Acceptable Reduction Research Articles

Fortification Effects in Preparation of Fresh Cheese (<i>Quesoblanco, Gybna beyda & Halloumi</i>) of Zebu Cow Milk Using Citric Acid Solution, Gambella, Godere Woreda, Ethiopia

Food Technology is on sustainable, priority area with competitive and efficient agri-food production and processing, encompassing and manufacture of safe, value added and innovative foods from milk. The research results revealed that fresh cheese fortification and DMs effects on storage durability, trace-nutrients, anti-nutrients & perception of processed & preserved fresh cheese. The experiment was conducted 3×3×2 in design of treatments expressed as 3 varieties of preserved fresh cheeses like G, H & Q, 3 preservatives (solanum, lemon juice & salt) and 2DMs (sun & oven drying) laid out in CRD. Preserved samples were checked for their safety followed by sensory evaluation & proximate analyses in each month. A total of 4.42 log10 cfu/g AeB was observed in fresh samples with absence of fungi in all varieties of preserved fresh cheeses. MC in freshly preserved was within 23-36% where as high load of 4.0-4.42 log10cfu/g AeB with (P>0.05) significant difference was observed in samples. Initial load of<1.31 log10cfu/g moulds were recorded. After three months of storage, max load of AeB & moulds were 4.83-6.65 and 0-6log10cfu/g, respectively. All parameters under the proximate analyses were vary due to absorption of moisture at ambient condition during the storage time. OA of treated samples reached min & max values of 4.83 and 5.33 after the storage of 3 months respectively. Overall load of 6.65 log10cfu/g AeB in almost all samples was detected and reasonable those samples were not allowed for panelists for taste after the three months storage. This was due to the ISO and EU sensory guidelines showed the point of sensory rejection in which the number of microbial load should be below the 107-108 log10cfu/g. In general, as the storage time of preserved cheese products increased, there were an increased of microbial population and reduction in acceptability of the products through the sample storage of three months. Fresh zebu cow milk was preserved in to new developed products (G, H and Q), lemon fruit juice and salt were used for the indicated preserved products. Anti-nutrient contents such as Hg and aflatoxin were negligible based on international standard requirements. The chemical composition of preserved fresh cheese products contents ranged in MC (23-37%), protein (19.67-40.33%), fat (13.67-32.33), ash (1-8.33%), CHO (10.67-86.67), energy (340.33-454.33kcal), Ca (720-1208g/100mg), Fe (25-41.67g/100g), Zn (4-11.67g/100g) and null contents of Hg were approved based on data analyzed in this research. Eventually, food innovation is a key of any society from local goods is made as an inference of this research work.

Evaluation of patient outcomes after operative treatment of intra-articular calcaneus fractures.

Background: Percutaneous reduction with fixation and open reduction internal fixation are often used to treat intra-articular calcaneus fractures with no consensus on the preferred method. Open techniques have been associated with an increased risk of wound complications, while percutaneous techniques may result in inferior reduction capabilities. These injuries pose a challenge to patients as they often result in poor patient outcomes. We retrospectively analyzed patient outcomes of a single surgeon’s experience in treating these injuries at a busy urban Level 1 trauma center. Methods: Patients with intra-articular calcaneus fractures managed operatively over 10 years with a minimum six-month follow-up were included. Patients were divided into two cohorts based on operative technique: closed reduction and percutaneous fixation (CRPF) or open reduction internal fixation (ORIF). Descriptive analysis of each cohort included postoperative infection, the need for repeat operations, development of post-traumatic subtalar arthritis, and reduction capabilities as assessed by Bohler’s angle. Results: Sixty-two patients were included in this study, with 33 patients in the CRPF group and 29 patients in the ORIF group. Infection requiring a return to the operating room occurred in 1 (3%) CRPF and 7 (24%) ORIF patients. Instrumentation was removed in 23 (70%) CRPF and 9 (31%) ORIF patients. Clinical subtalar arthritis developed in 10 (30%) CRPF and 7 (24%) ORIF patients, requiring arthrodesis in 2 (6%) and 5 (17%) patients, respectively. Both techniques had acceptable restoration of Bohler’s angle immediately postoperatively and at final follow-up. Conclusions: Percutaneous reduction with fixation and open reduction internal fixation may both be considered for the surgical treatment of intra-articular calcaneal fractures. Indications for each technique may vary between surgeons, and each has its own set of risk factors and complications, however, both have been shown to result in an acceptable reduction. Level of Evidence: Level IV.

