Open versus closed intramedullary nailing of femur shaft fractures in adults: a systematic review and meta-analysis.

PURPOSE: This systematic review and meta-analysis aimed to compare the outcomes of open- versus closed-reduction and intramedullary nailing (IMN) of adult femur shaft fractures. METHODS: Four databases were searched from inception until July 2022 for original studies that compared the outcomes of IMN following open-reduction versus closed-reduction technique. The primary outcome was the union rate; the secondary outcomes were time to union, nonunion, malalignment, revision, and infection. This review was conducted in line with PRISMA guidelines. RESULTS: A total of 12 studies with 1299 (1346 IMN cases) patients were included, with a mean age of 32.3 ± 3.25. The average follow-up was 2.3 ± 1.45 years. There was a statistically significant difference in union rate (OR, 0.66; 95% CI, 0.45-0.97; p-value, 0.0352), nonunion (OR, 2.06; 95% CI, 1.23-3.44; p-value, 0.0056), and infection rate (OR, 1.94; 95% CI, 1.16-3.25; p-value, 0.0114) between the open-reduction and closed-reduction groups in favour of the latter. However, malalignment was significantly higher in the closed-reduction group (OR, 0.32; 95% CI, 0.16-0.64; p-value, 0.0012), whereas time to union and revision rates were similar (p = NS). CONCLUSION: This study showed that closed-reduction and IMN had more favourable union rate, nonunion, and infection rates than the open-reduction group, yet malalignment was significantly less in the open-reduction group. Moreover, time to union and revision rates were comparable. However, these results must be interpreted in context due to confounding effects and the lack of high-quality studies.

A generalized heat conduction model of higher-order time derivatives and three-phase-lags for non-simple thermoelastic materials.

In the current work, a new generalized model of heat conduction has been constructed taking into account the influence of the microscopic structure into the on non-simple thermoelastic materials. The new model was established on the basis of the system of equations that includes three-phase lags of higher-order and two different temperatures, namely thermodynamic and conductive temperature. The two-temperature thermoelastic model presented by Chen and Gurtin (Z Angew Math Phys 19(4):614-627, 1968) and some other previous models have been introduced as special cases from the proposed model. As an application of the new model, we studied the thermoelastic interactions resulting from sudden heating in an isotropic solid subjected to external body force. The influence of the discrepancy parameter and higher-order of the time-derivative has been discussed. This work will enable future investigators to gain insight into non-simple thermoelasticity with different phase delays of higher-order in detail.

Intermittent lighting regime as a tool to enhance egg production and eggshell thickness in Rhode Island Red laying hens.

Influences of intermittent light regime as a tool to enhance egg production, egg quality, and blood parameters of laying hens were investigated. A total of 270 hens of Rhode Island Red (during 20 to 36 wk of age) were used to investigate the effects of intermittent light regime in completely randomized design. The birds were divided into 3 equal groups (6 replicates of 15 birds each) and housed in floor pens. The first group was served as non-treated control (C) and was exposed to continuous and constant light for 16 h light/day throughout the experimental period. Whereas, birds of the other groups were exposed to intermittent lights for 20 min/h + 40 min of constant light (T1; FLASH20) and 40 min/h + 20 min of constant light (T2; FLASH40) during the 16 h of light period. Hens of T1 group showed significantly (P ≤ 0.05) the highest concentration of total antioxidant capacity and the lowest one of malondialdehyde in comparison with the other groups. Hens of T1 group had significantly (P ≤ 0.05) the greatest egg laying rate and egg mass in comparison with the other counterparts. Feed consumption was similar in the groups under study. Hens exposed to FLASH20 had the lowest (P ≤ 0.05) FCR when compared with the other treatments. Eggs produced from hens exposed to FLASH20 had the highest value of shell thickness followed by the control and then that of those exposed to FLASH40. There were insignificant differences among the treatments in body weight of hens and all of other egg quality and egg problem traits. In conclusion, intermittent light regime of 20 min/h was the most efficient in comparison with the other ones. Finally, intermittent light regime of 20 min/h during laying period (during 20 to 36 wk of age) is highly recommended.

