Minimally invasive reconstruction of lateral tibial plateau fractures using the jail technique: a biomechanical study

Background: This study described a novel, minimally invasive reconstruction technique of lateral tibial plateau fractures using a three-screw jail technique and compared it to a conventional two-screw osteosynthesis technique. The benefit of an additional screw implanted in the proximal tibia from the anterior at an angle of 90° below the conventional two-screw reconstruction after lateral tibial plateau fracture was evaluated. This new method was called the jail technique. Methods: The two reconstruction techniques were tested using a porcine model (n = 40). Fracture was simulated using a defined osteotomy of the lateral tibial plateau. Load-to-failure and multiple cyclic loading tests were conducted using a material testing machine. Twenty tibias were used for each reconstruction technique, ten of which were loaded in a load-to-failure protocol and ten cyclically loaded (5000 times) between 200 and 1000 N using a ramp protocol. Displacement, stiffness and yield load were determined from the resulting load displacement curve. Failure was macroscopically documented. Results: In the load-to-failure testing, the jail technique showed a significantly higher mean maximum load (2275.9 N) in comparison to the conventional reconstruction (1796.5 N, p  0.05). In cyclic testing, the jail technique also showed better trends in displacement that were not statistically significant. Failure modes showed a tendency of screws cutting through the bone (cut-out) in the conventional reconstruction. No cut-out but a bending of the lag screws at the site of the additional third screw was observed in the jail technique. Conclusions: The results of this study indicate that the jail and the conventional technique have seemingly similar biomechanical properties. This suggests that the jail technique may be a feasible alternative to conventional screw osteosynthesis in the minimally invasive reconstruction of lateral tibial plateau fractures. A potential advantage of the jail technique is the prevention of screw cut-outs through the cancellous bone.<br

Dust-trapping Rossby vortices in protoplanetary disks

One of the most challenging steps in planet formation theory is the one leading to the formation of planetesimals of kilometre size. A promising scenario involves the existence of vortices able to concentrate a large amount of dust and grains in their centres. Up to now this scenario has been studied mostly in 2D razor thin disks. A 3D study including, simultaneously, the formation and resulting dust concentration of the vortices with vertical settling, was still missing. The Rossby wave instability self-consistently forms 3D vortices, which have the unique quality of presenting a large scale vertical velocity in their centre. Here we aim to study how this newly discovered effect can alter the dynamic evolution of the dust. We perform global 3D simulations of the RWI in a radially and vertically stratified disk using the code MPI-AMRVAC. After the growth phase of the instability, the gas and solid phases are modelled by a bi-fluid approach, where the dust is considered as a fluid without pressure. Both the drag force of the gas on the dust and the back-reaction of the dust on the gas are included. Multiple grain sizes from 1mm to 5cm are used with a constant density distribution. We obtain in a short timescale a high concentration of the largest grains in the vortices. Indeed, in 3 rotations the dust-to-gas density ratio grows from 10^-2 to unity leading to a concentration of mass up to that of Mars in one vortex. The presence of the radial drift is also at the origin of a dust pile-up at the radius of the vortices. Lastly, the vertical velocity of the gas in the vortex causes the sedimentation process to be reversed, the mm size dust is lifted and higher concentrations are obtained in the upper layer than in the mid-plane.Comment: Accepted for publication in Astronomy and Astrophysic

Peaks in the Hartle-Hawking Wave Function from Sums over Topologies

Recent developments in ``Einstein Dehn filling'' allow the construction of infinitely many Einstein manifolds that have different topologies but are geometrically close to each other. Using these results, we show that for many spatial topologies, the Hartle-Hawking wave function for a spacetime with a negative cosmological constant develops sharp peaks at certain calculable geometries. The peaks we find are all centered on spatial metrics of constant negative curvature, suggesting a new mechanism for obtaining local homogeneity in quantum cosmology.Comment: 16 pages,LaTeX, no figures; v2: some changes coming from revision of a math reference: wave function peaks sharp but not infinite; v3: added paragraph in intro on interpretation of wave functio

Sunscreens - Which and what for?

It is well established that sun exposure is the main cause for the development of skin cancer. Chronic continuous UV radiation is believed to induce malignant melanoma, whereas intermittent high-dose UV exposure contributes to the occurrence of actinic keratosis as precursor lesions of squamous cell carcinoma as well as basal cell carcinoma. Not only photocarcinogenesis but also the mechanisms of photoaging have recently become apparent. In this respect the use of sunscreens seemed to prove to be more and more important and popular within the last decades. However, there is still inconsistency about the usefulness of sunscreens. Several studies show that inadequate use and incomplete UV spectrum efficacy may compromise protection more than previously expected. The sunscreen market is crowded by numerous products. Inorganic sunscreens such as zinc oxide and titanium oxide have a wide spectral range of activity compared to most of the organic sunscreen products. It is not uncommon for organic sunscreens to cause photocontact allergy, but their cosmetic acceptability is still superior to the one given by inorganic sunscreens. Recently, modern galenic approaches such as micronization and encapsulation allow the development of high-quality inorganic sunscreens. The potential systemic toxicity of organic sunscreens has lately primarily been discussed controversially in public, and several studies show contradictory results. Although a matter of debate, at present the sun protection factor (SPF) is the most reliable information for the consumer as a measure of sunscreen filter efficacy. In this context additional tests have been introduced for the evaluation of not only the protective effect against erythema but also protection against UV-induced immunological and mutational effects. Recently, combinations of UV filters with agents active in DNA repair have been introduced in order to improve photoprotection. This article reviews the efficacy of sunscreens in the prevention of epithelial and nonepithelial skin cancer, the effect on immunosuppression and the value of the SPF as well as new developments on the sunscreen market. Copyright (C) 2005 S. Karger AG, Basel

