Early Treatment Outcome of Humeral Shaft Fracture Non-Union in Adults: Comparative Study of Plating versus Interlocking Nailing

Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are: (1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN;(2) to compare the time of radiologic fracture union of DCP with LIMN;(3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value Result: Forty five patients completed follow up. There was a male preponderance (4:1), right humerus predominated (3:2). Motor vehicular accidents were the commonest cause of the fractures (62%). Most non-union fractures occurred at the level of the middle 3rd of the humeral shaft (60%). Failed TBS treatment was the commonest indication for the osteosynthesis (71%). More patients had plating (53%) compared to 47% who had LIMN. Most patients (93.4%) had union between 3 to 6 months irrespective of fixation type with no significant statistical difference between the union rate of DCP and LIMN (p value 0.06) with similar functional outcome and complication rates irrespective of the type of fixation. Conclusion: This study showed that the success rates in term of fracture union, outcome functional grades and complication rates were not directly dependent on the types of the fixation: plating or locked intra-medullary nailing.

Open banking and inclusive finance in the European Union:perspectives from the Dutch stakeholder ecosystem

In the European Union(EU),the revised Payment Services Directive(PSD2)aims to provide more convenient and customized financial products through open banking(OB)platforms.However,little attention has been paid to the role of OB in improving the financial well-being of the growing number of the EU’s underserved groups,which currently constitute approximately a quarter of its population.This study examines how the PSD2 and OB impact inclusive finance in the EU based on the perspectives of the Netherlands’ecosystem,one of the leaders in the EU’s financial technology(FinTech)landscape.A fundamental distinction can be drawn between the OB users and the ecosystem’s players.Regarding the impact of financial services on the users’inclusivity,while the PSD2 strengthens the infrastructure necessary for financial inclusion,many challenges remain,mainly because it was not designed for this purpose.This study identifies several areas of improvement that include adjustments to the know your customer and anti-money laundering processes for underserved customers,innovative ways to communicate the PSD2’s potential,and the regulation of technology providers’activities to build trust.Meanwhile,from the ecosystem’s position,there is a need to strengthen and improve microfinance regulation according to the opportunities provided by the PSD2 to support microfinance institutions(MFIs)in scaling up and reaching underserved clients across borders with innovative services.OB improvements can also be achieved by organizations formed by MFIs and FinTechs in collaboration with banks.Such hybrid institutions will combine the best features of each of them:knowledge of the needs of local underserved clients from MFIs,technological innovations from FinTechs,and large and trusted customer bases,infrastructures,and access to institutional investments and governments from banks.Finally,an EU inclusive OB sector depends on the centrality of trusted regulators as coordination bodies.The PSD2 requires adjustments for underserved populations’specific needs.OB improvements can be achieved by organizations formed by MFIs and Fin-Techs in collaboration with banks.Regulated technical service providers(TSPs)are crucial to building trust and customer adoption in OB.The European Banking Authority(EBA)may function as coordination body to design inclusive rules by engaging with OB stakeholders.As inclusive finance moves into open-finance and data eras,an increasing regulatory complexity and scope will require networks of innovative and trusted regulators.

Research on the Regulatory Framework of Advanced Therapies in the European Union and the United States

Objective To study the regulatory framework of advanced therapies in the European Union and the United States,and to provide reference for the regulation of cell-and gene-based therapeutic products in China.Methods The legal and regulatory documents,annual reports,work information and related literature published on the websites of the FDA and European Medicines Agency(EMA)were reviewed to analyze the regulatory models of advanced therapies in the European Union and the United States.Results and Conclusion the United States and the European Union have carried out a lot of work in the classification standards of advanced therapies,policy formulation and accelerated listing procedures.Therefore,they have established a relatively mature regulatory system.China can learn from their experience and continuously improve the regulatory system to help the sustainable development of gene and cell therapy industry.

Research on the Interior Decoration Characteristics of Peking Union Medical College Phase I Project

Peking Union Medical College was founded in the late Qing Dynasty and the early Republic of China.Since then,society and politics have been rapidly changing,and its architectural aesthetics reflect the idea of advocating the West and inheriting tradition.Through research and actual investigation,this paper summarizes the current status of its building from two aspects,interior decoration art and interior decoration technology,analyzes the interior decoration characteristics of Peking Union Medical College Phase I Project,and records the archives of Peking Union Medical College’s decoration technology.

