Plasmodium falciparum and Plasmodium vivax Adjust Investment in Transmission in Response to Change in Transmission Intensity: A Review of the Current State of Research

Malaria parasites can adjust the proportion of parasites that develop into gametocytes, and thus the probability for human-to-vector transmission, through changes in the gametocyte conversion rate. Understanding the factors that impact the commitment of malaria parasites to transmission is required to design better control interventions. Plasmodium spp. persist across countries with vast differences in transmission intensities, and in sites where transmission is highly seasonal. Mounting evidence shows that Plasmodium spp. adjusts the investment in transmission according to seasonality of vector abundance, and transmission intensity. Various techniques to determine the investment in transmission are available, i.e., short-term culture, where the conversion rate can be measured most directly, genome and transcriptome studies, quantification of mature gametocytes, and mosquito feeding assays. In sites with seasonal transmission, the proportion of gametocytes, their densities and infectivity are higher during the wet season, when vectors are plentiful. When countries with pronounced differences in transmission intensity were compared, the investment in transmission was higher when transmission was low, thus maximizing the parasite’s chances to be transmitted to mosquitoes. Increased transmissibility of residual infections after a successful reduction of malaria transmission levels need to be considered when designing intervention measures.

Jumper’s fracture of the sacrum: a novel and reproducible way for successful reduction and fixation

Purpose Surgical treatment of jumper’s fractures is a highly demanding situation for the surgeon due to its rareness and frequent association with severe concomitant injuries. There is no current consensus regarding a standard treatment approach, thus reducing quality of care. Our objectives were to describe, apply and assess a novel surgical technic. Methods The presented research is an observational retrospective study of patients who underwent the described novel surgical intervention in a level 1 trauma center. We conducted analyses of the patient cohort using patient-related outcome measures at least 1 year after surgery, as well as investigating pain, quality of life and the clinical effectiveness of the procedure. Results A total of 24 patients (17 male and 7 female) with an average age 47 ± 16.3 years were included. ISS scores ranged from 9 to 66 with a mean ISS of 40 ± 15. Clinical scores exist of 15 out of 24 patients (62.5%). The mean VAS score was 53.7 ± 12.9. The mean EQ-5D index was 0.68 ± 0.22. Significant negative correlation existed between the ISS value and the EQ-5D index (r = − 0.704; p < 0.005) and EQ-5D VAS (r = − 0.809; p < 0.001). Anatomical reduction was achieved in all patients (n = 24). Radiological follow-up was performed in 58%. Conclusion We present one of the largest studies with operatively treated jumper’s fractures of the sacrum. The technique is capable of reproducibly restoring the physiological anatomy of the patient and allows pain-adapted mobilization.

IMAGING IN ANTERIOR SHOULDER DISLOCATION

Shoulder dislocation is a very common musculoskeletal injury. Imaging in such cases serves an important role in the diagnostic and therapeutic process. Despite a pretty simple clinical diagnosis, the process itself is long for the patient and associated with multiple steps and decision making to regain function with low risk of prolonged disability (Zygmunt et al., 2013; Lubiatowski et al., 2016). There are also many controversies as well as significant diversity among surgeons regarding the timing and choice of particular diagnostic modalities used in diagnostics of different scenarios of shoulder dislocation. The aim of imaging in shoulder dislocation is to confirm dislocation and its direction and finally successful reduction. That usually is served by conventional radiography. Additionally, imaging may be required to identify soft tissue or bone injuries or, when necessary vascular and nerve injuries using different modalities (CT, MR, US). The selective radiographic evaluation may reduce the number of X-rays, costs, and most of all time before reduction and spent by a patient in an emergency unite. That should be used carefully to avoid misdiagnosis. Keywords: shoulder dislocation, imaging, radiography, instability, magnetic resonance

Determination of the geometric parameters of the matrix during the volumetric compression of tin bronze bushings