Comparison of several methods of sires evaluation for total milk yield in a herd of Holstein cows in Yemen.

A total of 956 lactation records of Holstein cows kept at Kaa Albon station, Imuran Governorate, Yemen during the period from 1991 to 2003 were used to investigate the effect of some genetic and non-genetic factors (Sire, parity, season of calving, year of calving and age at first calving as covariate) on the Total Milk Yield (TMY), Lactation Length (LL), and Dry Period (DP). Components of variance for the random effects (mixed model) were estimated by Restricted Maximum Likelihood (REML) methodology. Sires were evaluated for the TMY by three methods, Best Linear Unbiased Prediction (BLUP) using Harvey program, Transmitting Ability (TA) according to the Least Square Means of sire progeny (TALSM) and according to Means (TAM). Results showed that TMY and DP were affected significantly (P < 0.01) by all factors except season of calving and age at first calving, while LL was affected significantly (P< 0.01) only by year of calving and parity. The averages of the TMY, LL, and DP were 3919.66 kg, 298.28 days, and 114.13 days respectively. The corresponding estimates of heritability (h(2)) were 0.35, 0.06, and 0.14 respectively. The highest and lowest BLUP values of sires for the TMY were - 542.44 kg and 402.14 kg, while the corresponding estimates for TALSM and TAM were - 470.38, 380.88 kg and - 370.12, 388.50 kg respectively. The Spearman rank correlation coefficients among BLUP, TALSM and TAM ranged from 0.81 to 0.67. These results provide evidence that the selection of sires will improve the TMY in this herd because of the wide differences in genetic poetical among sires, and a moderate estimation of heritability.

Tumor necrosis factor-alpha polymorphisms in women with idiopathic recurrent miscarriage.

We investigated the association of tumor necrosis factor-alpha (TNFalpha) gene polymorphisms with idiopathic recurrent miscarriage (RM). TNFalpha -1031T/C, -863C/A, -857C/T, -376G/A, -308G/A, -238G/A, and +488G/A single nucleotide polymorphisms (SNPs) were investigated in 204 RM women and 248 age-matched parous women by PCR-restriction fragment length polymorphism. Significantly higher frequencies of -1031C and -376A alleles were seen in RM patients; significant differences were also noted in the distribution of -1031T/C, -376G/A, and -238G/A genotypes between case and control subjects. Haploview analysis revealed high linkage disequilibrium between -857C/T and +488G/A SNPs, but was lower between the other polymorphisms. Of the possible 52 seven-locus haplotypes constructed, 10 were common, and were included in subsequent analysis. Increased frequency of CCCGGGG and CCCGGAA haplotypes, and reduced frequency of TCCGGGG and TCCGGGA haplotypes were seen in RM patients than in controls. When the Bonferroni correction was applied, differences were significant for the CCCGGAA haplotype, which was higher (OR=4.14; 95% CI=1.84-8.95), and the TCCGGGA haplotype, which were lower among RM cases (OR=0.09; 95% CI=0.02-0.68), thereby conferring RM susceptibility and protection to these haplotypes, respectively. Multivariate analysis confirmed the positive association of only CCCGGAA haplotype with RM (P=0.010; aOR=2.03; 95% CI=1.18-4.47), after controlling for a number of covariates. These results demonstrate that the TNFalpha polymorphisms, in particular the -1031T/C variant, are significantly associated with idiopathic RM. Additional replication studies on other racial groups are needed to confirm our findings.

Topical permeation characteristics of diclofenac sodium from NaCMC gels in comparison with conventional gel formulations.

