Inpatient surgical treatment of paediatric proximal humerus fractures between 2000 and 2012.

PURPOSE: To estimate the rate of surgical treatment of paediatric proximal humerus fractures over time utilizing a large, publicly available national database. METHODS: The Healthcare Cost and Utilization Project Kids' Inpatient Database was evaluated between the years 2000 and 2012. Proximal humerus fractures were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) diagnosis codes. ICD-9 CM procedure codes were used to identify patients who received surgical treatment. Univariable and multivariable logistic regression were used to determine variables associated with greater proportions of surgical treatment. All statistical analyses were performed utilizing SAS statistical software v.9.4. Statistical significance was set at p < 0.05. RESULTS: A total of 7520 proximal humerus fracture admissions were identified; 3247 (43.2%) were treated surgically. The percentage of patients receiving surgery increased from 39.3% in 2000 to 46.4% in 2012 (p < 0.001). After adjustment for potential confounders, increased age, increased ICD-9 derived injury severity scores (ICISS) and more recent year were associated with an increased proportion of patients receiving surgical treatment (p < 0.001). Medicaid payer status (p < 0.001) and admission to a children's hospital (p = 0.045) were associated with a lower proportion of surgical treatment. CONCLUSION: The rate of operative treatment of paediatric proximal humerus fractures increased over time between 2000 and 2012. Increased surgical rates were independently associated with older age, increased ICISS, treatment at a non-children's hospital and non-Medicaid insurance status. Further study is needed to provide evidence to support improved outcomes after operative treatment of paediatric proximal humerus fractures.

Transport gap renormalization at a metal-molecule interface using DFT-NEGF and spin unrestricted calculations.

A method is presented for predicting one-particle energies for a molecule in a junction with one metal electrode, using density functional theory methods. In contrast to previous studies, in which restricted spin configurations were analyzed, we take spin polarization into account. Furthermore, in addition to junctions in which the molecule is weakly coupled, our method is also capable of describing junctions in which the molecule is chemisorbed to the metal contact. We implemented a fully self-consistent scissor operator to correct the highest occupied molecular orbital-lowest unoccupied molecular orbital gap in transport calculations for single molecule junctions. We present results for various systems and compare our results with those obtained by other groups.

Increasing rates of surgical treatment for paediatric diaphyseal forearm fractures: a National Database Study from 2000 to 2012.

FOREARM: Purpose fractures are one of the most commonly sustained injuries in children and are often treated non-operatively. The purpose of this study was to estimate the rate of inpatient surgical treatment of paediatric forearm fractures over time using a large, publicly available, national database. METHODS: The Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) was evaluated between 2000 and 2012. Forearm fractures and surgeries were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) diagnosis and procedure codes. Univariable and multivariable logistic regression were used to determine variables associated with greater proportion of surgical treatment. All statistical analyses were performed using SAS statistical software v.9.4 (SAS Institute Inc., Cary, NC, USA). Statistical significance was set at p < 0.05. RESULTS: The database identified 30 936 forearm fracture admissions. Overall, 19 837 of these patients were treated surgically (64.12%). The percentage of patients treated with surgery increased from 59.3% in 2000 to 70.0% in 2012 (p < 0.001). Multivariable regression analysis found increased age (p < 0.001), more recent year (p < 0.001), male gender (p = 0.003) and admission to a children's hospital (p < 0.001) were associated with an increased proportion of patients receiving surgical treatment. Medicaid payer status was associated with a lower proportion of surgical treatment (p < 0.001). CONCLUSIONS: The rate of operative treatment for paediatric forearm fractures admitted to the hospital increased over time. Increased surgical rates were associated with older age, male gender, treatment at a children's hospital and non-Medicaid insurance status.

Low-cost and large-size nanoplasmonic sensor based on Fano resonances with fast response and high sensitivity.

We have developed a low-cost, fast and sensitive plasmonic sensor with a large-size for easy handling. The sensor is formed by a Au nanobelt grating fabricated by soft lithography with a period of 780 nm and a width of 355 nm in an even and uniform area of ~2 × 2 cm2. The sensor uses the Fano-shaped third order mode localized plasmon resonance of the Au nanobelts, which appears in the visible part of the transmission spectrum. We have found a detection resolution of 1.56 × 10-5 refractive index units with a temporal resolution of 1 s in a sensing area of 0.75 × 0.75 mm2. The high uniformity and size of the sensor permit the detection using a simple optical system, which provides the device with the potential to be used as an easy to handle, portable and disposable sensor.

