A study on clinical outcomes of complex subtrochanteric femoral fractures with cephalomedullary nail

Background: The aim of the study was to evaluate the clinical outcomes of complex subtrochanteric fractures treated by using cephalomedulary nail.Methods: This is a prospective observational study of 30 cases of complex subtrochanteric femoral fractures admitted to our hospital from January 2018 to June 2019. Cases were taken according to the inclusion and exclusion criteria i.e. type IV, type V Seinsheimer’s classification, above 18 years and those who are willing to participate in the study has been included and pathological fractures, open fractures were excluded. All the patients are followed up on 2 post-operative day, after 4 weeks, 8 weeks, 12 weeks and 6months. X-ray hip with thigh anteroposterior (AP) and lateral view taken during each follow up. Out comes was assessed using modified Harris hip score.Results: In our study of 30 cases there are 22 males and 8 females and the mean age of 43.7 years. 73.3% patients are due to Road traffic accidents predominance of right side. In our study 66% had type 4 Seinsheimers and 34% cases had type 5 Seinsheimers fracture. The mean duration of hospital stay was 17 days. Mean time for full weight bearing is 12 weeks. Good to excellent results are seen in 80% of type 4 subtrochanteric fractures and 75% of cases of type 5 subtrochanteric fractures. 4 cases had surgical site infection, 3 cases had varus, 1 case had developed implant failure, and 1 case had reverse Z effect.Conclusions: From this study, we conclude that proximal femoral nail is an excellent implant in the treatment of complex subtrochanteric femoral fractures the terms of successful outcome include a good understanding of fracture biomechanics, good preoperative planning and accurate instrumentation

Hsp90/Cdc37 Chaperone/co-chaperone complex, a novel junction anticancer target elucidated by the mode of action of herbal drug Withaferin A

<p>Abstract</p> <p>Background</p> <p>HSPs (Heat shock proteins) are highly conserved ubiquitous proteins among species which are involved in maintaining appropriate folding and conformation of other proteins and are thus referred to as molecular chaperones. Hsp90 (Heat-shock protein 90 kDa) is one of a group of molecular chaperones responsible for managing protein folding and quality control in cell environment. However it is also involved in the maturation and stabilization of a wide range of oncogenic client proteins which are crucial for oncogenesis and malignant progression. Hsp90 requires a series of co-chaperones to assemble into a super-chaperone complex for its function. These co-chaperones bind and leave the complex at various stages to regulate the chaperoning process. Arresting the chaperone cycle at these stages by targeting different co-chaperone/Hsp90 interactions seems to be quite a viable alternative and is likely to achieve similar consequences as that of Hsp90 direct inhibition with added favors of high specificity and reduced side effect profile. The study conducted here is an attempt to explore the potential of <it>Withania somnifera’s</it> major constituent WA (Withaferin A) in attenuating the Hsp90/Cdc37 chaperone/co-chaperone interactions for enhanced tumor arresting activity and to elucidate the underlying mode of action using computational approaches.</p> <p>Results</p> <p>Formation of active Hsp90/Cdc37 complex is one of the essential steps for facilitation of chaperone client interaction, non-assembly of which can lead to prevention of the chaperone-client association resulting in apoptosis of tumor cells. From our flexible docking analysis of WA into active Hsp90/Cdc37 complex in which key interfacing residues of the complex were kept flexible, disruption of the active association complex can be discerned. While docking of WA into segregated Hsp90 leaves the interface residues untouched. Thus the molecular docking analysis of WA into Hsp90 and active Hsp90/Cdc37 complex conducted in this study provides significant evidence in support of the proposed mechanism of chaperone assembly suppression by inhibition or disruption of active Hsp90/Cdc37 complex formation being accounted by non-assembly of the catalytically active Hsp90/Cdc37 complex. Results from the molecular dynamics simulations in water show that the trajectories of the protein complexed with ligand WA are stable over a considerably long time period of 4 ns, with the energies of the complex being lowered in comparison to the un-docked association complex, suggesting the thermodynamic stability of WA complexed Hsp90/Cdc37.</p> <p>Conclusions</p> <p>The molecular chaperone Hsp90 has been a promising target for cancer therapy. Cancer is a disease marked by genetic instability. Thus specific inhibition of individual proteins or signalling pathways holds a great potential for subversion of this genetic plasticity of cancers. This study is a step forward in this direction. Our computational analysis provided a rationalization to the ability of naturally occurring WA to alter the chaperone signalling pathway. The large value of binding energy involved in binding of WA to the active Hsp90/Cdc37 complex consolidates the thermodynamic stability of the binding. Our docking results obtained substantiate the hypothesis that WA has the potential to inhibit the association of chaperone (Hsp90) to its co-chaperone (Cdc37) by disrupting the stability of attachment of Hsp90 to Cdc37. Conclusively our results strongly suggest that withaferin A is a potent anticancer agent as ascertained by its potent Hsp90-client modulating capability.</p

