Search

This study aimed to investigate the mechanism of low-magnitude high-frequency vibration (LMHFV) treatment on angiogenesis and blood flow for enhancement of fracture healing. Nine-month-old ovariectomized (OVX) and sham-operated (Sham) rats received closed fractures creation at the femora and were randomized into LMHFV treatment (Sham-V, OVX-V) or control (Sham-C, OVX-C) groups. Pulsed-wave Doppler indicated an increase in blood flow velocity of the femoral artery at weeks 2 (OVX pair: p = 0.030) and 4 (OVX pair: p = 0.012; Sham pair: p = 0.020) post-treatment. Significantly enhanced vascular volume (VV) at the fracture site in the vibration groups was demonstrated by 3-D high-frequency power Doppler at week 2 (Sham pair: p = 0.021) and micro-computed tomography (microCT) microangiography at weeks 2 (OVX pair: p = 0.009) and 4 (OVX pair: p = 0.034), which echoed the osteogenesis findings by radiographic and microCT analysis. VV in the OVX groups was inferior to the Sham groups. However, OVX-V showed higher percentages of angiogenic enhancement than Sham-V. Despite impaired neo-angiogenesis in osteoporotic fractures, LMHFV could increase blood flow and angiogenesis in both normal and osteoporotic fractures, thus enhancing fracture healing. [ABSTRACT FROM AUTHOR]

Healthcare systems worldwide face escalating costs and demographic changes, necessitating effective evaluation tools to understand their underlying challenges. Switzerland's high-quality yet costly healthcare system underscores the need for robust assessment methods. Existing international rankings often lack transparency and comparability, highlighting the value of structured frameworks like the Health System Performance Assessment (HSPA) by the World Health Organization (WHO). This framework evaluates healthcare systems across multiple dimensions including governance, resource generation, financing, and service delivery. This paper aims to integrate Swiss healthcare indicators from the Swiss Health Observatory (Obsan) into the HSPA framework, addressing the central research question: How can these indicators be mapped to the HSPA framework, and what insights does this integration provide? Our methodology includes selecting and categorizing Obsan indicators, manually mapping them to HSPA sub-functions, and validating these mappings using word embeddings and cosine similarity. An R Shiny application was developed for interactive visualization. Results demonstrate accurate indicator assignment, enabling intuitive visualization and enhancing data structuring.

This study investigates the interpersonal meanings expressed by English tag questions in the context of British university seminars from two dimensions: evidential modification of tags and conduciveness of responses. The data for the study derive from seminars in the British Academic Spoken English (BASE) Corpus, which is herein both quantitative and qualitative analyzed. The findings reveal that: (1) three-quarters of tag questions in the data are utilized by teachers, and the unmarked form of tag questions in university seminars are generally positive-negative forms, with a few examples of other varieties; (2) regarding evidential modification of tags, depending on the degree of epistemic certainty of the speakers on the proposition of the anchor, the default function of teachers' tag questions in the data is to convey emphasis, followed by confirmatory function, with only a few cases of informational function; and (3) regarding conduciveness of responses, over 70% of tag questions are followed by no verbal response, while less than 30% are followed by explicit responses. Accordingly, these findings raise the question of whether tag questions can really provide sufficient scope for interactions in classroom. It is hoped that this nuanced, corpus-based analysis of tag question utilization within the context of British university seminars would empirically reveal the interpersonal relations between teachers and students and thereby shed light on more efficient seminar discussions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wei, Leung and Sun.)

