The management of complex periprosthetic humeral fractures: a case series of strut allograft augmentation, and a review of the literature.

There is little published discussion on the management of postoperative periprosthetic humeral fractures where rotator cuff function is poor, the bone stock is dwindling or both. This is a phenomenon increasingly seen in the older, more osteoporotic population and presents an interesting challenge especially in when faced with these patients with poor bone quality. We present the treatment of three fractures with the use of long-stem reverse geometry arthroplasty and other surgical techniques more commonly reserved for periprosthetic fractures of the proximal femur such as cortical strut allograft augmentation. We believe revision to reverse geometry long-stem implant with cortical strut allograft augmentation to be safe and appropriate in the management of these complex injuries, although technically challenging, and has excellent initial and medium-term results

Seroprevalence of HIV in pregnant women in North India: a tertiary care hospital based study

Abstract Background Estimating the seroprevalence of HIV in a low risk population such as pregnant women provides essential information for an effective implementation of AIDS control programmes, and also for the monitoring of HIV spread within a country. Very few studies are available from north India showing the current trend in HIV prevalence in the antenatal population;which led us to carry outthis study at a tertiary care hospital in north India Methods Blood samples from pregnant women attending antenatal clinics at the All India Institute of Medical Sciences, New Delhi were collected after informed consent and pre-test counseling. The samples were tested for HIV antibodies as per the WHO guidelines, over a period of four years from January 2003 to December 2006. Results Of the 3529 pregnant women tested in four years, 0.88% (CI 0.5 – 1.24) women were found to be HIV seroreactive. Majority of the seroreactive pregnant women (41.9%) were in the age group of 20–24 years followed by the 30–34 yrs (25.8%) and 25–29 years (22.6%) age group. The mean age of the HIV positive women was 24.9 years (SD ± 1.49 yrs). The HIV seroprevalence rates showed an increasing trend from 0.7% (CI 0.14 – 2.04) in 2003–2004 to 0.9% (CI 0.49 – 1.5) in 2005–2006. This prevalence rate indicates concern, as Delhi and its adjoining states are otherwise considered as 'low prevalence states'. Conclusion Seroprevalence of HIV infection was found to be increasing in the last four years amongst pregnant women of North India. These findings are in contrast to the national projections.</p

QTL analysis and marker assisted selection for improvement in grain protein content and pre-harvest sprouting tolerance in bread wheat

With the ever expanding possibilities to build supramotecutar structures, chemists are challenged to mimic nature including the construction of artificial cells or function thereof. Within the field of immunology, effective immunotherapy critically depends on efficient production of antigen-specific cytotoxic T-cells. Herein lies an opportunity for chemists to design and synthesize so-called artificial antigen presenting cells (aAPCs) that can promote T-cell activation and their subsequent expansion. In this review we discuss the current status of aAPC development, also focusing on developments in nanoscience which might improve future designs. As synthetic mimics of natural antigen-presenting cells, aAPCs encompass three basic signals required for T-cell activation: MHC-antigen complexes, costimulatory molecules and soluble immune modulating compounds. Both spatial and temporal organization of these signals during aAPC/T-cell contact is important for efficient T-cell activation. We discuss how signals have been incorporated in several aAPC designs, but also how physical properties such as size and shape are essential for targeting the aAPCs to T-cell rich areas in vivo

Assessing the Policy Landscape for Salt Reduction in South-East Asian and Latin American Countries – An Initiative Towards Developing an Easily Accessible, Integrated, Searchable Online Repository