微机网上的分布式专家联合系统UNION(上)

本文描述微机网上的分布式专家联合系统UNION的设计思想、目标、体系结构和原理。UNION是继1985年陆汝钤提出分布式专家系统的概念及其设计思想之后于次年夏天开始组织实现的一个实验系统。目标机型是配有UNOS操作系统、PASCAL和C语言的MC68000微机,它们用Ethernet局部网联网。UNION目前已完成支撑系统Sup- port1和通信系统,其余部分正在实现中。UNION的工程实现由中国科学院数学研究所承担。

微机网上的分布式专家联合系统UNION(下)

本文描述微机网上的分布式专家联合系统UNION的实现方法和技术。UNION是继1985年陆汝钤提出分布或专家系统的概念及其设计思想之后于 次年夏天开始组织实现的一个实验系统。目标机型是配有UNOS操作系统、PASCAL和C语言的MC68000微机,它们用Ethernet局部网联网。UNION目前已完成支撑系统Support1和通信系统,其余部分正在实现中。UNION的工程实现由中国科学院数学研究所承担。

风景园林设计的社会学属性--兼论Union Point公园的设计

风景园林设计的理念随着时代的变革而不断地演化,并趋于多样化。现代主义使得园林不再是贵族们隐居消闲的场所,而是作为一种社会基础设施进入公众的生活之中。后现代主义又使精英意识逐渐被平民情结所取代,公众参与的呼声日见高涨。以美国奥克兰市UnionPoint公园的设计过程为例,探讨了在后现代语境下风景园林设计的社会学属性,特别是"公众参与"的策略在公园设计过程中的应用和体现。同时结合国情,分析这种新的设计行为对我国风景园林设计师的借鉴意义。

Systematic review of dynamization vs exchange nailing for delayed/non-union femoral fractures

AIM To analyze the literature on efficacy of dynamamization vs exchange nailing in treatment of delayed and nonunion femur fractures.METHODS Ultimately, 31 peer-reviewed articles with 644 exchanged nailing patients and 131 dynamization patients were identified and analyzed. The following key words were inputted in different combinations in order to search the field of publications in its entirety: "nonunion", "delayed union", "ununited", "femur fracture", "femoral fracture", "exchange nailing", "dynaiz(s)ation", "secondary nailing", "dynamic", "static", and "nail revision". The initial search yielded over 150 results, and was refined based on the inclusion criteria: Only studies reporting on humans, non-unions and delayed unions, and the usage of exchange nailing and/or dynamization as a secondary treatment after failed IM nailing. The resulting 66 articles were obtained through online journal access. The results were filtered further based on the exclusion criteria: No articles that failed to report overall union rates, differentiate between success rates of their reported techniques, or articles that analyzed less than 5 patients. RESULTS Exchange nailing lead to fracture union in 84.785% of patients compared to the 66.412% of dynamization with statistically comparable durations until union(5.193 ± 2.310 mo and 4.769 ± 1.986 mo respectively). Dynamically locking exchange nails resulted in an average union time of 5.208 ± 2.475 mo compared to 5.149 ± 2.366 mo(P = 0.8682) in statically locked exchange nails. The overall union rate of the two procedures, statically and dynamically locked exchange nailing yielded union rates of 84.259% and 82.381% respectively. Therefore, there was no significant difference between the different locking methods of exchange nailing for union rate or time to union at a significance value of P < 0.05. The analysis showed exchange nailing to be the more successful choice in the treatment of femoral non-unions in respect to its higher success rate(491/567 EN, 24/57 dynam, P < 0.0001). However, there was no significant difference between the success rates of the two procedures for delayed union fractures(25/27 EN, 45/55 dynam, P = 0.3299). Nevertheless, dynamization was more efficient in the treatment of delayed unions(at rates comparable to exchange nailing) than in the treatment of non-unions.CONCLUSION In conclusion, after examination of factors, dynamization is recommended treatment of delayed femur fractures, while exchange nailing is the treatment of choice for non-unions.

