Background The aim of this study was to present our clinical outcomes and surgical technique in s... more Background The aim of this study was to present our clinical outcomes and surgical technique in strut allografts preparation using staggered holes to enhance osteointegration and demineralised bone matrix (DBM) as an adjunct to cortical strut allografts in salvage revision arthroplasty patients. Methods Retrospective consecutive series of patients who required strut allograft femoral reconstructions with minimum 2 years follow up between 2012 and 2018. Frozen washed irradiated, cortical struts were used and prepared adding 2 mm staggered drill holes along the length of the strut and applying DBM paste on the graft-host interface. Outcome measures included radiographic strut union, graft resorption, infection and complications. Results 15 patients included; 3 males and 12 females with median age 72 years (range 60-93). All had significant bony defects (Paprosky III/IV in 12 cases including 3 cases of periprosthetic hip fractures and further 3 cases of periprosthetic knee fractures around revision hinged implants). At final follow up, median 3.8 years (range 2.7-7.2), 14/15 (93.3%) struts had united at a median 6 months (range 5-8), complete incorporation with cortical round-off was seen at median 12 months (range 8-48) in 12/15 (80%) struts, 2/15 (13.3%) show radiographic evidence of proximal minimal graft resorptions although the remainder of the strut had integrated and were asymptomatic. There were no cases of infection. Conclusions Use of strut allografts helps to reconstruct bone defects, restore bone stock, and provide stable fixation for complex patterns of periprosthetic fractures around hip/knee implants and salvage revision cases with 93.3% union rate at median 6 months.
Introduction: We describe a reliable approach for double nerve transfer of the medial triceps bra... more Introduction: We describe a reliable approach for double nerve transfer of the medial triceps branch and thoracodorsal nerve to the axillary nerve to increase axonal input. We present a review of outcomes for both end-to-end and reverse end-to-side nerve transfer. Methods: A retrospective review of patients who underwent nerve transfer for improvement of shoulder abduction at Harborview Medical Center and Northwestern Memorial Hospital between 2012 and 2021 was conducted. Patients were prospectively contacted to fill out a 30 item Disabilities of the Arm, Shoulder and Hand questionnaire, with an option to upload a video demonstrating active range of motion. Results: Twenty-one patients with 23 affected extremities were included in the final analysis. Fifteen patients completed the prospective arm of the study (71% response rate). Seventy-nine percent of patient limbs achieved a Medical Research Council Motor Scale (MRC-MS) of 4 or greater, and measured shoulder abduction active rang...
Background: The American Board of Plastic Surgery has been collecting practice data on carpal tun... more Background: The American Board of Plastic Surgery has been collecting practice data on carpal tunnel syndrome treatment since 2004 as part of its Continuous Certification Program. These data allow plastic surgeons to compare their surgical experience to national trends and analyze those trends in relation to current evidence-based medicine. Methods: Data on carpal tunnel syndrome treatment from 2004 to 2014 were compared to those from 2015 to 2020. National practice trends observed in these data were evaluated relative to current literature regarding evidence-based practices. Results: A total of 11,090 carpal tunnel syndrome cases were included from 2004 to 2020. Electrodiagnostic and imaging studies were performed on most patients despite adding little sensitivity and specificity when physical examination tests are performed and not being considered cost-effective. An open “mini” approach has remained the most common surgical technique in carpal tunnel release for the last 15 years...
IMPORTANCE Concern regarding surgical trainees' operative autonomy has increased in recent years,... more IMPORTANCE Concern regarding surgical trainees' operative autonomy has increased in recent years, emphasizing patient safety and preparation for independent practice. Regarding abdominal wall reconstruction (AWR), long-term outcomes of fellow autonomy have yet to be delineated.
Background: The American Board of Plastic Surgery collects data on 20 common plastic surgery oper... more Background: The American Board of Plastic Surgery collects data on 20 common plastic surgery operations as part of the Continuous Certification process. The goal of this study was to describe clinical trends in Dupuytren contracture repair since 2008 as they relate to evidence-based medicine articles published in this timeframe. Methods: Cumulative tracer data for Dupuytren contracture were reviewed for the period from February of 2008 to March of 2020 and compared with evidence-based medicine articles published in Plastic and Reconstructive Surgery. Topics were categorized as (1) pearls, addressed in both the tracer data and evidence-based medicine articles, (2) topics only addressed in tracer data, and (3) topics only addressed in evidence-based medicine articles. Results: As of March of 2020, 230 cases of Dupuytren contracture had been entered. The median age at time of surgery was 65 years (range, 38 to 91 years). Practice patterns from 2008 through 2014 were compared with those...
