Cross-sectional TEM preparation of hybrid inorganic/organic materials systems by ultramicrotomy

Preparation of hybrid inorganic-organic systems (HIOS) for transmission electron microscopy (TEM) in cross sectional view is the key for understanding the interfacial structure. Strikingly different materials properties like hardness, cleavability and heat sensitivity limit the number of applicable preparation strategies. Successful preparation of a HIOS system combining ZnO and para-sexiphenyl (6P) is realized by ultramicrotomy. It is shown that the alignment of the cutting plane with respect to the (0001) cleavage plane of ZnO plays a decisive role for successful preparation of extended TEM lamellae and the preservation of the HIOS structure. In particular, for (0001) oriented ZnO substrates the optimum cut direction is parallel to the HIOS interface. In cross-sectional high-resolution TEM images (100) lattice planes of 6P are observed proving the appropriate preparation strategy.Peer Reviewe

The value of arthroscopy in the treatment of complex ankle fractures - a protocol of a randomised controlled trial

Background: An anatomical reconstruction of the ankle congruity is the important prerequisite in the operative treatment of acute ankle fractures. Despite anatomic restoration patients regularly suffer from residual symptoms after these fractures. There is growing evidence, that a poor outcome is related to the concomitant traumatic intra-articular pathology. By supplementary ankle arthroscopy anatomic reduction can be confirmed and associated intra-articular injuries can be treated. Nevertheless, the vast majority of complex ankle fractures are managed by open reduction and internal fixation (ORIF) only. Up to now, the effectiveness of arthroscopically assisted fracture treatment (AORIF) has not been conclusively determined. Therefore, a prospective randomised study is needed to sufficiently evaluate the effect of AORIF compared to ORIF in complex ankle fractures. Methods/design: We perform a randomised controlled trial at Munich University Clinic enrolling patients (18-65 years) with an acute ankle fracture (AO 44 A2, A3, B2, B3, C1 - C3 according to AO classification system). Patients meeting the inclusion criteria are randomised to either intervention group (AORIF, n = 37) or comparison group (ORIF, n = 37). Exclusion criteria are fractures classified as AO type 44 A1 or B1, pilon or plafond-variant injury or open fractures. Primary outcome is the AOFAS Score (American Orthopaedic Foot and Ankle Society). Secondary outcome parameter are JSSF Score (Japanese Society of Surgery of the Foot), Olerud and Molander Score, Karlsson Score, Tegner Activity Scale, SF-12, radiographic analysis, arthroscopic findings of intra-articular lesions, functional assessments, time to return to work/sports and complications. This study protocol is accordant to the SPIRIT 2013 recommendation. Statistical analysis will be performed using SPSS 22.0 (IBM). Discussion: The subjective and functional outcome of complex ankle fractures is regularly unsatisfying. As these injuries are very common it is essential to improve the postoperative results. Potentially, arthroscopically assisted fracture treatment can significantly improve the outcome by addressing the intra-articular pathologies. Given the absolute lack of studies comparing AORIF to ORIF in complex ankle fractures, this randomised controlled trail is urgently needed to evaluate the effectiveness of additional arthroscopy

The influence of knee position on ankle dorsiflexion - a biometric study

Background: Musculus gastrocnemius tightness (MGT) can be diagnosed by comparing ankle dorsiflexion (ADF) with the knee extended and flexed. Although various measurement techniques exist, the degree of knee flexion needed to eliminate the effect of the gastrocnemius on ADF is still unknown. The aim of this study was to identify the minimal degree of knee flexion required to eliminate the restricting effect of the musculus gastrocnemius on ADF. Methods: Bilateral ADF of 20 asymptomatic volunteers aged 18-40 years (50% female) was assessed prospectively at six different degrees of knee flexion (0 degrees, 20 degrees, 30 degrees, 45 degrees, 60 degrees, 75 degrees, Lunge). Tests were performed following a standardized protocol, non weightbearing and weightbearing, by two observers. Statistics comprised of descriptive statistics, t-tests, repeated measurement ANOVA and ICC. Results: 20 individuals with a mean age of 27 +/- 4 years were tested. No significant side to side differences were observed. The average ADF [95% confidence interval] for non weightbearing was 4 degrees{[}1 degrees-8 degrees] with the knee extended and 20 degrees [16 degrees-24 degrees] for the knee 75 flexed. Mean weightbearing ADF was 25 degrees[22 degrees-28 degrees] for the knee extended and 39 degrees[36 degrees-42 degrees] for the knee 75 degrees flexed. The mean differences between 20 degrees knee flexion and full extension were 15 degrees[12 degrees-18 degrees] non weightbearing and 13 degrees[11 degrees-16 degrees] weightbearing. Significant differences of ADF were only found between full extension and 20 degrees of knee flexion. Further knee flexion did not increase ADF. Conclusion: Knee flexion of 20 degrees fully eliminates the ADF restraining effect of the gastrocnemius. This knowledge is essential to design a standardized clinical examination assessing MGT

Avaliação do modelo CANEGRO/DSSAT para quatro cultivares de cana-de-açúcar.