Morphological analysis of fibrous webs electrospun from Polycaprolactone, polylactic acid and their blends in chloroform based solvent systems

In this study, polycaprolactone (PCL), polylactic acid (PLA), and PLA/PCL blend electrospun fibrous webs are prepared using chloroform based solvent systems at different concentrations. The solvents to be used with chloroform are selected in accordance with the morphological and rheological structures of the polymers. While the morphology of the produced networks is observed under a scanning electron microscope, fiber diameter measurements and pore analysis are performed with Image J Software System. Although bead-free webs could not be achieved for neat PCL samples, neat PLA samples and PCL/PLA blends result in smooth fiber surfaces with homogeneous fiber diameter distributions. The results show that the increase in PLA concentration does not cause much change in fiber diameter but induces an increase in the area of pores. Furthermore, in the PLA/PCL blend, it is determined that as the ratio of PCL in the mixture increases, the fiber diameter decreases even if there is an acceptable reduction in the average pore area.

Patella-height analysis and correlation with clinical outcome after primary total knee arthroplasty

BackgroundIt is the aim of this study to conceptualize a scheme for patellar-height analysis suitable for knees without and with implanted endoprosthesis. Furthermore, patellar-height and change of patellar-height by total-knee-arthroplasty (TKA) should be studied and correlated with clinical outcomes. We hypothesize that not only True-Patella-Infera (TPI) but also Pseudo-Patella-Infera (PPI) might be correlated with elevated anterior-knee-pain and reduced range-of-motion. MethodsSeveral patellar-height indices were measured by three independent raters in two passes. Indices were analyzed and intra- and interobserver agreements were determined. For radiographic and clinical evaluation of 92 knee arthroplasties, the Insall-Salvati Index (ISI) and the Caton-Deschamps Index (CDI) were used to determine patellar-height and especially the amounts of TPI and PPI. Patellar-height was correlated with clinical outcome parameters: pain, ROM, Oxford Knee Score, Knee Society Score, Kujala Score, SF-36, Tegner and Lysholm. ResultsAll used patellar-height indices demonstrated good intra- and interobserver agreement. Low preoperative ROM was correlated with low postoperative ROM after primary TKA. Postoperatively, 2.2% of the patients had a TPI and 9.8% had a PPI. Patella infera was not correlated with reduced subjective or objective clinical outcome parameters. ConclusionsPreoperative ROM is a good predictor of postoperative ROM after primary TKA. Patellar-height analysis can be sufficiently performed using the ISI and the CDI, respectively the derived CDI (dCDI) in cases with implanted endoprosthesis. As an alternative to the CDI/dCDI, the BPI/mBPI can be used. There seems to be a certain threshold of acceptable patellar-height reduction, in which clinical outcome is not deteriorated.

Neonatal Hyperbilirubinemia treatment by Locally Made Low-Cost Phototherapy Units.

