Abstract The limb deformity-based principles originate from a standard set of lower extremity radiographic angles and reference points. Objective radiographic measures are the building blocks for ...surgical planning. Critical preoperative planning and intraoperative and postoperative evaluation of radiographs are essential for proper deformity planning and correction of all foot and ankle cases. A total of 33 angles and reference points were measured on 24 healthy feet. The radiographic measurements were performed on standard weightbearing anteroposterior, lateral, and axial views of the right foot. A total of 4 measurements were made from the axial view, 12 from the lateral view, and 17 from the anteroposterior view. All angles were measured by both senior authors twice, independent of each other. The radiographic angles and measurements presented in the present study demonstrate a comprehensive and useful set of standard angles, measures, and reference points that can be used in clinical and perioperative evaluation of the foot and ankle. The standard radiographic measures presented in the present study provide the foundation for understanding the osseous foot and ankle position in a normal population.
Objectives. We previously presented nomograms combining preoperative serum prostate-specific antigen (PSA), clinical (TNM) stage, and biopsy Gleason score to provide the likelihood of various final ...pathologic stages at radical retropubic prostatectomy. The data for the original nomograms were collected from men treated between 1982 and 1996. During the past 10 years, the stage at presentation has shifted, with more men presenting with Stage T1c, Gleason score 5 to 6, and serum PSA levels less than 10.0 ng/mL. In this work, we update the “Partin Tables” with a more contemporary cohort of men treated since 1994 and with revised PSA and Gleason categories.
Methods. Multinomial log-linear regression analysis was used to estimate the likelihood of organ-confined disease, extraprostatic extension, seminal vesicle or lymph nodal status from the preoperative PSA stratified as 0 to 2.5, 2.6 to 4.0, 4.1 to 6.0, 6.1 to 10.0, and greater than 10 ng/mL, clinical (AJCC-TNM, 1992) stage (T1c, T2a, T2b, or T2c), and biopsy Gleason score stratified as 2 to 4, 5 to 6, 3 + 4 = 7, 4 + 3 = 7, or 8 to 10 among 5079 men treated with prostatectomy (without neoadjuvant therapy) between 1994 and 2000 at Johns Hopkins Hospital. The average age was 58 years.
Results. In this cohort, more than 60% had T1c, more than 75% had Gleason score of 6, more than 70% had PSA greater than 2.5 and less than 10.0 ng/mL, and more than 60% had organ-confined disease. Nomograms of the robust estimated likelihoods and 95% confidence intervals were developed from 1000 bootstrap analyses. The probability of organ-confined disease improved across the groups, and further stratification of the Gleason score and PSA level allowed better differentiation of individual patients.
Conclusions. These updated “Partin Tables” were generated to reflect the trends in presentation and pathologic stage for men newly diagnosed with clinically localized prostate cancer at our institution. Clinicians can use these nomograms to counsel individual patients and help them make important decisions regarding their disease.
We present the results of an extensive search for periodic and irregular variable pre-main sequence (PMS) stars in the young (2–4 Myr) open cluster NGC 2264, based on photometric monitoring using the ...Wide Field Imager (WFI) on the 2.2 m telescope on La Silla (Chile). In total, about 10 600 stars with $I_{{\rm C}}$ magnitudes between 9.8 mag and 21 mag have been monitored in our $34\arcmin$ $\times$ $33\arcmin$ field. Time series data were obtained in the $I_{{\rm C}}$ band in 44 nights between Dec. 2000 and March 2001; altogether we obtained 88 data points per star. Using two different time series analysis techniques (Scargle periodogram and CLEAN) we found 543 periodic variable stars with periods between 0.2 days and 15 days. Also, 484 irregular variable stars were identified using a $\chi^2$-test. In addition we have carried out nearly simultaneous observations in V, $R_{{\rm C}}$ and a narrow-band Hα filter. The photometric data enable us to reject background and foreground stars from our sample of variable stars according to their location in the $I_{{\rm C}}$ vs. $(R_{{\rm C}}-I_{{\rm C}})$ colour–magnitude