Reinsertion of an inverted osteochondral lesion of the talus: A case report

Osteochondral lesions of the talus (OLTs) occur infrequently and are missed at the initial presentation in up to 67% of cases. Probably more than 1500 OLTs have been reported in published studies, of which, thus far, only 5 cases have been an inverted anterolateral OLT. An anterolateral OLT results from a hypersupination trauma, in which the talar dome is caught behind the fibula. Apparently, if the forces are large enough a " flip of the coin" phenomenon occurs, causing the fragment to invert 180° upside down. We present the case of a young female patient with an inverted OLT that was treated with open reduction and internal fixation using bioabsorbable pins. Follow-up radiographs and computed tomography showed a congruent joint and complete healing of the osteochondral fragment. At the short-term follow-up visit, the functional outcome was promising

Care trajectories of chronically ill older adult patients discharged from hospital:a quantitative cross-sectional study using health insurance claims data

Background For older adults, a good transition from hospital to the primary or long-term care setting can decrease readmissions. This paper presents the 6-month post-discharge healthcare utilization of older adults and describes the numbers of readmissions and deaths for the most frequently occurring aftercare arrangements as a starting point in optimizing the post-discharge healthcare organization. Methods This cross-sectional study included older adults insured with the largest Dutch insurance company. We described the utilization of healthcare within 180 days after discharge from their first hospital admission of 2015 and the most frequently occurring combinations of aftercare in the form of geriatric rehabilitation, community nursing, long-term care, and short stay during the first 90 days after discharge. We calculated the proportion of older adults that was readmitted or had died in the 90-180 days after discharge for the six most frequent combinations. We performed all analyses in the total group of older adults and in a sub-group of older adults who had been hospitalized due to a hip fracture. Results A total of 31.7% of all older adults and 11.4% of the older adults with a hip fracture did not receive aftercare. Almost half of all older adults received care of a community nurse, whereas less than 5% received long-term home care. Up to 18% received care in a nursing home during the 6 months after discharge. Readmissions were lowest for older adults with a short stay and highest in the group geriatric rehabilitation + community nursing. Mortality was lowest in the total group of older aldults and subgroup with hip fracture without aftercare. Conclusions The organization of post-discharge healthcare for older adults may not be organized sufficiently to guarantee appropriate care to restore functional activity. Although receiving aftercare is not a clear predictor of readmissions in our study, the results do seem to indicate that older adults receiving community nursing in the first 90 days less often die compared to older adults with other types of aftercare or no aftercare. Future research is necessary to examine predictors of readmissions and mortality in both older adult patients discharged from hospital.</p

Aneurysmal and clinical characteristics as risk factors for intracerebral haematoma from aneurysmal rupture

Intracerebral haematoma (ICH) occurs in one-third of patients with aneurysmal subarachnoid haemorrhage (SAH) and is associated with poor prognosis. Identification of risk factors for ICH from aneurysmal rupture may help in balancing risks of treatment of unruptured aneurysms. We assessed potential clinical and aneurysmal risk factors for ICH from aneurysmal rupture. In all 310 SAH patients admitted to our service between 2005 and 2007, we compared clinical risk factors (gender, age, smoking, hypertension, history of SAH and family history) of patients with and without an ICH. From the latest admitted, 50 patients with and 50 without ICH, we compared the location, shape and direction of blood flow of the aneurysms on CT-angiography. Relative risks (RRs) of ICH were 1.2 (95% confidence interval, CI):0.7–1.8) for males, 1.0 (95%CI:0.7–1.4) for age ≥55 year, 1.0 (95%CI:0.6–1.6) for smoking, 0.9 (95%CI:0.5–1.5) for hypertension, 0.6 (95%CI:0.1–3.8) for history of SAH and 0.5 (95%CI:0.2–1.3) for family history of SAH. RRs of ICH were 1.8 (95%CI:1.2–2.5) for MCA aneurysms, 0.5 (95%CI:0.3–1.0) for ICA aneurysms, 0.4 (95%CI:0.1–1.3) for posterior circulation aneurysms, and 0.7 (95%CI:0.3–1.3) for multilobed aneurysms. The RRs of other aneurysmal characteristics varied between 0.9 and 1.2. Patients with MCA aneurysms are at a higher risk of developing ICH. The other aneurysmal or clinical factors have no or only minor influence on the risk of ICH after rupture and are, therefore, not helpful in deciding on treatment of unruptured aneurysms

