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Objectives: To determine whether adherence to hip fracture clinical care quality indicators influences mortality among people who undergo surgery after hip fracture in New South Wales, both overall and by individual indicator. Study design: Retrospective population‐based study; analysis of linked Australian and New Zealand Hip Fracture Registry (ANZHFR), hospital admissions, residential aged care, and deaths data. Setting, participants: People aged 50 years or older with hip fractures who underwent surgery in 21 New South Wales hospitals participating in the ANZHFR, 1 January 2015 – 31 December 2018. Main outcome measures: Thirty‐day (primary outcome), 120‐day, and 365‐day mortality (secondary outcomes) by clinical care indicator adherence level (low: none to three of six indicators achieved; moderate: four indicators achieved; high: five or six indicators achieved) and by individual indicator. Results: Registry data were available for 9236 hip fractures in 9058 people aged 50 years or older during 2015–2018; the mean age of patients was 82.8 years (standard deviation, 9.3 years), 5510 patients were women (69.4%). Complete data regarding adherence to clinical care indicators were available for 7951 fractures (86.1%); adherence to these indicators was high for 5135 (64.6%), moderate for 2249 (28.3%), and low for 567 fractures (7.1%). After adjustment for age, sex, comorbidity, admission year, pre‐admission walking ability, and residential status, 30‐day mortality risk was lower for high (adjusted relative risk [aRR], 0.40; 95% confidence interval [CI], 0.30–0.52) and moderate indicator adherence hip fractures (aRR, 0.61; 95% CI, 0.46–0.82) than for low indicator adherence hip fractures, as was 365‐day mortality (high adherence: aRR, 0.59 [95% CI, 0.51–0.68]; moderate adherence: aRR, 0.74 [95% CI, 0.63–0.86]). Orthogeriatric care (365 days: aRR, 0.78; 95% CI, 0.61–0.98) and offering mobilisation by the day after surgery (365 days: aRR, 0.74; 95% CI, 0.67–0.83) were associated with lower mortality risk at each time point. Conclusions: Clinical care for two‐thirds of hip fractures attained a high level of adherence to the six quality care indicators, and short and longer term mortality was lower among people who received such care than among those who received low adherence care. [ABSTRACT FROM AUTHOR]

Injectable hydrogels for cancer immunotherapy are effective for both active and passive approaches. Tumor‐infiltrating lymphocyte (TIL) immunoshaping can change the tumor microenvironment to favor tumor cell elimination. The primary objective of immunoshaping is to reduce regulatory T‐cells (Tregs), which can enhance the effectiveness of ex vivo immune cell therapy in solid tumors. A shear‐thinning injectable hydrogel that consists of gelatin and Laponite (Gel‐Lap) is used in this study. By optimizing the formulation, their immunotherapeutic and anti‐tumor properties are examined. Gemcitabine (GEM), an anti‐metabolite cancer chemotherapy agent, is loaded into a Gel‐Lap hydrogel (immunogel). The study compares the effects of immunogel on 4T1 inoculated breast cancer animal models. Results show that immunogel increases survival rates and significantly inhibits metastasis. The Treg cell population reduction is observed up to 70% in TILs and splenocyte population in line with CD8+ T‐cells population increment in inguinal lymph nodes near the tumor region; the CD8+ T‐cells function may be mediated through overexpression of eomesodermin (EOMES) as cytotoxic T lymphocyte (CTL) activation transcription factor. The human 3D cell culture model confirmed results in animal data demonstrating T‐cell migration through the hydrogel and anticancer efficacy. Local delivery of GEM using our silicate‐based hydrogel holds promise for editing tumor microenvironment in favor of systemic immune responses. [ABSTRACT FROM AUTHOR]

Reduced order modelling (ROMs) methods, such as proper orthogonal decomposition (POD), systematically reduce the dimensionality of high‐fidelity computational models and potentially achieve large gains in execution speed. Machine learning (ML) using neural networks has been used to overcome limitations of traditional ROM techniques when applied to nonlinear problems, which has led to the recent development of reduced order models augmented by machine learning (ML‐ROMs). However, the performance of ML‐ROMs is yet to be widely evaluated in realistic applications and questions remain regarding the optimal design of ML‐ROMs. In this study, we investigate the application of a non‐intrusive parametric ML‐ROM to a nonlinear, time‐dependent fluid dynamics problem in a complex 3D geometry. We construct the ML‐ROM using POD for dimensionality reduction and neural networks for interpolation of the ROM coefficients. We compare three different network designs in terms of approximation accuracy and performance. We test our ML‐ROM on a flow problem in intracranial aneurysms, where flow variability effects are important when evaluating rupture risk and simulating treatment outcomes. The best‐performing network design in our comparison used a two‐stage POD reduction, a technique rarely used in previous studies. The best‐performing ROM achieved mean test accuracies of 98.6% and 97.6% in the parent vessel and the aneurysm, respectively, while providing speed‐up factors of the order 105. [ABSTRACT FROM AUTHOR]