Hyperbilirubinemia is a very common finding in neonates and may occasionally cause severe morbidity and even mortality. Severe hyperbilirubinemia is typically treated, either with phototherapy or exchange transfusions. This study assessed the effectiveness of a locally manufactured phototherapy device for reducing serum bilirubin in neonates with severe hyperbilirubinemia. Retrospective chart review was carried out to assess the outcome of 32 infants who were treated for neonatal hyperbilirubinemia at Jimma Medical Center (JMC) from May, 2017 to April, 2018. RESULTS: Out of 75 charts reviewed, only 32 had subsequent bilirubin level determination, 18(56.3%) of them were males. The age at which jaundice was noticed and confirmed with plasma bilirubin level was 4 ± 2.7 days (mean±SD). Sepsis was thought to be the cause of hyperbilirubinemia in 13(40.5%) of the cases, while hemolysis from ABO incompatibility or RH incompatibility contributed in 5(15.6%) and 3(9.4) of the infants respectively. The mean (minimum, maximum) level of baseline TSB was 21.4(14, 55) mg/dL. Five infants (15.6%) had exchange transfusions because of extreme hyperbilirubinemia. The duration of phototherapy and decline in TSB were 5.34 ±2.8 days and 2.2±1.5mg/dl/day (mean±SD) respectively. The levels of TSB before and at the end of phototherapy were significantly different (p<0.001). Acceptable reduction of TSB was achieved by using locally manufactured PT devices. Benefits included better accessibility and lower price and maintenance costs. High mean baseline TSB was observed, and duration of phototherapy is prolonged which could indicate late diagnosis compared to similar studies.

Time-division multiple reference approach for multiple-channel active noise control system

The feedforward active noise control (ANC) requires the reference sensor to obtain the knowledge of the noise source in order to generate the corresponding anti-noise to cancel it. In some practical applications, the noise source is unknown or moving. The placement of the reference sensor is critical to achieve a reasonable performance. Conventionally, the multiple-channel ANC system using the multiple-reference/multiple-output filtered-x least mean square (MRMO-FXLMS) algorithm is the basic solution, however, the computational complexity is high. Therefore, this paper proposed a time-division multiple reference (TDMR) approach for the multiple-channel ANC system, which divides the input channel into different time slots and assigns a time slot to each reference sensor. The proposed system takes only one reference signal as an input at each iteration for the ANC system, it can reduce the computational complexity, and achieve acceptable noise attenuation performance at the same time. Without the demand of prior knowledge of the noise direction, the proposed method can attenuate the noise from anywhere and reduce enormous computational complexity. The real-time experiments of the multi-channel ANC implemented on an infant incubator show the acceptable noise reduction performance of the proposed method compared with other existing approaches.

Effective prevention of intimate partner violence through couples training: a randomised controlled trial of Indashyikirwa in Rwanda

BackgroundBetween 2015 and 2018, three civil society organisations in Rwanda implemented Indashyikirwa, a four-part intervention designed to reduce intimate partner violence (IPV) among couples and within communities. We assessed the...

Power Quality and Reliability Considerations of Photovoltaic Distributed Generation

Worldwide energy consumption is increasing at a faster pace than energy generation because of enhanced industrialization, growing population and, improved living standards. Using the Distributed Generation (DG) near the end consumers can support the electrical grid stability and enhance the power system quality. The DG is consisting of a small-scale technology to generate electrical power near the end consumers, which can be renewable energy or generators. Solar Photovoltaic (PV) system is considered as one of the best renewable energy sources, due to its low running cost and low environmental affection comparing with traditional power plants. The proposed PVDG units are employing maximum power point tracking (MPPT) system to track the maximum power available in PV arrays. The proposed DG system used Particle Swarm Optimization (PSO) technique to optimally allocate the PVDG units for minimum cost, transmission line losses, and improved voltage profile of busbars under different operating conditions. This paper proposes a smart optimization technique employing PSO in the design, operation, and control of the proposed system. Also, the paper discusses the PSO algorithm for optimal DGs sizing and allocations. The simulation in this paper uses the IEEE-7 busbars system with an extension of IEEE-3 busbars as a new remote load. The simulation has been carried out by the power world simulator software to compare the voltage and the power losses with and without PVDGs connected to the system. The simulation results showed an acceptable reduction in generating cost, transmission line losses, and improvement of the busbars voltage profile which proves the success of the proposed system.

