Percutaneous trigger thumb release: a safe push-pull technique

Background: Stenosing tenosynovitis of the thumb is an inflammation of flexor tendon sheath of A1 pulley. Percutaneous release has recently gained popularity. Successful percutaneous release depends upon proper prediction of the location of the A1 pulley and circumventing injury to the neurovascular bundles. The aim of this study was to determine the safety of percutaneous release of trigger thumb.Methods: Twenty eight patients were included in the study between 2015 and 2018. All the patients were percutaneously released using push-pull technique. Steroid injection was given following the release. Quinnell grading, patient questionnaire and visual analogue scale score was used to assess the patients at 2 weeks, 6 weeks and 6 months and 1 year.Results: Satisfactory results were found in 93% of patients. Two patients complained of pain and swelling till third week. No digital nerve injury occurred in any patients.Conclusions: Percutaneous trigger thumb release using this push-pull technique is a simple and a safe technique with very minimal complications.

Unusual medial tibial plateau fracture fixation using dual plating

Background: Medial tibial plateau fractures is a subtype of proximal tibial fractures that involve the articular surface and can present in several distinct patterns. Purpose of this study was to assess the clinical outcome of stabilizing these biplanar medial tibial plateau fractures using dual plating technique through a single incision.Methods: Between 2017 to 2019, 12 men and 8 women with closed medial tibial plateau fracture who underwent reconstruction using two plates through a posteromedial approach were included in the study group. The fractures were classified using the three column concept of Lou.Results: One patient had an articular step off that was unacceptable and two patients had an acceptable articular step off. Functional assessment was done using the objective scoring of Oxford knee score criteria and radiological assessment was done using the Rasmussen modified score.Conclusions: Biplanar reconstruction using dual plates is a reliable and safe technique to reconstruct complex medial tibial plateau fractures

A split-mouth randomized controlled trial to compare the rate of canine retraction after a soft tissue procedure compared against a corticotomy procedure for accelerated tooth movement

Background and Aim: Various methods to accelerate the orthodontic tooth movement have been used, among which corticotomy is considered to be the most common one. The suggested reasoning for such acceleration was the regional acceleratory phenomenon (RAP). Since the RAP is a property of both the hard and soft tissues, we designed a soft tissue flap procedure to compare the effects with the conventional corticotomy procedure. A split-mouth study was conducted where the two procedures were assessed in a single participant. Patients and Methods: The total sample size was calculated to be 40 with 20 participants in each group. The rate of tooth movement was the primary outcome measure, and the secondary outcomes were dentoalveolar changes, which were studied in both the conventional corticotomy and the flap-only procedure based on a cone-beam computed tomography (CBCT) wherein the alveolar bone density (BD) around canines, tipping, and rotational changes in canines, premolars, and molars were assessed. Results: Corticotomy resulted in greater canine angulation, lesser canine rotation and premolar rotation, and greater molar rotation compared with flap elevation, but these differences were statistically insignificant. Conclusion: Though the corticotomy resulted in higher BD, the differences were statistically insignificant. There was no significant difference in the rate of space closure assessed by the two techniques compared

Fission and cluster decay of 76^{76}Sr nucleus in the ground-state and formed in heavy-ion reactions

Calculations for fission and cluster decay of $^{76}Sr$ are presented for this nucleus to be in its ground-state or formed as an excited compound system in heavy-ion reactions. The predicted mass distribution, for the dynamical collective mass transfer process assumed for fission of $^{76}Sr$, is clearly asymmetric, favouring $\alpha$-nuclei. Cluster decay is studied within a preformed cluster model, both for ground-state to ground-state decays and from excited compound system to the ground-state(s) or excited states(s) of the fragments.Comment: 14 pages LaTeX, 5 Figures available upon request Submitted to Phys. Rev.

Impregnation of S-layer protein isolated from extremophilic Bacillus Licheniformis NARW 02 onto titanium phosphate ceramic enhances uranium removal from aqueous solution

In the present study, bioceramic was prepared by impregnating surface layer protein (S-layer) isolated from extremophilic bacteria Bacillus licheniformis NARW 02 onto sol–gel-derived titanium phosphate (TiP) ceramic. The prepared bioceramic was used for adsorption of uranium ions from aqueous solution and compared with control lacking S-layer protein. The distribution coefficient value of TiP and bioceramic for uranium adsorption was 100.65 and 432.48 ml/g respectively. This study indicates that the bacterial S-layer can be potentially used to enhance the adsorption efficiency of the ceramics used in separation of uranium from waste water

Quantitative assessment of fecal contamination in multiple environmental sample types in urban communities in Dhaka, Bangladesh using SaniPath microbial approach.

