Intermittent pneumatic compression reduces the risk of deep vein thrombosis during post-operative lower limb immobilisation : a prospective randomised trial of acute ruptures of the Achilles tendon.

Deep vein thrombosis is a common complication when immobilising the lower limb after surgery. We hypothesised that adjuvant intermittent pneumatic compression (IPC) during post-operative outpatient immobilisation of the lower limb could reduce the incidence of deep vein thrombosis (DVT). A total of 150 patients with acute Achilles tendon rupture were randomised to either treatment with IPC for six hours daily (n = 74) under an orthosis or treatment as usual (n = 74) in a plaster cast. At two weeks post-operatively the incidence of DVT was assessed using compression duplex ultrasound (CDU) by two ultrasonographers blinded to treatment. After the IPC intervention had ended, all patients were immobilised in the orthosis for another four weeks and a second CDU was performed. Trial registration: www.clinicaltrials.gov; NCT01317160. At two weeks the DVT rate was 21% in the IPC group and 38% in the control group (OR = 2.36; 95% CI 1.11 to 5.01). Age > 39 years was found to be a strong risk factor for DVT (OR = 4.84; 95% CI 2.14 to 10.96). Treatment with IPC corrected for age reduced the risk significantly (OR = 0.36; 95% CI 0.16 to 0.80). At six weeks, however, the frequency of DVT was 49% in the IPC group and 51% in the control group (OR = 0.94; 95% CI 0.49 to 1.83). IPC seems to be an effective method of reducing the risk of early DVT in leg-immobilised outpatients. A high risk of DVT during prolonged immobilisation warrants further study.Swedish Research CouncilStockholm County Council and Karolinska InstitutetAccepte

Transition from gynaecomastia to lipomastia in pubertal boys

ObjectiveGynaecomastia is frequent in pubertal boys and is regarded as a self-limiting abnormality. However, longitudinal studies proving this hypothesis are scarce.DesignLongitudinal follow-up study (median 2.4, range 1.0-4.8 years).MethodsThe regression of breast diameter was analysed in 31 pubertal boys aged 11.7-16.1 (median 13.2) years with gynaecomastia. Furthermore, weight changes (as BMI-SDS) and pubertal stage, oestradiol [E2], oestriol, oestrone, androstenedione, testosterone [T], dihydrotestosterone, gonadotropins, IGF-1, and IGFBP-3 serum concentrations determined at first clinical presentation were related to breast diameter regression determined by palpation and disappearance of breast glandular tissue in ultrasound in follow-up to identify possible predictors of breast regression.ResultsDuring the observation period, the breast diameter decreased (in median -1 (interquartile range [IQR] -5 to +1) cm). At follow-up, 6% of boys had no breast enlargement any more, and 65% developed lipomastia. Gynaecomastia was still present in 29%. None of the analysed hormones was related significantly to breast diameter regression or disappearance of breast glandular tissue. In multiple linear regression analyses adjusted for observational period, as well as age and BMI-SDS at first presentation, changes in BMI-SDS (β-coefficient 6.0 ± 2.3, p = .015) but not the E2/T ratio or any other hormone determined at baseline was related to changes in breast diameter.ConclusionsBreast diameter regression seems not to be predictable by a hormone profile in pubertal boys with gynaecomastia. In pubertal boys presenting with gynaecomastia, conversion to lipomastia of smaller volume is common. The reduction of weight status was the best predictor of breast diameter regression

Complement factor D regulates collagen type I expression and fibroblast migration to enhance human tendon repair and healing outcomes

