Outcome Analysis of Distal Radius Fracture with Orthosis Versus Cast Immobilization after Palmar Plate Osteosynthesis: A Randomized Controlled Study

Although the benefits of hand orthoses were shown in previous studies, they have not been able to establish themselves in clinical routines. With a focus on patient satisfaction, this study aimed to evaluate the latest generation of hand orthoses after palmar plate osteosynthesis for isolated distal radius fractures in comparison with circular plaster casts. 50 patients (16% dropout rate) were randomly assigned to an orthotic group (immobilization by orthosis, OG) or a control group (immobilization by a plaster cast, CG). Intra-articular fractures were present in 74% of the cases, and unstable AO C3 fractures in 26%. Questionnaires on patient satisfaction, documentation of the time required, clinical scores (DASH, SF-36), range of motion, grip measurements and radiographs were used for evaluation. The OG proved to be equivalent to the plaster treatment in terms of patient satisfaction, and stability of the reduction, as well as clinical scores DASH and SF-36. The OG was even superior in terms of personal hygiene (p = 0.011), handling (p = 0.008) and better adaptability (p = 0.013). Significantly less time was required to apply the orthosis (p < 0.001). In addition to the good results achieved so far, the study showed that the latest generation of orthoses has several advantages over plaster cast therapy, and could therefore become established in everyday clinical practice

Additions to the checklist of terrestrial biodiversity of Cabo Verde

Em resultado de seis semanas passadas em trabalho de campo em seis ilhas caboverdianas em Setembro/ Outubro de 2016 e 2017, apresentamos 18 adições à lista da biodiversidade terrestre do arquipélago (dez artrópodes, uma ave, dois fungos e cinco plantas). Quatro deles são os primeiros registos para Cabo Verde, os outros para ilhas particulares. De entre as espécies mais interessantes refira-se a mosca da fruta da maçã-de-Sodoma Dacus longistylus, provavelmente introduzida para o biocontrole da árvore tóxica da maçã-de-Sodoma e novas adições à distribuição de várias espécies de abelhas dos géneros Amegilla, Megachile e Xylocopa. As nossas observações indicam que o conhecimento da biodiversidade de Cabo Verde ainda está incompleto e que mais trabalho de campo é necessário.Based on six weeks spent in the field on six Cabo Verdean Islands in September/ October 2016 and 2017, we present 18 additions to the checklist of terrestrial biodiversity of the archipelago (ten arthropods, one bird, two fungi, and five flowering plants). Four of them are first records for Cabo Verde, the others for particular islands. Most interesting are the apple of Sodom fruit fly Dacus longistylus, perhaps actively introduced for biocontrol of the toxic apple of Sodom tree and the additions to the distribution of several bee species of the genera Amegilla, Megachile, and Xylocopa. Our observations indicate that the biodiversity of Cabo Verde is still incompletely known and more fieldwork is needed

Successful Aging and Subjective Aging: Toward a Framework to Research a Neglected Connection

peer reviewedResearch related to subjective aging, which describes how individuals perceive, interpret and evaluate their own aging, has substantially grown in the past two decades. Evidence from longitudinal studies shows that subjective aging predicts health, quality of life, and functioning in later life. However, the existing literature on successful aging has mostly neglected the role of subjective aging. This paper proposes an extended framework of successful aging linking subjective aging conceptually and empirically to Rowe and Kahn’s (1997) three original key criteria of successful aging (i.e., avoiding disease and disability, maintaining high cognitive and physical function, and engagement with life). A particular focus is placed on subjective aging as an antecedent of successful aging. A review of the empirical subjective aging literature shows that subjective aging concepts consistently predict all three of Rowe and Kahn’s criteria of successful aging. Mechanisms underlying these relations are discussed at three levels, namely psychological, behavioral, and physiological pathways. The proposed addition also takes into consideration the interconnections between subjective aging and successful aging throughout the lifespan and across historical time. Finally, we discuss the importance of facilitating successful aging through systematic interventions that support more positive views of aging at the individual and societal level

Improving the continuity and coordination of ambulatory care through feedback and facilitated dialogue—a study protocol for a cluster-randomised trial to evaluate the ACD study (Accountable Care in Germany)