and $(R_{{\rm C}}-{\rm H}\alpha)$ vs. $(R_{{\rm C}}-I_{{\rm C}})$ colour–colour diagrams. We identified 405 periodic variable and 184 irregular variable PMS stars as cluster members using these two different tests. In addition 35 PMS stars for which no significant variability were detected could be identified as members using an $\rm H\alpha$ emission index criterion. This yields a total of 624 PMS stars in NGC 2264, of which only 182 were previously known. Most of the newly found PMS stars are fainter than $I_{{\rm C}} \simeq 15~{\rm mag}$ and of late spectral type ($\ga$M 2). We find that the periodic variables, as a group, have a smaller degree of variability and smaller $\rm H\alpha$ index than the irregular variables. This suggests that the sample of periodic variables is biased towards weak-line T Tauri stars (WTTSs) while most of the irregular variables are probably classical T Tauri stars (CTTSs). We have quantified this bias and estimated that the expected fraction of WTTSs among PMS stars in the cluster is $77\%$. This is relatively close to the fraction of WTTSs among the periodic variables which is $85\%$. We also estimated the total fraction of variables in the cluster using only two well selected concentrations of PMS stars called NGC 2264 N & S in which we can easily estimate the total number of PMS stars. We find that at least $74\%$ of the PMS stars in the cluster with $I_{{\rm C}}\leq 18.0~{\rm mag}$ were found to be variable (either periodic or irregular) by our study. This number shows that our search for PMS stars in NGC 2264 through extensive and accurate photometric monitoring is very efficient in detecting most PMS stars down to at least $I_{{\rm C}}=18.0~{\rm mag}$.
The NuTeV Collaboration has extracted the electroweak parameter sin(2)theta(W) from the measurement of the ratios of neutral current to charged current nu and (-)nu cross sections. Our value, ...sin(2)theta((on-shell))(W) = 0.2277 +/- 0.0013(stat) +/- 0.0009(syst), is 3 standard deviations above the standard model prediction. We also present a model independent analysis of the same data in terms of neutral-current quark couplings.
Infections often involve the mucosal surfaces of the body, which form a
boundary with the outside world. This review focuses on immunoglobulin A (IgA)
antibodies because IgA is the principal mucosal ...antibody class. IgA is
synthesized by local plasma cells and has a specific polymeric immunoglobulin
receptor-mediated transport mechanism for entry into the secretions. By serving
as an external barrier capable of inhibiting attachment of microbes to the
luminal surface of the mucosal epithelial lining, IgA antibodies form the first
line of immune defense. In addition to this traditional mode of extracellular
antibody function, recent evidence suggests that IgA antibodies can also
function in a nontraditional fashion by neutralizing viruses intracellularly,
if a virus is infecting an epithelial cell through which specific IgA antibody
is passing on its way to the secretions. IgA antibodies are also envisaged as
providing an internal mucosal barrier beneath the mucosal lining. Antigens
intercepted by IgA antibodies here can potentially be ferried through the
epithelium and thereby excreted. In addition to the polymeric immunoglobulin
receptor on mucosal epithelial cells, IgA antibodies can bind to receptors on a
variety of leukocytes and have been shown, in some experimental systems, to be
capable of activating the alternative complement pathway, making IgA antibodies
potential participants in inflammatory reactions. Although the relationship of
IgA antibodies to inflammation is not entirely clear, the bias presented is
that IgA is basically noninflammatory, perhaps even anti-inflammatory.
According to this view, the major role of the Fc portion of IgA antibodies is
to transport IgA across mucosal epithelial cells and not, as in the case of the
other classes of antibody, to activate secondary phenomena of the kind that
contribute to inflammation. Because of IgA's key role as an initial
barrier to infection, much current research in mucosal immunology is directed
toward developing new vectors and adjuvants that can provide improved
approaches to mucosal vaccines. Finally, because of advances in monoclonal
antibody technology, topical application of antibodies to mucosal surfaces has
significant potential for preventing and treating infections.