Surface finishing of additively manufactured stainless steel surgical instruments

PurposeAdditive manufacturing (AM) has the potential to revolutionise the fabrication of complex surgical instruments. However, AM parts typically have a higher surface roughness compared to machined or fine cast parts. High surface roughness has important implications for surgical instruments, particularly in terms of cleanliness and aesthetic considerations. In this study, bulk surface finishing methods are described to produce end-use selective laser melting parts.Design/methodology/approachThe aim was to achieve a surface finish as close as possible to machined parts (Ra = 0.9 µm, Wa = 0.2 µm, Pv = 7.3 µm). A sample coupon was designed to systematically evaluate different finishing techniques. Processes included bulk finishing, blasting and centrifugal finishing methods on individual parts, as well as heat treatment before and after surface finishing.FindingsAbrasive blasting or centrifugal finishing alone was not adequate to achieve an end-use surface finish. White oxide vapour blasting at high water pressure was the most effective of the abrasive blasting processes. For centrifugal finishing, a 4 h runtime resulted in an acceptable reduction in surface roughness (Ra = 2.9 µm, Wa = 2.0 µm, Pv = 34.6 µm: inclined surface [30°]) while not significantly increasing part radii. The combination of finishing methods resulting in the smoothest surfaces was white oxide blasting followed by 4 h of centrifugal finishing and a final glass bead blast (Ra = 0.6 µm, Wa = 0.9 µm, Pv = 6.9 µm: inclined surface [30°]). The order of these methods was important because white oxide blasting was significantly less effective when applied after the centrifugal finishing.Originality/valueCollectively, these results describe the development of a practical bulk finishing method for stainless steel surgical instruments produced by AM.

Requirements Justification to Digital Signal Synthesizers for Various Types of Radar Systems

The paper justifies the requirements for the level of distortion of radar stations with pulse and quasi-continuous radiation, built on the basis of digital signal synthesizers of four types: digital synthesizers of voltage counts and digital synthesizers of phase counts with uniform sampling, digital synthesizers of voltage counts and digital synthesizers of phase counts with uneven sampling. When building a radar master device, the question arises about choosing the type of digital signal synthesizer. The main initial criteria are the maximum operating range of the digital synthesizer and the level of in-band distortion. When choosing the type of digital signal synthesizer, you have to take into account a large number of factors, the main of which are the complexity of the execution of the digital readout shaper, the possibility of implementing a digital readout shaper with the required speed and number of digits [1, 2]. When making requirements for the total level of distortion, the criterion of acceptable reduction of the probability of correct detection in comparison with its potential value for a fixed probability of false alarm is used. Based on this criterion, in pulse radars, the maximum relative RMS value of the distortion of the intercorrelation function of a signal with angular modulation generated by a digital synthesizer should not exceed Dδx ≤ –(51...67) dB. In a radar with quasi-continuous radiation, the maximum relative mean-square value of the distortion of the autocorrelation function of the signal with angular modulation should not exceed Dδ ≤ –(80...120) dB. The number of bits of phase quantization, voltage and time delay compensation in digital signal synthesizers depends not only on the maximum relative RMS value of the distortion of the intercorrelation function, but also on the number of samples of the signal with angular modulation. Therefore, initially you need to select the reference frequency of the digital signal synthesizer, setting the type of modulation and the effective spectrum width of the signal with angular modulation based on the tactical and technical characteristics radar

Does the Location of Initial Management After Distal Radius Fracture Impact the Ultimate Need for Operative Intervention?