This article reports on a case of osteoid osteoma in the distal radius that presented with symptoms similar to Brodie's abscess. The patient, a 17-year-old male, had a history of a distal radius fracture and subsequent re-fracture. Initial radiographs suggested chronic infection, but further evaluation and a biopsy confirmed the diagnosis of osteoid osteoma. The patient underwent open curettage and experienced significant improvement in pain and function. This case highlights the importance of considering a range of differential diagnoses and involving a multidisciplinary team in the assessment and management of bony lesions. [Extracted from the article]

Dysbiosis of vaginal microbiota is associated with increased HIV‐1 acquisition, but the underlying cellular mechanisms remain unclear. Vaginal Langerhans cells (LCs) protect against mucosal HIV‐1 infection via autophagy‐mediated degradation of HIV‐1. As LCs are in continuous contact with bacterial members of the vaginal microbiome, we investigated the impact of commensal and dysbiosis‐associated vaginal (an)aerobic bacterial species on the antiviral function of LCs. Most of the tested bacteria did not affect the HIV‐1 restrictive function of LCs. However, Prevotella timonensis induced a vast uptake of HIV‐1 by vaginal LCs. Internalized virus remained infectious for days and uptake was unaffected by antiretroviral drugs. P. timonensis‐exposed LCs efficiently transmitted HIV‐1 to target cells both in vitro and ex vivo. Additionally, P. timonensis exposure enhanced uptake and transmission of the HIV‐1 variants that establish infection after sexual transmission, the so‐called Transmitted Founder variants. Our findings, therefore, suggest that P. timonensis might set the stage for enhanced HIV‐1 susceptibility during vaginal dysbiosis and advocate targeted treatment of P. timonensis during bacterial vaginosis to limit HIV‐1 infection. Synopsis: Vaginal Langerhans cells (LCs) destroy HIV‐1 upon capture, thereby protecting against infection. Investigation of various commensal and dysbiotic bacteria reveals that Prevoptella timonensis selectively subverts these restrictive cells into reservoirs mediating efficient HIV‐1 transmission to target T cells.P. timonensis, but not other dysbiosis‐associated vaginal bacteria, enhances HIV‐1 uptake in LCs.P. timonensis transforms LCs into HIV‐1 reservoirs.HIV‐1 remains infectious for several days in P. timonensis‐exposed LCs.P. timonensis‐exposed LCs efficiently transmit captured HIV‐1 to target cells. [ABSTRACT FROM AUTHOR]

The use of cricoid pressure (CP) to prevent aspiration during rapid sequence induction (RSI) has become controversial, although CP is considered central to the practice of RSI. There is insufficient research to support its efficacy in reducing aspiration, and emerging concerns it reduces the first‐pass success (FPS) of intubation. This systematic review aims to assess the safety and efficacy of CP during RSI in EDs by investigating its effect on FPS and the incidence of complications, including gastric regurgitation and aspiration. A systematic review of four databases was performed for all primary research investigating CP during RSI in EDs. The primary outcome was FPS; secondary outcomes included complications such as gastric regurgitation, aspiration, hypoxia, hypotension and oesophageal intubation. After screening 4208 citations, three studies were included: one randomised controlled trial (n = 54) investigating the incidence of aspiration during the application of CP and two registry studies (n = 3710) comparing the rate of FPS of RSI with and without CP. The results of these individual studies are not sufficient to draw concrete conclusions but do suggest that aspiration occurs regardless of the application of CP, and that FPS is not reduced by the application of CP. There is insufficient evidence to conclude whether applying CP during RSI in EDs affects the rate of FPS or the incidence of complications such as aspiration. Further research in the ED, including introducing CP usage into other existing airway registries, is needed. [ABSTRACT FROM AUTHOR]