SummaryClubroot is one of the most important diseases for many important cruciferous vegetables a... more SummaryClubroot is one of the most important diseases for many important cruciferous vegetables and oilseed crops worldwide. Different clubroot resistance (CR) loci have been identified from only limited species in Brassica, making it difficult to compare and utilize these loci. European fodder turnip ECD04 is considered one of the most valuable resources for CR breeding. To explore the genetic and evolutionary basis of CR in ECD04, we sequenced the genome of ECD04 using de novo assembly and identified 978 candidate R genes. Subsequently, the 28 published CR loci were physically mapped to 15 loci in the ECD04 genome, including 62 candidate CR genes. Among them, two CR genes, CRA3.7.1 and CRA8.2.4, were functionally validated. Phylogenetic analysis revealed that CRA3.7.1 and CRA8.2.4 originated from a common ancestor before the whole‐genome triplication (WGT) event. In clubroot susceptible Brassica species, CR‐gene homologues were affected by transposable element (TE) insertion, resu...
ABSTRACT Background: The Lancet Global Health Commission (LGHC) has argued that quality of care (... more ABSTRACT Background: The Lancet Global Health Commission (LGHC) has argued that quality of care (QoC) is an emergent property that requires an iterative process to learn and implement. Such iterations are required given that health systems are complex adaptive systems. Objective: This paper explores the multiple roles that evaluations need to play in order to help with iterative learning and implementation. We argue evaluation needs to shift from a summative focus toward an approach that promotes learning in complex systems. A framework is presented to help guide the iterative learning, and includes the dimensions of clinical care, person-centered care, continuum of care, and ‘more than medicine. Multiple roles of evaluation corresponding to each of the dimensions are discussed. Methods: This paper is informed by reviews of the literature on QoC and the roles of evaluation in complex systems. The proposed framework synthesizes the multiple views of QoC. The recommendations of the roles of evaluation are informed both by review and experience in evaluating multiple QoC initiatives. Results: The specific roles of different evaluation approaches, including summative, realist, developmental, and participatory, are identified in relationship to the dimensions in our proposed framework. In order to achieve the potential of LGHC, there is a need to discuss how different evaluation approaches can be combined in a coherent way to promote iterative learning and implementation of QoC initiatives. Conclusion: One of the implications of the QoC framework discussed in the paper is that time needs to be spent upfront in recognizing areas in which knowledge of a specific intervention is not complete at the outset. This, of course, implies taking stock of areas of incompleteness in knowledge of context, theory of change, support structures needed in order for the program to succeed in specific settings. The role of evaluation should not be limited to only providing an external assessment, but an important goal in building evaluation capacity should be to promote adaptive management among planners and practitioners. Such iterative learning and adaptive management are needed to achieve the goals of sustainable development goals.
Antagonism between yoghurt bacteria and probiotic bacteria isolated from four commercial starter ... more Antagonism between yoghurt bacteria and probiotic bacteria isolated from four commercial starter cultures, three commercial yoghurts and a probiotic capsule was studied. Streptococcus thermophilus (7 strains), Lactobacillus delbrueckii subsp. bulgaricus (5 strains), Lactobacillus acidophilus (8 strains) and bifidobacteria (8 strains) were isolated and the isolates used as both producer and indicator organisms for inhibitory activity using modified spot on lawn and agar well diffusion assays. Seven out of 8 strains of L. acidophilus produced antimicrobial substances active against all 5 strains of L. delbrueckii subsp. bulgaricus; the inhibitory substances were sensitive to proteolytic enzymes and were active at neutral pH. At pH 5.5 and 6.0, there was increased production of a bacteriocin-like inhibitory substance (BLIS). Inhibition of 5 strains of S. thermophilus and 2 strains of bifidobacteria was due to organic acids not to BLIS.
