a population of drug using offenders attending a court mandated treatment programme, and how this relates to recent offending and substance use. Fifty drug using offenders attending a Birmingham Drug Intervention Programme clinic under the terms of a Drug Rehabilitation Requirement (DRR) completed standardized measures of self-control and criminal thinking. Associations were found between both self-control and criminal thinking and drug use and offending. A strong association was found between low self-control and high criminal thinking. Lower levels of self-control were associated with younger age, and there was some evidence of a link between younger age and higher criminal thinking. The links between drug use and crime are more complex than could be explained by either the self-control model of crime or criminal thinking alone, although the current findings suggest a mediating role for age and indications that drugs-crime linkage is mediated by patterns of substance use and offending