[Bilateral amputation in diabetic patient with blindness, the use of inadequate prosthesis. Case report]. / Amputación bilateral en paciente diabética con ceguera, el uso de prótesis inadecuadas. Reporte de caso.

The most frequent diabetes-related complications are diabetic foot and glaucoma, which lead to amputation and loss of vision, respectively. Current scientific and technologic developments have permitted the design and implementation of prosthetic systems that are optimal for these patients, as the latter adapt themselves to them and can resume activities of daily living. The lack of economic resources compromises the quality of the prostheses patients can afford, as they resort to «artisanal¼ or «rustic¼ systems that hamper their adaptation process. We present herein the case of a 47 year-old female patient, housewife, with bilateral paresthesias and phantom limb sensation associated with amputation neuromas resulting from type II diabetes mellitus that had affected the patient for eight years. This patient of a low socioeconomic stratum underwent a post-amputation assessment and was diagnosed as being heavily dependent when performing activities of daily living and required assisted wheelchair for ambulation. This is a frequent variant resulting from bilateral loss of lower limbs together with complete loss of vision. We describe the rehabilitation therapy during the pre- and post-prosthetic stages, together with the results of the assessments to show the effectiveness of the treatment process, without forgetting the participation of the caregiver as a fundamental co-therapeutic element in this process.

Las complicaciones más frecuentes asociadas con la diabetes incluyen al pie diabético y al glaucoma, que suelen llevar a la amputación y a la pérdida de la visión, respectivamente. El desarrollo científico y tecnológico actual ha permitido el diseño e implementación de sistemas protésicos óptimos para estos pacientes, asegurando una reincorporación a las actividades de la vida diaria, así como una correcta adaptación al uso de las mismas. La falta de recursos económicos compromete la adquisición de las prótesis ideales, recurriendo al uso de sistemas «artesanales¼ o «rústicos¼ que afectan la adaptación. Se presenta el caso de un paciente femenino de 47 años de edad, ama de casa, quien presenta parestesias bilaterales y sensación de miembro fantasma asociado a neuromas de amputación por diabetes mellitus tipo II de ocho años de evolución. La paciente, con bajos recursos económicos, es evaluada postamputación con diagnóstico de dependencia grave en la ejecución de las actividades de la vida diaria, con desplazamiento en silla de ruedas asistido; esta presentación es una variante frecuente como consecuencia de la pérdida bilateral de miembros inferiores, concomitante a la ausencia total de la visión. Se presenta el tratamiento de rehabilitación en etapa preprotésica y protésica, acompañados por los resultados de las evaluaciones para mostrar la efectividad del proceso terapéutico, sin olvidar la participación del cuidador como ente coterapéutico fundamental en el proceso.

Comparative mathematical modelling of a green approach for bioaccumulation of cobalt from wastewater.

Cobalt is an essential element, but its wide use in industry generates important environmental and biological problems. The present study explores theoretical and empirical models of a green process for cobalt {Co2+} bioaccumulation from aqueous solutions. Two Gram-positive Bacillus subtilis species, strains CECT 4522 and LMM (the latter a former laboratory isolate from wastewater samples, which was phylogenetically characterized for the present work), were selected among others as the best Co2+ accumulation systems. Mathematical models representing kinetic and steady-state conditions for discrete and large amounts of bacterial biomass were expanded. In this way, it was possible to theoretically calculate the amount of Co2+ retained on the outer cell wall layer and incorporated inside the cell at any time. Theoretical and empirical hyperbolic-type models were suitable to fit the experimental bioaccumulation data for discrete amounts of bacteria biomass. In addition, kinetic relationships between the amount of Co2+ accumulated and the time before (or after) reaching steady state were established for large amounts of bacterial biomass. Other kinetic approaches were also satisfactorily tested. The two Gram-positive bacteria assayed are promising agents for developing heavy metal removal systems from industrial waste.