To study stress tolerance of a set of breeding lines, it is necessary to evaluate the lines under... more To study stress tolerance of a set of breeding lines, it is necessary to evaluate the lines under stressed conditions and control conditions without stress. Thus, the evaluation involves two factors, i.e. stress treatment (with levels 'control' and 'stressed') and genotypes. There are many valid experimental designs for factorial experiments, which involve randomization of stress treatment-by-genotype combinations. Conducting trials laid out according to such standard designs may be difficult, however, due to potential neighbour effects between plots receiving different stress treatments. This frequently leads plant breeders to assess stress treatments in completely separated trials. For example, one trial may be conducted for the control treatment and one trial for the stress treatment. This approach limits the type of inferences that are available. In this paper it will be shown that inferences based on between-trial information are not possible. Inference based on within-trial information is feasible, however, as will be illustrated using an example. The practical implication is that a genotype-specific stress tolerance index cannot be estimated with this approach, but that a relative comparison of the genotypes' stress tolerance is possible.
Introduction: Surgical site infection is one of the common healthcare associated infections, has ... more Introduction: Surgical site infection is one of the common healthcare associated infections, has significant impact on associated morbidity, mortality and exerts economic burden on the patient as well as on health care system. In addition to other measures, local inhibition of colonization of bacteria would provide clinical benefits. Antibacterial suture such as Triclosan coated suture prevents local growth of bacteria during critical initial stage of wound healing. At the end of 24 hrs of incubation at 37°C, 17-19 mm of zone of inhibition was seen for both S aureus and MRSA for Triclosan coated suture, while no zone was found around for non-coated suture. Methods: The study evaluated in vitro efficacy of antibiotic coated Triclosan suture using zone of inhibition model against commonly reported organisms in SSI (Staphylococcus aureus, Methicillin resistant Staphylococcus aureus. Results: Triclosan coated suture prevents colonization of bacteria at the surgical site, thus reduce the...
Canadian Journal of Kidney Health and Disease, 2021
Background: People receiving in-center hemodialysis (HD) have prioritized the need for more indiv... more Background: People receiving in-center hemodialysis (HD) have prioritized the need for more individualized health information and better communication with nephrologists. The most common setting for patient-nephrologist interactions is during the HD treatment, which is a time pressured setting that lacks privacy. Objective: To facilitate effective communication in the hemodialysis (HD) unit, we evaluated the usability of a web application (web app) from both the patient and physician perspective. The main aim of the web app was to support patients in prioritizing their dialysis concerns outside of the clinical HD encounter. Design: Mixed method, parallel arm, multi-site, pilot randomized controlled trial. Setting: Two outpatient Canadian HD centers. Participants: Adult patients receiving in-center HD and their attending nephrologists. Methods: Patients were randomized to either a web application or an active control (paper form) for logging concerns to be addressed at weekly encount...
Objective: To assess the prevalence of upper crossed syndrome among students of Doctor of Physica... more Objective: To assess the prevalence of upper crossed syndrome among students of Doctor of Physical Therapy (DPT) and Bachelors of Eastern Medicine and Surgery (BEMS) at university of Balochistan Quetta, Pakistan. Background: Upper cross syndrome is characterized as a pattern of tightness or over facilitation of chronically contracted and shortened muscles on one side and weakness or inhibition of chronically lengthened muscles on other side due to the muscle imbalance leading to postural abnormalities including, forward head posture, shoulder protraction, winging of scapula. These changes, in turn, lead to overstress of the cervical cranio-cervical junction, cervical and thoracic spine and shoulders, which can cause neck and/or jaw pain, headaches, and shoulder problems. The purpose of this study was to figure out the number of students of DPT and BEMS suffering from upper crossed syndrome at university of Balochistan Quetta, Pakistan. Methodology: A descriptive cross-sectional stud...
OBJECTIVES This study was undertaken to measure the concerns of students whose medical schools do... more OBJECTIVES This study was undertaken to measure the concerns of students whose medical schools do not have a plastic surgery training program to help educators better understand their perspectives. This is essential to improve plastic surgery education for almost 50% of students in the United States at institutions without a residency program. DESIGN An anonymous survey was distributed to the clerkship directors of the applicable medical schools. They were then asked to forward this survey to their student body. The survey was divided as follows: demographics; exposure to plastic surgery; mentorship; suggestions for improvement; perceived impact on matching. RESULTS We received 265 responses from 16 unique institutions. About 38% consider themselves underrepresented in medicine. The most common initial professional exposure to plastic surgery was shadowing (20%). About 10% reported exposure to plastic surgery in their school curriculum. About 51% reported having no professional exposure to plastic surgery. About 89% did not identify a mentor. All students applying to away rotations reported difficulties facilitating these sub-internships. About 64% felt extremely concerned about matching. CONCLUSIONS Students from schools without plastic surgery training programs are at a disadvantage. The academic community needs to support these students to achieve a more diverse field. All students should be given an introduction to plastic surgery as part of their curriculum, and they should be encouraged to explore a career in plastic surgery as a realistic option. If 1 perceives themselves as non-competitive due to institutional shortcomings, this will translate into a non-competitive applicant and discourage our specialty's serious pursuit by almost half the country's medical students.
