This pilot study aimed to evaluate prospectively the use of inlet radiographs of the hip as an alternative method of the assessment of reduction after the surgical treatment of developmental ...dysplasia of the hip (DDH).
The children in this study underwent surgery between January 2013 and January 2015. All had inlet radiographs and CT scans post-operatively. Data were analysed by determining inter-observer reliability and intra-observer reproducibility, using the kappa value (K). Differences were settled by discussion between the two observers until a consensus was reached. The sensitivity and specificity of the radiographic and CT results were compared. A total of 26 radiographs were obtained from 23 children, with a mean age of 2.38 years (one to five).
Similar high levels of intra- and inter-observer agreement were observed (K = 0.834, 95% confidence interval (CI)). There was a high agreement between the radiographic and CT results (K = 0.834, 5% CI), with excellent sensitivity and a specificity of 95.5%.
These results suggest that inlet radiographs may be a reliable method of assessing the reduction of the hip after the surgical treatment of DDH. Cite this article:
2017;99-B:697-701.
The recent commercialisation of the first disease-modifying drugs for Alzheimer's disease emphasises the need for consensus recommendations on the rational use of biomarkers to diagnose people with ...suspected neurocognitive disorders in memory clinics. Most available recommendations and guidelines are either disease-centred or biomarker-centred. A European multidisciplinary taskforce consisting of 22 experts from 11 European scientific societies set out to define the first patient-centred diagnostic workflow that aims to prioritise testing for available biomarkers in individuals attending memory clinics. After an extensive literature review, we used a Delphi consensus procedure to identify 11 clinical syndromes, based on clinical history and examination, neuropsychology, blood tests, structural imaging, and, in some cases, EEG. We recommend first-line and, if needed, second-line testing for biomarkers according to the patient's clinical profile and the results of previous biomarker findings. This diagnostic workflow will promote consistency in the diagnosis of neurocognitive disorders across European countries.
Short stature and ovarian failure are the main features in Turner syndrome (TS). To optimize GH and estrogen treatment, we studied 68 previously untreated girls with TS, age 2-11 yr, who were ...randomly assigned to one of three GH dosage groups: group A, 4 IU/m2 day (approximately 0.045 mg/kg x day); group B, first yr 4, thereafter 6 IU/m2 x day (approximately 0.0675 mg/kg/day); group C, first yr 4, second yr 6, thereafter 8 IU/m2 x day (approximately 0.090 mg/kg x day). In the first 4 yr of GH treatment, no estrogens for pubertal induction were given to the girls. Thereafter, girls started with 17beta-estradiol (5 microg/kg bw x day, orally) when they had reached the age of 12 yr. Subjects were followed up until attainment of adult height or until cessation of treatment because of satisfaction with the height achieved. Seven-year data of all girls were evaluated to compare the growth-promoting effects of three GH dosages during childhood. After 7 yr, 85% of the girls had reached a height within the normal range for healthy Dutch girls. The 7-yr increment in height SD-score was significantly higher in groups B and C than in group A. In addition, we evaluated the data of 32 of the 68 girls who had completed the trial after a mean duration of treatment of 7.3 yr (range, 5.0 - 8.75). Mean (SD) height was 158.8 cm (7.1), 161.0 cm (6.8), and 162.3 cm (6.1) in groups A, B, and C, respectively. The mean (SD) difference between predicted adult height before treatment and achieved height was 12.5 cm (2.1), 14.5 cm (4.0), and 16.0 cm (4.1) for groups A, B, and C, respectively, being significantly different between group A and group C. GH treatment was well tolerated in all three GH dosage groups. In conclusion, GH treatment starting in relatively young girls with TS results in normalization of height during childhood, as well as of adult height, in most of the individuals. With this GH and estrogen treatment regimen, most girls with TS can grow and develop much more in conformity with their healthy peers.
During the SARS-CoV-2 pandemic, novel and traditional vaccine strategies have been deployed globally. We investigated whether antibodies stimulated by mRNA vaccination (BNT162b2), including ...third-dose boosting, differ from those generated by infection or adenoviral (ChAdOx1-S and Gam-COVID-Vac) or inactivated viral (BBIBP-CorV) vaccines. We analyzed human lymph nodes after infection or mRNA vaccination for correlates of serological differences. Antibody breadth against viral variants is lower after infection compared with all vaccines evaluated but improves over several months. Viral variant infection elicits variant-specific antibodies, but prior mRNA vaccination imprints serological responses toward Wuhan-Hu-1 rather than variant antigens. In contrast to disrupted germinal centers (GCs) in lymph nodes during infection, mRNA vaccination stimulates robust GCs containing vaccine mRNA and spike antigen up to 8 weeks postvaccination in some cases. SARS-CoV-2 antibody specificity, breadth, and maturation are affected by imprinting from exposure history and distinct histological and antigenic contexts in infection compared with vaccination.
