BackgroundHemiarthroplasty and total hip arthroplasty are commonly used to treat displaced intracapsular fractures of the femoral neck, but each has disadvantages and the optimal treatment of these ...fractures remains controversial.MethodsIn the present prospectively randomized study, eighty-one patients who had been mobile and lived independently before they had sustained a displaced fracture of the femoral neck were randomized to receive either a total hip arthroplasty or a hemiarthroplasty. The mean age of the patients was seventy-five years. Outcome was assessed with use of the Oxford hip score, and final radiographs were assessed.ResultsAfter a mean duration of follow-up of three years, the mean walking distance was 1.17 mi (1.9 km) for the hemiarthroplasty group and 2.23 mi (3.6 km) for the total hip arthroplasty group, and the mean Oxford hip score was 22.3 for the hemiarthroplasty group and 18.8 for the total hip arthroplasty group. Patients in the total hip arthroplasty group walked farther (p = 0.039) and had a lower (better) Oxford hip score (p = 0.033) than those in the hemiarthroplasty group. Twenty of thirty-two living patients in the hemiarthroplasty group had radiographic evidence of acetabular erosion at the time of the final follow-up. None of the hips in the hemiarthroplasty group dislocated, whereas three hips in the total hip arthroplasty group dislocated. In the hemiarthroplasty group, two hips were revised to total hip arthroplasty and three additional hips had acetabular erosion severe enough to indicate revision. In the total hip arthroplasty group, one hip was revised because of subsidence of the femoral component.ConclusionsTotal hip arthroplasty conferred superior short-term clinical results and fewer complications when compared with hemiarthroplasty in this prospectively randomized study of mobile, independent patients who had sustained a displaced fracture of the femoral neck.Level of EvidenceTherapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
We present a design and evaluation of a simple and easy-to-fabricate conductive heater intended for ultra-high vacuum experiments. We demonstrate a compact and power-dense heater that has minimal ...outgassing up to nearly 200 °C. We further detail a method for using the heater in air to heat an object in vacuum by partially replacing a glass vacuum chamber wall with silicon, avoiding some possible outgassing issues. This method has successfully loaded a 2D magneto-optical trap feeding a 3D magneto-optical trap in rubidium 87.
The purpose of the study was to assess the positive predictive value of mammographic features and final assessment categories described in the Breast Imaging Reporting and Data System (BI-RADS) for ...lesions on which biopsies have been performed.
We prospectively evaluated 492 impalpable mammographically detected lesions on which surgical biopsy (as opposed to percutaneous biopsy) was performed. Each lesion was classified according to BI-RADS descriptors for masses (margins and shape) and calcifications (morphology and distribution) and was categorized by the BI-RADS final assessment categories as category 3 ("probably benign"), category 4 ("suspicious abnormality"), or category 5 ("highly suggestive of malignancy"). Mammographic and pathologic findings were reviewed.
Carcinoma was present in 225 (46%) of 492 lesions. For the 492 lesions subject to biopsy, BI-RADS final assessment categories were category 3 in eight lesions (2%), category 4 in 355 (72%), and category 5 in 129 (26%). The features with highest positive predictive value for carcinoma were spiculated margins (81%), irregular shape (73%), linear calcification morphology (81%), and segmental or linear calcification distribution (74% and 68%, respectively). Carcinoma was present in 105 (81%) of 129 category 5 lesions compared with 120 (34%) of 355 category 4 lesions (p < .001). The frequency of carcinoma was higher in category 5 than in category 4 lesions for all mammographic lesion types and all interpreting radiologists.
The standardized terminology of the BI-RADS lexicon allows quantification of the likelihood of carcinoma in an impalpable breast lesion. The features with highest positive predictive value--spiculated margins, irregular shape, linear morphology, and segmental or linear distribution--warrant designation of a lesion as category 5.
Abstract The Virus Pathogen Resource (ViPR; www.viprbrc.org ) and Influenza Research Database (IRD; www.fludb.org ) have developed a metadata-driven Comparative Analysis Tool for Sequences ...(meta-CATS), which performs statistical comparative analyses of nucleotide and amino acid sequence data to identify correlations between sequence variations and virus attributes (metadata). Meta-CATS guides users through: selecting a set of nucleotide or protein sequences; dividing them into multiple groups based on any associated metadata attribute (e.g. isolation location, host species); performing a statistical test at each aligned position; and identifying all residues that significantly differ between the groups. As proofs of concept, we have used meta-CATS to identify sequence biomarkers associated with dengue viruses isolated from different hemispheres, and to identify variations in the NS1 protein that are unique to each of the 4 dengue serotypes. Meta-CATS is made freely available to virology researchers to identify genotype-phenotype correlations for development of improved vaccines, diagnostics, and therapeutics.
•There is differential miRNA regulation between B-ALL and healthy donor B cells.•Current miRNA profiling techniques for B-ALL shows no clear miRNA signature.•A promising consensus 8-gene list was ...identified for B-ALL using meta-analysis.•Target prediction for promising miRNAs identifies mRNA targets linked to signaling.
B cell acute lymphoblastic leukemia (B-ALL) is the most prevalent pediatric cancer. MicroRNAs (miRNAs) are 18-22nt non-coding transcripts shown to be essential for the development of many cancers. While some miRNAs are reportedly expressed differentially between healthy and B-ALL, no studies have reported a consensus miRNA signature. Therefore, we performed a reanalysis of five miRNA datasets to identify differentially expressed miRNAs (DEmiRs) and a meta-analysis of previously identified DEmiRs from 25 studies. Overall, the re-analysis showed that the DEmiR data clustered by platform and not by disease state. The meta-analysis also did not reveal a consensus miRNA signature as there were many miRNAs upregulated in some studies and downregulated in others. However, eight promising miRNAs (miR-181b, miR-128b, miR-181a, miR-128, miR-128a, miR-181c, miR-155, miR-142-3p, and miR-451) were identified from the meta-analysis, which could be the basis of future investigations. These analyses reveal that standardization of miRNA isolation and analysis is needed in B-ALL to enable cross-study comparisons and identify a consensus signature.
Abstract The aim of this study was to investigate the use of large diameter head THR to treat fractured neck of femur, and to demonstrate if this conferred greater stability. Forty-six independent, ...mentally alert patients with displaced intracapsular fractures underwent THR. Mean age was 72.1 years. Outcome measures were dislocation, reoperation/revision rate, Oxford hip score (OHS), EuroQol (EQ-5D) and residential status. At mean follow-up (13.5 months) there were no dislocations. Reoperation, revision and infection rate were all 0%. Two patients died (4.3%). Mean pre-injury and postoperative OHS were 12.1 and 17.6, respectively. Mean pre-injury and postoperative EQ-5D index scores were 0.97 and 0.83, respectively. Mean postoperative walking distance was 2.5 miles. There were no changes in residential status. This is the first published series using 36-mm diameter metal-on-metal THR for the treatment of fractured neck of femur. We have demonstrated that it affords patients excellent stability with no recorded dislocations.
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