BACKGROUND: Fractures of the radius and/or ulna comprise the largest proportion (44%) of the estimated 1.5 million cases of hand and forearm fractures seen in Unites States emergency departments each year.1 Displaced distal radius fractures (DRFs) are often managed with closed reduction and splinting. After initial management of these injuries, patients are referred to tertiary care facilities or specialty groups for continuing care. Failure to obtain a stable, near-anatomic reduction may lead a specialist to recommend and/or perform surgery to re-establish appropriate radiographic relationships. Complication rates associated with nonoperative management have been studied though data on conversion to surgical management are not widely reported.2 Surgery incurs a significant financial and physical cost to the patient and healthcare system. The primary aim of this study was to assess how location and type of facility at which a DRF is initially managed impacts rates of surgical intervention. Specifically, we compared a tertiary care facility, staffed with hand specialists, to referring community institutions where no hand specialists were readily available. METHODS: We performed a retrospective chart review of all patients treated at University of Wisconsin—Hospital and Clinics (UW) for DRFs from January 1, 2018 to December 31, 2018. Patients were placed into one of 2 groups: (1) initial treatment performed at any location within the UW system and (2) initial treatment performed at any location outside of the UW system. We calculated the operative rate for each group. We also analyzed the effect of sex and type of injury on the conversion to surgical management. RESULTS: We identified 1,337 patient encounters associated with a DRF current procedural terminology (CPT) code. Eight hundred twenty-four patients were initially managed at UW Health, whereas 513 patients were initially managed at non-UW facilities. Patients initially managed at UW went on to surgical intervention at a significantly lower rate of 15.0% (n = 124) compared to those patients initially treated outside of UW Health who underwent surgery 26.3% of the time (n = 135) (P < 0.0001). Type of injury was not a predictor of conversion to surgery nor initial presentation to UW. Sex was not a predictor of surgical conversion. CONCLUSIONS: These data suggest that initial management of DRFs at UW Hospital and Clinics significantly decreases the rate of operative reduction and fixation. A decrease in operative intervention reduces both the physical and financial impact of DRFs. This indicates that there may be a need to educate community providers to either perform an acceptable bony reduction or refer patients to treating facilities capable of performing these techniques in the early postinjury period. REFERENCES: 1. Chung C, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am. 2001;26:908–915. 2. Chung KC, Malay S, Shauver MJ, et al, for the WRIST Group. Assessment of distal radius fracture complications among adults 60 years or older: a secondary analysis of the WRIST Randomized Clinical Trial. JAMA Netw Open. 2019;2:e187053.

Effect of Intraoperative Multidimensional Fluoroscopy Versus Conventional Fluoroscopy on Syndesmotic Reduction.

Despite multiple techniques to improve syndesmotic reduction accuracy, syndesmotic malreduction in unstable ankle fractures remains prevalent. We performed a prospective, observational study to assess the ability of intraoperative multidimensional fluoroscopy to lead a surgeon to change the syndesmotic reduction obtained by conventional fluoroscopic techniques with the goal of achieving an accurate reduction. Thirty patients with unilateral malleolar ankle fractures and syndesmotic instability were enrolled. Following fixation of the malleollar fractures, the syndesmosis was provisionally reduced. Once the surgeon believed acceptable reduction was obtained by comparison with the contralateral, uninjured ankle mortise and lateral fluoroscopic images, provisional fixation was used to maintain reduction. Intraoperative, multidimensional fluoroscopy was used to generate cross-sectional images to assess the reduction. The surgeon then decided if a change in the reduction was needed, and fixation proceeded per surgeon preference. Postoperative bilateral computed tomography (CT) scans of the ankles were used to assess the reduction. The main outcome recorded was syndesmotic reduction change by the attending surgeon following 3-dimensional (3D) fluoroscopic imaging. The secondary outcome was syndesmotic reduction accuracy on postoperative CT scan. Fourteen of 30 patients had intraoperative reduction change following 3D fluoroscopic imaging. Three of 30 patients had residual malreduction compared with the contralateral ankle on bilateral postoperative CT scan. Intraoperative 3D fluoroscopy frequently led the surgeon to change the syndesmotic reduction obtained by conventional techniques and provided additional information not available with 2-dimensional fluoroscopy. A 10% syndesmotic malreduction rate was obtained with this technique. Diagnostic level II, prospective comparative study.