Expression and DNA methylation of TNF, IFNG and FOXP3 in colorectal cancer and their prognostic significance.

BACKGROUND: Colorectal cancer (CRC) progression is associated with suppression of host cell-mediated immunity and local immune escape mechanisms. Our aim was to assess the immune function in terms of expression of TNF, IFNG and FOXP3 in CRC. METHODS: Sixty patients with CRC and 15 matched controls were recruited. TaqMan quantitative PCR and methylation-specific PCR was performed for expression and DNA methylation analysis of TNF, IFNG and FOXP3. Survival analysis was performed over a median follow-up of 48 months. RESULTS: TNF was suppressed in tumour and IFNG was suppressed in peripheral blood mononuclear cells (PBMCs) of patients with CRC. Tumours showed enhanced expression of FOXP3 and was significantly higher when tumour size was >38 mm (median tumour size; P=0.006, Mann-Whitney U-test). Peripheral blood mononuclear cell IFNG was suppressed in recurrent CRC (P=0.01). Methylated TNFpromoter (P=0.003) and TNFexon1 (P=0.001) were associated with significant suppression of TNF in tumours. Methylated FOXP3cpg was associated with significant suppression of FOXP3 in both PBMC (P=0.018) and tumours (P=0.010). Reduced PBMC FOXP3 expression was associated with significantly worse overall survival (HR=8.319, P=0.019). CONCLUSIONS: We have detected changes in the expression of immunomodulatory genes that could act as biomarkers for prognosis and future immunotherapeutic strategies

Extremely thinned continental crust underneath the Ligurian Basin?

The Ligurian Basin is situated at the transition from the western Alpine orogeny to the Apennine system, an area where a change in subduction polarity is observed. The back-arc basin was generated by the southeast trench retreat of the Apennines-Calabrian subduction zone. The opening took place from late Oligocene to Miocene. While the extension led to continental thinning and subsidence, oceanic spreading with unroofing of mantle material was proposed for the late opening period, 21-16 Ma. To shed light on the present day crustal and lithospheric architecture of the Ligurian Basin, active and passive seismic data have been recorded on ocean bottom seismometers of a long-term network consisting of 29 broad-band stations, installed from June 2017 to February 2018 in the framework of SPP2017 4D-MB, the German component of AlpArray. Two refraction seismic profiles were shot to serve two aspects: (1) Determine the orientation of the horizontal components of the long-term instruments and (2) estimate the velocity distribution of the upper lithosphere, to provide a velocity model for the passive seismic data analysis. Good quality data have been recorded, regional and teleseismic events as well as active shots could be detected by the network stations. The majority of the refraction seismic data show mantle phases at offsets up to 70 km and a very prominent wide-angle reflection originating at the crust mantle boundary. Its features share a number of characteristics (i.e. offset range, continuity) generally associated with continental settings rather than mimicking seafloor spreading lithosphere emplaced in back-arc basins. Based on traveltime tomography along the refraction lines, the crust-mantle boundary is determined at ~9.5 km depth below seafloor. The acoustic basement is difficult to map seismically. The transition to the crystalline basement is indicated at a depth of ~6.5 km below seafloor. The absolute seismic velocities can be interpreted as hyper-extended continental crust or serpentinised mantle. The thick sedimentary coverage allows for long lasting extension of the crust. The crustal portion interpreted from the seismic velocities thickens towards the north which is in good agreement with the anti-clockwise rotation of the Corsica-Sardinia block and an associated gradual opening of the Ligurian Basin

Regulation of mammary gland branching morphogenesis by the extracellular matrix and its remodeling enzymes.

A considerable body of research indicates that mammary gland branching morphogenesis is dependent, in part, on the extracellular matrix (ECM), ECM-receptors, such as integrins and other ECM receptors, and ECM-degrading enzymes, including matrix metalloproteinases (MMPs) and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs). There is some evidence that these ECM cues affect one or more of the following processes: cell survival, polarity, proliferation, differentiation, adhesion, and migration. Both three-dimensional culture models and genetic manipulations of the mouse mammary gland have been used to study the signaling pathways that affect these processes. However, the precise mechanisms of ECM-directed mammary morphogenesis are not well understood. Mammary morphogenesis involves epithelial 'invasion' of adipose tissue, a process akin to invasion by breast cancer cells, although the former is a highly regulated developmental process. How these morphogenic pathways are integrated in the normal gland and how they become dysregulated and subverted in the progression of breast cancer also remain largely unanswered questions