A quench detection system was developed for protecting and monitoring the superconducting (SC) solenoids for the Muon-to-Electron Conversion Experiment (Mu2e) at Fermilab. The quench system was ...designed for a high level of dependability and long-term continuous operation. It is based on three tiers: Tier-1, FPGA-based Digital Quench Detection (DQD); Tier-2, Analog Quench Detection (AQD); and Tier-3, the quench controls and data management system. The Tier-1 and Tier-2 systems are completely independent and fully redundant. The Tier-3 system is based on National Instruments (NI) cRIO and provides the user interface for quench controls and data management. It is independent from Tiers 1 & 2. The DQD provides both quench detection and quench characterization (monitoring) capability. Both DQD and AQD have built-in high voltage isolation and user programmable gains and attenuations. The DQD and AQD also includes user configured current dependent thresholding and validation times. A 1 st article of the three-tier system was fully implemented on the new Fermilab magnet test stand for the HL-LHC Accelerator Upgrade Project (AUP). It successfully provided quench protection and monitoring (QPM) for a cold superconducting bus test in November 2020. The Mu2e quench detection design has since been implemented for production testing of the AUP magnets. A detailed description of the system along with results from the AUP superconducting bus test will be presented.
Brachymetatarsia: A Classification for Surgical Treatment Lamm, Bradley M.; Lamm, Tyler B.
The Journal of foot and ankle surgery,
January-February 2023, 2023 Jan-Feb, 2023-01-00, 20230101, Letnik:
62, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Brachymetatarsia is a congenital osseous and soft tissue deformity of a ray(s) of the foot. Because there is no particular consensus of methodology of lengthening for brachymetatarsia, the authors ...introduce a comprehensive anatomic classification and a surgical guide to treatment of each classification type. This classification combines the number of the metatarsal(s) affected and the letter(s) indicating the type of brachymetatarsia deformity (A = axial deficiency of the metatarsal, B = bowing of the metatarsal, C = congruency of metatarsal phalangeal joint). This study reviewed of 300 brachymetatarsals in 166 patients. Fifty of the 166 (30%) patients had bilateral brachymetatarsia. Of the 300 metatarsals with brachymetatarsia, 64 (21%) were first metatarsals, 22 (7%) were second metatarsals, 28 (9%) were third metatarsals, 12 (4%) were fifth metatarsals, and 174 (58%) were fourth metatarsals. Classification types that were found was a total of 165 (55%) type A, a total of 6 (2%) type B, a total of 72 (24%) type AB, a total of 39 (13%) type AC, and a total of 18 (6%) type ABC. A total of 16 (10%) male and 150 (90%) female patients were evaluated. The mean preoperative amount of shortening of the metatarsal was 15 mm (range, 4-20 mm), as determined by the preoperative metatarsal parabola deficiency, equating to 30% of the preoperative metatarsal length. Brachymetatarsia is a complex congenital deformity which until now has not been critically analyzed. This study outlines a comprehensive brachymetatarsia classification system which provides an accurate diagnosis of the deformity and offers a surgical treatment algorithm.
Different solidification conditions are employed to produce sets of single-crystal samples with different primary dendrite arm spacings, i.e., 600 µm, 400 µm, and 250 µm. The material with the ...smaller dendrite arm spacing is shown to possess considerably increased high-cycle fatigue life. Fatigue cracks are found to originate from shrinkage porosity rather than from carbides, in which the size of the largest pores in the samples scales with the primary dendrite arm spacing. Fatigue life can be rationalized using a fracture mechanics approach based on a Kitagawa-Takahashi plot. The impact of the results with respect to the development of new commercial casting processes that produce higher temperature gradients and cooling rates will be discussed. PUBLICATION ABSTRACT
Abstract Percutaneous surgical techniques and minimally invasive procedures in foot and ankle surgery are gaining interest for both patients and surgeons. Percutaneous surgery is defined by a soft ...tissue or osseous procedure performed through the smallest possible incision without direct visualization of the underlying target structures. Percutaneous surgery has many potential advantages, including quicker operative times, multiplanar osteotomy correction, smaller incisions, decreased scarring, lower complication rates, and faster recovery times. The potential disadvantages include the need for specific equipment, that it cannot be used for large deformities, and that it requires an extensive learning curve. A commonly attempted percutaneous procedure is first metatarsal osteotomy for correction of hallux abductovalgus or bunion. We present our preoperative planning and intraoperative techniques for percutaneous hallux abductovalgus correction.
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