BACKGROUND: High dietary salt intake is an avoidable cause of hypertension and associated cardiovascular diseases (CVDs). Thus, salt reduction is recommended as one of the most cost-effective interventions for CVD prevention and for achieving the World Health Organization’s (WHO) 25% reduction in premature non-communicable disease (NCD) mortality by 2025. However, current and comprehensive information about national salt reduction policies and related actions across different regions are difficult to access and impede progress and monitoring. OBJECTIVES: As an initial step to developing an online repository of salt reduction policies and related actions, and to track nation-wise progress towards the WHO’s 25 by 25 goal, we aimed to identify and assess salt reduction policies and actions in select countries from two of the top five most populous regions of the world- the South-East Asia and Latin America. METHODS: We conducted a literature review to identify national and regional salt reduction policies in the selected South-East Asian and Latin American countries, from January 1990–August 2020, available in English and Spanish. We also contacted selected WHO country offices (South-East Asian region) or relevant national authorities (Latin America) to gain access to unpublished documents. RESULTS: In both regions, we found only a few dedicated stand-alone salt reduction policies: Bhutan, Sri-Lanka and Thailand from South East Asia and Costa Rica from Latin America. Available polices were either embedded in other national health/nutritional policy documents/overall NCD policies or were unpublished and had to be accessed via personal communication. CONCLUSIONS: Salt reduction policies are limited and often embedded with other policies which may impede their implementation and utility for tracking national and international progress towards the global salt reduction target associated with the 25 by 25 goal. Developing an online repository could help countries address this gap and assist researchers/policymakers to monitor national progress towards achieving the salt reduction target

Molecular Characterization of Indian Potato (Solanum tuberosum L.) Varieties for Cold - Induced Sweetening Using SSR Markers

Cold - induced sweetening developed during storage of potatoes (Solanum tuberosum L .) at low temperature is a crucial factor influencing the processing quality of potato tubers and remains one of the principal concerns of potato processing industry . Developing CIS - resistant genotypes is the most effective method to cope with this stress . In this study , the genetic diversity of 11 Indian potato varieties with different reactions to CIS was assessed using 10 SSR primers . The primers detected a total of 42 alleles arranged in 44 different configurations , among which 37 alleles (88%) were polymorphic . The polymorphic information content (PIC) value of the SSR locus ranged from 0 . 473 to 0 . 787 thus indicating a high utility of these markers for study of genetic diversity in potato . A number of polymorphic fragments appeared to be specific to a given sugar - forming group . Primer Sti007 generated one fragment Sti007 131bp present only in all the high sugar - forming varieties . The dendrogram derived from Dice ’ s similarity coefficients among the 11 varieties could partially but efficiently differentiate close parents and sugar - forming groups among the varieties . These findings demonstrate the effectiveness of SSR markers to assess the genetic variation among potato cultivars in order to develop molecular markers associated with CIS to improve potato breeding programs

Discovering and Visualizing Disease-Specific Electrocardiogram Features Using Deep Learning: Proof-of-Concept in Phospholamban Gene Mutation Carriers

BACKGROUND: ECG interpretation requires expertise and is mostly based on physician recognition of specific patterns, which may be challenging in rare cardiac diseases. Deep neural networks (DNNs) can discover complex features in ECGs and may facilitate the detection of novel features which possibly play a pathophysiological role in relatively unknown diseases. Using a cohort of PLN (phospholamban) p.Arg14del mutation carriers, we aimed to investigate whether a novel DNN-based approach can identify established ECG features, but moreover, we aimed to expand our knowledge on novel ECG features in these patients. METHODS: A DNN was developed on 12-lead median beat ECGs of 69 patients and 1380 matched controls and independently evaluated on 17 patients and 340 controls. Differentiating features were visualized using Guided Gradient Class Activation Mapping++. Novel ECG features were tested for their diagnostic value by adding them to a logistic regression model including established ECG features. RESULTS: The DNN showed excellent discriminatory performance with a c-statistic of 0.95 (95% CI, 0.91-0.99) and sensitivity and specificity of 0.82 and 0.93, respectively. Visualizations revealed established ECG features (low QRS voltages and T-wave inversions), specified these features (eg, R- and T-wave attenuation in V2/V3) and identified novel PLN-specific ECG features (eg, increased PR-duration). The logistic regression baseline model improved significantly when augmented with the identified features (P<0.001). CONCLUSIONS: A DNN-based feature detection approach was able to discover and visualize disease-specific ECG features in PLN mutation carriers and revealed yet unidentified features. This novel approach may help advance diagnostic capabilities in daily practice