Ultrasound Directed Reduction of Colles' type distal radial fractures in ED (UDiReCT): a feasibility randomised controlled trial.

Background: There is a high rate of surgical fixation of displaced Colles' type distal radial wrist fractures despite fracture manipulation in the ED. Point-of-care ultrasound has been used to guide ED manipulations but its effect on the quality of fracture reduction or subsequent need for surgical fixation is unknown. This study aims to assess the feasibility of conducting a definitive randomised controlled trial to assess the use of ultrasound to guide these fracture manipulations.

The E3 ubiquitin-protein ligase Rbx1 regulates cardiac wall morphogenesis in zebrafish.

Cardiac trabeculae are muscular ridge-like structures within the ventricular wall that are crucial for cardiac function. In zebrafish, these structures first form primarily through the delamination of compact wall cardiomyocytes (CMs). Although defects in proteasomal degradation have been associated with decreased cardiac function, whether they also affect cardiac development has not been extensively analyzed.

Endothelial ontogeny and the establishment of vascular heterogeneity.

The establishment of distinct cellular identities was pivotal during the evolution of Metazoa, enabling the emergence of an array of specialized tissues with different functions. In most animals including vertebrates, cell specialization occurs in response to a combination of intrinsic (e.g.

An improved zebrafish transcriptome annotation for sensitive and comprehensive detection of cell type-specific genes.

The zebrafish is ideal for studying embryogenesis and is increasingly applied to model human disease. In these contexts, RNA-sequencing (RNA-seq) provides mechanistic insights by identifying transcriptome changes between experimental conditions. Application of RNA-seq relies on accurate transcript annotation for a genome of interest.

Metabolic modulation regulates cardiac wall morphogenesis in zebrafish.

During cardiac development, cardiomyocytes form complex inner wall structures called trabeculae. Despite significant investigation into this process, the potential role of metabolism has not been addressed. Using single cell resolution imaging in zebrafish, we find that cardiomyocytes seeding the trabecular layer actively change their shape while compact layer cardiomyocytes remain static.

Carpal tunnel decompression in patients with normal nerve conduction studies.

Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19 had clinical features of carpal tunnel syndrome but normal nerve conduction studies, and underwent decompression after failure of conservative management.

Paraxial Mesoderm Is the Major Source of Lymphatic Endothelium.

Endothelial cells (ECs), which line blood and lymphatic vessels, are generally described to come from the lateral plate mesoderm despite experimental evidence for a broader source of origin, including the paraxial mesoderm (PXM). Current dogma suggests that following specification from mesoderm, local environmental cues establish the distinct molecular and functional characteristics of ECs in different vascular beds. Here we present evidence to challenge this view, showing that lymphatic EC fate is imprinted during transition through the PXM lineage.

Using all transverse degrees of freedom in quantum communications based on a generic mode sorter.

The dimension of the state space for information encoding offered by the transverse structure of light is usually limited by the finite size of apertures. The widely used orbital angular momentum (OAM) number of Laguerre-Gaussian (LG) modes in free-space communications cannot achieve the theoretical maximum transmission capacity unless the radial degree of freedom is multiplexed into the protocol. While the methodology to sort the radial quantum number has been developed, the application of radial modes in quantum communications requires an additional ability to efficiently measure the superposition of LG modes in the mutually unbiased basis.

Realization of a scalable Laguerre-Gaussian mode sorter based on a robust radial mode sorter.

The transverse structure of light is recognized as a resource that can be used to encode information onto photons and has been shown to be useful to enhance communication capacity as well as resolve point sources in superresolution imaging. The Laguerre-Gaussian (LG) modes form a complete and orthonormal basis set and are described by a radial index p and an orbital angular momentum (OAM) index ℓ. Earlier works have shown how to build a sorter for the radial index p or/and the OAM index ℓ of LG modes, but a scalable and dedicated LG mode sorter which simultaneous determinate p and ℓ is immature.

Loss of pyruvate kinase M2 limits growth and triggers innate immune signaling in endothelial cells.

Despite their inherent proximity to circulating oxygen and nutrients, endothelial cells (ECs) oxidize only a minor fraction of glucose in mitochondria, a metabolic specialization that is poorly understood. Here we show that the glycolytic enzyme pyruvate kinase M2 (PKM2) limits glucose oxidation, and maintains the growth and epigenetic state of ECs. We find that loss of PKM2 alters mitochondrial substrate utilization and impairs EC proliferation and migration in vivo.

The long-term outcome of simple trapeziectomy.

The aim of this study was to investigate the long-term outcome of simple trapeziectomy by a single surgeon and to compare this with pre-operative function. Two hundred and five patients completed the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH) and the EuroQoL five-dimensional questionnaire (EQ-5D) scores at a mean of 8.2 (range 3.

Distinct myocardial lineages break atrial symmetry during cardiogenesis in zebrafish.