Background and aimsComplications of bicuspid aortic valve commonly include aortic stenosis, aorti... more Background and aimsComplications of bicuspid aortic valve commonly include aortic stenosis, aortic regurgitation, and ascending aortic dilation. The progression of these lesions is not well described.Materials and methodsWe reviewed 249 bicuspid aortic valve patients with at least two echocardiograms from 2006 to 2016. Valve morphology (right–left or right–noncoronary cusp fusion) was confirmed by visual inspection, and aortic stenosis and regurgitation were quantified according to current guidelines; the ascending aorta was measured at end‐systole 2–3 cm above the sinotubular junction. Annualized progression of stenosis, regurgitation, and aortic dilation from first to most recent echocardiogram were compared between right–left and right–nonfused valves using multivariable logistic regression to adjust for baseline differences in groups.ResultsAmong 249 bicuspid aortic valve patients (mean age 47.6 ± 13.5 years, 66.3% male), 75.9% had right–left cusp fusion. At baseline, aortic ste...
Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty. Design: Retrosp... more Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty. Design: Retrospective review of data submitted during Maintenance of Certification (MOC). Setting: Evaluation of MOC data from the American Board of Plastic Surgery. Participants: Tracer data for secondary cleft rhinoplasty were reviewed from August 2006 through March 2020, and the data subdivided from 20062012 and 20132020 to evaluate changes in practice patterns. Interventions: Practice patterns in tracer data were compared to those from evidence-based medicine (EBM) literature over this time period. Main Outcome Measures: Practice patterns were compared to EBM trends during the study period. Results: A total of 90 cases of secondary cleft rhinoplasty were identified. The average age at operation was 13 years (range 4-77). Cumulative data demonstrated 61% to present with nasal airway obstruction and 21% to have undergone primary nasal correction at the time of cleft lip repair; 72% of patients experi...
Tocopherol is an essential fat‐soluble nutrient for humans. Increasing the tocopherol content in ... more Tocopherol is an essential fat‐soluble nutrient for humans. Increasing the tocopherol content in Brassica napus seeds can add value to rapeseed vegetable oil; this has become an important breeding target. However, there is no efficient and non‐destructive method for selecting rapeseed accessions with high tocopherol contents. Here, we report the first near‐infrared reflectance spectroscopy (NIRS)‐based technique for predicting rapeseed tocopherol content. Individual seed tocopherol compositions were estimated from 373 rapeseed genotypes of different origins. This method and chemical methods produced comparable predicted values of the tocopherol constituents in the seeds. Three equations were generated for the prediction of tocopherol content by using a modified partial least squares (MPLS) model. The total tocopherol content for the determination coefficient of cross‐validation (R2cv) (0.74), determination coefficient (RSQ) (0.76) and one minus the ratio of unexplained variance to t...
Salt stress is considered one of the main abiotic factors to limit crop growth and productivity b... more Salt stress is considered one of the main abiotic factors to limit crop growth and productivity by affecting morpho-physiological and biochemical processes. Genetically, a number of salt tolerant Brassica varieties have been developed and introduced, but breeding of such varieties is time consuming. Therefore, current focus is on transgenic technology, which plays an important role in the development of salt tolerant varieties. Various salt tolerant genes have been characterized and incorporated into Brassica. Therefore, such genetic transformation of Brassica species is a significant step for improvement of crops, as well as conferring salt stress resistance qualities to Brassica species. Complete genome sequencing has made the task of genetically transforming Brassica species easier, by identifying desired candidate genes. The present review discusses relevant information about the principles which should be employed to develop transgenic Brassica species, and also will recommend ...
