Symptomatic epiphyseal sprains and stress fractures of the finger phalanges in adolescent sport climbers

The purpose of this study was to document and evaluate patient characteristics, injury mechanisms and clinical outcomes of epiphyseal stress fractures of the finger phalanges in adolescent rock climbers to identify contributing factors to this injury. Twenty-eight climbers with epiphyseal pain treated at our clinic between 2006 and 2018 were included in the study. Sixteen patients completed a questionnaire addressing injury details as well as training regimen before and after the injury. The mean age at the time of injury was 13.7 years (± 1.9 years) with the injury occurring predominantly in male athletes. Middle (58%) and ring (30%) fingers were the most commonly affected sites out of a total of 67 fingers affected; 54% had a radiologically documented epiphyseal fracture (Salter Harris type II/III) while 46% suffered from a symptomatic sprain, which could potentially lead to a stress fracture. Mean time for radiological union of a fracture was 35 weeks. Recovery time for a symptomatic sprain was on average slightly shorter at 24 weeks. All patients were treated conservatively with load reduction for 3-12 months until the symptoms disappeared. Although most patients had a positive outcome when treated correctly, this injury can damage the growth plate when left untreated, resulting in articular surface incongruency (1 severe, 1 moderate, 6 mild) with permanent impairment of the affected finger. Therefore, pain on the dorsal aspect of the proximal interphalangeal joint in adolescent climbers must be assessed carefully

Predicting Expressibility of Parameterized Quantum Circuits using Graph Neural Network

Parameterized Quantum Circuits (PQCs) are essential to quantum machine learning and optimization algorithms. The expressibility of PQCs, which measures their ability to represent a wide range of quantum states, is a critical factor influencing their efficacy in solving quantum problems. However, the existing technique for computing expressibility relies on statistically estimating it through classical simulations, which requires many samples. In this work, we propose a novel method based on Graph Neural Networks (GNNs) for predicting the expressibility of PQCs. By leveraging the graph-based representation of PQCs, our GNN-based model captures intricate relationships between circuit parameters and their resulting expressibility. We train the GNN model on a comprehensive dataset of PQCs annotated with their expressibility values. Experimental evaluation on a four thousand random PQC dataset and IBM Qiskit's hardware efficient ansatz sets demonstrates the superior performance of our approach, achieving a root mean square error (RMSE) of 0.03 and 0.06, respectively

Retinal venous pressure in the non-affected eye of patients with retinal vein occlusions

Background: To measure the retinal venous pressure (RVP) in both eyes of patients with unilateral central retinal vein occlusions and to compare these values to controls. Methods: The study included 31 patients with unilateral central retinal vein occlusions (CRVO) and 31 controls who were matched by age, sex, and systemic disease. RVP was measured in all patients bilaterally by means of contact lens ophthalmodynamometry, and the RVP measurements of the affected and unaffected eyes of patients were compared to the RVPs of controls. Ophthalmodynamometry is done by applying an increasing pressure on the eye via a contact lens. The minimum force required to induce a venous pulsation is called ophthalmodynamometric force (ODF). The RVP is defined and calculated as the sum of ODF and intraocular pressure (IOP) [RVP = ODF + IOP]. Results: The RVP group means ± SD were as follows: patient's affected eyes (45.0 ± 11.6mmHg), patient's unaffected eyes (38.0 ± 11.1mmHg) ,and (17.7 ± 6.7mmHg) in the eyes of controls. The values of RVP, even in the patients unaffected eyes, were significantly higher than in the eyes of controls (P <0.001). Conclusions: In patients with CRVO, the RVP is increased in both the affected as well as in the unaffected contralateral eye

Referral rates in Swiss primary care with a special emphasis on reasons for encounter

Questions under study: Referrals from primary to secondary care reflect a crucial role of primary care physicians (PCPs). Most referral rates are based on the number of consultations, rather than on the number of problems addressed during consultations (reasons for encounter = RFE). The aim of the study was to update data on consultations, RFE and referrals in Swiss primary care and calculate a referral rate based on RFE rather than on the number of consultations. Method: Cross-sectional study in Swiss primary care. PCPs collected data on consultations on fifteen different days in three non-consecutive months in 2012/2013. Demographic data of patients and up to six RFE per consultation was collected. For each RFE the PCP had to indicate whether a referral was initiated. Data was analyzed using descriptive statistics. Results: Ninety PCPs (18.9% females) participated and 24’774 consultations with 42’890 RFE (corresponding to 1.73 (SD 1.07) RFE per consultation) were recorded. 2427 RFE (of 2341 consultations) led to a referral, corresponding to a referral rate of 9.44% (95%-CI 9.08-9.81%) based on consultations and 5.65% (95%-CI 5.43-5.87%) based on the number of RFE. Conclusions: An average of 1.7 RFE per consultations and a broad clinical spectrum of problems were presented in primary care; nevertheless 94.3% of all problems were solved in primary care, reflecting the crucial role of PCPs as a coordinator of healthcare

