Treatment of malunion in ankle fractures

Malunions are fractured bones that have healed in pathological positions. This leads to nonphysiological load transfer. Clinical symptoms at the ankle may include swelling, pain and impaired function. Lateral, posterolateral or posteromedial subluxation of the talus will be visible on the radiographs. Surgical correction may be indicated if the malunion is symptomatic. Different osteotomies have been described, but the goal of surgery will always be the reduction and retention of the subluxed talus in an effort to recreate stable conditions.Eighty percent of patients show good results with significant pain reduction in mid-term follow-up studies. Ankle arthrodesis after corrective osteotomy is rarely necessar

Accelerating the United Nation's 2030 Global Agenda: Why Prioritization of the Gender Goal is Essential

In September 2015, Member States of the United Nations (UN) committed to work towards a transformative policy agenda consisting of 17 ambitious Sustainable Development Goals (SDGs) to be achieved by 2030. However, implementation progress has been slow and at the current rate the SDG agenda will fall far short on delivery of its 169 targets. In order to accelerate progress at global, national and local levels it is necessary to prioritize goals and targets. One standalone SDG that is also cross‐cutting and universal is Goal 5: Gender equality and empowerment of all women and girls. In this article we assemble evidence to make the case that decisively (and politically) placing the gender equality goal (SDG5 and its 9 targets) together with 54 gender indicators across all goals as the priority focus of the 2030 agenda is the most impactful way to ensure measurable achievements are made across the agenda to deliver on all 5 pillars of the global commitment: namely People, Planet, Peace, Prosperity and Partnerships

Westinghouse Hanford Company special nuclear material vault storage study

Category 1 and 2 Special Nuclear Materials (SNM) require storage in vault or vault type rooms as specified in DOE orders 5633.3A and 6430.1A. All category 1 and 2 SNM in dry storage on the Hanford site that is managed by Westinghouse Hanford Co (WHC) is located in the 200 West Area at Plutonium Finishing Plant (PFP) facilities. This document provides current and projected SNM vault inventories in terms of storage space filled and forecasts available space for possible future storage needs

Parathyroid localization

Twenty-nine consecutive patients with suspected primary hyperparathyroidism were examined preoperatively using ultrasound, sonographically guided fine needle aspiration, and aspirate immunostaining for PTH. In 25 patients, localization of enlarged parathyroid glands was successful. In 2 patients, the tumors were located retrosternally and, thus, could not be detected by ultrasound. One patient had a multinodular goiter which impeded localization. In 1 patient with renal osteodystrophy, 2 enlarged parathyroid glands in the neck were not visualized preoperatively. Cytology was not diagnostic, although some cytological features were suggestive of parathyroid cells. Immunostaining of the aspirated smears for PTH, however, correctly diagnosed all preoperatively localized lesions. Ultrasound should be the routine procedure of choice for preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism. Fine needle aspiration and immunocytochemistry can supply confirmation, if necessary

‘The Blue-Eyed’ in Our School – Overcoming Stereotypes as a Way to Create Better Classroom Development Conditions for Students

The article outlines a universal and selective prevention program aiming at weakening the risk factors – child peer rejection and the emergence and prevalence of a low skills stereotype. It is based on the cooperation of researchers with pairs of faculty members teaching in the same 4th grade: the class host and a Polish, math or a foreign language teacher. The goal of this cooperation is to create better psychosocial development conditions in interactions with teachers and peers, diminishing the sense of helplessness during Polish and math classes, the risk of stereotypes and the school– and learning-re-lated stress. The results of the seven-month cooperation will be assessed through research conducted in 18 classes randomly assigned to the trial group (9 classes) and the control group (9 classes). The pretest, after-test and the measurement of results extended for a year after the conclusion of the program will include students with the after-test covering also teachers. The socio-economic status of students’ families will be the variable controlled for

Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors

Breast cancer; Evidence-generating care; Risk-adjusted preventionCáncer de mama; Atención generadora de evidencia; Prevención ajustada al riesgoCàncer de mama; Atenció generadora d'evidències; Prevenció ajustada al riscBackground: Risk-adjusted cancer screening and prevention is a promising and continuously emerging option for improving cancer prevention. It is driven by increasing knowledge of risk factors and the ability to determine them for individual risk prediction. However, there is a knowledge gap between evidence of increased risk and evidence of the effectiveness and efficiency of clinical preventive interventions based on increased risk. This gap is, in particular, aggravated by the extensive availability of genetic risk factor diagnostics, since the question of appropriate preventive measures immediately arises when an increased risk is identified. However, collecting proof of effective preventive measures, ideally by prospective randomized preventive studies, typically requires very long periods of time, while the knowledge about an increased risk immediately creates a high demand for action. Summary: Therefore, we propose a risk-adjusted prevention concept that is based on the best current evidence making needed and appropriate preventive measures available, and which is constantly evaluated through outcome evaluation, and continuously improved based on these results. We further discuss the structural and procedural requirements as well as legal and socioeconomical aspects relevant for the implementation of this concept.The project was funded by the German Federal Ministry of Health (grant No. 2515FSB401 to Rita Schmutzler and Christiane Woopen) for supporting the international expert meetings, and a grant of the EU Horizon 2020 program, BRIDGES (grant No. 634935, PI Peter Devilee, WP5-PI Rita Schmutzler), for the compilation of the most recent findings of genetic risk prediction