Iron oxychloride (FeOCl) is known for reactive oxygen species (ROS) generation through Fenton chemistry. The activity of FeOCl is preserved in the slightly acidic pH value of the tumor microenvironment (pH 6.5−6.9). Such property can be advantageous in biobased systems, where ROS generation can be modulated in slightly acidic conditions, which is characteristic of the solid tumor microenvironment. In the present study, BSA‐stabilized FeOCl nanosheets (NSs) are synthesized and characterized by transmission electron microscope, Fourier transform infrared spectroscopy, zeta potential analysis, dynamic light scattering, and UV–vis spectroscopy. The morphology of the nanoparticles is flake‐like, and their hydrodynamic diameter is around 200 nm. MTT, apoptosis assay, and trypan blue staining evaluate the toxicity of FeOCl NSs toward the 4T1 cell line. It is found that the toxicity of the NSs is higher in physiological conditions of solid tumors (pH 6.5, H2O2 100 × 10−6m) than in the conditions of healthy organs (pH 7.4). Specifically, cancer cells are in their late apoptotic stage by more than eight times higher at pH 6.5 than pH 7.4. The toxicity results are in agreement with the in vitro catalytic assay of the NSs. Therefore, the FeOCl NSs can be the building blocks for constructing chemodynamic therapy agents. [ABSTRACT FROM AUTHOR]

As human life expectancy increases, there is an increased prevalence of neurodegenerative disorders and dementia. There are many ongoing research trials for early diagnosis and management of dementia, and neuroimaging is a critical part of such studies. However, conventional neuroimaging often fails to provide enough diagnostic findings in patients with neurodegenerative disorders. In this context, different MRI sequences are currently under investigation to facilitate the accurate diagnosis of such disorders. Susceptibility‐weighted imaging (SWI) is an innovative MRI technique that utilizes "magnitude" and "phase" images to produce an image contrast that is sensitive for the detection of susceptibility differences of the tissues. As many neurodegenerative disorders are associated with accelerated iron deposition and/or microhemorrhages in different parts of the brain, SWI can be applied to detect these diagnostic clues. For instance, in cerebral amyloid angiopathy, SWI can demonstrate cortical microhemorrhages, which are predominantly in the frontal and parietal regions. Or in Parkinson disease, abnormal swallow‐tail sign on high‐resolution SWI is highly diagnostic. Also, SWI is a useful sequence to detect the low signal intensity of precentral cortices in patients with amyotrophic lateral sclerosis. Being familiar with SWI findings in neurodegenerative disorders is critical for an accurate diagnosis. In this paper, the authors review the technical parameters of SWI, physiologic, and pathologic iron deposition in the brain, and the role of SWI in the evaluation of neurodegenerative disorders in daily practice. [ABSTRACT FROM AUTHOR]

Abstract: Criegee intermediates (CIs) are formed during the ozonolysis of unsaturated hydrocarbons in the troposphere. The fate of CIs is of critical importance to tropospheric oxidation chemistry, particularly in the context of radical and secondary organic aerosol formation. Using the high‐level ab initio G4(MP2) method, we investigate the 1,4 hydrogen shift reaction in CIs formed from ozonolysis of two common biogenic hydrocarbons: isoprene and α‐pinene. We consider the uncatalysed reaction, as well as the reaction catalysed by a water molecule and by sulphuric acid. We show that sulphuric acid is a very effective catalyst, leading to a barrierless tautomerization relative to the free reactants and to very low reaction barrier heights relative to the reactant complexes. In particular, we obtain reaction barrier heights of Δ H 298 ‡ = 24.5 (isoprene CI) and 8.4 (α‐pinene CI) kJ mol−1 relative to the reactant complexes. Given the reaction of OH radicals with SO2 in the troposphere can ultimately yield sulphuric acid, these findings may have significant consequences for current atmospheric chemical models for regions of high sulphur concentrations. [ABSTRACT FROM AUTHOR]

Virtual endovascular treatment models ( VETMs) have been developed with the view to aid interventional neuroradiologists and neurosurgeons to pre-operatively analyze the comparative efficacy and safety of endovascular treatments for intracranial aneurysms. Based on the current state of VETMs in aneurysm rupture risk stratification and in patient-specific prediction of treatment outcomes, we argue there is a need to go beyond personalized biomechanical flow modeling assuming deterministic parameters and error-free measurements. The mechanobiological effects associated with blood clot formation are important factors in therapeutic decision making and models of post-treatment intra-aneurysmal biology and biochemistry should be linked to the purely hemodynamic models to improve the predictive power of current VETMs. The influence of model and parameter uncertainties associated to each component of a VETM is, where feasible, quantified via a random-effects meta-analysis of the literature. This allows estimating the pooled effect size of these uncertainties on aneurysmal wall shear stress. From such meta-analyses, two main sources of uncertainty emerge where research efforts have so far been limited: (1) vascular wall distensibility, and (2) intra/intersubject systemic flow variations. In the future, we suggest that current deterministic computational simulations need to be extended with strategies for uncertainty mitigation, uncertainty exploration, and sensitivity reduction techniques. WIREs Syst Biol Med 2017, 9:e1385. doi: 10.1002/wsbm.1385 For further resources related to this article, please visit the . [ABSTRACT FROM AUTHOR]

