This Letter reports a measurement of the cross section for producing pairs of central prompt isolated photons in proton-antiproton collisions at a total energy sqrts = 1.96 TeV using data ...corresponding to 9.5 fb(-1) integrated luminosity collected with the CDF II detector at the Fermilab Tevatron. The measured differential cross section is compared to three calculations derived from the theory of strong interactions. These include a prediction based on a leading order matrix element calculation merged with a parton shower model, a next-to-leading order calculation, and a next-to-next-to-leading order calculation. The first and last calculations reproduce most aspects of the data, thus showing the importance of higher-order contributions for understanding the theory of strong interaction and improving measurements of the Higgs boson and searches for new phenomena in diphoton final states.
Primary vasculitis of the central nervous system (PVCNS) is an uncommon disorder that can present with a variety of symptoms, making diagnosis and management difficult. We describe a case of cerebral ...infarction that occurred from nonbacterial thrombotic endocarditis (NBTE) and presented with clinical and radiologie imaging features that suggested PVCNS. The patient was a 58-year-old woman with left hemiparesis, aphasia, and episodic confusion. Magnetic resonance imaging of the brain demonstrated multifocal lesions consistent with infarction involving both cerebral hemispheres, and cerebral angiography showed changes consistent with vasculitis. Although brain biopsy findings were normal, the patient was treated for presumed vasculitis with cyclophosphamide and pred-nisone. Four months later respiratory failure secondary to polymicrobial pneumonia and adult respiratory distress syndrome developed, and she died. Autopsy revealed multiple infarcts in the heart, lungs, right kidney, spleen, and brain. Multiple thrombotic platelet-fibrin vegetations consistent with NBTE were found on all cardiac valves. Examination of the brain revealed no evidence of active or healed vasculitis. Cerebral angiography may show findings that suggest vasculitis, but it is not diagnostic, as several other conditions may cause similar changes. Nonbacterial thrombotic endocarditis may cause multiple cerebral infarctions and can be difficult to distinguish from vasculitis, as specific diagnostic tests for PVCNS are lacking.
Objectives:
Limited research has examined the independent relationship between psychosocial factors and patient-reported outcomes during the early postoperative period following ACL reconstruction ...(ACLR). The purpose of this study was to examine the association between preoperative psychosocial characteristics and return to sport and sports function at 6 months after ACLR. A secondary objective was to examine the importance of psychosocial characteristics to knee-specific quality of life (QOL).
Methods:
Fifty-four patients, 18 to 33 years of age, undergoing a primary, unilateral ACLR were enrolled between November 2012 and December 2013. Demographic characteristics and a series of validated psychosocial and outcome measures were collected preoperatively. Patient expectations for having a successful surgery were assessed with a 10-item numeric rating scale. Fear of movement was measured with the activity avoidance and somatic focus subscales from the 13-item Tampa Scale for Kinesiophobia, pain catastrophizing with the Pain Catastrophizing Scale, depressive symptoms with the Patient Health Questionnaire-9, and general and knee-specific self-efficacy with the Generalized Self-Efficacy Scale and Knee Self-Efficacy Scale. Return to sport was assessed with the Subjective Patient Outcome for Return to Sport (SPORTS) and sports function and knee-specific QOL were assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) subscales. Patients completed an identical set of outcome instruments at 6 months after surgery. Separate multivariable linear regression analyses were used to examine the association between preoperative psychosocial variables and patient-reported outcomes at 6 months after ACLR, controlling for age, education, and preoperative outcome score.
Results:
The follow-up rate at 6 months was 93%. Ninety-six percent of patients (48/50) reported returning to sport at 6 months after ACLR, with 46% returning at the same pre-injury level of effort and performance (Table 1). Higher preoperative activity avoidance scores was significantly associated with not returning to sport at same level of effort and performance as before onset of impairment (OR = .73, p = .02), and worse scores on the KOOS QOL subscale (β = -1.4, p = .05) at 6-month follow-up. Higher preoperative expectations was a significant risk factor for worse outcomes on the KOOS subscales, with a 1-point increase in expectations associated with a 5.6-point decrease in KOOS sports/rec (p = .03) and 4.7-point decrease in KOOS QOL (p = .05) scores. Preoperative pain catastrophizing, depression, and self-efficacy were not statistically associated with patient-reported outcomes (p > .05).