IntroductionDense connective tissues (DCTs) such as tendon, ligament, and cartilage are important stabilizers and force transmitters in the musculoskeletal system. The healing processes after DCT injuries are highly variable, often leading to degenerative changes and poor clinical outcome. Biomarkers in relation to repair quality for human DCTs, especially tendon are lacking. This study expands our previous findings and aimed to characterize the mechanisms by which a potential biomarker of good outcomes, complement factor D (CFD), regulates tendon healing. MethodsQuantitative mass spectrometry (QMS) profiling of tissue biopsies from the inflammatory phase of healing (n = 40 patients) and microdialysates from the proliferative phase of healing (n = 28 patients) were used to identify specific biomarkers for tendon healing. Further bioinformatic and experimental investigations based on primary fibroblasts and fibroblast cell line were used to confirm the identified biomarkers.ResultsThe QMS profiling of tissue biopsies from the inflammatory phase of healing identified 769 unique proteins, and microdialysates from the proliferative phase of healing identified 1423 unique proteins in Achilles tendon rupture patients. QMS-profiling showed that CFD expression was higher during the inflammatory- and lower during the proliferative healing phase in the good outcome patients. Further bioinformatic and experimental explorations based on both inflammatory and proliferative fibroblast models demonstrated that CFD potentially improved repair by regulating cell migration and modulating collagen type I (Col1a1) expression. Moreover, it was shown that the enhanced Col1a1 expression, through increased fibroblast migration, was correlated with the validated clinical outcome. DiscussionThe results of the current studies characterized underlying inflammatory- and proliferative healing mechanisms by which CFD potentially improved tendon repair. These findings may lead to improved individualized treatment options, as well the development of effective therapies to promote good long-term clinical outcomes after tendon and other DCT injuries. Trial registrationhttp://clinicaltrials.gov, identifiers NCT02318472, NCT01317160

Optimizing tendon repair and regeneration: how does the in vivo environment shape outcomes following rupture of a tendon such as the Achilles tendon?

Risk for rupture of the Achilles tendon, and other tendons increases with age. Such injuries of tissues that function in high load environments generally are believed to heal with variable outcome. However, in many cases, the healing does not lead to a good outcome and the patient cannot return to the previous level of participation in active living activities, including sports. In the past few years, using proteomic approaches and other biological techniques, reports have appeared that identify biomarkers that are prognostic of good outcomes from healing, and others that are destined for poor outcomes using validated criteria at 1-year post injury. This review will discuss some of these recent findings and their potential implications for improving outcomes following connective tissue injuries, as well as implications for how clinical research and clinical trials may be conducted in the future where the goal is to assess the impact of specific interventions on the healing process, as well as focusing the emphasis on regeneration and not just repair

Electrostatics and the Assembly of an RNA Virus

Electrostatic interactions play a central role in the assembly of single-stranded RNA viruses. Under physiological conditions of salinity and acidity, virus capsid assembly requires the presence of genomic material that is oppositely charged to the core proteins. In this paper we apply basic polymer physics and statistical mechanics methods to the self-assembly of a synthetic virus encapsidating generic polyelectrolyte molecules. We find that (i) the mean concentration of the encapsidated polyelectrolyte material depends on the surface charge density, the radius of the capsid, and the linear charge density of the polymer but neither on the salt concentration or the Kuhn length, (ii) the total charge of the capsid interior is equal but opposite to that of the empty capsid, a form of charge reversal. Unlike natural viruses, synthetic viruses are predicted not to be under an osmotic swelling pressure. The design condition that self-assembly only produces filled capsids is shown to coincide with the condition that the capsid surface charge exceeds the desorption threshold of polymer surface adsorption. We compare our results with studies on the self-assembly of both synthetic and natural viruses.Comment: 41 pages, 4 figure