Background The aim of this study was to present our clinical outcomes and surgical technique in s... more Background The aim of this study was to present our clinical outcomes and surgical technique in strut allografts preparation using staggered holes to enhance osteointegration and demineralised bone matrix (DBM) as an adjunct to cortical strut allografts in salvage revision arthroplasty patients. Methods Retrospective consecutive series of patients who required strut allograft femoral reconstructions with minimum 2 years follow up between 2012 and 2018. Frozen washed irradiated, cortical struts were used and prepared adding 2 mm staggered drill holes along the length of the strut and applying DBM paste on the graft-host interface. Outcome measures included radiographic strut union, graft resorption, infection and complications. Results 15 patients included; 3 males and 12 females with median age 72 years (range 60-93). All had significant bony defects (Paprosky III/IV in 12 cases including 3 cases of periprosthetic hip fractures and further 3 cases of periprosthetic knee fractures around revision hinged implants). At final follow up, median 3.8 years (range 2.7-7.2), 14/15 (93.3%) struts had united at a median 6 months (range 5-8), complete incorporation with cortical round-off was seen at median 12 months (range 8-48) in 12/15 (80%) struts, 2/15 (13.3%) show radiographic evidence of proximal minimal graft resorptions although the remainder of the strut had integrated and were asymptomatic. There were no cases of infection. Conclusions Use of strut allografts helps to reconstruct bone defects, restore bone stock, and provide stable fixation for complex patterns of periprosthetic fractures around hip/knee implants and salvage revision cases with 93.3% union rate at median 6 months.
Introduction: We describe a reliable approach for double nerve transfer of the medial triceps bra... more Introduction: We describe a reliable approach for double nerve transfer of the medial triceps branch and thoracodorsal nerve to the axillary nerve to increase axonal input. We present a review of outcomes for both end-to-end and reverse end-to-side nerve transfer. Methods: A retrospective review of patients who underwent nerve transfer for improvement of shoulder abduction at Harborview Medical Center and Northwestern Memorial Hospital between 2012 and 2021 was conducted. Patients were prospectively contacted to fill out a 30 item Disabilities of the Arm, Shoulder and Hand questionnaire, with an option to upload a video demonstrating active range of motion. Results: Twenty-one patients with 23 affected extremities were included in the final analysis. Fifteen patients completed the prospective arm of the study (71% response rate). Seventy-nine percent of patient limbs achieved a Medical Research Council Motor Scale (MRC-MS) of 4 or greater, and measured shoulder abduction active rang...
Background: The American Board of Plastic Surgery has been collecting practice data on carpal tun... more Background: The American Board of Plastic Surgery has been collecting practice data on carpal tunnel syndrome treatment since 2004 as part of its Continuous Certification Program. These data allow plastic surgeons to compare their surgical experience to national trends and analyze those trends in relation to current evidence-based medicine. Methods: Data on carpal tunnel syndrome treatment from 2004 to 2014 were compared to those from 2015 to 2020. National practice trends observed in these data were evaluated relative to current literature regarding evidence-based practices. Results: A total of 11,090 carpal tunnel syndrome cases were included from 2004 to 2020. Electrodiagnostic and imaging studies were performed on most patients despite adding little sensitivity and specificity when physical examination tests are performed and not being considered cost-effective. An open “mini” approach has remained the most common surgical technique in carpal tunnel release for the last 15 years...
IMPORTANCE Concern regarding surgical trainees' operative autonomy has increased in recent years,... more IMPORTANCE Concern regarding surgical trainees' operative autonomy has increased in recent years, emphasizing patient safety and preparation for independent practice. Regarding abdominal wall reconstruction (AWR), long-term outcomes of fellow autonomy have yet to be delineated.
Background: The American Board of Plastic Surgery collects data on 20 common plastic surgery oper... more Background: The American Board of Plastic Surgery collects data on 20 common plastic surgery operations as part of the Continuous Certification process. The goal of this study was to describe clinical trends in Dupuytren contracture repair since 2008 as they relate to evidence-based medicine articles published in this timeframe. Methods: Cumulative tracer data for Dupuytren contracture were reviewed for the period from February of 2008 to March of 2020 and compared with evidence-based medicine articles published in Plastic and Reconstructive Surgery. Topics were categorized as (1) pearls, addressed in both the tracer data and evidence-based medicine articles, (2) topics only addressed in tracer data, and (3) topics only addressed in evidence-based medicine articles. Results: As of March of 2020, 230 cases of Dupuytren contracture had been entered. The median age at time of surgery was 65 years (range, 38 to 91 years). Practice patterns from 2008 through 2014 were compared with those...