Effect of coatings made by new hydrocolloids on the oil uptake during deep‐fat frying: A review

High‐fat content in fried products reduced its shelf life and causes a reduction in product total acceptability to consumers. The oil uptake (OU) problem associated with fried products can be decreased using gums (hydrocolloids) as edible coating (EC). Gum‐based ECs have been effective in decreasing the OU in deep‐fat fried products. The efficiency of natural gums in decreasing the OU during deep‐fat frying has been reported by some researcher. The present review summarized the effect of coatings made by new and natural hydrocolloids on the heat and mass transfer (HMT) and OU of deep‐fat fried products such as eggplant, potato, carrot, banana, cereal product, puri, cassava, and shrimp. Application of various gums as hydrocolloid coatings decreased the heat transfer coefficient (HTC) and OU during the deep‐fat frying process. In addition, coated fried products have better textural characteristics, chewiness, juiciness, and higher total acceptability scores, due to decreasing in moisture loss, lipid oxidation, and OU during deep‐fat frying. PRACTICAL APPLICATIONS: The OU problem associated with fried products can be decreased using hydrocolloids as EC. Also, the sensorial examination results showed that the coated products with gums have total acceptability better than the uncoated samples. The present review summarized the effect of coatings made by new and natural hydrocolloids on the HMT and OU of deep‐fat fried products such as eggplant, potato, carrot, banana, cereal product, puri, cassava, and shrimp. Application of various gums as hydrocolloid coatings decreased the HTC and OU during the deep‐fat frying process.

Factors affecting early re-displacement of paediatric diaphyseal forearm fractures at Korle Bu Teaching Hospital.

Complete fractures of the forearm have the potential to displace and angulate with overriding fracture fragments. Maintaining acceptable reduction is not always possible, and re- displacement or re-angulation is the most commonly reported complication. Factors responsible for the re-displacement after an initial acceptable reduction have not been clearly defined. The study aimed to determine the factors that influence early re-displacement of paediatric diaphyseal forearm fractures in Korle-Bu Teaching Hospital. A prospective study in a cohort of 72 children below the age of 12 years with diaphyseal forearm fracture attending the Orthopaedic clinic were followed with close reduction casting from April 2017-December, 2017. Factors analysed included demographics, initial fracture features and the radiographic indices of the cast quality. 93.1% (67) of the fractures were because of the children falling on an outstretched arm. Majority of the children had a fracture of the distal 1/3 of the radius (n=38, 52.6%). The overall C.I was 0.8 (SD 0.1). The only significant predictor for predicting re-displacement was children falling on an outstretched hand (p-value=0.0). This study has shown that the degree of initial displacement and the ability to achieve good reduction with a well moulded cast, constitute the major factors for early re-displacement of paediatric forearm fractures. Personal funding.

Reliability of Postoperative Radiographies in Ankle Fractures.

The accuracy of reduction of ankle fractures using postoperative plain radiographies (x-ray) remains widely controversial. Some authors have demonstrated that postoperative computed tomography (CT) scan can be useful for these patients. In current study, the efficacy of x-rays after fixation of ankle fractures was investigated based on the CT scan findings. A total of 73 patients with ankle fractures who were subjected to open reduction internal fixation (ORIF) were enrolled. After surgery, if the reduction was acceptable based on the x-rays according to standard measurements, the patient was referred for CT scanning. Forty four patients were included in the study. Undesirable CT scan findings including malreduction of fragments or articular surfaces, device malpositioning, missed fractures, and undetected intra-articular fragments were documented. Undesirable CT findings were seen in 25 patients (56.8%). CT scan showed acceptable reduction without device malpositioning in 19 patients. The most prevalent findings in CT images were malreduction and device malpositioning in 17 and 16 patients, respectively. There was no abnormal finding in CT imaging of lateral malleolar fractures. In two thirds of the injured syndesmosis, device malpositioning, and malreduction were detected in CT scan. Despite acceptable postoperative x-rays, a considerable number of patients with ankle fractures had inappropriate reduction or undesirable findings in their postoperative CT scan. It seems necessary to use CT scan after ORIF of ankle fractures in order to examine the accuracy of reduction. Further validation of postoperative CT scan in ankle fracture surgery should be investigated.