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•Vaccination confers broader IgG binding of variant RBDs than SARS-CoV-2 infection•Imprinting from initial antigen exposures alters IgG responses to viral variants•Histology of mRNA vaccinee lymph nodes shows abundant GCs•Vaccine spike antigen and mRNA persist for weeks in lymph node GCs
Human antibody responses to SARS-CoV-2 differ between vaccination and infection, with mRNA vaccination inducing more productive lymph node GC responses and several vaccine types stimulating IgG antibodies capable of recognizing a broader range of viral variants.
The aim of this paper is to improve the correlation between the experimental and the numerical prediction of unstable frequencies for automotive brake systems considering uncertainty. First, an ...experimental quantification of uncertainty and a discussion analysing the contributions of uncertainty to a numerical squeal simulation are proposed. Frequency and transient simulations are performed considering nominal values of model parameters, determined experimentally. The obtained results are compared with those derived from experimental tests to highlight the limitation of deterministic simulations. The effects of the different kinds of uncertainty detected in working conditions of brake system, the pad boundary condition, the brake system material properties and the pad surface topography are discussed by defining different unstable mode classes. Finally, a correlation between experimental and numerical results considering uncertainty is successfully proposed for an industrial brake system. Results from the different comparisons reveal also a major influence of the pad topography and consequently the contact distribution.
•The fugitive nature of squeal is highlighted with measurements from brakes of the same vehicle.•Limitations of frequency and transient stability simulations performed on a deterministic model are shown.•Variability of the material and topographic parameters of brake components (disk, pad, lining) are quantified experimentally.•A better correlation with dynamometer tests can be obtained using non-deterministic finite element brake simulation by integrating variability of pad topography.•A robustness criterion based on occurrence of identical unstable modes, rather than damping rate threshold, is investigated to better predict unstable modes responsible for squeal.
•FNA cytology can obtain a precise insight of the salivary gland lumps.•The MSRSGC is a 6-tiered classification which estimates the risk of malignancy (ROM).•The revised MSRSGC supplements FNA ...cytology with some crucial clinical consideration.
Fine-needle aspiration cytology (FNAC) is a basic step in the diagnosis of salivary gland tumors that have a wide variety of histological types. The recent Milan system for reporting salivary gland cytopathology (MSRSGC) can correlate the risk of malignancy with precise cytological features. A revised version was recently proposed to improve the surgical relevance and facilitate uniform management.
A multicenter study retrospectively used the original and revised MSRSGC criteria to classify a series of patients who received surgery after FNAC.
We enrolled 503 patients from three tertiary centers. The risk of malignancy for the MSRSGC resulted 19.5% in cat. I, 14.3% in cat. II, 17.6% in cat. III, 3.6% in cat. IVa, 24.6% in cat. IVb, 66.7% in cat. V, and 96.8% in cat. VI. The results from the revised MSRSGC were consistent with the original values.
The MSRSGC is a promising classification system. In our opinion, the revised version of the MSRSGC supplements FNAC with some crucial clinical information and can better identify the appropriate treatment in each category.
Aims.
The Spectrometer Telescope for Imaging X-rays (STIX) on Solar Orbiter is a hard X-ray imaging spectrometer, which covers the energy range from 4 to 150 keV. STIX observes hard X-ray ...bremsstrahlung emissions from solar flares and therefore provides diagnostics of the hottest (⪆10 MK) flare plasma while quantifying the location, spectrum, and energy content of flare-accelerated nonthermal electrons.
Methods.
To accomplish this, STIX applies an indirect bigrid Fourier imaging technique using a set of tungsten grids (at pitches from 0.038 to 1 mm) in front of 32 coarsely pixelated CdTe detectors to provide information on angular scales from 7 to 180 arcsec with 1 keV energy resolution (at 6 keV). The imaging concept of STIX has intrinsically low telemetry and it is therefore well-suited to the limited resources available to the Solar Orbiter payload. To further reduce the downlinked data volume, STIX data are binned on board into 32 selectable energy bins and dynamically-adjusted time bins with a typical duration of 1 s during flares.
Results.