Indications and anatomic landmarks for the application of lower extremity traction: a review.

PURPOSE: Fractures of the lower extremity, particularly of the femur and acetabulum, may be difficult to immobilize with splinting alone. These injuries may be best stabilized with the application of various types of skeletal traction. Often, traction is applied percutaneously in an emergent setting, making the knowledge of both superficial and deep anatomy crucial to successful placement. METHODS: Review was performed via PubMed search as well as referencing the Orthopaedic literature. Relevant articles to the anatomy of the knee, ankle and calcaneus as they pertain to traction placement were referenced in compiling the optimal recommendations for traction placement. CONCLUSION: By palpating and marking superficial landmarks and observing specific anatomic relationships, safe application of traction pins can be performed while minimizing iatrogenic injury to vital anatomic structures, and avoiding intra-articular placement which could potentially lead to joint infection.

Choosing the best image processing method for masticatory performance assessment when using two-coloured specimens.

Objective masticatory performance assessment using two-coloured specimens relies on image processing techniques; however, just a few approaches have been tested and no comparative studies are reported. The aim of this study was to present a selection procedure of the optimal image analysis method for masticatory performance assessment with a given two-coloured chewing gum. Dentate participants (n = 250; 25 ± 6·3 years) chewed red-white chewing gums for 3, 6, 9, 12, 15, 18, 21 and 25 cycles (2000 samples). Digitalised images of retrieved specimens were analysed using 122 image processing methods (IPMs) based on feature extraction algorithms (pixel values and histogram analysis). All IPMs were tested following the criteria of: normality of measurements (Kolmogorov-Smirnov), ability to detect differences among mixing states (anova corrected with post hoc Bonferroni) and moderate-to-high correlation with the number of cycles (Spearman's Rho). The optimal IPM was chosen using multiple criteria decision analysis (MCDA). Measurements provided by all IPMs proved to be normally distributed (P < 0·05), 116 proved sensible to mixing states (P < 0·05), and 35 showed moderate-to-high correlation with the number of cycles (|ρ| > 0·5; P < 0·05). The variance of the histogram of the Hue showed the highest correlation with the number of cycles (ρ = 0·792; P < 0·0001) and the highest MCDA score (optimal). The proposed procedure proved to be reliable and able to select the optimal approach among multiple IPMs. This experiment may be reproduced to identify the optimal approach for each case of locally available test foods.

Image effects in transport at metal-molecule interfaces.

We present a method for incorporating image-charge effects into the description of charge transport through molecular devices. A simple model allows us to calculate the adjustment of the transport levels, due to the polarization of the electrodes as charge is added to and removed from the molecule. For this, we use the charge distributions of the molecule between two metal electrodes in several charge states, rather than in gas phase, as obtained from a density-functional theory-based transport code. This enables us to efficiently model level shifts and gap renormalization caused by image-charge effects, which are essential for understanding molecular transport experiments. We apply the method to benzene di-amine molecules and compare our results with the standard approach based on gas phase charges. Finally, we give a detailed account of the application of our approach to porphyrin-derivative devices recently studied experimentally by Perrin et al. [Nat. Nanotechnol. 8, 282 (2013)], which demonstrates the importance of accounting for image-charge effects when modeling transport through molecular junctions.

Broadband telecom transparency of semiconductor-coated metal nanowires: more transparent than glass.

Metallic nanowires (NW) coated with a high permittivity dielectric are proposed as means to strongly reduce the light scattering of the conducting NW, rendering them transparent at infrared wavelengths of interest in telecommunications. Based on a simple, universal law derived from electrostatics arguments, we find appropriate parameters to reduce the scattering efficiency of hybrid metal-dielectric NW by up to three orders of magnitude as compared with the scattering efficiency of the homogeneous metallic NW. We show that metal@dielectric structures are much more robust against fabrication imperfections than analogous dielectric@metal ones. The bandwidth of the transparent region entirely covers the near IR telecommunications range. Although this effect is optimum at normal incidence and for a given polarization, rigorous theoretical and numerical calculations reveal that transparency is robust against changes in polarization and angle of incidence, and also holds for relatively dense periodic or random arrangements. A wealth of applications based on metal-NWs may benefit from such invisibility.