The reaction of a series of dinucleating bis(β-diketiminate) pro-ligands with mesitylcopper in the presence and absence of mono and diphosphines has allowed the isolation of a new series of dicopper(i) complexes. Inclusion of trans-1,2-cyclohexyl (1), 2,6-pyridyl (2), and 2,2'-oxydiaryl (3) spacers between the β-diketiminate units has been studied. The isolation of three new copper(i) phosphine complexes [1·Cu2(PPh3)2], [2·Cu2(PPh3)2] and [3·Cu2(PPh3)2] is reported. While these compounds display large CuCu separations of 5.4-7.9 Å in the solid state, solution data are consistent with a large degree of conformational freedom. Modification of the monophosphine to a diphosphine, DPPE, allowed the isolation of the novel 11-membered bimetallic macrocycle [2·Cu2(DPPE)] containing both a binucleating nitrogen based ligand and a chelating diphosphine. While acetonitrile adducts of this series could also be generated in situ, under forcing conditions reaction of the 2,6-pyridyl bridged ligand with mesityl copper led to the formation [2·Cu2]2. This latter complex is a dimer of dicopper(i) units in which the bis(β-diketiminate) ligand now binds four copper(i) centers through not only the expected κ 2 -N,N'-chelation but also κ 1 - and η 2 -binding of the central pyridine through orthogonal Cu-N and Cu-arene interactions. Reversible coordination of alkenes, pyridine and quinoline to the copper cluster was identified allowing the isolation and structural characterisation of a further series of dinuclear complexes [2·Cu2(pyridine)2], [2·Cu2(cyclopentene)2] and [2·Cu2(norbornene)2]. Solution studies allow quantification of the reversible binding event through a van't Hoff analysis. Both solution and the solid state data suggest a weak anagostic interaction exists in the latter two alkene complexes of copper(i). The new complexes have been characterized by X-ray diffraction, multinuclear NMR spectroscopy and CHN analysis.

The treatment of chronic osteomyelitis requires both appropriate surgical and antibiotic management. Prolonged intravenous antibiotic therapy followed by oral therapy is widely utilised. Despite this, the long-term recurrence rate can be up to 30%. A cohort of 50 patients from a 7-year period, 2003 to 2010, with chronic osteomyelitis was identified. This cohort was treated by surgical marginal resection in combination with local application of antibiotics (Collatamp G - gentamicin in a collagen fleece), a short course of systemic antibiotics post-operatively and conversion to oral antibiotics on discharge. Information was retrieved from case notes and computerized records. Outcomes from this cohort were compared with a historical cohort treated with marginal resection followed by 6 weeks of systemic antibiotics and 6 weeks of oral antibiotics. The mean follow-up duration was 3.2 years (SD 1.8). The average length of admission was 9.8 days (SD 11.4). 6 patients (12%) suffered recurrence of infection requiring further treatment. We used the Cierny and Mader classification to stratify the patients. 'A' hosts had a shorter duration of admission (7.1 days) than 'B' hosts (12.3 days). There was no significant difference between recurrence rates of 'A' and 'B' hosts. Where available, we found pre-operative C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels had no correlation with disease recurrence. Disease-free probability for this cohort compared favourably with the historical cohort. We believe local administration of gentamicin in a collagen fleece is a useful component in the management of chronic osteomyelitis.

The novel duolayer system, comprising a monolayer of ethylene glycol monooctadecyl ether (C18E1) and the water-soluble polymer poly(vinylpyrrolidone) (PVP), has been shown to resist forces such as wind stress to a greater degree than the C18E1 monolayer alone. This paper reports all-atom molecular dynamics simulations comparing the monolayer (C18E1 alone) and duolayer systems under an applied force parallel to the air/water interface. The simulations show that, due to the presence of PVP at the interface, the duolayer film exhibits an increase in chain tilt, ordering, and density, as well as a lower lateral velocity compared to the monolayer. These results provide a molecular rationale for the improved performance of the duolayer system under wind conditions, as well as an atomic-level explanation for the observed efficacy of the duolayer system as an evaporation suppressant, which may serve as a useful guide for future development for thin films where resistance to external perturbation is desirable.

Understanding, and improving, the behavior of thin surface films under exposure to externally applied forces is important for applications such as mimicking biological membranes, water evaporation mitigation, and recovery of oil spills. This paper demonstrates that the incorporation of a water-soluble polymer into the surface film composition, i.e., formation of a three-duolayer system, shows improved performance under an applied dynamic stress, with an evaporation saving of 84% observed after 16 h, compared to 74% for the insoluble three-monolayer alone. Canal viscometry and spreading rate experiments, performed using the same conditions, demonstrated an increased surface viscosity and faster spreading rate for the three-duolayer system, likely contributing to the observed improvement in dynamic performance. Brewster angle microscopy and dye-tagged polymers were used to visualize the system and demonstrated that the duolayer and monolayer system both form a homogeneous film of uniform, single-molecule thickness, with the excess material compacting into small floating reservoirs on the surface. It was also observed that both components have to be applied to the water surface together in order to achieve improved performance under dynamic conditions. These findings have important implications for the use of surface films in various applications where resistance to external disturbance is required.