Hip injuries, Fractures, bone, Orthopedic procedures, Trauma surgery, Mortality, Health services for the aged, Aged Keywords: Hip injuries; Fractures, bone; Orthopedic procedures; Trauma surgery; Mortality; Health services for the aged; Aged EN Hip injuries Fractures, bone Orthopedic procedures Trauma surgery Mortality Health services for the aged Aged 420 421 2 05/04/22 20220501 NES 220501 Hip fractures are devastating for older people. Improved survival rates after hip fracture surgery in New South Wales, 2011-2018. [Extracted from the article]

For researchers, policymakers, and practitioners facing a new field, undertaking a systematic review can typically present a challenge due to the enormous number of relevant papers. A scoping review is a method suggested for addressing this dilemma; however, scoping reviews present their own challenges. This paper introduces the 'scoping meta-review' (SMR) for expanding current methodologies and is based on our experiences in mapping the field of consumer engagement in healthcare. During this process, we developed the novel SMR method. An SMR combines aspects of a scoping review and a meta-review to establish an evidence-based map of a field. Similar to a scoping review, an SMR offers a practical and flexible methodology. However, unlike in a traditional scoping review, only systematic reviews are included. Stages of the SMR include: undertaking a preliminary nonsystematic review; building a search strategy; interrogating academic literature databases; classifying and excluding studies based on titles and abstracts; saving the refined database of references; revising the search strategy; selecting and reviewing the full text papers; and thematically analyzing the selected texts and writing the report. The main benefit of an SMR is to map a new field based on high-level evidence provided by systematic reviews. [ABSTRACT FROM AUTHOR]

Keywords: Hip injuries; Fractures; bone; Orthopedic procedures; Trauma surgery; Transportation of patients; Mortality; Aged EN Hip injuries Fractures bone Orthopedic procedures Trauma surgery Transportation of patients Mortality Aged 87 88 2 07/29/21 20210715 NES 210715 Australians have around 19 000 hip fractures each year,1 and the estimated cost to the health care system was $445 million in 2015-16.2 Surgery within 48 hours of initial presentation to hospital is widely accepted as a clinically meaningful indicator of best practice care, and is supported by the Australian Hip Fracture Care Clinical Care Standard when there are no clinical contraindications.3 However, timely access to emergency orthopaedic hip fracture surgery is difficult in a country as large and geographically diverse as Australia; patients admitted to remote or regional hospitals that do not provide orthopaedic surgery must be transferred to larger regional centres. Impact of pre-surgery hospital transfer on time to surgery and 30-day mortality for people with hip fractures Hip injuries, Fractures, bone, Orthopedic procedures, Transportation of patients, Mortality, Aged, Trauma surgery. [Extracted from the article]

Background Routine outcome measurement ( ROM) in CAMHS is supported by U.K. Government policy. However, little is known about how measures are used in practice. Method Data describing use of ROM, knowledge and attitudes regarding implementation were collected using a regional case-note audit, online survey and stakeholder workshop. Results While the principle of ROM was supported by stakeholders, baseline and follow-up outcome measurement occurred in less than a fifth of cases. Barriers to implementation included lack of training and resources, clinicians' perceptions of the limitations of existing measures and lack of regular feedback of outcome data. Conclusions Implementation of ROM may be facilitated by session-by-session measures with immediate feedback to clinicians and patients. [ABSTRACT FROM AUTHOR]

Antinociceptive potency of opioids is greater against various noxious stimuli in animals with peripheral inflammation. Opioid agonists stimulate activation of G-protein-coupled receptor. Changes in the resting levels of G-protein subtypes could have an effect on intracellular signalling pathways. The present study was designed to investigate the effects of analgesic morphine treatment on the level G-protein subunits mRNA in the presence and absence of inflammation. Our results showed that the carrageenan administration increased G-protein subunits. Administration of analgesic dose of morphine alone and in the presence of inflammation induced different alterations in the levels of G-protein mRNA. Taken together, the results obtained using real time RT-PCR suggested that G-protein genes expression levels following the acute administration of morphine between animals with and without inflammation could influence, at least in part, analgesic responsiveness. [ABSTRACT FROM AUTHOR]