Enhanced and directional emission of semiconductor nanowires tailored through leaky/guided modes.

Photoluminescence from finite semiconductor nanowires is theoretically investigated, exploring and predicting their antenna-like properties for light emission in a variety of configurations of interest in Nanophotonics. The theoretical analysis is based on the leaky/guided mode dispersion relation for infinite nanowires, which govern the local density of available electromagnetic states. Light emission from finite nanowires is then numerically investigated in various scenarios with regard to its enhancement and directionality. A simple analytical model is derived that, upon tuning leaky/guided mode coupling through dipole position/orientation and nanowire length, allows us to predict their antenna-like behavior and thus to tailor photoluminescence (including magnetic dipole transitions) at will, with regard to both enhancement/inhibition and associated radiation patterns.

Ultra low-loss, isotropic optical negative-index metamaterial based on hybrid metal-semiconductor nanowires.

Recently, many fascinating properties predicted for metamaterials (negative refraction, superlensing, electromagnetic cloaking,…) were experimentally demonstrated. Unfortunately, the best achievements have no direct translation to the optical domain, without being burdened by technological and conceptual difficulties. Of particular importance within the realm of optical negative-index metamaterials (NIM), is the issue of simultaneously achieving strong electric and magnetic responses and low associated losses. Here, hybrid metal-semiconductor nanowires are proposed as building blocks of optical NIMs. The metamaterial thus obtained, highly isotropic in the plane normal to the nanowires, presents a negative index of refraction in the near-infrared, with values of the real part well below -1, and extremely low losses (an order of magnitude better than present optical NIMs). Tunability of the system allows to select the operating range in the whole telecom spectrum. The design is proven in configurations such as prisms and slabs, directly observing negative refraction.

The present Pyrenean population of bearded vulture (Gypaetus barbatus): its genetic characteristics.

The Pyrenean population of the endangered bearded vulture (Gypaetus barbatus) is the largest natural population in Europe. In this study, its current genetic variability was assessed using 110 animals of the recent population in order to know what the present situation. Sex identification by DNA methodology in the 110 bearded vultures, mitochondrial DNA (mtDNA) and eight microsatellite markers in 87 bearded vultures have been analysed. Our results for sex identification present a number of 49 males and 61 females; no significant differences for number of males and females in this population have been observed. mtDNA studies indicate that nucleotide and haplotype diversities and number of variable sites were low. Tajima's D test and Fu and Li's D* and F* tests suggest that mutations are selectively neutral and the population is expanding. A mean number of alleles per locus and a mean observed heterozygosity have been obtained by microsatellite analysis. FIS is not high, and inbreeding depression could be discarded in the near future. The results suggest that the Pyrenean population of bearded vultures have to be controlled in order to avoid the loss of genetic variability. This data should be taken into account when considering conservation plans for the species.

Heuristic optimization for the design of plasmonic nanowires with specific resonant and scattering properties.

In this contribution, we propose a computational tool for the synthesis of metallic nanowires with optimized optical properties, e.g. maximal scattering cross-section at a given wavelength. For this, we employ a rigorous numerical method, based on the solution of surface integral equations, along with a heuristic optimization technique that belongs to the population-based set known as Evolutionary Algorithms. Also, we make use of a general representation scheme to model, in a more realistic manner, the arbitrary geometry of the nanowires. The performance of this approach is evaluated through some examples involving various wavelengths, materials, and optimization strategies. The results of our numerical experiments show that this hybrid technique is a suitable and versatile tool straightforwardly extensible for the design of different configurations of interest in Plasmonics.

Retention of arsenate using genetically modified coryneform bacteria and determination of arsenic in solid samples by ICP-MS.

A novel method for the retention of arsenate [As(V)] combining time-controlled solid-phase extraction with living bacterial biomass is presented. As(V) retention was carried out by exposing the extractant, consisting of a living double-mutant of Corynebacterium glutamicum strain ArsC1-C2, to the sample for a retention time of 1-7min, before the arsenic distribution equilibrium between the sample solution and the extractant was established. The amount of As(V) retained in the biomass was measured by inductively coupled plasma-mass spectrometry (ICP-MS) after the sample had been treated with nitric acid. A theoretical model of the retention process was developed to describe the experimental retention-time profiles obtained with the bacterial cells. This relationship provided a feasible quantification of the retention process before steady-state was reached, providing that the agitation conditions and the retention time had been controlled. An analytical procedure for the retention/quantification of As(V) was then developed; the detection limit was 0.1 ng As(V)mL(-1) and the relative standard deviation 2.4-3.0%. The maximum effective retention capacity for As(V) was about 12.5mgAs(g biomass)(-1). The developed procedure was applied to the determination of total arsenic in coal fly ash, using a sample that had undergone oxidative pre-treatment.