Conclusion:
Screening patients for fear of movement and unrealistic expectations prior to ALCR may help identify patients at-risk for poorer outcomes. Targeted psychosocial rehabilitation strategies that address activity avoidance related to fear and expectations have the potential to improve return to sport at same level of effort and performance and knee-specific health outcomes during the early recovery period.
The top-quark mass M sub(top) is measured using top quark-antiquark pairs produced in proton-antiproton collisions at a center-of-mass energy of 1.96 TeV and that decay into a fully hadronic final ...state. The full data set collected with the CDF II detector at the Fermilab Tevatron Collider, corresponding to an integrated luminosity of 9.3 fb super(-1), is used. Events are selected that have six to eight jets, at least one of which is identified as having originated from a b quark. In addition, a multivariate algorithm, containing multiple kinematic variables as inputs, is used to discriminate signal events from background events due to QCD multijet production. Templates for the reconstructed top-quark mass are combined in a likelihood fit to measure M sub(top) with a simultaneous calibration of the jet energy scale. A value of M sub(top) = 175.07 + or - 1.19(stat) (ProQuest: Formulae and/or non-USASCII text omitted)(syst) GeV /c super(2) is obtained for the top-quark mass.
The management of unruptured intracranial aneurysms requires knowledge of the natural history of these lesions and the risks of repairing them.
A total of 2621 patients at 53 participating centers in ...the United States, Canada, and Europe were enrolled in the study, which had retrospective and prospective components. In the retrospective component, we assessed the natural history of unruptured intracranial aneurysms in 1449 patients with 1937 unruptured intracranial aneurysms; 727 of the patients had no history of subarachnoid hemorrhage from a different aneurysm (group 1), and 722 had a history of subarachnoid hemorrhage from a different aneurysm that had been repaired successfully (group 2). In the prospective component, we assessed treatment-related morbidity and mortality in 1172 patients with newly diagnosed unruptured intracranial aneurysms.
In group 1, the cumulative rate of rupture of aneurysms that were less than 10 mm in diameter at diagnosis was less than 0.05 percent per year, and in group 2, the rate was approximately 11 times as high (0.5 percent per year). The rupture rate of aneurysms that were 10 mm or more in diameter was less than 1 percent per year in both groups, but in group 1, the rate was 6 percent the first year for giant aneurysms (> or =25 mm in diameter). The size and location of the aneurysm were independent predictors of rupture. The overall rate of surgery-related morbidity and mortality was 17.5 percent in group 1 and 13.6 percent in group 2 at 30 days and was 15.7 percent and 13.1 percent, respectively, at 1 year. Age independently predicted surgical outcome.
The likelihood of rupture of unruptured intracranial aneurysms that were less than 10 mm in diameter was exceedingly low among patients in group 1 and was substantially higher among those in group 2. The risk of morbidity and mortality related to surgery greatly exceeded the 7.5-year risk of rupture among patients in group 1 with unruptured intracranial aneurysms smaller than 10 mm in diameter.
Objectives:
Meniscus repairs are commonly performed concurrently with anterior cruciate ligament reconstruction (ACLR) in the acutely injured knee. Properly functioning menisci coupled with knee ...stability are thought to be critical factors in achieving optimal outcomes. While meniscal repair in conjunction with ACLR has demonstrated good success at 2 years, no large-scale, prospective, multicenter studies have evaluated long-term patient-oriented outcomes after combined ACLR and meniscus repair. We hypothesize that patient-centered outcome scores will deteriorate and ipsilateral reoperations will increase at 6 years following combined ACLR and meniscus repair.
Methods:
All unilateral primary ACL reconstructions from the Multicenter Orthopaedic Outcomes Network (MOON) between 2002 and 2004 were evaluated, and patients who underwent concurrent meniscus repair were selected. Validated patient-oriented outcome data Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities (WOMAC) scores, Marx activity scores and International Knee Documentation Committee (IKDC) scores was gathered at 2 and 6 years following the index procedure. Subsequent ipsilateral knee re-operation was confirmed by operative reports to evaluate for failure of meniscal repairs.