Inflammatory responses are closely related to cancer progression and several diseases. Anti-inflammatory drugs that bind to inducible enzymes can be used as biomarkers for molecular imaging. Selective targeted contrast agents are expected to improve contrast-to-noise ratio (CNR) in MRI at the site of inflammation. In this work, three new Gd(3+) DO3A-amide MRI contrast agents (CAs) that conjugated to mefenamic acid (MA), a commonly used nonsteroidal anti-inflammatory drug (NSAID), through different linkers, ethylenediamine (GdL1), 2,2'-oxidiethylamine (GdL2) and 4,7,10-trioxa-1,13-tridecanediamine (GdL3) were studied. Their relaxivities were GdL1 (4.74 mM(-1) s(-1)), GdL2 (4.77 mM(-1) s(-1)), and GdL3 (4.95 mM(-1) s(-1)) at 400 MHz at 25 °C. Their serum albumin binding properties were studied by tryptophan emission-quenching experiments, with GdL1 showing a preferential binding toward HSA and BSA as compared with GdL2 and GdL3. They showed low cytotoxicities toward HeLa cells at high concentration (0.5 mM) and high cellular uptake in U87 cells as compared with GdDOTA. In vivo MRI showed increased T1-weighted contrast after intravenous injection of the agents. Moreover, T1 contrast was significantly enhanced for 1.5 h in the U87 tumor model and 2 h in the arthritis joint in adjuvant-induced arthritis (AIA) model at dosages of 0.1 and 0.03 mmol/kg, respectively. Most of the agents were cleared at 24 h post-administration in the AIA model with no observable T1 contrast. GdL1-3 showed superior retentions and intensity enhancements (IEs) at the kidney, liver, tumor, and arthritis joint to those of GdDOTA. GdL3 showed the highest relaxivity and IE at the arthritis joint and is therefore a potential candidate to be developed as MRI CAs that target inflammation.

Unlabelled: This study is a prospective cluster-randomized controlled clinical trial involving 710 elderly subjects to investigate the long-term effects of low-magnitude high-frequency vibration (LMHFV) on fall and fracture rates, muscle performance, and bone quality. The results confirmed that LMHFV is effective in reducing fall incidence and enhancing muscle performance in the elderly., Introduction: Falls are direct causes of fragility fracture in the elderly. LMHFV has been shown to improve muscle function and bone quality. This study is to investigate the efficacy of LMHFV in preventing fall and fractures among the elderly in the community., Methods: A cluster-randomized controlled trial was conducted with 710 postmenopausal females over 60 years. A total of 364 participants received daily 20 min LMHFV (35 Hz, 0.3 g), 5 days/week for 18 months; 346 participants served as control. Fall or fracture rate was taken as the primary outcome. Also, quadriceps muscle strength, balancing abilities, bone mineral density (BMD), and quality of life (QoL) assessments were done at 0, 9, and 18 months., Results: With an average of 66.0% compliance in the vibration group, 18.6% of 334 vibration group subjects reported fall or fracture incidences compared with 28.7% of 327 in the control (adjusted HR = 0.56, p = 0.001). The fracture rate of vibration and control groups were 1.1 and 2.3 % respectively (p = 0.171). Significant improvements were found in reaction time, movement velocity, and maximum excursion of balancing ability assessment, and also the quadriceps muscle strength (p < 0.001). No significant differences were found in the overall change of BMD. Minimal adverse effects were documented., Conclusion: LMHFV is effective in fall prevention with improved muscle strength and balancing ability in the elderly. We recommend its use in the community as an effective fall prevention program and to decrease related injuries.