SummaryClubroot is one of the most important diseases for many important cruciferous vegetables a... more SummaryClubroot is one of the most important diseases for many important cruciferous vegetables and oilseed crops worldwide. Different clubroot resistance (CR) loci have been identified from only limited species in Brassica, making it difficult to compare and utilize these loci. European fodder turnip ECD04 is considered one of the most valuable resources for CR breeding. To explore the genetic and evolutionary basis of CR in ECD04, we sequenced the genome of ECD04 using de novo assembly and identified 978 candidate R genes. Subsequently, the 28 published CR loci were physically mapped to 15 loci in the ECD04 genome, including 62 candidate CR genes. Among them, two CR genes, CRA3.7.1 and CRA8.2.4, were functionally validated. Phylogenetic analysis revealed that CRA3.7.1 and CRA8.2.4 originated from a common ancestor before the whole‐genome triplication (WGT) event. In clubroot susceptible Brassica species, CR‐gene homologues were affected by transposable element (TE) insertion, resu...
ABSTRACT Background: The Lancet Global Health Commission (LGHC) has argued that quality of care (... more ABSTRACT Background: The Lancet Global Health Commission (LGHC) has argued that quality of care (QoC) is an emergent property that requires an iterative process to learn and implement. Such iterations are required given that health systems are complex adaptive systems. Objective: This paper explores the multiple roles that evaluations need to play in order to help with iterative learning and implementation. We argue evaluation needs to shift from a summative focus toward an approach that promotes learning in complex systems. A framework is presented to help guide the iterative learning, and includes the dimensions of clinical care, person-centered care, continuum of care, and ‘more than medicine. Multiple roles of evaluation corresponding to each of the dimensions are discussed. Methods: This paper is informed by reviews of the literature on QoC and the roles of evaluation in complex systems. The proposed framework synthesizes the multiple views of QoC. The recommendations of the roles of evaluation are informed both by review and experience in evaluating multiple QoC initiatives. Results: The specific roles of different evaluation approaches, including summative, realist, developmental, and participatory, are identified in relationship to the dimensions in our proposed framework. In order to achieve the potential of LGHC, there is a need to discuss how different evaluation approaches can be combined in a coherent way to promote iterative learning and implementation of QoC initiatives. Conclusion: One of the implications of the QoC framework discussed in the paper is that time needs to be spent upfront in recognizing areas in which knowledge of a specific intervention is not complete at the outset. This, of course, implies taking stock of areas of incompleteness in knowledge of context, theory of change, support structures needed in order for the program to succeed in specific settings. The role of evaluation should not be limited to only providing an external assessment, but an important goal in building evaluation capacity should be to promote adaptive management among planners and practitioners. Such iterative learning and adaptive management are needed to achieve the goals of sustainable development goals.
Antagonism between yoghurt bacteria and probiotic bacteria isolated from four commercial starter ... more Antagonism between yoghurt bacteria and probiotic bacteria isolated from four commercial starter cultures, three commercial yoghurts and a probiotic capsule was studied. Streptococcus thermophilus (7 strains), Lactobacillus delbrueckii subsp. bulgaricus (5 strains), Lactobacillus acidophilus (8 strains) and bifidobacteria (8 strains) were isolated and the isolates used as both producer and indicator organisms for inhibitory activity using modified spot on lawn and agar well diffusion assays. Seven out of 8 strains of L. acidophilus produced antimicrobial substances active against all 5 strains of L. delbrueckii subsp. bulgaricus; the inhibitory substances were sensitive to proteolytic enzymes and were active at neutral pH. At pH 5.5 and 6.0, there was increased production of a bacteriocin-like inhibitory substance (BLIS). Inhibition of 5 strains of S. thermophilus and 2 strains of bifidobacteria was due to organic acids not to BLIS.