Results:
In total, 1440 primary ACLR’s were performed between 2002 and 2004 as part of the study cohort. Of these, 286 subjects underwent concurrent meniscus repair (298 meniscal repairs). 235/286 (82.2%) were available for follow up at 6 years (154 medial meniscus repairs, 72 lateral meniscal repairs, and 9 patients who underwent both lateral and medial meniscal repairs). Overall, the success rate of meniscal repair at the time of ACLR was 86% (202/235) at 6 years. We found an 86.4% six year success rate with combined ACLR and medial meniscal repair, 86.1% for lateral meniscal repairs and 77.8% when both medial and lateral menisci were repaired. 27.3% (9/33) of the failures were associated revision ACL surgery. Medial meniscal repairs failed earlier (mean 2.1 years) than lateral meniscal repairs (mean 3.7 years) (p=0.01). All-inside techniques were performed in 88.5% of cases. There were 31 failures with this technique representing a 14.9% failure rate. There was one failure in the inside-out technique group (1/19, 5.2%), and one failure noted in the outside-in technique group (1/6, 16.6%). Significant improvements were observed in patient reported outcomes KOOS Symptoms, KOOS Pain, KOOS KRQOL, WOMAC Pain, and IKDC scores when baseline scores were compared to 6-year follow-up. No significant clinical differences were observed between 2 and 6 year follow up indicating there was no clinical deterioration over this time period. Marx Activity levels gradually declined from time of injury to 6-year follow-up.
Conclusion:
Concurrent meniscal repair with ACLR is associated with success rates approximating 86% at 6-year follow-up. Patient-oriented outcome measures were generally similar between 2 and 6 years follow up. Surgeons may expect good clinical outcomes 6 years after combined ACLR and meniscus repairs.
The production of several single-chain Fv (sFv) antibody proteins was examined by three modes of mammalian cell expression. Our primary model was the 741F8 anti-c-erbB-2 sFv, assembled as either the ...VH-VL or VL-VH, and expressed alone, with C-terminal cysteine for dimerization, or as fusion proteins with carboxyl-terminal effector domains, including interleukin-2, the B domain of staphylococcal protein A, the S-peptide of ribonuclease S, or hexa-histidine metal chelate peptide. Constructs were expressed and secreted transiently in 293 cells and stably in CHO or Sp2/0 cell lines, the latter yielding up to 10 mg per liter. Single-chain constructs of MOPC 315 myeloma and 26-10 monoclonal antibodies were also expressed, as were hybrids comprising unrelated VH and VL regions. Our results suggest that mammalian expression is a practical and valuable complement to the bacterial expression of single-chain antibodies.
Five commercially available suture anchor devices were tested to failure in human cadaveric proximal tibiae. A total of 198 trials were completed. Insertion was uncomplicated for all anchors, with ...the exception of the Acufex Rod TAG device, with five of 22 (23%) of these breaking upon insertion into thicker cortical bone. Overall, the anchors performed significantly (p < 0.05) better when placed in thicker cortical bone, further away from the joint surface, and when loaded in a direction parallel to the bone surface. The Mitek GII anchor failed (pulled out of bone) less often than the other anchors (19% vs. 46%). In loading perpendicular to the bone surface, the Mitek GII and Statak were the strongest (p < 0.05), with mean loads at failure of 82.5 and 90.2 N, respectively. The Acufex Rod TAG, Acufex Wedge TAG, and Mitek GI failed at 67.2, 65.5, and 49.4 N respectively.
We present a measurement of the ratio of the top-quark branching fractions R=B(t→Wb)/B(t→Wq), where q represents any quark flavor, in events with two charged leptons, imbalance in total transverse ...energy, and at least two jets. The measurement uses proton-antiproton collision data at center-of-mass energy 1.96 TeV, corresponding to an integrated luminosity of 8.7 fb^{-1} collected with the Collider Detector at Fermilab during Run II of the Tevatron. We measure R to be 0.87±0.07, and extract the magnitude of the top-bottom quark coupling to be |V_{tb}|=0.93±0.04, assuming three generations of quarks. Under these assumptions, a lower limit of |V_{tb}|>0.85(0.87) at 95% (90%) credibility level is set.
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