Two-stage surgical treatment for septic non-union of the forearm

AIM To investigate the effectiveness of a two-stage surgical procedure for the treatment of septic forearm non-union.METHODS Septic non-unions are rare complications of forearm fractures. When they occur, they modify the relationship between forearm bones leading to a severe functional impairment. Treatment is challenging and surgery and antibiotic therapy are required to achieve infection resolution. It is even harder to obtain non-union healing with good functional results. The aim of this study is to present a two stages surgical treatment for septic forearm non-union with revision and temporary stabilization of the non-union until infection has cleared and subsequently perform a new synthesis with plate, opposite bone graft strut and intercalary graft. We retrospectively reviewed 18 patients with a mean age at the time of primary injury of 34.5 years(19-57 years) and a mean follow-up of 6 years(2-10 years). All patients presented an atrophic nonunion with a mean length of the bone defect of 1.8 cm(1.2-4 cm). Complications and clinical results after surgical treatment were recorded. RESULTS Mean time to resolution of the infectious process was 8.2 wk(range 4-20 wk) after the first surgery and specific antibiotic therapy. All the non-union healed with an average time of 5 mo(range 2-10 mo) after the second step surgery. Cultures on intraoperative samples werepositive in all cases. No major intraoperative complications occurred. Two patients developed minor complications and one needed a second surgical debridement for infection resolution. At the last follow-up functional results were excellent in 5(27.8%) patients, satisfactory in 10(55.5%) and unsatisfactory in 3(16.7%) patients. No activities of daily living(ADLs) limitations were reported by 12(66.6%) patients, slight by 3(16.6%) and severe limitation by 3(16.6%) patients. Mean visual analog scale at the last follow-up was 1(0-3).CONCLUSION The two-step technique has proven to be effective to achieve resolution of the infectious process and union with good functional results and low rate of complications.

基于Union-Find的图像聚类方法

传统的图像聚类方法存在对初始数据敏感且计算复杂度高的问题,且图像全局特征难以有效地表达图像内容。针对这些问题,提出一种基于Union-Find的图像聚类方法。首先,该方法采用视觉词袋模型Bo VWM(Bag of Visual Words Model)来描述图像内容并且利用投票方法来计算每对图像的相似度得分;然后,对于相似度得分大于给定阈值的图像对进行union和find两个操作并将相连的分量形成聚类结果。实验结果表明,该方法较之于传统方法能较好地改善图像聚类效果,且不需要初始聚类数目作为先验参数。

TH—union教学机微程序控制器部件实验的实现

本文介绍了TH—union教学机微程序控制器部件实验的原理及实现方法.

Neighbourhood Unions and Vertex pancyclicity *

Let G be a 2 connected simple graph of order n ( n ≥5) and minimum degree δ . In this paper, we show that if for any two nonadjacent vertices u , v of G there holds | N(u)∪N(v)|≥n-δ , then G is {3,4} - vertex pancyclic unless G≌K n2,n2 .

从“Fab-Union Space”看数字化建筑与传统建筑学的融合

通过回顾现代建筑原型,文章不仅将创盟国际的建筑作品"Fab-Union space"视为当代数字化建筑的一个实践案例,而且将它与现代建筑学的历史语境联系起来进行理解。文章指出,数字化建筑应该并且也能够与传统建筑学相融合,而不是彼此分离。

Hamiltonicity,neighborhood union and square graphs of claw-free graphs

Let G be a graph, the square graph G 2 of G is a graph satisfying V(G 2)=V(G) and E(G 2)=E(G)∪｛uv: dist G(u, v)=2｝ . In this paper, we use the technique of vertex insertion on l -connected ( l=k or k+1, k≥2 ) claw-free graphs to provide a unified proof for G to be Hamiltonian, 1 -Hamiltonian or Hamiltonian-connected. The sufficient conditions are expressed by the inequality concerning ∑ k i=0N(Y i) and n(Y) in G for each independent set Y=｛y 0, y 1, …, y k｝ of the square graph of G , where b ( 0<b<k+1 ) is an integer, Y i=｛y i, y i-1, …, y i-(b-1)｝Y for i∈｛0, 1, …, k｝ , where subscriptions of y j s will be taken modulo k+1 , and n(Y)=｛v∈ V(G): dist (v, Y)≤ 2｝ .

Long Bone Non-Unions and Malunions: Risk Factors and Treatment Outcomes in Calabar, Southern Nigeria