Rapid urbanization has led to a growing sanitation crisis in urban areas of Bangladesh and potential exposure to fecal contamination in the urban environment due to inadequate sanitation and poor fecal sludge management. Limited data are available on environmental fecal contamination associated with different exposure pathways in urban Dhaka. We conducted a cross-sectional study to explore the magnitude of fecal contamination in the environment in low-income, high-income, and transient/floating neighborhoods in urban Dhaka. Ten samples were collected from each of 10 environmental compartments in 10 different neighborhoods (4 low-income, 4 high-income and 2 transient/floating neighborhoods). These 1,000 samples were analyzed with the IDEXX-Quanti-Tray technique to determine most-probable-number (MPN) of E. coli. Samples of open drains (6.91 log10 MPN/100 mL), surface water (5.28 log10 MPN/100 mL), floodwater (4.60 log10 MPN/100 mL), produce (3.19 log10 MPN/serving), soil (2.29 log10 MPN/gram), and street food (1.79 log10 MPN/gram) had the highest mean log10 E. coli contamination compared to other samples. The contamination concentrations did not differ between low-income and high-income neighborhoods for shared latrine swabs, open drains, municipal water, produce, and street foodsamples. E. coli contamination levels were significantly higher (p <0.05) in low-income neighborhoods compared to high-income for soil (0.91 log10 MPN/gram, 95% CI, 0.39, 1.43), bathing water (0.98 log10 MPN/100 mL, 95% CI, 0.41, 1.54), non-municipal water (0.64 log10 MPN/100 mL, 95% CI, 0.24, 1.04), surface water (1.92 log10 MPN/100 mL, 95% CI, 1.44, 2.40), and floodwater (0.48 log10 MPN/100 mL, 95% CI, 0.03, 0.92) samples. E. coli contamination were significantly higher (p<0.05) in low-income neighborhoods compared to transient/floating neighborhoods for drain water, bathing water, non-municipal water and surface water. Future studies should examine behavior that brings people into contact with the environment and assess the extent of exposure to fecal contamination in the environment through multiple pathways and associated risks

Management of cyclic vomiting syndrome in adults: Evidence review

BackgroundThis evidence review was conducted to inform the accompanying clinical practice guideline on the management of cyclic vomiting syndrome (CVS) in adults.MethodsWe followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and focused on interventions aimed at prophylactic management and abortive treatment of adults with CVS. Specifically, this evidence review addresses the following clinical questions: (a) Should the following pharmacologic agents be used for prophylaxis of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, or mitochondrial supplements? (b) Should the following pharmacologic agents be used for abortive treatment: triptans or aprepitant?ResultsWe found very low‐quality evidence to support the use of the following agents for prophylactic and abortive treatment of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, and mitochondrial supplements. We have moderate certainty of evidence for the use of triptans as abortive therapy. We found limited evidence to support the use of ondansetron and the treatment of co‐morbid conditions and complementary therapies.ConclusionsThis evidence review helps inform the accompanying guideline for the management of adults with CVS which is aimed at helping clinicians, patients, and policymakers, and should improve patient outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149694/1/nmo13605.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149694/2/nmo13605_am.pd

Effect of promoter architecture on the cell-to-cell variability in gene expression

According to recent experimental evidence, the architecture of a promoter, defined as the number, strength and regulatory role of the operators that control the promoter, plays a major role in determining the level of cell-to-cell variability in gene expression. These quantitative experiments call for a corresponding modeling effort that addresses the question of how changes in promoter architecture affect noise in gene expression in a systematic rather than case-by-case fashion. In this article, we make such a systematic investigation, based on a simple microscopic model of gene regulation that incorporates stochastic effects. In particular, we show how operator strength and operator multiplicity affect this variability. We examine different modes of transcription factor binding to complex promoters (cooperative, independent, simultaneous) and how each of these affects the level of variability in transcription product from cell-to-cell. We propose that direct comparison between in vivo single-cell experiments and theoretical predictions for the moments of the probability distribution of mRNA number per cell can discriminate between different kinetic models of gene regulation.Comment: 35 pages, 6 figures, Submitte

The Ligand Binding Domain of GCNF Is Not Required for Repression of Pluripotency Genes in Mouse Fetal Ovarian Germ Cells

In mice, successful development and reproduction require that all cells, including germ cells, transition from a pluripotent to a differentiated state. This transition is associated with silencing of the pluripotency genes Oct4 and Nanog. Interestingly, these genes are repressed at different developmental timepoints in germ and somatic cells. Ovarian germ cells maintain their expression until about embryonic day (E) 14.5, whereas somatic cells silence them much earlier, at about E8.0. In both somatic cells and embryonic stem cells, silencing of Oct4 and Nanog requires the nuclear receptor GCNF. However, expression of the Gcnf gene has not been investigated in fetal ovarian germ cells, and whether it is required for silencing Oct4 and Nanog in that context is not known. Here we demonstrate that Gcnf is expressed in fetal ovarian germ cells, peaking at E14.5, when Oct4 and Nanog are silenced. However, conditional ablation of the ligand-binding domain of Gcnf using a ubiquitous, tamoxifen-inducible Cre indicates that Gcnf is not required for the down-regulation of pluripotency genes in fetal ovarian germ cells, nor is it required for initiation of meiosis and oogenesis. These results suggest that the silencing of Oct4 and Nanog in germ cells occurs via a different mechanism from that operating in somatic cells during gastrulation.Howard Hughes Medical InstituteNational Institutes of Health (U.S.) (2R01HG00257-20)National Human Genome Research Institute (U.S.) (2R01HG00257-20

Nanomedicines towards targeting intracellular Mtb for the treatment of tuberculosis

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), causes the most human deaths than any other diseases from a single infectious agent. Treatments are long and costly and have many associated side effects. Intracellular bacilli are slow growing and difficult to target, which is augmenting the emergence of multi?drug resistance. A hallmark trait of TB is the formation of granulomas, chronic cellular aggregates, which limit bacterial growth but provides a survival reservoir where bacilli may disseminate from. Targeting intracellular Mtb is challenging, but nanomedicine may offer a solution. Nanomedicine is a significantly growing research area and offers the potential for specific disease targeting, dosage reduction, and intracellular drug delivery. This review discusses the application of the various forms of nanomedicine towards targeting of Mtb