Outcomes following operative and non-operative management of humeral midshaft fractures: a prospective, observational cohort study of 47 patients

Background Although the non-operative management of closed humeral midshaft fractures has been advocated for years, the increasing popularity of operative intervention has left the optimal treatment choice unclear. Objective To compare the outcomes of operative and non-operative treatment of traumatic closed humeral midshaft fractures in adult patients. Methods A multicentre prospective comparative cohort study across 20 centres was conducted. Patients with AO type 12 A2, A3 and B2 fractures were treated with a functional brace or a retrograde-inserted unreamed humeral nail. Follow-up measurements were taken at 6, 12 and 52 weeks after the injury. The primary outcome was fracture healing after 1 year. Secondary outcomes included sub-items of the Constant score, general patient satisfaction, complications and cost-effectiveness parameters. Functions of the uninjured extremity were used as reference parameters. Intention-to-treat analysis was applied with the use of t-tests, Fisher’s exact tests, Mann–Whitney U-tests and adjusted analysis of variance (ANOVA). Results Forty-seven patients were included. The patient sample consisted of 23 women and 24 men, with a mean age of 52.7 years (range 17–86 years). Of the 47 cases, 14 were treated non-operatively and 33 operatively. The follow-up rate at 1 year was 81%. After 1 year, 11 fractures (100%) healed in the non-operative group and at least 24 fractures (≥89%) healed in the operative group [1 non-union patient (4%) and no data for 2 patients (7%)]. There were no significant differences in pain, range of motion (ROM) of the shoulder and elbow, and return to work after 6 weeks, 12 weeks and 1 year. Although operatively treated patients showed significantly greater shoulder abduction strength (p = 0.036), elbow flexion strength (p = 0.021), functional hand positioning (p = 0.008) and return to recreational activities (p = 0.043) after 6 weeks, no statistically significant differences existed in any outcome measure at the 1-year follow-up. Conclusions Our findings indicate that the non-operative management of humeral midshaft fractures can be expected to have similar functional outcomes and patient satisfaction at 1 year, despite an early benefit to operative treatment. If no radiological evidence of fracture healing exists in non-operatively treated patients during early follow-up, a switch to surgical treatment results in good functional outcomes and patient satisfaction. Keywords: Humeral shaft fracture, Non-operative treatment, Functional brace, Operative treatment, Unreamed humeral nail (UHN), Prospective, Cohort study

A preference-based semantics for CTD reasoning

In [8] the authors developed a logical system based on the definition of a new non-classical connective ⊗ capturing the notion of reparative obligation. The system proved to be appropriate for handling well-known contrary-to-duty paradoxes but no model-theoretic semantics was presented. In this paper we fill the gap and define a suitable possible-world semantics for the system for which we can prove soundness and completeness. The semantics is a preference-based non-normal one extending and generalizing semantics for classical modal logics.

p53 and little brother p53/47: linking IRES activities with protein functions

The tumor suppressor p53 represents a paradigm for gene regulation. Its rapid induction in response to DNA damage conditions has been attributed to both increased half-life of p53 protein and also increased translation of p53 mRNA. Recent advances in our understanding of the post-transcriptional regulation of p53 include the discovery of internal ribosome entry sites (IRESs) within the p53 mRNA. These IRES elements regulate the translation of the full length as well as the N-terminally truncated isoform, p53/47. The p53/47 isoform is generated by alternative initiation at an internal AUG codon present within the p53 ORF. The aim of this review is to summarize the role of translational control mechanisms in regulating p53 functions. We discuss here in detail how diverse cellular stress pathways trigger alterations in the cap-dependent and cap-independent translation of p53 mRNA and how changes in the relative expression levels of p53 isoforms result in more differentiated p53 activity.

Structure of Sesbania Mosaic Virus at 4·7 Å Resolution and Partial Sequence of the Coat Protein

Sesbania mosaic virus (SMV) is a plant virus infecting Sesbania grandiflora plants in Andhra Pradesh, India. Amino acid sequence of the tryptic peptides of SMV coat protein were determined using a gas phase sequenator. These sequences showed identical amino acids at 69% of the positions when aligned with the corresponding residues of southern bean mosaic virus (SBMV).Crystals diffracting to better than 3 Å resolution were obtained by precipitating the virus with ammonium sulphate. The crystals belonged to rhombohedral space group R3 with α = 291·4 Å and α = 61·9°. Three-dimensional X-ray diffraction data on these crystals were collected to a resolution of 4·7 Å, using a Siemens-Nicolet area detector system. Self-rotation function studies revealed the icosahedral symmetry of the virus particles, as well as their precise orientation in the unit cell. Cross-rotation function and modelling studies with SBMV showed that it is a valid starting model for SMV structure determination. Low resolution phases computed using a polyalanine model of SBMV were subjected to refinement and extension by real-space electron density averaging and solvent flattening. The final electron density map revealed a polypeptide fold similar to SBMV. The single disulphide bridge of SBMV coat protein is retained in SMV. Four icosahedrally independent cation binding sites have been tentatively identified. Three of these sites, related by a quasi threefold axis, are also found in SBMV. The fourth site is situated on the quasi threefold axis. Aspartic acid residues, which replace Ile218 of SBMV from the quasi threefold-related subunits are suitable ligands to the cation at this site