Background: Diaphyseal non-unions and malunions constitute significant morbidities in fracture care. Fracture treatment modalities seek to restore anatomic orientation and functional rehabilitation as soon as possible after a fracture incident. Malunions and non unions present a treatment challenge with the need for prolonged hospitalization, multiple surgical interventions and economic burden. In the developing world, traditional bonesetting practices are popular and these often result in a host of preventable complications. The added socioeconomic costs of treating these complications present a considerable strain on the resources of these already fragile economies and households. Aim: To document the risk factors, treatment options and outcomes for diaphyseal non-unions and malunions in our environment. Patients and Methods: Fifty-two consecutive patients comprising 37 non-unions and 15 malunions who presented in the orthopaedic unit of a tertiary hospital in Southern Nigeria were evaluated. Information sought included biodata, location of pathology, type of incident fracture, local risk factors including traditional bonesetting;treatment options and final outcomes. Information obtained was analyzed using SPSS version 20 (IBM, New York). Results are presented in simple frequency tables. Results: There were 34 males and 18 females (M:F = 1.9:1) with a mean age of 38.76 ± 14.55 years. There were 37 non-unions and 15 malunions. The femur was the commonest site of pathology in 21 (40.4%) cases, and among the non-unions, the atrophic variety was the commonest type (n = 26;70.3%). The mean fracture-to-surgery interval was 11.35 ± 7.95 months and traditional bonesetting was the commonest risk factor (n = 36;69.2%). Plate and screw Osteosynthesis with bonegraft augmentation was the commonest treatment modality and the overall union rate was 94%. Conclusion: Traditional bonesetting plays a major role in the health seeking behaviour of many African societies. The complications are varied and add to the overall socioeconomic burden of fracture care in these developing economies. Identification of traditional bonesetting practices as an important risk factor should translate into a focus on these practices in preventive public health decisions in fracture care. Continuing public health education backed by political will and can potentially drive a paradigm shift in health seeking attitudes in the developing word.

Neighborhood Union of Essential Sets and Hamiltonicity of Claw-Free Graphs

Let G be a graph, an independent set Y in G is called an essential independent set (or essential set for simplicity), if there is {y 1,y 2} Y such that dist (y 1,y 2)=2. In this paper, we will use the technique of the vertex insertion on l connected ( l=k or k+1,k≥2 ) claw free graphs to provide a unified proof for G to be hamiltonian or 1 hamiltonian, the sufficient conditions are expressed by the inequality concerning ∑ki=0N(Y i) and n(Y) for each essential set Y={y 0,y 1,...,y k} of G , where Y i={y i,y i-1 ,...,y i-(b-1) }Y for i∈{0,1,...,k} (the subscriptions of y j ’s will be taken modulo k+1 ), b ( 0【b【k+1 ) is an integer, and n(Y)={v∈V(G): dist (v,Y)≤2 }.

Final Move for an Integrated EU Energy Market： Energy Union

EU is in position of world＇s largest energy importer and plays an active role in energy markets. Therefore, the EU＇s energy policy has not only local but also global effects. Because of the two oil crises in the 1970＇s, energy has taken an important place in the EU＇s agenda and has become one of the EU＇s highest priorities as the part of the EU＇s goal of Single Market. Especially, the 1987 Single European Act followed by the goal of Single Market has come to dominate the idea of the necessity of having a single market for energy. A chapter about energy has been added into the letter of the 2009 Treaty of Lisbon for the first time, thus energy has gained a new dimension and has had a legal basis. However, although there are energy rules defined at European level, there are 28 national regulatory structures in practice. Therefore, an integrated energy market is needed to create more competition, to increase market efficiency through better use of energy generation facilities across the EU, to produce affordable prices for consumers, and to move as whole, not as 28 separate countries. In this regard, the idea of creation of the Energy Union has emerged and the European Commission has published a detailed action plan for the Energy Union on February 25, 2015. In this study, historical process of initiatives for the creation of common energy policy in the EU is analyzed and the future of Energy Union is discussed.

面向海量数据的并行UNION查询技术研究与实现

分析了目前海量并行数据库中的UNION查询时所面临的问题,设计并实现了一种面向海量数据的并行UNION查询系统UQS(UnionQuerySystem)。从UQS的体系结构出发,提出了一组新的并行UNION查询算法。新的算法采用增量多路连接、双缓冲并行处理和多路并行归并的策略和算法,在中间件层上支持并行海量数据库U-NION查询,并在Oracle10g集群上基于CORBA技术实现新的算法。理论分析和实验结果表明,基于新算法的UQS的性能显著优于传统查询方法。

SQL语句中UNION子句的使用

本文通过两个常见查询的产生来介绍如何利用VisualFoxPRO的SQL语句中UNION子句产生复杂查询．

The Management and Use of Trade Union Funds in Public Institutions

Trade union funds are the basis and guarantee for various activities in public institutions.It is of great significance to constantly enhance the vitality of trade unions and the competitiveness of public institutions to continuously improve the management and use of trade union funds,thus giving full play to the role of trade union funds to better serve workers.This paper analyzes the management and use of trade union funds in the present situation and proposes several measures for improvement.