To study stress tolerance of a set of breeding lines, it is necessary to evaluate the lines under... more To study stress tolerance of a set of breeding lines, it is necessary to evaluate the lines under stressed conditions and control conditions without stress. Thus, the evaluation involves two factors, i.e. stress treatment (with levels 'control' and 'stressed') and genotypes. There are many valid experimental designs for factorial experiments, which involve randomization of stress treatment-by-genotype combinations. Conducting trials laid out according to such standard designs may be difficult, however, due to potential neighbour effects between plots receiving different stress treatments. This frequently leads plant breeders to assess stress treatments in completely separated trials. For example, one trial may be conducted for the control treatment and one trial for the stress treatment. This approach limits the type of inferences that are available. In this paper it will be shown that inferences based on between-trial information are not possible. Inference based on within-trial information is feasible, however, as will be illustrated using an example. The practical implication is that a genotype-specific stress tolerance index cannot be estimated with this approach, but that a relative comparison of the genotypes' stress tolerance is possible.
Introduction: Surgical site infection is one of the common healthcare associated infections, has ... more Introduction: Surgical site infection is one of the common healthcare associated infections, has significant impact on associated morbidity, mortality and exerts economic burden on the patient as well as on health care system. In addition to other measures, local inhibition of colonization of bacteria would provide clinical benefits. Antibacterial suture such as Triclosan coated suture prevents local growth of bacteria during critical initial stage of wound healing. At the end of 24 hrs of incubation at 37°C, 17-19 mm of zone of inhibition was seen for both S aureus and MRSA for Triclosan coated suture, while no zone was found around for non-coated suture. Methods: The study evaluated in vitro efficacy of antibiotic coated Triclosan suture using zone of inhibition model against commonly reported organisms in SSI (Staphylococcus aureus, Methicillin resistant Staphylococcus aureus. Results: Triclosan coated suture prevents colonization of bacteria at the surgical site, thus reduce the...
Canadian Journal of Kidney Health and Disease, 2021
Background: People receiving in-center hemodialysis (HD) have prioritized the need for more indiv... more Background: People receiving in-center hemodialysis (HD) have prioritized the need for more individualized health information and better communication with nephrologists. The most common setting for patient-nephrologist interactions is during the HD treatment, which is a time pressured setting that lacks privacy. Objective: To facilitate effective communication in the hemodialysis (HD) unit, we evaluated the usability of a web application (web app) from both the patient and physician perspective. The main aim of the web app was to support patients in prioritizing their dialysis concerns outside of the clinical HD encounter. Design: Mixed method, parallel arm, multi-site, pilot randomized controlled trial. Setting: Two outpatient Canadian HD centers. Participants: Adult patients receiving in-center HD and their attending nephrologists. Methods: Patients were randomized to either a web application or an active control (paper form) for logging concerns to be addressed at weekly encount...
Objective: To assess the prevalence of upper crossed syndrome among students of Doctor of Physica... more Objective: To assess the prevalence of upper crossed syndrome among students of Doctor of Physical Therapy (DPT) and Bachelors of Eastern Medicine and Surgery (BEMS) at university of Balochistan Quetta, Pakistan. Background: Upper cross syndrome is characterized as a pattern of tightness or over facilitation of chronically contracted and shortened muscles on one side and weakness or inhibition of chronically lengthened muscles on other side due to the muscle imbalance leading to postural abnormalities including, forward head posture, shoulder protraction, winging of scapula. These changes, in turn, lead to overstress of the cervical cranio-cervical junction, cervical and thoracic spine and shoulders, which can cause neck and/or jaw pain, headaches, and shoulder problems. The purpose of this study was to figure out the number of students of DPT and BEMS suffering from upper crossed syndrome at university of Balochistan Quetta, Pakistan. Methodology: A descriptive cross-sectional stud...
OBJECTIVES This study was undertaken to measure the concerns of students whose medical schools do... more OBJECTIVES This study was undertaken to measure the concerns of students whose medical schools do not have a plastic surgery training program to help educators better understand their perspectives. This is essential to improve plastic surgery education for almost 50% of students in the United States at institutions without a residency program. DESIGN An anonymous survey was distributed to the clerkship directors of the applicable medical schools. They were then asked to forward this survey to their student body. The survey was divided as follows: demographics; exposure to plastic surgery; mentorship; suggestions for improvement; perceived impact on matching. RESULTS We received 265 responses from 16 unique institutions. About 38% consider themselves underrepresented in medicine. The most common initial professional exposure to plastic surgery was shadowing (20%). About 10% reported exposure to plastic surgery in their school curriculum. About 51% reported having no professional exposure to plastic surgery. About 89% did not identify a mentor. All students applying to away rotations reported difficulties facilitating these sub-internships. About 64% felt extremely concerned about matching. CONCLUSIONS Students from schools without plastic surgery training programs are at a disadvantage. The academic community needs to support these students to achieve a more diverse field. All students should be given an introduction to plastic surgery as part of their curriculum, and they should be encouraged to explore a career in plastic surgery as a realistic option. If 1 perceives themselves as non-competitive due to institutional shortcomings, this will translate into a non-competitive applicant and discourage our specialty's serious pursuit by almost half the country's medical students.