Effect of neodymium (Nd) doping on the dielectric and ferroelectric characteristics of sol-gel derived lead zirconate titanate (53/47) thin films

The results of the studies on the effect of rare earth Nd doping on the phase formation behavior and electrical properties of sol-gel derived Pb-1.05(Zr0.53Ti0.47)O-3 (PZT) thin films are presented. The perovskite phase is obtained up to 5 at. % doping and beyond that pyrochlore phase was found to coexist with the perovskite phase in all the films. The transition temperature of undoped lead zirconate titanate (PZT) film was found to be reduced with Nd doping. The Nd doped films also exhibited typical relaxor-type behavior and a diffuse phase transition, similar to that observed in relaxor materials. The introduction of Nd into the PZT lattice probably introduces disorder in the B site of ABO(3) lattice, which causes the observed dielectric relaxation. Efforts were made to isolate the irreversible component contributions in low field dielectric and high field polarization switching behavior. (C) 2001 American Institute of Physics.

Gd1.96-xYxEu0.04O3 (x=0.0, 0.49, 0.98, 1.47, 1.96 mol%) nanophosphors: Propellant combustion synthesis, structural and luminescence studies

Gd1.96-xYxEu0.04O3 (x = 0.0, 0.49, 0.98, 1.47, 1.96 mol%) nanophosphors were synthesized by propellant combustion method at low temperature (400 degrees C). The powder X-ray diffraction patterns of as formed Gd1.96Eu0.04O3 showed monoclinic phase, however with the addition of yttria it transforms from monoclinic to pure cubic phase. The porous nature increases with increase of yttria content. The particle size was estimated from Scherrer's and W-H plots which was found to be in the range 30-40 nm. These results were in well agreement with transmission electron microscopy studies. The optical band gap energies estimated were found to be in the range 5.32-5.49 eV. PL emission was recorded under 305 nm excitation show an intense emission peak at 611 nm along with other emission peaks at 582, 641 nm. These emission peaks were attributed to the transition of D-5(0) —> F-7(J) (J = 0, 1, 2, 3) of Eu3+ ions. It was observed that PL intensity increases with increase of Y content up to x = 0.98 and thereafter intensity decreases. CIE color co-ordinates indicates that at x = 1.47 an intense red bright color can be achieved, which could find a promising application in flat panel displays. The cubic and monoclinic phases show different thermoluminescence glow peak values measured under identical conditions. The response of the cubic phase to the applied dose showed good linearity, negligible fading, and simple glow curve structure than monoclinic phase indicating that suitability of this phosphor in dosimetric applications. (C) 2014 Elsevier B.V. All rights reserved.

Letras, 2002-2003, nº 46-47 (número completo)

Contenido: Resúmenes – Ángel J. Battistessa, 1902-2002 – Un abordaje lingüístico del texto. La sintaxis de la oralidad en “Cae la noche tropical” de Manuel Puig / Norma Carricaburo – Una lectura de los “Cuatro Cuartetos” de T. S. Eliot / Inés de Cassagne – El mundo de la palabra en la comunicación oral: percepción, reconocimiento y acceso al léxico / María Amalia García Jurado – La pluralidad discursiva en la narrativa argentina de las últimas décadas / Luis Martínez Cuitiño – Una perspectiva humanista para el estudio de las letras: los aportes de la fenomenología y la hermenéutica / Graciela Maturo – La acrecibilidad como rasgo genérico y la edición de una crónica medieval en dos versiones / José Luis Moure – Del Siglo de Oro al cine argentino / Saura, Norma – La locución conjuntiva tanto que y la correlación anafórica tanto… que en la subordinación temporal y consecutiva del “Amadís de Gaula” de Garci Rodríguez de Montalvo / Aquilino Suárez Pallasá – Notas – Reseñas bibliográficas

Prudentia Iuris, 1998, n° 47-48 (número completo)

Contenido: Editorial – Perspectivas del Derecho del Trabajo / Jorge Rodríguez Mancini – Conciliación laboral / Santiago A. Zarza – Modificaciones introducidas al régimen remuneratorio por la ley 24.700 / Liliana Hebe Litterio – Pago de la remuneración mediante depósito bancario / Liliana Hebe Litterio – Régimen de asignaciones familiares / José B. Gómez Paz – Trabajo humano y retribución justa / Mario F. Vivino – La reforma laboral según la Ley 25.013 / Juan Manuel Arias – Reflexiones contemporáneas: Presentación – La filosofía de la guerra y la paz más allá de las tres “tradiciones” / Hernando V. Cañardo – Democracia, modernidad y cristianismo / Philippe Benetón – Derechas e izquierdas en el pensamiento político contemporáneo / Dalmacio Negro Pavón – El mercado común del cono sur - Mercosur / Fernando P. Brebbia – Integración sudamericana y derecho / Francisco Arias Pellerano – Discurso televisivo y discurso judicial / Luis María Bandieri – Recensiones – Anexo legislativo

Sapientia, 1958, Vol. XIII, nº 47 (número completo)

Contenido: Ascética y filosofía / La Dirección – Ontología de la historia / Octavio N. Derisi – La filosofía moral en el cinismo / Benito R. Raffo Magnasco -- Despotismo universal y Katéchon Paulino en Donoso Cortés (I) / Alberto Caturelli – Notas y comentarios – Bibliografía