Colour-duplex ultrasonography of the temporal and ophthalmic arteries in the diagnosis and follow-up of giant cell arteritis.

OBJECTIVE: To evaluate the diagnostic value of colour-duplex ultrasonography (CDU) of the temporal and ophthalmic arteries in the diagnosis of giant cell arteritis (GCA) and its usefulness in the follow-up of the disease. Furthermore, to examine the relationship between CDU abnormalities in ophthalmic arteries and blindness. METHODS: This is a prospective study of all patients with clinical suspicion of GCA or polymyalgia rheumatica (PMR) seen consecutively at the Internal Medicine Department at Vall d'Hebron University Hospital, Spain, between March 2003 and July 2006. Patients were evaluated with regard to the sensitivity and specificity of the dark halo sign in the temporal artery for the diagnosis of GCA, as well as the sensitivity and specificity of the presence of stenosis in temporal and/or ophthalmic arteries. Additionally, the usefulness of the dark halo sign in the follow-up of GCA was addressed. RESULTS: Forty-seven patients (30 with GCA, 17 with PMR) and 13 controls were included in the study. The sensitivity and specificity for the diagnosis of biopsy-proven GCA were higher for the temporal halo (72% in both cases) than for temporal artery stenosis (41% and 89%, respectively), or for ophthalmic artery stenosis (58% and 89%, respectively). Disappearance of the halo was observed in 50% of patients six months after diagnosis, although all patients were in clinical remission, and laboratory parameters were within normal values. CONCLUSION: CDU of the temporal arteries may be a valid tool in the diagnosis of GCA. However, its role in the follow up of the disease deserves re-evaluation. CDU of the ophthalmic arteries is less useful for CGA diagnosis and no relationship with blindness is suspected.

Local and anisotropic excitation of surface plasmon polaritons by semiconductor nanowires.

We demonstrate a novel functionality of semiconductor nanowires as local sources for surface plasmon polaritons (SPPs). Photoexcited semiconductor nanowires decay non-radiatively exciting SPPs when they are on top of a metallic surface. We have investigated the anisotropic excitation of SPPs by nanowires by placing individual InP nanowires inside gold bullseye gratings. The gratings serve to couple SPPs to free space radiation that is detected with a scanning confocal microscope. The circular geometry of the grating allows to conclude that SPPs are preferentially generated in the direction along the nanowire axis.

Excitation and emission enhancement of single molecule fluorescence through multiple surface-plasmon resonances on metal trimer nanoantennas.

We study theoretically the light scattering from trimers of metal nanowires, with emphasis on the occurrence of multiple surface-plasmon resonances, showing that such resonances can be exploited to achieve twofold-enhanced fluorescence from a single molecule placed in the nanotrimer gaps, even if excitation and emission frequencies are separated. Pump enhancement stems from the local field enhancement coinciding with one of the resonances, whereas a strong enhancement of the radiative decay rate (and quantum yield) is revealed at a different resonance, leading to a large overall signal emission.

Deformable brain atlas validation of the location of subthalamic nucleus using T1-weighted MR images of patients operated on for Parkinson's.

Parkinson's disease is a degenerative disease of the central nervous system. One of the most effective treatments is deep brain stimulation. This technique requires the localization of an objective structure: the subthalamic nucleus. Unfortunately this structure is difficult to locate. In this work the creation of a deformable brain atlas that enables the identification of the subthalamic nucleus in T1-weighted magnetic resonance imaging (MRI) in an automatic, precise and fast way is presented. The system has been validated using data from 10 patients (20 nucleus) operated on for Parkinson's. Our system offers better results using a Wendland function with an error of 1.8853+/-0.9959mm.