Design of QSD Multiplier Using VHDL

The need for high speed digital circuits became more prominent as portable multimedia and communication applications incorporating information processing and computing. The drawback of modern computers lead to the worsening in performance of arithmetic operations such as addition, subtraction, multiplication on the aspects of carry propagation time delay, high power consumption and large circuit complexity.Binary Signed Digit Numbers are known to allow limited carry propagation with more complex addition process. Some of the limitations of this system are computational speed which limits formation and propagation of carry especially as the number of bits increases. Therefore it provides large complexity and low storage density. Carry free arithmetic operations can be achieved using a higher radix number system such as Quaternary Signed Digit (QSD) and it allows higher information storage density, less complexity. A high speed area effective adders and multipliers can be implemented using this technique. Carry free addition and other operations on a large number of digits such as 64, 128, or more can be implemented with constant delay and less complexity. The Design is simulated & synthesized using Xilinx 13.1

Putting the pieces together: Integration for forest landscape restoration implementation

© 2019 John Wiley & Sons, Ltd. The concept of forest landscape restoration (FLR) is being widely adopted around the globe by governmental, non-governmental agencies, and the private sector, all of whom see FLR as an approach that contributes to multiple global sustainability goals. Originally, FLR was designed with a clearly integrative dimension across sectors, stakeholders, space and time, and in particular across the natural and social sciences. Yet, in practice, this integration remains a challenge in many FLR efforts. Reflecting this lack of integration are the continued narrow sectoral and disciplinary approaches taken by forest restoration projects, often leading to marginalisation of the most vulnerable populations, including through land dispossessions. This article aims to assess what lessons can be learned from other associated fields of practice for FLR implementation. To do this, 35 scientists came together to review the key literature on these concepts to suggest relevant lessons and guidance for FLR. We explored the following large-scale land use frameworks or approaches: land sparing/land sharing, the landscape approach, agroecology, and socio-ecological systems. Also, to explore enabling conditions to promote integrated decision making, we reviewed the literature on understanding stakeholders and their motivations, tenure and property rights, polycentric governance, and integration of traditional and Western knowledge. We propose lessons and guidance for practitioners and policymakers on ways to improve integration in FLR planning and implementation. Our findings highlight the need for a change in decision-making processes for FLR, better understanding of stakeholder motivations and objectives for FLR, and balancing planning with flexibility to enhance social–ecological resilience.The Frank Jackson Foundatio

Shear-driven annular flow-boiling in millimeter-scale channels: Direct numerical simulations for convective component of the overall heat transfer coefficient

Many contemporary high heat-flux cooling applications are facilitated by controlled operation of millimeter-scale flow-boilers that operate in the steady annular or steady-in-the-mean (with superposed large amplitude standing waves in the liquid film) annular regimes – with micrometer-scale liquid film thicknesses. That is, a thin evaporating liquid film flow covers the heated boiling-surface – with or without superposed micron/sub-micron-scale nucleate boiling regime. Therefore, to begin with, to characterize convective boiling component of experimentally measured values of heat transfer coefficient (HTC), it becomes important to fully characterize the underlying steady annular flows under the assumption of suppressed nucleation. For such steady cases, and liquid thickness values in the range of tens to hundreds of micrometers that are much smaller than the mm-scale hydraulic diameter of the ducts, this paper presents a direct numerical simulations (DNS) approach for laminar liquid and laminar vapor flows. Representative detailed steady solutions for annular flow-boiling of FC-72 in a horizontal channel (heated from below) are presented, the flow-physics is studied, and HTC values are correlated. Furthermore, a one-dimensional correlations-based design tool is developed and discussed, along with its future extensions for covering laminar liquid and turbulent vapor are annular flow realizations that may also occur in the aforementioned operations of flow-boiling

Putting the pieces together: Integration for forest landscape restoration implementation

© 2019 John Wiley & Sons, Ltd. The concept of forest landscape restoration (FLR) is being widely adopted around the globe by governmental, non-governmental agencies, and the private sector, all of whom see FLR as an approach that contributes to multiple global sustainability goals. Originally, FLR was designed with a clearly integrative dimension across sectors, stakeholders, space and time, and in particular across the natural and social sciences. Yet, in practice, this integration remains a challenge in many FLR efforts. Reflecting this lack of integration are the continued narrow sectoral and disciplinary approaches taken by forest restoration projects, often leading to marginalisation of the most vulnerable populations, including through land dispossessions. This article aims to assess what lessons can be learned from other associated fields of practice for FLR implementation. To do this, 35 scientists came together to review the key literature on these concepts to suggest relevant lessons and guidance for FLR. We explored the following large-scale land use frameworks or approaches: land sparing/land sharing, the landscape approach, agroecology, and socio-ecological systems. Also, to explore enabling conditions to promote integrated decision making, we reviewed the literature on understanding stakeholders and their motivations, tenure and property rights, polycentric governance, and integration of traditional and Western knowledge. We propose lessons and guidance for practitioners and policymakers on ways to improve integration in FLR planning and implementation. Our findings highlight the need for a change in decision-making processes for FLR, better understanding of stakeholder motivations and objectives for FLR, and balancing planning with flexibility to enhance social–ecological resilience.The Frank Jackson Foundatio