Ultrasound of the knee during voluntary quadriceps contraction: A technique for detecting otherwise occult effusions

Objective To describe 1) a technique that can detect synovial effusions not seen on static ultrasound (US) examination and 2) the characteristics of patients with knee osteoarthritis (OA) for whom this technique proved useful. Methods From reviewed records of 76 patients with knee OA (112 knees) that we had seen for US-guided injections over a defined period, we found 45 knees with no detectable effusion on static US, of which 18 (14 patients) showed fluid when scanned during voluntary quadriceps contraction. For all patients, we had recorded effusion features (physical examination, presence and size on US), and success of joint entry was determined by getting synovial fluid and/or seeing an air echo or inflow of injected material. Results The 14 patients we studied were obese (mean ± SEM body mass index 32.7 ± 2.3 kg/m 2 ; 3 morbidly obese), with moderate to severe OA by radiography in most (Kellgren/Lawrence class 3 or 4 in 10 of 14 knees for which radiographs were available). The suprapatellar synovial space seen by US was small (mean ± SEM depth 0.38 ± 0.04 cm). Arthrocentesis obtained 0.5–16 ml of synovial fluid (mean ± SEM 2.9 ± 0.6 ml), which correlated with the depth of effusion as seen on US with the quadriceps in maximum contraction (Spearman's Ρ = 0.5597, P = 0.0157). In 4 knees where arthrocentesis failed to retrieve fluid, we observed at injection the inflow of material and a linear air echo. Conclusion US of the knee during voluntary quadriceps contraction can find effusions not detectable on static US. Such effusions provide targets for accurate aspiration and injection that would not be appreciated with static US.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75770/1/20047_ftp.pd

The Ratio of W + N jets To Z/gamma + N jets As a Precision Test of the Standard Model

We suggest replacing measurements of the individual cross-sections for the production of W + N jets and Z/gamma + N jets in searches for new high-energy phenomena at hadron colliders by the precision measurement of the ratios (W+0 jet)/(Z+0 jet), (W+1 jet)/(Z+1 jet), (W+2 jets)/(Z+2 jets),... (W+N jets)/(Z+N jets), with N as large as 6 (the number of jets in ttbarH). These ratios can also be formed for the case where one or more of the jets is tagged as a b or c quark. Existing measurements of the individual cross sections for Wenu + N jets at the Tevatron have systematic uncertainties that grow rapidly with N, being dominated by uncertainties in the identification of jets and the jet energy scale. These systematics, and also those associated with the luminosity, parton distribution functions (PDF's), detector acceptance and efficiencies, and systematics of jet finding and b-tagging, are expected to substantially cancel in calculating the ratio of W to Z production in each N-jet channel, allowing a greater sensitivity to new contributions in these channels in Run II at the Tevatron and at the LHC.Comment: 10 pages, 8 figures, added reference

H-1 Nuclear Magnetic Resonance Spin-Lattice Relaxation, C-13 Magic-Angle-Spinning Nuclear Magnetic Resonance Spectroscopy, Differential Scanning Calorimetry, and X-Ray Diffraction of Two Polymorphs of 2,6-Di-Tert-Butylnaphthalene

Polymorphism, the presence of structurally distinct solid phases of the same chemical species, affords a unique opportunity to evaluate the structural consequences of intermolecular forces. The study of two polymorphs of 2,6-di-tert-butylnaphthalene by single-crystal x-ray diffraction, differential scanning calorimetry (DSC), C-13 magic-angle-spinning (MAS) nuclear magnetic resonance (NMR) spectroscopy, and H-1 NMR spin-lattice relaxation provides a picture of the differences in structure and dynamics in these materials. The subtle differences in structure, observed with x-ray diffraction and chemical shifts, strikingly affect the dynamics, as reflected in the relaxation measurements. We analyze the dynamics in terms of both discrete sums and continuous distributions of Poisson processes

Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD): Methodology for a Population-Based Study of Black, Hispanic and White Patients with Ovarian Cancer

INTRODUCTION: Less than 40% of patients with ovarian cancer (OC) in the USA receive stage-appropriate guideline-adherent surgery and chemotherapy. Black patients with cancer report greater depression, pain and fatigue than white patients. Lack of access to healthcare likely contributes to low treatment rates and racial differences in outcomes. The Ovarian Cancer Epidemiology, Healthcare Access and Disparities study aims to characterise healthcare access (HCA) across five specific dimensions-Availability, Affordability, Accessibility, Accommodation and Acceptability-among black, Hispanic and white patients with OC, evaluate the impact of HCA on quality of treatment, supportive care and survival, and explore biological mechanisms that may contribute to OC disparities. METHODS AND ANALYSIS: We will use the Surveillance Epidemiology and Ends Results dataset linked with Medicare claims data from 9744 patients with OC ages 65 years and older. We will recruit 1641 patients with OC (413 black, 299 Hispanic and 929 white) from cancer registries in nine US states. We will examine HCA dimensions in relation to three main outcomes: (1) receipt of quality, guideline adherent initial treatment and supportive care, (2) quality of life based on patient-reported outcomes and (3) survival. We will obtain saliva and vaginal microbiome samples to examine prognostic biomarkers. We will use hierarchical regression models to estimate the impact of HCA dimensions across patient, neighbourhood, provider and hospital levels, with random effects to account for clustering. Multilevel structural equation models will estimate the total, direct and indirect effects of race on treatment mediated through HCA dimensions. ETHICS AND DISSEMINATION: Result dissemination will occur through presentations at national meetings and in collaboration with collaborators, community partners and colleagues across othercancer centres. We will disclose findings to key stakeholders, including scientists, providers and community members. This study has been approved by the Duke Institutional Review Board (Pro00101872). Safety considerations include protection of patient privacy. All disseminated data will be deidentified and summarised

Redesigning the Warren Animal Shelter

The new shelter should incorporate improved natural lighting and ventilation, adequate space for laundry facilities and more space for the animals\u27 living and bathing needs. The design should consider how to prevent dogs from barking and disturbing one another while in the kennels. Increased storage is necessary for the animal shelter to contain the food and living amenities for the incoming animals

Feeding Induced by Cannabinoids Is Mediated Independently of the Melanocortin System

Cannabinoids, the active components of marijuana, stimulate appetite, and cannabinoid receptor-1 (CB1-R) antagonists suppress appetite and promote weight loss. Little is known about how CB1-R antagonists affect the central neurocircuitry, specifically the melanocortin system that regulates energy balance

Structural and Functional Evaluation of C. elegans Filamins FLN-1 and FLN-2

Filamins are long, flexible, multi-domain proteins composed of an N-terminal actin-binding domain (ABD) followed by multiple immunoglobulin-like repeats (IgFLN). They function to organize and maintain the actin cytoskeleton, to provide scaffolds for signaling components, and to act as mechanical force sensors. In this study, we used transcript sequencing and homology modeling to characterize the gene and protein structures of the C. elegans filamin orthologs fln-1 and fln-2. Our results reveal that C. elegans FLN-1 is well conserved at the sequence level to vertebrate filamins, particularly in the ABD and several key IgFLN repeats. Both FLN-1 and the more divergent FLN-2 colocalize with actin in vivo. FLN-2 is poorly conserved, with at least 23 IgFLN repeats interrupted by large regions that appear to be nematode-specific. Our results indicate that many of the key features of vertebrate filamins are preserved in C. elegans FLN-1 and FLN-2, and suggest the nematode may be a very useful model system for further study of filamin function