Charge dependent azimuthal correlations in Pb--Pb collisions at sNN=2.76\sqrt{s_{NN}} = 2.76 TeV

Separation of charges along the extreme magnetic field created in non-central relativistic heavy--ion collisions is predicted to be a signature of local parity violation in strong interactions. We report on results for charge dependent two particle azimuthal correlations with respect to the reaction plane for Pb--Pb collisions at $\sqrt{s_{NN}} = 2.76$ TeV recorded in 2010 with ALICE at the LHC. The results are compared with measurements at RHIC energies and against currently available model predictions for LHC. Systematic studies of possible background effects including comparison with conventional (parity-even) correlations simulated with Monte Carlo event generators of heavy--ion collisions are also presented.Comment: Published in the proceedings of "Quark Matter 2011", Annecy-Franc

Gas Detection with a Micro FTIR Spectrometer in the MIR Region

We report on the application of a silicon micromachined lamellar grating interferometer in a Fourier Transform Infrared (FTIR) spectrometer for the detection of gases in the mid-infrared (MIR) region. The FTIR spectrometer was equipped with MIR optical fibers for light coupling. Gas measurements in the MIR region were focused on specific gases (CO2, CH4) in order to determine the limit of detection and the selectivity that could be obtained using such a micro-spectrometer. The influence of humidity on the gas response has also been investigated. Using two different spectral regions we were able to detect concentrations of carbon dioxide over a span from 100 ppm to 9000 ppm with a theoretical detection limit evaluated at 10 ppm. The performed gas measurements showed the proof of principle of a miniaturised FTIR gas analyzer based on a micromachined spectrometer

Algorithmic statistics: forty years later

Algorithmic statistics has two different (and almost orthogonal) motivations. From the philosophical point of view, it tries to formalize how the statistics works and why some statistical models are better than others. After this notion of a "good model" is introduced, a natural question arises: it is possible that for some piece of data there is no good model? If yes, how often these bad ("non-stochastic") data appear "in real life"? Another, more technical motivation comes from algorithmic information theory. In this theory a notion of complexity of a finite object (=amount of information in this object) is introduced; it assigns to every object some number, called its algorithmic complexity (or Kolmogorov complexity). Algorithmic statistic provides a more fine-grained classification: for each finite object some curve is defined that characterizes its behavior. It turns out that several different definitions give (approximately) the same curve. In this survey we try to provide an exposition of the main results in the field (including full proofs for the most important ones), as well as some historical comments. We assume that the reader is familiar with the main notions of algorithmic information (Kolmogorov complexity) theory.Comment: Missing proofs adde

Quantifying methane vibrational and rotational temperature with Raman scattering

This work describes the theoretical basis and implementation of the measurement of vibrational (T vib) and rotational (T rot) temperatures in CH4 by fitting spontaneous Raman scattering spectra in the Pentad region. This method could be applied for thermal equilibrium temperature measurements applications, e.g. in combustion, or vibrational-rotational non-equilibrium applications, such as in plasma chemistry. The method of calculating these temperatures is validated against known temperature thermal equilibrium spectra up to 860 K from published data, giving an estimated relative error of 10%. This demonstrates that both the calculated stick spectrum and the algorithm to determine T vib and T rot for CH4 is robust to 860 K, but we expect it is valid to 1500 K. Additionally, a number of non-equilibrium spectra generated with a pulsed microwave plasma are fitted to find T vib and T rot, further demonstrating the applicability of this method in fitting non-equilibrium spectra.</p

Genome sequences of seven Megrivirus strains from chickens in The Netherlands

We report seven chicken megrivirus genome sequences identified in chicken fecal samples from a broiler farm in The Netherlands. The sequences were determined using metagenomic sequencing and would expand our understanding of the genome diversity of megriviruses