The study of the influence of the geometric parameters of the matrix on the quality of the process of reduction of bushings made of tin bronze is carried out. It is established, that for successful reduction plastic deformation should not exceed 10÷15 %, and the angle of the intake part of the crimping matrix should be within 25÷45°, a further increase in this angle significantly reduces the quality of the process. It is shown, that the angle of the lead-in part of the crimping matrix has an insignificant influence on the limiting compression ratio of the bushings, and an increase in the friction coefficient does not significantly affect the deformation parameters. Keywords: bushing, crimping matrix, plastic deformation, compression ratio, wrinkling, degree of deformation [email protected]

Successful Management of Cleft Lip and Palate Malformation without Pre-Surgical Infant Orthopedics

Objective: To investigate the effect of lip closure on reduction of cleft palates when no pre-surgical infant orthopedics (PSIO) are used. Study design: Retrospective patient chart-review in our department for Cranio-Maxillofacial Surgery at the University Medical Centre Freiburg, Germany. 19 patients at the age of 5.9 ± 2.1 months with surgical treatment of uni- (UCLP), or bilateral cleft lip and palate (BCLP) without any use of PSIO were included. Results: Early soft tissue correction of the lip leads to an effective reduction of the maxillary arch without any use of PSIO. The presented conventional and digital measurements appeared to be reliable. A successful reduction of the cleft width (UCLP = 3.88 ± 2.42mm, BCLP = 7.33 ± 5.00mm), the width of the alveolar arch (1.91 ± 1.36mm) and the sagittal depth of the alveolar arch (3.07 ± 2.71 mm) could be achieved with the presented workflow. Conclusions: Cleft reduction was obtainable without PSIO when lip closure after Tennison-Randall was performed.

Experimental Study on the Flexural Behavior of Reinforced Polystyrene Blocks in Concrete Beams

A new type of lightweight beam system was recently proposed by embedding polystyrene in beams to improve structural efficiency. This removes the non-performing concrete in the neutral axis and tension region to provide a comparable strength as a solid beam. There are, however, limited studies conducted to investigate the structural behavior of such beams. Therefore, this research presents an experimental investigation to assess the effect of polystyrene shapes in the beams. This involved testing a solid beam and five lightweight beams under flexural load using a four-point load test. The inclusion of polystyrene was estimated to have reduced the self-weight of beams by 8.6% to 11.8% when compared with the solid beam. The results also showed the ellipse polystyrene with a width of 70 mm and height of 50 mm produced the highest effective strength to weight ratio (sw) of 1.12 and performed 12% better than the solid beam. Moreover, the lightweight beams have more weight reduced than the strength, and those with ellipse polystyrene were found to have performed better than circular ones based on first crack load, ultimate load, and effective strength to weight ratio (sw). The beams with ellipse polystyrene allowed better stress distribution and this gave them a higher strength than sphere shape. For industry application, the polystyrene content is recommended to be greater than 10% while the effective strength to weight ratio (sw) of the beam is greater than 1. The successful reduction of the weight without affecting the structural performance has the ability to help in reducing construction costs.

105 The Mustaq Method: Could This be The Simplest Shoulder Dislocation Reduction Method?

Introduction The Mushtaq Method is a new shoulder reduction technique. It is a simple, reliable, and less traumatic time modulated procedure. Method Patients are placed in the supine position if plausible. Fully adducting the affected arm with the elbow at right angle. The practitioner applies gentle traction above the elbow with the other hand placed deep into the axilla, palpation of the humeral head is followed by lateral pressure resulting in a successful relocation. Internal rotation and a broad arm sling complete the technique. No assistants are needed, and simple analgesia was often enough. Results 95% had a successful reduction within 5 minutes. 75% required analgesia alone, and no periprocedural complications were observed. Conclusions With so many options already, available it is essential to understand what dictates the success and failures of these methods. We have a new, safe, easy to use method requiring minimal force. We hope to increase our cohort size in the future to draw firm conclusions.