Complex regional pain syndrome (CRPS) is an uncommon complication of orthopedic surgery, and few investigators have considered the incidence in foot and ankle surgery. In the present retrospective cohort study of 390 patients who had undergone elective foot and/or ankle surgery in our department from January to December 2009, the incidence of postoperative CRPS was calculated and explanatory variables were analyzed. A total of 17 patients (4.36%) were identified as meeting the International Association for the Study of Pain criteria for the diagnosis of CRPS. Of the 17 patients with CRPS, the mean age was 47.2 ± 9.7 years, and 14 (82.35%) were female. All the operations were elective, and 9 (52.94%) involved the forefoot, 3 (17.65%) the hindfoot, 3 (17.65%) the ankle, and 2 (11.76%) the midfoot. Twelve patients (70.59%) had new-onset CRPS after a primary procedure, and 5 (29.41%) had developed CRPS after multiple surgeries. Three patients (17.65%) had documented nerve damage intraoperatively and thus developed new-onset CRPS type 2. Blood test results were available for 14 patients (82.35%) at a minimum of 3 months postoperatively, and none had elevated inflammatory markers. Five of the patients (29.41%) were smokers, and 8 (47.06%) had had a pre-existing diagnosis of anxiety and/or depression. From our findings, we recommend that middle-age females and those with a history of anxiety or depression, who will undergo elective foot surgery, should be counseled regarding the risk of developing CRPS during the consent process. We recommend similar studies be undertaken in other orthopedic units, and we currently are collecting data from other orthopedic departments within Scotland., (Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Mixed monolayers of 1-octadecanol (C18OH) and ethylene glycol monooctadecyl ether (C18E1) were studied to assess their evaporation suppressing performance. An unexpected increase in performance and stability was found around the 0.5:0.5 bicomponent mixture and has been ascribed to a synergistic effect of the monolayers. Molecular dynamics simulations have attributed this to an additional hydrogen bonding interaction between the monolayer and water, due to the exposed ether oxygen of C18E1 in the mixed system compared to the same ether oxygen in the pure C18E1 system. This interaction is maximized around the 0.5:0.5 ratio due to the particular interfacial geometry associated with this mixture.

We aimed to establish a novel approach with 3D high frequency power Doppler ultrasonography (3D-HF-PDU) to assess microvasculature at the fracture site in rat femurs by comparing with microCT-based microangiography. Twenty-four 9-month-old ovariectomized (OVX) osteoporotic rats and age-matched sham-ovariectomized (Sham) rats were used for establishing closed fracture models on right femora. At 2, 4, and 8 weeks post-operatively, four rats in each group underwent in vivo 3D-HF-PDU scanning for evaluation of vascularization and blood flow at the fracture site. Then the fractured femora were harvested for ex vivo microangiography, and neovasculatures within the callus were reconstructed for vascular volume analysis. Correlation between the vascular volumes of the two methodologies was examined. Both 3D-HF-PDU and microangiography showed a decline of vascular volume at the fracture site from 2 to 8 weeks and a significantly larger volume in the Sham group than the OVX group. A significant linear positive correlation (r = 0.87, p < 0.001) was detected between the volumes measured by the two methodologies. Osteoporotic rats had a diminished angiogenic response and lower blood perfusion than Shams. We believe 3D-HF-PDU is feasible and reproducible for in vivo assessment of microvasculature during femoral fracture healing in rats., (Copyright © 2011 Orthopaedic Research Society.)

Background: There are no clear guidelines on implant removal. Few have assessed the long-term outcomes of patients with implants left in-situ, or removed. Therefore, removal of implants after fracture fixation remains controversial., Methods: In this retrospective study, we reviewed 53 patients with implant for fracture fixation in-situ for more than 3 years. All patients were younger than 60 years. Quality of life of each patient was assessed with the Chinese (Hong Kong) validated Short Form-36 and the pain was assessed with visual analogue scale (VAS). All patients were clinically examined and plain radiographs were taken., Results: The total SF-36 score of the patients was not statistically different from the Hong Kong norm (P > 0.05). Mean score of VAS was 2.08. Thirty-three patients (62.3%) reported limited range of movement, 9 patients (17%) complained of cosmetic problems, and 10 patients (18.9%) complained of weakness. Clinically, 82.6% of patients had no scarring, 84.7% of patients had full range of movement and all had no tenderness on assessment. Radiologically, no abnormality was detected except for one patient with known avascular necrosis of the femoral head after screw fixation., Conclusion: As most patients were clinically and radiologically normal with quality of life scores comparable to the norm, removal of implants is not advisable as a routine practice.

Low-magnitude high-frequency vibration (LMHFV) (35 Hz, 0.3 g) accelerates fracture healing by enhancing callus formation and mineralization for both normal and osteoporotic rats in our previous studies.1,2 We hypothesized that LMHFV enhances fracture healing through bone remodeling. Ibandronate was used to suppress LMHFV-stimulated bone remodeling and changes in remodeling were investigated to verify our hypothesis. Closed femoral fractures were created in 80 osteoporotic female Sprague-Dawley rats. The rats were randomly assigned into control (CG), LMHFV (VG) (20 min/day, 5 days/week), ibandronate (BG) (7 µg/kg/week), or LMHFV + ibandronate (VBG) for a treatment duration of 2, 4, 6, or 8 weeks. Blood was taken and the femora were harvested for histological and radiological analyses. VG had the fastest drop in callus area (CA) and width (CW), and bone volume to tissue volume ratio (BV/TV); whereas, a plateaued trend in BG and VBG was observed. The fastest callus reduction, highest mineral apposition rate at week 6, and increased serum concentration of osteocalcin and TRAP5b in VG suggested enhanced remodeling. LMHFV partially reversed the inhibition of bone remodeling by ibandronate suggested LMHFV had an opposite effect on bone remodeling to ibandronate. In conclusion, LMHFV accelerated fracture healing by enhancing bone remodeling and the administration of ibandronate can impair this enhancement. LMHFV has great potential in improving fracture outcome clinically., (Copyright © 2010 Orthopaedic Research Society.)