Importance of calculating various casting indices in predicting radiological outcomes of paediatric forearm fractures

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The present study is aimed at determining the importance of various casting indices in predicting the outcome of paediatric forearm fractures treated with closed reduction and plaster application in our department.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Thirty children, aged 5 to 15 years, with closed forearm fractures not requiring surgical fixation were included to assess their casting indices and radiological outcomes using X-rays. After satisfactory casting, patients were followed up weekly till 6 weeks with anteroposterior (AP) and lateral X-ray.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Acceptable reduction was achieved in 26 cases, while re-manipulation was done in 4 cases. Cast Index ranged from 0.80±0.09 at first week to 0.78±0.09 at 6 weeks, Padding Index was 0.30±0.04 at first week and increased to 0.31±0.03 at 6 weeks, Canterbury Index was 1.07±0.24 at first week and 1.07±0.78 at 6 weeks, Gap Index 0.15±0.02 remained the same throughout, and Three Point Index changed from 0.81±0.08 at first week to 0.77±0.18 six weeks. Radial bow of children showed no significant change at various time points of assessment. Rotational mal-alignment was observed in 5 patients, one had a 0.5 cm radial overlap, while none had an ulnar overlap. Radial angulation was observed in five and six children on AP and lateral X-ray respectively. Ulnar angulation was seen in two and one child on AP and lateral X-ray respectively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Continued use of these casting indices to assess paediatric forearm cast adequacy is supported by this study.&lt;/p&gt;

Towards a starter culture of Lactobacillus plantarum AFS13: Assessment of more relevant effects for in vitro production and preservation thereof, via fractional factorial design methodology

Spontaneous fermentation by native strains of lactic acid bacteria has traditionally been used to preserve table olives, by taking advantage of a proactive and competitive reduction of growth of unwanted microorganisms. Starter cultures have proven effective in stabilizing fermentation processes at large. Despite the many starter cultures available commercially, few have originated on the native microflora – and table olives have seldom been processed via deliberate inoculation with them. This study screened variables relevant for the growth of Lactobacillus plantarum AFS13 originally obtained from brines in Alto Douro (Portugal); and for preservation thereof as the starter, should it prove appropriate. A 2IV6−2 factorial design was used to assess six parameters (and their interactions): 19 fermentation batches were carried out to ascertain growth rates. Temperature and aeration degree were the most significant processing parameters. Maximum growth rate, 0.356 h−1, was attained under anaerobic conditions, at 37 °C, and in the absence of NaCl; ca. 9 log10 CFU mL−1 was reached by 6 h. Glucose concentration, pH, and stirring rate proved not significant, so economic considerations should fix their optimum levels. The starter culture could be preserved for up to 4 mo after freeze-drying in sucrose, with an acceptable reduction in cell viability.

Utilization of Virtual Surgical Planning for Surgical Splint-Assisted Comminuted Maxillomandibular Fracture Reduction and/or Fixation.

This article was a technical note. To demonstrate the utilization of virtual surgical planning for surgical splint (VSPSS) fabrication. The VSPSS was used as an intraoperative assisting and guiding tool for reduction and/or fixation of treatment of comminuted maxillomandibular fractures. The presented technical note showed the fabrication process that began with data acquisition and presurgical planning using virtual surgical planning (VSP). The VSPSS was designed and fabricated after the fractures were reduced digitally in VSP. In the operating room, the VSPSS was seated to guide reduction and/or allow satisfactory fixation in three different situations. Postoperative radiographs showed an acceptable reduction of the fractures. All patients had stable and repeatable occlusion postoperatively. The VSPSS is a feasible tool for surgeons to assist in the comminuted maxillomandibular fracture management, decrease operating time, and improve fracture stability.

