Adolescent idiopathic Scoliosis (AIS) affects 2% to 3% of the population of which only 0.3% to 0.5% of affected patients will have a curvature of >20 degrees, the curve magnitude at which treatment ...is generally recommended. For AIS the current natural history data is limited and most of the information comes from a small body of literature from the University of Iowa.
The Iowa natural history studies began as retrospective reviews but beginning in 1976, the cohort was followed prospectively. Outcomes assessed in this group of patients included; mortality, pulmonary function, pregnancy-(effect of pregnancy on scoliosis and the effect of scoliosis on pregnancy), radiographic, curve progression, and osteoarthritis. In addition, validated questionnaires were used to evaluate back pain, pulmonary symptoms, general function, depression, and body image.
Patients with untreated AIS can function well as adults, become employed, get married, have children, and grow to become active older adults. Unfortunately, untreated scoliosis may lead to increased back pain and pulmonary symptoms for patients with large thoracic curves. Patients with untreated AIS can also develop substantial deformity, and the cosmetic aspect of this condition cannot be disregarded.
The summary findings of this unique lifetime natural history of AIS patients provides patients and parents a solid evidence base upon which to make informed decisions.
The extraction of neutrino mixing parameters from accelerator-based neutrino-oscillation experiments relies on proper modeling of neutrino-nucleus scattering processes using neutrino interaction ...event generators. Experimental tests of these generators are difficult due to the broad range of neutrino energies produced in accelerator-based beams and the low statistics of current experiments. Here we overcome these difficulties by exploiting the similarity of neutrino and electron interactions with nuclei to test neutrino event generators using high-precision inclusive electron-scattering data. To this end, we revised the electron-scattering mode of the genie event generator (e-genie) to include electron-nucleus bremsstrahlung radiation effects and to use, when relevant, the exact same physics models and model parameters, as the standard neutrino-scattering version. We also implemented new models for quasielastic (QE) scattering and meson exchange currents (MECs) based on the theory-inspired super scaling approach SuSAv2. Comparing the new e-genie predictions with inclusive electron-scattering data, we find an overall adequate description of the data in the QE- and MEC-dominated lower energy transfer regime, especially when using the SuSAv2 models. Higher energy transfer interactions, which are dominated by resonance production, are still not well modeled by e-genie.
Mechanisms of spin-flavor SU(6) symmetry breaking in quantum chromodynamics (QCD) are studied via an extraction of the free neutron structure function from a global analysis of deep inelastic ...scattering (DIS) data on the proton and on nuclei from A=2 (deuterium) to 208 (lead). Modification of the structure function of nucleons bound in atomic nuclei (known as the EMC effect) are consistently accounted for within the framework of a universal modification of nucleons in short-range correlated (SRC) pairs. Our extracted neutron-to-proton structure function ratio F_{2}^{n}/F_{2}^{p} becomes constant for x_{B}≥0.6, equaling 0.47±0.04 as x_{B}→1, in agreement with theoretical predictions of perturbative QCD and the Dyson-Schwinger equation, and in disagreement with predictions of the scalar diquark dominance model. We also predict F_{2}^{^{3}He}/F_{2}^{^{3}H}, recently measured, as yet unpublished, by the MARATHON Collaboration, the nuclear correction function that is needed to extract F_{2}^{n}/F_{2}^{p} from F_{2}^{^{3}He}/F_{2}^{^{3}H}, and the theoretical uncertainty associated with this extraction.
Adolescent idiopathic scoliosis Weinstein, Stuart L, Dr; Dolan, Lori A, PhD; Cheng, Jack CY, MD ...
The Lancet (British edition),
05/2008, Letnik:
371, Številka:
9623
Journal Article
Recenzirano
Summary Adolescent idiopathic scoliosis (AIS) affects 1–3% of children in the at-risk population of those aged 10–16 years. The aetiopathogensis of this disorder remains unknown, with misinformation ...about its natural history. Non-surgical treatments are aimed to reduce the number of operations by preventing curve progression. Although bracing and physiotherapy are common treatments in much of the world, their effectiveness has never been rigorously assessed. Technological advances have much improved the ability of surgeons to safely correct the deformity while maintaining sagittal and coronal balance. However, we do not have long-term results of these changing surgical treatments. Much has yet to be learned about the general health, quality of life, and self-image of both treated and untreated patients with AIS.