Through hard X-ray diagnostics, STIX provides critical information for understanding the acceleration of electrons at the Sun and their transport into interplanetary space and for determining the magnetic connection of Solar Orbiter back to the Sun. In this way, STIX serves to link Solar Orbiter’s remote and in-situ measurements.
Introduction
Overweight is a well‐established risk factor for hidradenitis suppurativa (HS). In this cross‐sectional study, we compare HS patients with a high body mass index (BMI) with HS patients ...with a low BMI to investigate differences in disease characteristics.
Materials and method
Patients were recruited from 17 dermatological centres from four continents. A total of 246 patients with a BMI below 25 were compared to 205 patients with a BMI of above 35.
Results
Patients with a high BMI suffered more severe disease (Hurley, physician global assessment, number of areas affected and patient‐reported severity (PRS), P < 0.001 for all). There was no difference in smoking (P = 0.783) nor in family history (P = 0.088). In both low and high BMI patients, early onset of HS was a predictor of positive family history (P < 0.001, for each). For low BMI patients, an increase in BMI significantly increased PRS (P < 0.001). For patients with a high BMI, number of pack‐years significantly increased PRS (P = 0.001). Cluster analysis of eruption patterns was location specific for low BMI patients but severity specific for high BMI patients.
Discussion
Patients with a low and high BMI could represent two clinically different subtypes. We suggest a non‐linear relationship between BMI and impact of HS. As patients go from a low BMI patient to a high BMI patient (or from high to low), eruption patterns and risk factors may change.
We present a catalog of 5324 massive stars in the Small Magellanic Cloud (SMC), with accurate spectral types compiled from the literature, and a photometric catalog for a subset of 3654 of these ...stars, with the goal of exploring their infrared properties. The photometric catalog consists of stars with infrared counterparts in the Spitzer SAGE-SMC survey database, for which we present uniform photometry from 0.3to24 Delta *mm in the UBVIJHKs +IRAC+MIPS24 bands. We compare the color-magnitude diagrams and color-color diagrams to those of stars in the Large Magellanic Cloud (LMC), finding that the brightest infrared sources in the SMC are also the red supergiants, supergiant Be (sgBe) stars, luminous blue variables, and Wolf-Rayet stars, with the latter exhibiting less infrared excess, the red supergiants being less dusty and the sgBe stars being on average less luminous. Among the objects detected at 24 Delta *mm in the SMC are a few very luminous hypergiants, four B-type stars with peculiar, flat spectral energy distributions, and all three known luminous blue variables. We detect a distinct Be star sequence, displaced to the red, and suggest a novel method of confirming Be star candidates photometrically. We find a higher fraction of Oe and Be stars among O and early-B stars in our SMC catalog, respectively, when compared to the LMC catalog, and that the SMC Be stars occur at higher luminosities. We estimate mass-loss rates for the red supergiants, confirming the correlation with luminosity even at the metallicity of the SMC. Finally, we confirm the new class of stars displaying composite A & F type spectra, the sgBe nature of 2dFS1804 and find the F0 supergiant 2dFS3528 to be a candidate luminous blue variable with cold dust.
We report an evolutionary analysis of the V1R gene family across 37 mammalian genomes. V1Rs comprise one of three chemosensory receptor families expressed in the vomeronasal organ, and contribute to ...pheromone detection. We first demonstrate that Trace Archive data can be used effectively to determine V1R family sizes and to obtain sequences of most V1R family members. Analyses of V1R sequences from trace data and genome assemblies show that species-specific expansions previously observed in only eight species were prevalent throughout mammalian evolution, resulting in "semi-private" V1R repertoires for most mammals. The largest families are found in mouse and platypus, whose V1R repertoires have been published previously, followed by mouse lemur and rabbit (approximately 215 and approximately 160 intact V1Rs, respectively). In contrast, two bat species and dolphin possess no functional V1Rs, only pseudogenes, and suffered inactivating mutations in the vomeronasal signal transduction gene Trpc2. We show that primate V1R decline happened prior to acquisition of trichromatic vision, earlier during evolution than was previously thought. We also show that it is extremely unlikely that decline of the dog V1R repertoire occurred in response to selective pressures imposed by humans during domestication. Functional repertoire sizes in each species correlate roughly with anatomical observations of vomeronasal organ size and quality; however, no single ecological correlate explains the very diverse fates of this gene family in different mammalian genomes. V1Rs provide one of the most extreme examples observed to date of massive gene duplication in some genomes, with loss of all functional genes in other species.
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