Topical gel formulations of diclofenac sodium were prepared by using sodium carboxymethylcellulose (NaCMC), a low-toxicity cellulose polymer as a gel-forming material that is biocompatible and biodegradable. The influence of various formulation variables, such as initial drug concentrations and NaCMC concentration, and certain skin permeation enhancers on release characteristics of the diclofenac sodium from the prepared gels through a standard cellophane membrane was studied in comparison with four commercially available gel formulations of diclofenac sodium,. The cumulative amounts released and the apparent release rates were higher for the prepared gels in comparison with the commercial formulations. Skin permeation studies using abdominal rat skin revealed good improvement of skin permeation characteristics of diclofenac sodium using NaCMC gels as compared to the commercial gels. The cumulative amount permeated at 6 h (microg/cm2), steady-state flux Jss (microg/cm2 h), lag time tL (h), permeability coefficient kp (cm/s), partition coefficient k, and diffusion coefficient D (cm2/s) were determined for the prepared gels in comparison with the commercial gels. Skin permeation enhancers such as isopropyl alcohol (IPA), Tween 80, and alpha-tocopherol polyethylene glycol succinate (TPGS) exhibited little or no effect on the permeation characteristics of diclofenac sodium. Infrared (IR) spectrum and differential scanning calorimetry (DSC) studies on the pure diclofenac sodium, NaCMC, and their physical mixture at a 1:1 ratio revealed that there was no positive evidence for the interactions between the drug and NaCMC, indicating the compatibility of the drug and the vehicle. Based on experimental results, preparation of diclofenac sodium gels using NaCMC vehicle is promising.

In vitro effects of trace elements on blood clotting and platelet function. B--Zinc and magnesium.

The in vitro effects of zinc and magnesium salts on blood coagulation mechanism and platelet aggregation were studied on rat plasma. Addition of zinc sulphate to pooled rat plasma in a range of concentrations (0.3-1 mg/ml) caused a dose dependent significant prolongation of recalcification, prothrombin and partial thromboplastin times. These effects reached a peak after 30 minutes while the thrombin clotting time was not significantly altered and was even shortened in the presence of highest concentration of zinc tested (1 mg/ml). Incubation of thrombin with zinc sulphate (150 micrograms/ml) for up to 30 minutes did not affect significantly the action of thrombin. Incubation of the same concentrations of zinc sulphate with fibrinogen produced non clotting of fibrinogen after 0-minutes. Addition of rising concentrations of zinc sulphate to rat PRP produced inhibition of ADP-induced platelet aggregation. On the other hand, collagen-induced aggregation was insignificantly inhibited in the presence of zinc. In contrast, in vitro additions of rising concentrations of magnesium sulphate (2-5 mg/ml) to pooled rat plasma exerted no effect on recalcification time immediately after addition (0-minutes), but after 5 minutes following incubation it produced significant shortening of recalcification time in all the doses tested. The prothrombin time showed a general trend of shortening, maximal after 5-minutes incubation. The results of partial thromboplastin times revealed clotting before addition of calcium chloride. The thromboplastin time also showed progressive shortening with rising concentrations of magnesium sulphate. When thrombin solution was exposed to magnesium sulphate (2.5 mg/ml) no effect on the activity of thrombin was seen for up to 30 minutes. Fibrinogen solution similarly exposed to the same concentration of magnesium sulphate did not show any significant effect on its clottability with thrombin for up to 30 minutes. Magnesium sulphate in the range of doses tested significantly enhanced platelet aggregation of PRP in response to both ADP and collagen, and the responses observed were not dose dependent. The mechanisms underlying the effects of these two metals on blood clotting and platelet aggregation are discussed.

Determination of traces of Zn, Cd, Pb and Cu in white sugar by anodic stripping voltammetry and a modified oxygen-flask combustion technique.

Anodic stripping voltammetry with a hanging-drop mercury electrode is used for determination of traces of Zn, Cd, Pb and Cu in white sugar. The sample (1.5 g) is decomposed by ignition in oxygen in a specially modified system.

Ion exchange method for rapid determination of alkalinity of water-soluble tea ash containing high levels of manganese.

An ion exchange method to determine the alkalinity of water-soluble tea ash containing high levels of manganese is described. A chromatographic column containing a strong cation exchange resin (20-50 mesh) in Na+ form, with a bed volume of 5 mL is used. The present ion exchange method is compared to pH titrations and also to the official AOAC methods (31.012, 31.015, 31.016). Results with the new method are accurate and precise.