This Letter shows quantitatively that the magnitude of the EMC effect measured in electron deep inelastic scattering at intermediate x(B), 0.35≤x(B)≤0.7, is linearly related to the short range ...correlation (SRC) scale factor obtained from electron inclusive scattering at x(B)≥1. The observed phenomenological relationship is used to extract the ratio of the deuteron to the free pn pair cross sections and F(2)(n)/F(2)(p), the ratio of the free neutron to free proton structure functions. We speculate that the observed correlation is because both the EMC effect and SRC are dominated by the high virtuality (high momentum) nucleons in the nucleus.
This study describes a new procedure for a safer and easier access for the intrathecal injection of the recently approved nusinersen therapy in spinal muscular atrophy. This therapy changed the ...natural history of the disease, but, to date, scoliosis surgery was an excluding criteria for nusinersen therapy. The bone mass, due to the posterior spinal fusion of the scoliosis surgery, prevents the needle for the nusinersen administration from intervertebral access. This is a single-center, single-surgeon case series descriptive study. A laminotomy at the L3-L4 level was performed to provide safer access for the intrathecal injection. The procedure was carried out during the scoliosis surgery in patients who underwent posterior spinal fusion (PSF) after the nusinersen therapy was introduced, whereas for those who underwent PSF earlier, a second procedure was necessary to perform a laminotomy. A fat grafting was used to prevent bone overgrowth in the laminotomy. Markers were applied as radiographic references for the intrathecal injection. Five patients were enrolled, four females and one male. The mean age of the patients was 11 years. Three patients underwent PSF before the introduction of the nusinersen therapy. Two patients underwent PSF after the nusinersen therapy was available. All of them underwent a laminotomy with a fat grafting at the L3-L4 laminotomy level and received nusinersen therapy without complications. The procedure described is simple and effective in providing safe intrathecal access to make these patients eligible for such important therapy.
Capacitive deionization (CDI) is a water desalination technology in which salt ions are removed from brackish water by flowing through a spacer channel with porous electrodes on each side. Upon ...applying a voltage difference between the two electrodes, cations move to and are accumulated in electrostatic double layers inside the negatively charged cathode and the anions are removed by the positively charged anode. One of the key parameters for commercial realization of CDI is the salt adsorption capacity of the electrodes. State-of-the-art electrode materials are based on porous activated carbon particles or carbon aerogels. Here we report the use for CDI of carbide-derived carbon (CDC), a porous material with well-defined and tunable pore sizes in the sub-nanometer range. When comparing electrodes made with CDC with electrodes based on activated carbon, we find a significantly higher salt adsorption capacity in the relevant cell voltage window of 1.2–1.4 V. The measured adsorption capacity for four materials tested negatively correlates with known metrics for pore structure of the carbon powders such as total pore volume and BET-area, but is positively correlated with the volume of pores of sizes <1 nm, suggesting the relevance of these sub-nanometer pores for ion adsorption. The charge efficiency, being the ratio of equilibrium salt adsorption over charge, does not depend much on the type of material, indicating that materials that have been identified for high charge storage capacity can also be highly suitable for CDI. This work shows the potential of materials with well-defined sub-nanometer pore sizes for energy-efficient water desalination.
Genomic imprinting is an epigenetic phenomenon affecting a small number of genes, which leads to differential expression from the two parental alleles. Imprinted genes are known to regulate fetal ...growth and a 'kinship' or 'parental conflict' model predicts that paternally and maternally expressed imprinted genes promote and inhibit fetal growth, respectively. In this review we examine the role of imprinted genes in postnatal growth and metabolism, with an emphasis on the GNAS/Gnas locus. GNAS is a complex imprinted locus with multiple oppositely imprinted gene products, including the G-protein alpha-subunit G(s)alpha that is expressed primarily from the maternal allele in some tissues and the G(s)alpha isoform XLalphas that is expressed only from the paternal allele. Maternal, but not paternal, G(s)alpha mutations lead to obesity in Albright hereditary osteodystrophy. Mouse studies show that this phenomenon is due to G(s)alpha imprinting in the central nervous system leading to a specific defect in the ability of central melanocortins to stimulate sympathetic nervous system activity and energy expenditure. In contrast mutation of paternally expressed XLalphas leads to opposite metabolic effects in mice. Although these findings conform to the 'kinship' model, the effects of other imprinted genes on body weight regulation do not conform to this model.
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