We describe a search underway for periodic gravitational waves from the central compact object in the supernova remnant Cassiopeia A. The object is the youngest likely neutron star in the Galaxy. Its ...position is well known, but the object does not pulse in any electromagnetic radiation band and thus presents a challenge in searching the parameter space of frequency and frequency derivatives. We estimate that a fully coherent search can, with a reasonable amount of time on a computing cluster, achieve a sensitivity at which it is theoretically possible (though not likely) to observe a signal even with the initial LIGO noise spectrum. Cassiopeia A is only the second object after the Crab pulsar for which this is true. The search method described here can also obtain interesting results for similar objects with current LIGO sensitivity.
•A crate for measuring the individual hoof load of sheep was successfully developed.•Healthy front hooves of sheep support more weight than healthy back hooves.•Front hoof loads decrease after ...contracting mild infection but back hooves do not.•Large load difference between healthy hooves and those with an extensive infection.•The hoof weigh crate may be a viable tool for detecting extensive hoof infection.
Lameness is a leading cause of morbidity in sheep but routine inspection of sheep for lameness is labor intensive. The objectives of the current study were to (i) build and test a custom hoof weigh crate (HWC) to measure the individual hoof load of sheep, (ii) quantify the relationship between hoof health status and the load a sheep distributes to each hoof, and (iii) evaluate the ability of the HWC to differentiate healthy from infected hooves. The overall footprint of the HWC was 950 mm × 450 mm, wherein two strain-gauge load cells were placed underneath each of four individual hoof platforms. An experiment was conducted over nine non-consecutive days between July and October 2017. On each experimental day, a total of 20 ewes (consisting of lame and healthy ewes) were placed on the HWC for five-minutes each. Each sheep hoof was visually assessed for lesions by three independent operators and a hoof lesion score assigned (scale from 0- healthy to 4-severe footrot). In addition to individual hoof load, the load placed on each hoof was divided by the sum of the load of the respective contralateral pair (front or back hooves), and multiplied by 100 to express the contralateral load percentage. A linear mixed model was invoked for each of the two load parameters as the dependent variable while hoof lesion score, contralateral pair, and their interaction were included as fixed effects. Each hoof was classified into a hoof lesion score category based on its load parameter values, and the numbers of correct and incorrect classifications were quantified. Healthy front hooves naturally carried more weight (60% of total weight) in comparison to healthy back hooves (40% of total weight), but when front or back hooves were infected to the same extent, they carried the same load. Results from the linear mixed model showed a small mean difference (4.5 kg) in hoof load between healthy front hooves and those with a mild infection (i.e., score = 1), but there was no hoof load difference between healthy back hooves and those with a mild infection (P < 0.05). The lowest proportion of misclassified hooves (sensitivity of 100% and specificity of 95%) was observed when the contralateral load percentage was used to differentiate between healthy hooves and those with extensive inter-digital dermatitis. Results herein indicate that the HWC could be used to automatically detect extensive infection in sheep hooves.
The Laser Interferometer Gravitational-Wave Observatory has performed a third science run with much improved sensitivities of all three interferometers. We present an analysis of approximately 200 ...hours of data acquired during this run, used to search for a stochastic background of gravitational radiation. We place upper bounds on the energy density stored as gravitational radiation for three different spectral power laws. For the flat spectrum, our limit of omega0 < 8.4 x 10(-4) in the 69-156 Hz band is approximately 10(5) times lower than the previous result in this frequency range.
Persistent cloaca is a complex malformation that remains a difficult reconstructive challenge, and data on long-term outcome are scarce. Gynecological abnormalities are common with cloaca but may ...remain asymptomatic until puberty or adult life. We evaluate long-term gynecological sequelae in these patients with persistent cloaca.
The records and radiographs of postpubertal patients (mean age 16.8 years, range 10 to 32) treated for cloacal malformation at 1 institution from 1970 to 2001 were retrospectively reviewed. Outcome data at puberty were available in 41 patients. Of the patients 24 are currently older than 16 years and outcome data for sexual activity were available in 21 with 3 lost to followup.