A parametrização do modelo DSSAT/CANEGRO para a realidade brasileira é de grande importância para a obtenção de uma ferramenta para o monitoramento de safras agrícolas e para a elaboração de cenários agrícolas futuros. O presente trabalho enfocou as cultivares R570, NCo376, RB72-454 e SP83-2847 nas condições de Piracicaba/SP. Os dados biométricos foram coletados no Centro de Tecnologia Canavieira, comparando-se os valores observados com as simulações para as seguintes variáveis: perfilhamento, altura de colmo, IAF, número de folhas verdes; e a fitomassa da parte aérea. O modelo apresentou resultados satisfatórios para todas as cultivares testadas, com exceção da NCo376, para a qual houve subestimativa da massa seca da parte aérea (-32%) e índice de área foliar (-13%).CBA 2009

Unguis incarnatus – konservative oder operative Therapie?

Unguis incarnatus, an ingrown toenail, is a common condition in primary care, which is encountered by various medical professions. Inconsistent conservative treatment and nonindicated surgical treatment often result in complications and recurrence of the disease. Patients must be thoroughly informed about the complexity of the nail organ. This is a prerequisite to prevent trivialization of the disease and to achieve appropriate patient compliance for treatment. In this article a practical diagnostic and treatment algorithm for unguis incarnatus is presented. In mild cases of acute unguis incarnatus a consistent conservative treatment is the first-line strategy showing promising results. In cases of moderate to severe forms of acute unguis incarnatus, surgical procedures that preserve the nail matrix should be applied. For cases of chronic unguis incarnatus without an acute infection, elective partial matrixectomy can be indicated. Prior to any surgical intervention, detailed informed consent must be obtained from the patients. ZUSAMMENFASSUNG Der Unguis incarnatus ist ein häufiges Krankheitsbild, mit dem sich Patienten in der Hausarztpraxis, der dermatologischen Klinik oder der chirurgischen Notaufnahme vorstellen. Häufig führt die inkonsequente konservative Therapie oder die falsch-indizierte operative Intervention zu langwierigen und komplikationsreichen Verläufen, inklusive Rezidiven. Die Patienten sollten über die Komplexität des Nagelorgans aufgeklärt werden, um der Banalisierung der Erkrankung vorzubeugen, und eine entsprechende Compliance in der Therapie zu erreichen. In diesem Manuskript wird die sachgerechte Versorgung des Unguis incarnatus im Sinne eines praktischen Behandlungsalgorithmus dargestellt. Die konsequente konservative Therapie ist bei akutem Unguis incarnatus mit milder Ausprägung die Therapie der ersten Wahl mit guten Behandlungsergebnissen. Nagelerhaltende operative Eingriffe kommen bei moderaten/schweren akuten Formen zum Einsatz. Der chronische Unguis incarnatus, ohne floride Infektion, stellt eine elektive Operationsindikation dar. Sowohl bei den nagelerhaltenden Eingriffen als auch bei erweiterten operativen Maßnahmen ist eine chirurgische Operationsaufklärung obligat

Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: a cohort study of free-text electronic medical records

Electronic medical records from first opinion equine veterinary practice may represent a unique resource for epidemiologic research. The appropriateness of this resource for risk factor analyses was explored as part of an investigation into clinical and pharmacologic risk factors for laminitis. Amalgamated medical records from seven UK practices were subjected to text mining to identify laminitis episodes, systemic or intra-synovial corticosteroid prescription, diseases known to affect laminitis risk and clinical signs or syndromes likely to lead to corticosteroid use. Cox proportional hazard models and Prentice, Williams, Peterson models for repeated events were used to estimate associations with time to first, or subsequent laminitis episodes, respectively. Over seventy percent of horses that were diagnosed with laminitis suf- fered at least one recurrence. Risk factors for first and subsequent laminitis episodes were found to vary. Corticosteroid use (prednisolone only) was only significantly associated with subsequent, and not ini- tial laminitis episodes. Electronic medical record use for such analyses is plausible and offers important advantages over more traditional data sources. It does, however, pose challenges and limitations that must be taken into account, and requires a conceptual change to disease diagnosis which should be considered carefully

Facilitation of information literacy through a multilingual MOOC considering cultural aspects

Purpose The purpose of this paper is to demonstrate the rationale, technical framework, content creation workflow and evaluation for a multilingual massive open online course (MOOC) to facilitate information literacy (IL) considering cultural aspects. Design/methodology/approach A good practice analysis built the basis for the technical and content framework. The evaluation approach consisted of three phases: first, the students were asked to fill out a short self-assessment questionnaire and a shortened adapted version of a standardized IL test. Second, they completed the full version of the IL MOOC. Third, they were asked to fill out the full version of a standardized IL test and a user experience questionnaire. Findings The results show that first the designed workflow was suitable in practice and led to the implementation of a full-grown MOOC. Second, the implementation itself provides implications for future projects developing multilingual educational resources. Third, the evaluation results show that participants achieved significantly higher results in a standardized IL test after attending the MOOC as mandatory coursework. Variations between the different student groups in the participating countries were observed. Fourth, self-motivation to complete the MOOC showed to be a challenge for students asked to attend the MOOC as nonmandatory out-of-classroom task. It seems that multilingual facilitation alone is not sufficient to increase active MOOC participation. Originality/value This paper presents an innovative approach of developing multilingual IL teaching resources and is one of the first works to evaluate the impact of an IL MOOC on learners' experience and learning outcomes in an international evaluation study