Assessing the impact of climate change on sugarcane and adaptation actions in Pakistan

Climate change is a challenging global issue for the sustainable production of various crops around the world as change in climatic patterns can create a stressful environment for plant growth. This study assesses the impact of climate change on future water demand and sugarcane yield in Pakistan for the baseline (1981–2005) and future timescales (2020s, 2050s and 2080s). For evaluating the crop water requirement and yield under future climate, CROPWAT 8.0 and AquaCrop models were used, respectively. For the estimation of future climate, three different Regional Climatic Models were applied under two projection scenarios i.e. RCP 4.5 and RCP 8.5. Maximum temperature, precipitation and minimum temperature displayed an increasing trend under the projected future climatic conditions. The results revealed a growth in the crop water requirement with a subsequent escalating irrigation demand caused due to rise in projected temperature; this is because the projected increase in precipitation under forecasted weather conditions cannot compensate for the increased evaporative demand. Moreover, the results showed a general increasing trend of sugarcane yield under projected climate. By delaying the crop calendar, an overall decrease in crop water requirement in the range of 10.7–12.6% and increase in the yield in the range of 0.37–6.48 tha−1 can be observed under both climate change scenarios. Moreover, 90% of control irrigation level proved beneficial in terms of saving around 10% irrigation water with acceptable yield reduction. The outcomes of the study are supportive for growers to gain more yield using less amount of water and to adapt to changing climate. The results are also helpful for policy makers to develop adaptation strategies to improve sugarcane productivity and to address water stress in Pakistan.

Pediatric Type II Supracondylar Humerus Fractures: Factors Associated With Successful Closed Reduction and Immobilization.

The debate on the treatment of type IIa supracondylar humerus fractures has yet to be resolved. The purpose of this study was to assess the factors associated with successful closed reduction and immobilization and to assess the efficacy of a novel radiographic "hourglass" angle measurement in the management of type IIa supracondylar humerus fractures within the pediatric population. An institutional review board-approved retrospective review of all children who underwent closed reduction and casting or splinting of an isolated type IIa supracondylar humerus fractures treated at 2 pediatric hospitals from January 1, 2009 to August 31, 2016. Analyzed radiographic parameters included Baumann angle (BA), humerocondylar angle (HCA), perpendicular distance (PD) from the anterior humeral line to the capitellum, and the hourglass angle (HGA). These parameters were measured on injury radiographs (XR), postreduction XR, and at the first and final follow-up XR. The success of closed reduction was defined as maintenance of an acceptable reduction without a secondary procedure. The interobserver reliability was calculated. There were 77 elbows treated with closed reduction and long-arm cast or splint immobilization. Of those closed reductions, 76.62% of elbows (59/77) maintained their reduction alignment and did not require surgical treatment for percutaneous pinning. In this series, the BA was not significantly different following closed reduction ([INCREMENT]1.04 degrees; P=0.081); however, the PD ([INCREMENT]1.89 mm), HGA ([INCREMENT]7.38 degrees), and HCA ([INCREMENT]5.07 degrees) had significant improvement following closed reduction (P<0.001 for all). The use of procedural sedation during reduction was strongly associated with success, 83.05% (49/59) with sedation compared with 55.56% (10/18) success without sedation (P=0.025). Furthermore, fractures that underwent a secondary procedure had 6.20 degrees less HGA following a closed reduction (P=0.016) and required additional follow-up visits (P=0.0037). The success of type IIa supracondylar humerus fractures did not significantly differ based on sex (P=0.5684), laterality (P=0.6975), mechanism of injury (P>0.9999), location of care-emergency department versus clinic (P=0.1160), or type of fracture immobilization (P=0.7411). The mean HGA in normal elbows was 177.8 degrees. The interobserver reliability for HCA was poor [intraclass correlation coefficient (ICC)=0.342]; fair for BA (ICC=0.458); and excellent for both PD and HGA (ICC=0.769 and 0.805, respectively) (P<0.001 for all). Improved and acceptable radiographic parameters were achieved by a closed reduction in the majority of minimally displaced type IIa fractures treated by closed reduction and immobilization in this series. HCA upon presentation was significantly greater in successful cases, and failure to improve and maintain HGA and PD following closed reduction was associated with loss of reduction. Procedural sedation during reduction was strongly associated with success. The HGA and PD were consistent parameters used to determine effective management of type IIa fractures. This study adds support for a nonoperative closed reduction under sedation with immobilization of selected type IIa supracondylar humerus fractures.