Background!#!Patients in Germany are free to seek care from any office-based physician and can always ask for multiple opinions on a diagnosis or treatment. The high density of physicians and the freedom to choose among them without referrals have led to a need for better coordination between the multiple health professionals treating any given patient. The objectives of this study are to (1) identify informal networks of physicians who treat the same patient population, (2) provide these physicians with feedback on their network and patients, using routine data and (3) give the physicians the opportunity to meet one another in facilitated network meetings.!##!Methods!#!The Accountable Care Deutschland (ACD) study is a prospective, non-blinded, cluster-randomised trial comprising a process and economic evaluation of informal networks among 12,525 GPs and office-based specialists and their 1.9 million patients. The units of allocation are the informal networks, which will be randomised either to the intervention (feedback and facilitated meetings) or control group (usual care). The informal networks will be generated by identifying connections between office-based physicians using complete datasets from the Regional Associations of Statutory Health Insurance (SHI) Physicians in Hamburg, Schleswig Holstein, North Rhine and Westphalia Lip, as well as data from three large statutory health insurers in Germany. The physicians will (a) receive feedback on selected indicators of their own treatment activity and that of the colleagues in their network and (b) will be invited to voluntary, facilitated network meetings by their Regional Association of SHI physicians. The primary outcome will be ambulatory-care-sensitive hospitalisations at baseline, at the end of the 2-year intervention period, and at six months and at 12 months after the end of the intervention period. Data will be analysed using the intention-to-treat principle. A pilot study preceded the ACD study.!##!Discussion!#!Cochrane reviews show that feedback can improve everyday medical practice by shedding light on previously unknown relationships. Providing physicians with information on how they are connected with their colleagues and what the outcomes are of care delivered within their informal networks can help them make these improvements, as well as strengthen their awareness of possible discontinuities in the care they provide.!##!Trial registration!#!German Clinical Trials Register DRKS00020884 . Registered on 25 March 2020-retrospectively registered

Actin flows mediate a universal coupling between cell speed and cell persistence

Cell movement has essential functions in development, immunity, and cancer. Various cell migration patterns have been reported, but no general rule has emerged so far. Here, we show on the basis of experimental data in vitro and in vivo that cell persistence, which quantifies the straightness of trajectories, is robustly coupled to cell migration speed. We suggest that this universal coupling constitutes a generic law of cell migration, which originates in the advection of polarity cues by an actin cytoskeleton undergoing flows at the cellular scale. Our analysis relies on a theoretical model that we validate by measuring the persistence of cells upon modulation of actin flow speeds and upon optogenetic manipulation of the binding of an actin regulator to actin filaments. Beyond the quantitative prediction of the coupling, the model yields a generic phase diagram of cellular trajectories, which recapitulates the full range of observed migration patterns

Study protocol for a mixed methods exploratory investigation of aftercare services for gestational diabetes in women to develop a new patient-centred model in Germany: the GestDiNa_basic study

Introduction Women with gestational diabetes mellitus (GDM) have a higher risk of developing type 2 diabetes mellitus compared with women who never had GDM. Consequently, the question of structured aftercare for GDM has emerged. In all probability, many women do not receive care according to the guidelines. In particular, the process and interaction between obstetrical, diabetic, gynaecological, paediatric and general practitioner care lacks clear definitions. Thus, our first goal is to analyse the current aftercare situation for women with GDM in Germany, for example, the participation rate in aftercare diabetes screening, as well as reasons and attitudes stated by healthcare providers to offer these services and by patients to participate (or not). Second, we want to develop an appropriate, effective and patient-centred care model. Methods and analysis This is a population-based mixed methods study using both quantitative and qualitative research approaches. In various working packages, we evaluate data of the GestDiab register, of the Association of Statutory Health Insurance Physicians of North Rhine and the participating insurance companies (AOK Rheinland/Hamburg, BARMER, DAK Gesundheit, IKK classic, pronova BKK). In addition, quantitative (postal surveys) and qualitative (interviews) surveys will be conducted with randomly selected healthcare providers (diabetologists, gynaecologists, paediatricians and midwives) and affected women, to be subsequently analysed. All results will then be jointly examined and evaluated. Ethics and dissemination The study was approved by the ethics committee of the Faculty of Medicine, Heinrich-Heine-University Dusseldorf (Ethics Committee No.: 2019-738). Participants of the postal surveys and interviews will be informed in detail about the study and the use of data as well as the underlying data protection regulations before voluntarily participating. The study results will be disseminated through peer-reviewed journals, conferences and public information