The ultimate formation of a four-chambered heart allowing the separation of the pulmonary and systemic circuits was key for the evolutionary success of tetrapods. Complex processes of cell diversification and tissue morphogenesis allow the left and right cardiac compartments to become distinct but remain poorly understood. Here, we describe an unexpected laterality in the single zebrafish atrium analogous to that of the two atria in amniotes, including mammals.

Corrigendum: Cloche is a bHLH-PAS transcription factor that drives haemato-vascular specification.

This corrects the article DOI: 10.1038/nature18614.

CNS-resident progenitors direct the vascularization of neighboring tissues.

Organ growth requires the coordinated invasion and expansion of blood vessel networks directed by tissue-resident cells and morphogenetic cues. A striking example of this intercellular communication is the vascularization of the central nervous system (CNS), which is driven by neuronal progenitors, including neuroepithelial cells and radial glia. Although the importance of neuronal progenitors in vascular development within the CNS is well recognized, how these progenitors regulate the vasculature outside the CNS remains largely unknown.

Frameshift indels introduced by genome editing can lead to in-frame exon skipping.

The introduction of frameshift indels by genome editing has emerged as a powerful technique to study the functions of uncharacterized genes in cell lines and model organisms. Such mutations should lead to mRNA degradation owing to nonsense-mediated mRNA decay or the production of severely truncated proteins. Here, we show that frameshift indels engineered by genome editing can also lead to skipping of "multiple of three nucleotides" exons.

Long-Term Follow-up of Arthrodesis vs Total Joint Arthroplasty for Hallux Rigidus.

Background: The optimal operative management of hallux rigidus is still a matter for debate among surgeons. Despite arthrodesis widely considered to be the gold standard treatment, many surgeons advocate arthroplasty as a suitable alternative. There are, however, few long-term or high-quality studies evaluating these modalities.

Differential regulation of blood flow-induced neovascularization and mural cell recruitment by vascular endothelial growth factor and angiopoietin signalling.

Key Points: Combining nitric oxide (NO)-mediated increased blood flow with angiopoietin-1-Tie2 receptor signalling induces arteriolargenesis - the formation of arterioles from capillaries - in a model of physiological angiogenesis. This NO-Tie-mediated arteriolargenesis requires endogenous vascular endothelial growth factor (VEGF) signalling. Inhibition of VEGF signalling increases pericyte coverage in microvessels.

Cloche is a bHLH-PAS transcription factor that drives haemato-vascular specification.

Vascular and haematopoietic cells organize into specialized tissues during early embryogenesis to supply essential nutrients to all organs and thus play critical roles in development and disease. At the top of the haemato-vascular specification cascade lies cloche, a gene that when mutated in zebrafish leads to the striking phenotype of loss of most endothelial and haematopoietic cells and a significant increase in cardiomyocyte numbers. Although this mutant has been analysed extensively to investigate mesoderm diversification and differentiation and continues to be broadly used as a unique avascular model, the isolation of the cloche gene has been challenging due to its telomeric location.

A Cross-sectional Study of Current Doctors' Performance in a Modified Version of a Medical School Admission Aptitude Test: The UKCAT.

The 2-hour long United Kingdom Clinical Aptitude Test (UKCAT) is used by many universities in the United Kingdom as part of their selection process for undergraduate medical and dentistry degrees. We aimed to compare the performance of senior doctors in primary and secondary care and across a range of specialties, in a modified version of the medical school entrance examination-the mUKCAT. Lay people were also included in the study.

Tip cell-specific requirement for an atypical Gpr124- and Reck-dependent Wnt/β-catenin pathway during brain angiogenesis.

Despite the critical role of endothelial Wnt/β-catenin signaling during central nervous system (CNS) vascularization, how endothelial cells sense and respond to specific Wnt ligands and what aspects of the multistep process of intra-cerebral blood vessel morphogenesis are controlled by these angiogenic signals remain poorly understood. We addressed these questions at single-cell resolution in zebrafish embryos. We identify the GPI-anchored MMP inhibitor Reck and the adhesion GPCR Gpr124 as integral components of a Wnt7a/Wnt7b-specific signaling complex required for brain angiogenesis and dorsal root ganglia neurogenesis.

An unusual complication after shoulder hemiarthroplasty.

Hemiarthroplasty of the shoulder can be a safe and an effective treatment for pain in patients with rheumatoid arthritis. Many complications have been previously described in the literature; the most common of which are dislocation, loosening, periprosthetic fractures, and infection. We report a patient who presented with a discharging sinus over the tip of the acromium which was created by the displacement of the prosthesis and erosion of the AC joint and distal clavicle.

Deep infection after hip fracture surgery: predictors of early mortality.

Introduction: This study analysed the predictors of mortality in patients who are diagnosed with deep infection following hip fracture surgery.

Methods: Data were prospectively collected for 3 years from all patients undergoing hip fracture surgery and who had developed a subsequent deep infection. Infection was defined as positive microbiology culture from deep tissue or fluid samples.