Is there any advantage in placing an additional calcar screw in locked nailing of proximal humeral fractures?

AbstractBackgroundThe objective of this study was to evaluate the biomechanical effect of an additional unlocked calcar screw compared to a standard setting with three proximal humeral head screws alone for fixation of an unstable 2-part fracture of the surgical neck.HypothesisThe additional calcar screw improves stiffness and failure load.MethodsFourteen fresh frozen humeri were randomized into two equal sized groups. An unstable 2-part fracture of the surgical neck was simulated and all specimens were fixed with the MultiLoc®-nail. Group I represented a basic screw setup, with three locked head screws and two unlocked shaft screws. Group II was identical with a supplemental unlocked calcar screw (CS). Stiffness tests were performed in torsional loading, as well as in axial and in 20° abduction/20° adduction modes. Subsequently cyclic loading and load-to-failure tests were performed. Resulting stiffness, displacement under cyclic load and ultimate load were compared between groups using the t-test for independent variables (α=0.05).ResultsNo significant differences were observed between the groups in any of the biomechanical parameters. Backing out of the CS was observed in three cases.DiscussionThe use of an additional unlocked calcar screw does not provide mechanical benefit in locked nailing of an unstable 2-part fracture of the surgical neck.Level of evidenceLevel III. Experimental biomechanical study with human specimen

Magnonic Metamaterials

A large proportion of the recent growth of the volume of electromagnetics research has been associated with the emergence of so called electromagnetic metamaterials1 and the discovered ability to design their unusual properties by tweaking the geometry and structure of the constituent “meta-atoms”. For example, negative permittivity and negative permeability can be achieved, leading to negative refractive index metamaterials. The negative permeability could be obtained via geometrical control of high frequency currents, e.g. in arrays of split ring resonators, or alternatively one could rely on spin resonances in natural magnetic materials, as was suggested by Veselago. The age of nanotechnology therefore sets an intriguing quest for additional benefits to be gained by structuring natural magnetic materials into so called magnonic metamaterials, in which the frequency and strength of resonances based on spin waves (magnons) are determined by the geometry and magnetization configuration of meta-atoms. Spin waves can have frequencies of up to hundreds of GHz (in the exchange dominated regime) and have already been shown to play an important role in the high frequency magnetic response of composites. Moreover, in view of the rapid advances in the field of magnonics, which in particular promises devices employing propagating spin waves, the appropriate design of magnonic metamaterials with properties defined with respect to propagating spin waves rather than electromagnetic waves acquires an independent and significant importance

Effects of Intermittent IL-2 Alone or with Peri-Cycle Antiretroviral Therapy in Early HIV Infection: The STALWART Study

The Study of Aldesleukin with and without antiretroviral therapy (STALWART) evaluated whether intermittent interleukin-2 (IL-2) alone or with antiretroviral therapy (ART) around IL-2 cycles increased CD4+ counts compared to no therapy

Addressing unmet needs in understanding asthma mechanisms

Asthma is a heterogeneous, complex disease with clinical phenotypes that incorporate persistent symptoms and acute exacerbations. It affects many millions of Europeans throughout their education and working lives and puts a heavy cost on European productivity. There is a wide spectrum of disease severity and control. Therapeutic advances have been slow despite greater understanding of basic mechanisms and the lack of satisfactory preventative and disease modifying management for asthma constitutes a significant unmet clinical need. Preventing, treating and ultimately curing asthma requires co-ordinated research and innovation across Europe. The European Asthma Research and Innovation Partnership (EARIP) is an FP7-funded programme which has taken a co-ordinated and integrated approach to analysing the future of asthma research and development. This report aims to identify the mechanistic areas in which investment is required to bring about significant improvements in asthma outcomes. Copyright ©ERS 2017