Classification of Myoviridae bacteriophages using protein sequence similarity

BACKGROUND: We advocate unifying classical and genomic classification of bacteriophages by integration of proteomic data and physicochemical parameters. Our previous application of this approach to the entirely sequenced members of the Podoviridae fully supported the current phage classification of the International Committee on Taxonomy of Viruses (ICTV). It appears that horizontal gene transfer generally does not totally obliterate evolutionary relationships between phages. RESULTS: CoreGenes/CoreExtractor proteome comparison techniques applied to 102 Myoviridae suggest the establishment of three subfamilies (Peduovirinae, Teequatrovirinae, the Spounavirinae) and eight new independent genera (Bcep781, BcepMu, FelixO1, HAP1, Bzx1, PB1, phiCD119, and phiKZ-like viruses). The Peduovirinae subfamily, derived from the P2-related phages, is composed of two distinct genera: the "P2-like viruses", and the "HP1-like viruses". At present, the more complex Teequatrovirinae subfamily has two genera, the "T4-like" and "KVP40-like viruses". In the genus "T4-like viruses" proper, four groups sharing >70% proteins are distinguished: T4-type, 44RR-type, RB43-type, and RB49-type viruses. The Spounavirinae contain the "SPO1-"and "Twort-like viruses." CONCLUSION: The hierarchical clustering of these groupings provide biologically significant subdivisions, which are consistent with our previous analysis of the Podoviridae

Технология проведения безостановочного ремонта магистрального нефтепровода

Объектом исследования является магистральный нефтепровод "20S20" с диаметром 1220 мм и толщиной стенки 12 мм. Цель работы – выбор наиболее эффективных технологий ремонта магистрального нефтепровода без остановки перекачки. В результате исследования был произведен выбор универсальной технологии, которая отвечает современным требования ремонта. Область применения: данная технология применяется для ремонта любого дефекта на нефтепроводе без остановки перекачки и позволяет производить при этом замену участка.The object of the study is the main oil pipeline "20S20" with a diameter of 1220 mm and a wall thickness of 12 mm. The purpose of the work is to select the most effective technologies for repairing the main oil pipeline without stopping pumping. As a result of the research, a universal technology was chosen that meets modern repair requirements. Scope: This technology is used to repair any defect in the pipeline without stopping the transfer and allows you to make a replacement site

A cryogenic beam of refractory, chemically reactive molecules with expansion cooling

Cryogenically cooled buffer gas beam sources of the molecule thorium monoxide (ThO) are optimized and characterized. Both helium and neon buffer gas sources are shown to produce ThO beams with high flux, low divergence, low forward velocity, and cold internal temperature for a variety of stagnation densities and nozzle diameters. The beam operates with a buffer gas stagnation density of ~10^15-10^16 cm^-3 (Reynolds number ~1-100), resulting in expansion cooling of the internal temperature of the ThO to as low as 2 K. For the neon (helium) based source, this represents cooling by a factor of about 10 (2) from the initial nozzle temperature of about 20 K (4 K). These sources deliver ~10^11 ThO molecules in a single quantum state within a 1-3 ms long pulse at 10 Hz repetition rate. Under conditions optimized for a future precision spectroscopy application [A C Vutha et al 2010 J. Phys. B: At. Mol. Opt. Phys. 43 074007], the neon-based beam has the following characteristics: forward velocity of 170 m/s, internal temperature of 3.4 K, and brightness of 3x10^11 ground state molecules per steradian per pulse. Compared to typical supersonic sources, the relatively low stagnation density of this source, and the fact that the cooling mechanism relies only on collisions with an inert buffer gas, make it widely applicable to many atomic and molecular species, including those which are chemically reactive, such as ThO

Search for Relativistic Magnetic Monopoles with IceCube

We present the first results in the search for relativistic magnetic monopoles with the IceCube detector, a subsurface neutrino telescope located in the South Polar ice cap containing a volume of 1 km$^{3}$. This analysis searches data taken on the partially completed detector during 2007 when roughly 0.2 km$^{3}$ of ice was instrumented. The lack of candidate events leads to an upper limit on the flux of relativistic magnetic monopoles of \Phi_{\mathrm{90%C.L.}}\sim 3\e{-18}\fluxunits for $\beta\geq0.8$. This is a factor of 4 improvement over the previous best experimental flux limits up to a Lorentz boost $\gamma$ below $10^{7}$. This result is then interpreted for a wide range of mass and kinetic energy values.Comment: 11 pages, 11 figures. v2 is minor text edits, no changes to resul