We present a case of intraarticular myositis ossificans in the right knee of a child. Myositis ossificans (MO), though relatively rare in childhood and even more uncommon within a joint, should be included in the differential diagnosis of an intra-articular mass when indicated by the typical clinical, radiographic, and histologic findings. An 11-year-old male presented with a history of trauma to his right knee. Four weeks after the initial injury, an MRI demonstrated evidence of an ACL rupture with a "cystic mass" within the intercondylar notch along the anterior surface of the torn ligament. At subsequent arthroscopy, the mass noted on MRI was removed. The histology was consistent with MO. The authors believe this to be the first case of MO in the intercondylar notch detected by MRI, treated by arthroscopy, and confirmed by histology.

Fracture healing is impaired in osteoporotic bone. Low-magnitude high-frequency vibration (LMHFV) has recently been proven to be osteogenic in osteoporotic intact bone. Our previous study found that LMHFV significantly enhanced fracture healing in adult rats. This study was designed to explore whether LMHFV was able to promote fracture healing in osteoporotic bone by enhancing callus formation, remodeling, and mineralization and to compare with age-matched nonosteoporotic ones. Nine-month-old ovariectomy (OVX)-induced osteoporotic rats were randomized into control (OVX-C) or vibration group (OVX-V); age-matched sham-operated rats were assigned into control (Sham-C) or vibration group (Sham-V). LMHFV (35 Hz, 0.3 g) was given 20 min/day and 5days/week to the treatment groups, while sham treatment was given to the control groups. Weekly radiographs and endpoint micro-CT, histomorphometry, and mechanical properties were evaluated at 2, 4, and 8 weeks post-treatment. Results confirmed that the fracture healing in OVX-C was significantly inferior to that in Sham-C. LMHFV was shown to be effective in promoting the fracture healing in OVX group in all measured parameters, particularly in the early phases of healing, with the outcomes comparable to that of age-matched normal fracture healing. Callus formation, mineralization and remodeling were enhanced by 25-30%, with a 70% increase in energy to failure than OVX-C. However, Sham-V was found to have lesser fracture healing enhancement, with significant increase in callus area only on week 2 and 3 than Sham-C, suggesting non-OVX aged bones were less sensitive to mechanical loading. The findings of this study provide a good basis to suggest that proceeding to clinical trials is the next step to evaluate the efficacy of LMHFV on osteoporotic fracture healing., (Copyright (c) 2009 Elsevier Inc. All rights reserved.)

Squamous metaplasia and cystic change can appear in the thyroid and mimic a variety of lesions. In this report, a patient with two dominant left thyroid nodules underwent fine needle aspiration (FNA) biopsy for each nodule. One of the nodules was diagnosed as consistent with papillary carcinoma and the other as suspicious for papillary carcinoma. Subsequent near total thyroidectomy revealed both lesions to be part of a goiter with extensive squamous metaplasia. This article discusses a potential pitfall in the interpretation of fine needle aspirates of squamous metaplastic cells in the thyroid.

A robust method for the identification of Campylobacter spp. based on direct sequencing of PCR-amplified partial cpn60 sequences and comparison of these to a reference database of cpn60 sequences is reported. A total of 53 Campylobacter isolates, representing 15 species, were identified and distinguished from phenotypically similar Helicobacter and Arcobacter strains. Pairwise cpn60 sequence identities between Campylobacter spp. ranged from 71 to 92 %, with most between 71 and 79 %, making discrimination of these species obvious. The method described overcomes limitations of existing PCR-based methods, which require time-consuming and complex post-amplification steps such as the cloning of amplification products. The results of this study demonstrate the potential for use of the reference chaperonin sequence database, cpnDB, as a tool for identification of bacterial isolates based on cpn60 sequences amplified with universal primers.