All 41 patients were evaluated at puberty, and 28 (68%) had uterine function, 13 (32%) were menstruating normally and 15 (36%) presented with hematometra/hematocolpos. All 15 girls with an obstructed uterus required surgery, which included hysterectomy in 2, partial hysterectomy with vaginoplasty in 3 and vaginoplasty in 9. There was 1 complex case of fistula. Etiology of the obstructed uterus was vaginal stenosis after reconstruction in 3 cases, stenosis of persistent urogenital sinus (no previous reconstruction) in 11 and cervical stenosis in 1. Ten patients experienced primary amenorrhoea, which was confirmed in 8 (20%) while 2 (5%) continue to be followed for possible cryptic obstruction. In 10 girls the diagnosis of absent/vestigial uterus was made at early laparotomy but this was erroneous in 6 in whom uterine function developed at puberty. Of the 21 older girls (age at review 17 to 32 years, mean 24) 12 are or have been sexually active and 6 have been examined by a gynecologist and have an adequate vagina but are not sexually active. To date 4 patients have required revision vaginal surgery in adulthood to facilitate intercourse (re-do vaginoplasty in 3, introitoplasty in 1). One woman has postponed vaginal reconstructive procedures and 2 others are currently being followed. There have been no pregnancies in this series to date.
Patients born with persistent cloaca have a high incidence of gynecological problems at the onset of menses and in early adult life. Therefore, it is necessary to reassess these girls at early puberty by ultrasound/magnetic resonance imaging and vaginoscopy. Additional surgery may then be necessary to create a vagina for menstruation and sexual intercourse.
Background Rotator cuff tears have a lifetime incidence between 25% and 40% in the United States, but optimum treatment strategies and protocol have not yet been widely accepted. This study evaluated ...the proportions of patients treated with nonoperative and operative modalities and how this proportion has changed during an 8-year period (2005-2012) among patients with Medicare. Methods Using the PearlDiver patient record database, we identified Medicare patients having been diagnosed with a rotator cuff tear. These patients were then stratified on the basis of treatment with physical therapy, subacromial/glenohumeral injection, or rotator cuff repair. We analyzed the data in regard to standard demographic information, comorbidities, and the Charlson Comorbidity Index. Results During the study period, 878,049 patients were identified and 397,116 patients had rotator cuff repair. The proportion of patients treated initially with physical therapy dropped from 30.0% in 2005 to 13.2% in 2012, and the subacromial/glenohumeral injection proportion decreased from 6.00% to 4.19% ( P < .001). The proportion of patients who had rotator cuff repair increased from 33.8% to 40.4% from 2005 to 2012 ( P < .001). Charlson Comorbidity Indexes were significantly lower in operative patients compared with each nonoperative treatment examined. Discussion This analysis demonstrates a significant decrease in the initial trial of nonoperative treatment and an increase in the rate of surgery. Patients undergoing rotator cuff repair had fewer comorbidities than those undergoing nonoperative treatments. It also demonstrates that patients who had a trial of injection had a higher incidence of eventual rotator cuff repair compared with the patients with an initial trial of physical therapy.
Objective Congenital uterine abnormalities are common and may be associated with developmental renal abnormalities. Mutations of the hepatocyte nuclear factor-1β ( HNF1B) gene are associated with ...renal and uterine abnormalities. We aimed to study the role of HNF1B mutations in a cohort with congenital uterine abnormalities. Study Design We tested 108 probands with uterine abnormalities for HNF1B mutations. We collected clinical information from patient records. Results Nine of 108 women (8%) had a mutation or deletion in the HNF1B gene. Abnormal HNF1B was found in 18% of the 50 probands who had both uterine and renal abnormalities but in none of the 58 women with isolated uterine abnormalities. Conclusion Mutations of the HNF1B gene are found in women with both uterine and renal abnormalities but are rare in isolated uterine abnormalities. We suggest that HNF1B testing should be performed in patients with both renal and uterine abnormalities, but not in patients with isolated uterine abnormalities.
Background Access to orthopaedic care for pediatric patients has been shown in previous studies to be decreased for patients with Medicaid compared with those with private insurance. The relationship ...between type of insurance and access to care for adult patients with acute rotator cuff tears has not yet been examined. This study aimed to determine if type of health insurance would have an impact on access to care for an adult patient with an acute rotator cuff tear. Methods Seventy-one orthopaedic surgery practices within the state of North Carolina were randomly selected and contacted on 2 different occasions separated by 3 weeks. The practices were presented with an appointment request for a fictitious 42-year-old man with an acute rotator cuff tear. Insurance status was reported as Medicaid for the first call and as private insurance during the second call. Results Of the 71 practices contacted, 51 (72%) offered the patient with Medicaid an appointment, whereas 68 (96%) offered the patient with private insurance an appointment. The difference in these rates was statistically significant ( P < .001). The likelihood of patients with private insurance obtaining an appointment was 8.8 times higher than that of patients with Medicaid (95% CI: 2.5, 31.5). Conclusion For patients with acute rotator cuff tears, access to care is decreased for those with Medicaid compared with those with private insurance. Patients with private insurance are 8.8 times more likely than those with Medicaid to obtain an appointment.
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