Influenza is a viral respiratory pathogen responsible for frequent seasonal epidemics. There are currently three major human influenza viruses in global circulation namely A/H1N1, A/H3N2, and B. The objective of this study was to determine the human influenza virus genotypes in Shiraz, the capital of the Fars province of Iran. Three hundred patients suspected with human influenza virus infection were enrolled in this survey (2004–2005). The throat samples were cultured and titrated by hemagglutination (HA) assay. Typing and subtyping were performed by an in‐house developed multiplex RT–PCR. Moreover, the phylogenetic analysis was carried out for HA gene. A total of 24 samples were found to be positive for human influenza virus infection, 17 H1N1 and 7 H3N2. These results were in agreement with the HI assay. The phylogenetic analysis results revealed that the Iranian H1N1 isolated were close to the A/New Caledonia/20/99 vaccine strain genetically and the Iranian H3N2 isolates were also related closely to the Fujian/411/021 and California/7/2004 vaccine strains. However, a slight genetic drift was found in these isolates. In conclusion, it was demonstrated that both influenza A subtypes A/H1N1 and A/H3N2 were dominant among Iranian patients in Shiraz during the 2004/5 winter season. J. Med. Virol. 79: 803–810, 2007. © 2007 Wiley‐Liss, Inc. [ABSTRACT FROM AUTHOR]

Computational fluid dynamics models are increasingly proposed for assisting the diagnosis and management of vascular diseases. Ideally, patient‐specific flow measurements are used to impose flow boundary conditions. When patient‐specific flow measurements are unavailable, mean values of flow measurements across small cohorts are used as normative values. In reality, both the between‐subjects and within‐subject flow variabilities are large. Consequently, neither one‐shot flow measurements nor mean values across a cohort are truly indicative of the flow regime in a given person. We develop models for both the between‐subjects and within‐subject variability of internal carotid flow. A log‐linear mixed effects model is combined with a Gaussian process to model the between‐subjects flow variability, while a lumped parameter model of cerebral autoregulation is used to model the within‐subject flow variability in response to heart rate and blood pressure changes. The model parameters are identified from carotid ultrasound measurements in a cohort of 103 elderly volunteers. We use the models to study intracranial aneurysm flow in 54 subjects under rest and exercise and conclude that OSI, a common wall shear‐stress derived quantity in vascular CFD studies, may be too sensitive to flow fluctuations to be a reliable biomarker. [ABSTRACT FROM AUTHOR]

Introduction: The significant rise in incidence of Hepatitis C virus (HCV) infection among men‐who‐have‐sex‐with‐men (MSM) living with HIV‐1 suggests that HCV under specific circumstances is transmitted via sexual contact. During sexual transmission HCV has to cross the epithelial barrier to either directly enter the blood stream or indirectly via mucosal immune cells. However, the mechanisms of sexual transmission of HCV remain unclear. We investigated the role of Langerhans cells (LCs) in HCV susceptibility during sexual contact as LCs are among the first cells in mucosal tissues to encounter invading viruses. Methods: We investigated the phenotype of primary LCs in anal biopsies from MSM living with HIV‐1. To investigate the role of primary LCs in HCV infection and transmission, we have used both isolated primary skin LCs and the ex vivo tissue transmission model. Results: Our data identified an important role for mucosal LCs in facilitating HCV transmission after HIV‐1 exposure or immune activation. LCs were detected within mucosal anal tissues obtained from HIV‐1 positive MSM biopsies. In order to perform functional studies, we used primary LCs from skin, which have a similar phenotype as mucosal LCs. Immature LCs were neither infected nor transmitted HCV to hepatocytes. Notably, exposure to HIV‐1 significantly increased HCV transmission by LCs in the ex vivo transmission model. HIV‐1 replication was crucial for the increased HCV transmission as HIV‐1 inhibitors significantly reduced HIV‐1‐induced HCV transmission. Moreover, tissue immune activation of LCs also increased HCV transmission to target cells. Conclusions: Thus, our data strongly indicate that HIV‐1 or immune activation in MSM leads to capture of HCV by mucosal LCs, which might facilitate transmission to other cells or allow entry of HCV into the blood. This novel transmission mechanism by LCs also implicates that the activation state of LCs is an important cellular determinant for HCV susceptibility after sexual contact. [ABSTRACT FROM AUTHOR]