ORCID Profile
0000-0002-0852-8868
Current Organisation
University of Science and Technology of China
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Publisher: BMJ
Date: 03-2017
Publisher: American Chemical Society (ACS)
Date: 04-05-2021
Publisher: Wiley
Date: 08-03-2018
DOI: 10.1111/ANS.14445
Abstract: This systematic review aims to determine the effectiveness of surgical and non-surgical management for the type B ankle fracture with minimal talar shift. Two authors independently systematically searched the following databases: MEDLINE, EMBASE and CENTRAL. Only randomized controlled trials were included that evaluated surgical versus non-surgical management of type B ankle fracture with minimal talar shift in adults. Two authors independently performed study selection, risk of bias assessment and data extraction. Main outcomes extracted were general health and ankle function. Heterogeneity was assessed using I Two studies were included involving 241 patients. The pooled mean difference for the physical component score was 0.60 (95% confidence interval (CI): -1.62 to 2.82) non-significantly favouring surgical management. One study reported no significant difference in ankle function (mean difference: 3.20 95% CI: -6.56 to 12.96) whilst the other reported a significant difference favouring non-surgical management (mean difference: 3.20 95% CI: 0.44-5.96). Ankle function scores were not pooled due to heterogeneity. Meta-analysis showed that the surgical group was more likely to develop a minor infection (odds ratio: 12.46 95% CI: 2.29-67.78) or undergo hardware removal (odds ratio: 4.40 95% CI: 1.09-17.84). There was no significant difference in major infection between the two groups (odds ratio: 4.03 95% CI: 0.44-36.65 favouring non-surgical management). There was no significant difference in the general health outcome or ankle function for patients treated surgically versus non-surgically at 12 months. Further follow-up is needed to evaluate longer-term ankle function.
Publisher: Wiley
Date: 07-04-2023
DOI: 10.1111/ANS.18456
Abstract: Traumatic tarsometatarsal joint (TMTJ) injuries are uncommon, but can cause significant morbidity due to delayed or missed diagnosis. Recent evidence highlights the importance of achieving anatomical reduction via operative management. This study aims to analyse trends in rates of open reduction internal fixation (ORIF) for Lisfranc injuries in Australia according to Nationwide claims data. Claims according to the Medicare Benefits Schedule (MBS) on ORIF of traumatic TMTJ injuries were collated for the period from January 2000 to December 2020. Paediatric patients were excluded. Two negative binomial models were utilized to analyse the trends in TMTJ injuries over time after controlling for sex, age group and population changes. Results were absolute and per 100 000 population. 7840 patients underwent TMTJ ORIF over the period studied. There was a mean yearly increase of 12% ( P 0.001). Age group ( P 0.001) and year ( P 0.001) were significant predictors for TMTJ fixation, whilst sex was not ( P = 0.48). Patients older than 65 years were noted to have a 53% lower rate of TMTJ ORIF per person, when compared to the reference group of 25–34 year‐olds ( P 0.001). Five‐year block analysis revealed increases in rate of fixation for all age groups. Rates of operative fixation for TMTJ injuries are increasing in Australia. This is likely due to improved diagnostics, understanding of optimal treatment goals, and increased orthopaedic subspecialisation. Further studies with clinical and patient reported outcomes, as well as comparing rates of operative intervention to incidence, will be useful.
Publisher: Springer Science and Business Media LLC
Date: 10-2021
DOI: 10.1038/S41467-021-25984-8
Abstract: Metal/oxide interface is of fundamental significance to heterogeneous catalysis because the seemingly “inert” oxide support can modulate the morphology, atomic and electronic structures of the metal catalyst through the interface. The interfacial effects are well studied over a bulk oxide support but remain elusive for nanometer-sized systems like clusters, arising from the challenges associated with chemical synthesis and structural elucidation of such hybrid clusters. We hereby demonstrate the essential catalytic roles of a nanometer metal/oxide interface constructed by a hybrid Pd/Bi 2 O 3 cluster ensemble, which is fabricated by a facile stepwise photochemical method. The Pd/Bi 2 O 3 cluster, of which the hybrid structure is elucidated by combined electron microscopy and microanalysis, features a small Pd-Pd coordination number and more importantly a Pd-Bi spatial correlation ascribed to the heterografting between Pd and Bi terminated Bi 2 O 3 clusters. The intra-cluster electron transfer towards Pd across the as-formed nanometer metal/oxide interface significantly weakens the ethylene adsorption without compromising the hydrogen activation. As a result, a 91% selectivity of ethylene and 90% conversion of acetylene can be achieved in a front-end hydrogenation process with a temperature as low as 44 °C.