Background and aimsComplications of bicuspid aortic valve commonly include aortic stenosis, aorti... more Background and aimsComplications of bicuspid aortic valve commonly include aortic stenosis, aortic regurgitation, and ascending aortic dilation. The progression of these lesions is not well described.Materials and methodsWe reviewed 249 bicuspid aortic valve patients with at least two echocardiograms from 2006 to 2016. Valve morphology (right–left or right–noncoronary cusp fusion) was confirmed by visual inspection, and aortic stenosis and regurgitation were quantified according to current guidelines; the ascending aorta was measured at end‐systole 2–3 cm above the sinotubular junction. Annualized progression of stenosis, regurgitation, and aortic dilation from first to most recent echocardiogram were compared between right–left and right–nonfused valves using multivariable logistic regression to adjust for baseline differences in groups.ResultsAmong 249 bicuspid aortic valve patients (mean age 47.6 ± 13.5 years, 66.3% male), 75.9% had right–left cusp fusion. At baseline, aortic ste...
Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty. Design: Retrosp... more Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty. Design: Retrospective review of data submitted during Maintenance of Certification (MOC). Setting: Evaluation of MOC data from the American Board of Plastic Surgery. Participants: Tracer data for secondary cleft rhinoplasty were reviewed from August 2006 through March 2020, and the data subdivided from 20062012 and 20132020 to evaluate changes in practice patterns. Interventions: Practice patterns in tracer data were compared to those from evidence-based medicine (EBM) literature over this time period. Main Outcome Measures: Practice patterns were compared to EBM trends during the study period. Results: A total of 90 cases of secondary cleft rhinoplasty were identified. The average age at operation was 13 years (range 4-77). Cumulative data demonstrated 61% to present with nasal airway obstruction and 21% to have undergone primary nasal correction at the time of cleft lip repair; 72% of patients experi...
Tocopherol is an essential fat‐soluble nutrient for humans. Increasing the tocopherol content in ... more Tocopherol is an essential fat‐soluble nutrient for humans. Increasing the tocopherol content in Brassica napus seeds can add value to rapeseed vegetable oil; this has become an important breeding target. However, there is no efficient and non‐destructive method for selecting rapeseed accessions with high tocopherol contents. Here, we report the first near‐infrared reflectance spectroscopy (NIRS)‐based technique for predicting rapeseed tocopherol content. Individual seed tocopherol compositions were estimated from 373 rapeseed genotypes of different origins. This method and chemical methods produced comparable predicted values of the tocopherol constituents in the seeds. Three equations were generated for the prediction of tocopherol content by using a modified partial least squares (MPLS) model. The total tocopherol content for the determination coefficient of cross‐validation (R2cv) (0.74), determination coefficient (RSQ) (0.76) and one minus the ratio of unexplained variance to t...
Salt stress is considered one of the main abiotic factors to limit crop growth and productivity b... more Salt stress is considered one of the main abiotic factors to limit crop growth and productivity by affecting morpho-physiological and biochemical processes. Genetically, a number of salt tolerant Brassica varieties have been developed and introduced, but breeding of such varieties is time consuming. Therefore, current focus is on transgenic technology, which plays an important role in the development of salt tolerant varieties. Various salt tolerant genes have been characterized and incorporated into Brassica. Therefore, such genetic transformation of Brassica species is a significant step for improvement of crops, as well as conferring salt stress resistance qualities to Brassica species. Complete genome sequencing has made the task of genetically transforming Brassica species easier, by identifying desired candidate genes. The present review discusses relevant information about the principles which should be employed to develop transgenic Brassica species, and also will recommend ...
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Papers by Nikhil Shah