Variable Angle Locking Compression Plate as Alternative Fixation for Jones Fractures: A Case Series.

INTRODUCTION: Jones fractures pose many challenges for the treating surgeon and can cause significant disability for some patients. The aim of this study was to review the results of using a variable angle locking compression plate as an alternative fixation method in the treatment of Jones fractures. METHODS: A retrospective chart review was conducted of patients who had undergone fixation of Jones fracture with a variable angle locking compression plate from September 2012 through February 2016. Radiographs of the preoperative and six-week postoperative and postoperative follow-up outcomes, including complication and hardware removal, were collected. RESULTS: Twenty-three cases met the inclusion/exclusion criteria. The overall bony union rate was 96% at six-week postoperative and 100% at 20-week postoperative. Mean age was 30 ± 16 years, and mean BMI was 30.7 ± 5.2 kg/m2. Three patients (13%) had plate removal: two (9%) were due to irritation caused by shoe wearing and one patient (4%) had a skin infection (cellulitis) which was treated with intravenous antibiotics. One patient (4%) had developed deep vein thrombosis (DVT) that was resolved with anticoagulant without implant removal. No fixation loss and no associated complications developed from implant removal. CONCLUSIONS: Based on our limited experience, this study provided evidence that the variable angle locking compression plate may be an alternative form of fixation for Jones fractures with a low complication rate. This procedure seemed to provide a safe, reliable method that can achieve an anatomic reduction, stable fixation, rapid healing, and good results in the treatment of Jones fractures.

Development and characterization of the first dsRNA-resistant insect population from western corn rootworm, Diabrotica virgifera virgifera LeConte.

The use of dsRNA to control insect pests via the RNA interference (RNAi) pathway is being explored by researchers globally. However, with every new class of insect control compounds, the evolution of insect resistance needs to be considered, and understanding resistance mechanisms is essential in designing durable technologies and effective resistance management strategies. To gain insight into insect resistance to dsRNA, a field screen with subsequent laboratory selection was used to establish a population of DvSnf7 dsRNA-resistant western corn rootworm, Diabrotica virgifera virgifera, a major maize insect pest. WCR resistant to ingested DvSnf7 dsRNA had impaired luminal uptake and resistance was not DvSnf7 dsRNA-specific, as indicated by cross resistance to all other dsRNAs tested. No resistance to the Bacillus thuringiensis Cry3Bb1 protein was observed. DvSnf7 dsRNA resistance was inherited recessively, located on a single locus, and autosomal. Together these findings will provide insights for dsRNA deployment for insect pest control.

Elimination of socioeconomic and racial disparities related to lung cancer: closing the gap at a high volume community cancer center.

BACKGROUND: Healthcare disparities have afflicted the healthcare industry for decades and there have been many campaigns in recent years to identify and eliminate disparities. The purpose of this study was to identify disparities in the lung cancer population of a single community cancer center and to report the results in accordance with industry goals. METHODS: This was a retrospective cohort study of data on non-small cell lung cancer patients recorded in the Christiana Care Tumor Registry (CCTR) in Delaware. Gender, age, race, socioeconomic status and insurance status were used as potential variables in identifying disparities. RESULTS: We found no significant disparities between sexes, race or patients who were classified as having socioeconomic status 1-3. There was a lower survival rate associated with having the poorest socioeconomic status and in patients who used Medicare. Uninsured patients had the best survival outcomes and patients with Medicare had the poorest survival outcomes. CONCLUSION: Although we have closed the gap on sex and racial disparities, there remains a difference in survival outcomes across socioeconomic classes and insurance types.