Publisher: SAGE Publications
Date: 15-12-2022
DOI: 10.1177/10711007221131818
Abstract: We report the short-term outcomes of a retrospective cohort of Trabecular Metal total ankle arthroplasties (TAAs) via a transfibular approach from a single, nondesigner surgeon in Australia. This was a retrospective cohort study. Demographic, clinical, and patient-reported outcome measures (PROMs) were collected. The primary outcome was the Foot and Ankle Outcome Score (FAOS), and secondary outcomes included patient satisfaction, the EuroQol-5 Dimension (EQ5D), and complications including revision rates. Between 2016 and 2019, 84 trabecular metal prostheses were implanted in 84 patients. Mean age (SD) at time of surgery was 68 (7.8) years, and 46 (55%) were male. Mean follow-up (SD) was 26.1 (13) months. There were significant ( P .001) improvements in the FAOS in the subscales of pain (47.9 to 79.1), activities of daily living (59.5 to 83.7), and quality of life (25.5 to 60.2) and EQ-5D (0.55 to 0.75) ( P .001), and overall satisfaction was 69.6%. The commonest complications were wound infection or breakdown (11.9%, n=10), fibular nonunion (3.5%), plate irritation (3.5%), and tibial nerve neuropathy (3.5%). There were no thromboembolic complications. Implant survivorship was 100%, with Trabecular Metal components retained in all patients. Two patients developed deep infection, with 1 requiring debridement and polyethylene exchange. No patients experienced implant loosening. Our results demonstrate that the trabecular metal survival rates are comparable with other total ankle implants in the Australian Orthopaedic Association National Joint Replacement Registry and as published in other international literature. Overall patient satisfaction was high, as were PROMs. However, the data highlight potential complications uniquely associated with this implant. The authors believe that these figures support TAA via a transfibular approach as a viable option in the treatment of ankle arthritis. Level IV, retrospective cohort study.
Publisher: Wiley
Date: 19-01-2023
DOI: 10.1111/ANS.18282
Abstract: Patients referred to public orthopaedic clinics can experience long waiting times before assessment. This study aims to evaluate the effectiveness of a collaborative Shoulder/Elbow Triage and Assessment (SHELTA) model of care involving orthopaedic surgeons and physiotherapists to reduce the waitlist and improve service and clinical outcomes for patients on an orthopaedic shoulder/elbow clinic waitlist. Patients on the waitlist were triaged by surgeons and physiotherapists and invited to an assessment by experienced physiotherapists. Patients were treated nonoperatively or transferred to orthopaedic management based on clinical discussion. The primary outcome was the number of patients on the waitlist. Secondary outcomes included adverse events, patient satisfaction, re‐referral and conversion to surgery rates. Pain, function and patient global impression of change were recorded for participants managed nonoperatively. From July 2019 to December 2019, the waitlist reduced from 451 to 298 patients with no adverse events. Seventy‐nine patients could not be contacted and 25 no longer required assessment, and were removed from the waitlist. Nonoperatively managed participants reported satisfaction with the service, a median score of 6 on a 7‐point Patient Global Impression of Change scale, change in pain of −2.5/10 (95% CI −3.3, −1.7 P 0.001) on a numerical pain rating scale, and change in function of −17.4/100 (95% CI: −24.1, −10.8 P 0.001) on the QuickDASH, indicating improvement. The SHELTA model of care effectively reduced the number of patients on an orthopaedic shoulder/elbow clinic waitlist with good service and clinical outcomes.
Publisher: Wiley
Date: 10-10-2022
DOI: 10.1111/ANS.17272
No related grants have been discovered for Rajat Mittal.