Elevational species richness gradients in a hyperdiverse insect taxon: a global meta-study on geometrid moths

AIMS: We aim to document elevational richness patterns of geometrid moths in a globally replicated, multi-gradient setting, and to test general hypotheses on environmental and spatial effects (i.e. productivity, temperature, precipitation, area, mid-domain effect and human habitat disturbance) on these richness patterns. LOCATION: Twenty-six elevational gradients world-wide (latitudes 28° S to 51° N). METHODS: We compiled field datasets on elevational gradients for geometrid moths, a lepidopteran family, and documented richness patterns across each gradient while accounting for local undersampling of richness. Environmental and spatial predictor variables as well as habitat disturbance were used to test various hypotheses. Our analyses comprised two pathways: univariate correlations within gradients, and multivariate modelling on pooled data after correcting for overall variation in richness among different gradients. RESULTS: The majority of gradients showed midpeak patterns of richness, irrespective of climate and geographical location. The exclusion of human-affected sampling plots did not change these patterns. Support for univariate main drivers of richness was generally low, although there was idiosyncratic support for particular predictors on single gradients. Multivariate models, in agreement with univariate results, provided the strongest support for an effect of area-integrated productivity, or alternatively for an elevational area effect. Temperature and the mid-domain effect received support as weaker, modulating covariates, while precipitation-related variables had no explanatory potential. MAIN CONCLUSIONS: Despite the predicted decreasing diversity–temperature relationship in ectotherms, geometrid moths are similar to ants and salamanders as well as small mammals and ferns in having predominantly their highest diversity at mid-elevations. As in those comparative analyses, single or clear sets of drivers are elusive, but both productivity and area appear to be influential. More comparative elevational studies for various insect taxa are necessary for a more comprehensive understanding of elevational diversity and productivity

A multicenter phase II trial of anti-EGFR-immunoliposomes loaded with doxorubicin in patients with advanced triple negative breast cancer

Advanced triple negative breast cancer (TNBC) is an aggressive, but initially chemo-sensitive disease. The prognosis is poor and more than three quarters of patients experience progression 12 months after the initiation of conventional first-line chemotherapy. Approximately two thirds of TNBC express epidermal growth factor receptor 1 (EGFR). We have developed an anti-EGFR targeted nanocontainer drug by inserting anti-EGFR antibody fragments into the membrane of pegylated liposomes (anti-EGFR-ILs-dox). The payload consists of doxorubicin, a standard drug for TNBC. In a first-in-human phase I trial in 26 patients with various advanced solid malignancies, anti-EGFR-ILs-dox has shown little toxicity and encouraging efficacy. In this single-arm phase II trial, we assessed the efficacy of anti-EGFR-ILs-dox as first-line therapy in patients with advanced, EGFR + TNBC. The primary endpoint was progression-free survival at 12 months (PFS12m). Secondary endpoints included overall response rate (ORR), duration of response (DOR), time to progression (TTP), overall survival (OS) and adverse events (AEs). 48 patients received anti-EGFR-ILs-dox 50 mg/m$^{2}$ iv, on day one of a 28 days-cycle until progression. The Kaplan-Meier estimate for PFS12m was 13% (one-sided 90% CI 7%, 95% CI [5%, 25%]), median PFS was 3.5 months (95% CI 1.9, 5.4). The trial has not reached its primary endpoint. There were no new toxicity signals. Based on these results, anti-EGFR-ILs-dox should not be further developed for TNBC. It remains an open question whether anti-EGFR-ILs-dox would offer more opportunities in other EGFR-expressing malignancies, where targeting this receptor has already shown anticancer effects.Trial registration: This trial was registered at clinicaltrials.gov: NCT02833766. Registered 14/07/2016

Primary Postnatal Dorsal Root Ganglion Culture from Conventionally Slaughtered Calves

Neurological disorders in ruminants have an important impact on veterinary health, but very few host-specific in vitro models have been established to study diseases affecting the nervous system. Here we describe a primary neuronal dorsal root ganglia (DRG) culture derived from calves after being conventionally slaughtered for food consumption. The study focuses on the in vitro characterization of bovine DRG cell populations by immunofluorescence analysis. The effects of various growth factors on neuron viability, neurite outgrowth and arborisation were evaluated by morphological analysis. Bovine DRG neurons are able to survive for more than 4 weeks in culture. GF supplementation is not required for neuronal survival and neurite outgrowth. However, exogenously added growth factors promote neurite outgrowth. DRG cultures from regularly slaughtered calves represent a promising and sustainable host specific model for the investigation of pain and neurological diseases in bovines

Beam test performance of a prototype module with Short Strip ASICs for the CMS HL-LHC tracker upgrade

The Short Strip ASIC (SSA) is one of the four front-end chips designed for the upgrade of the CMS Outer Tracker for the High Luminosity LHC. Together with the Macro-Pixel ASIC (MPA) it will instrument modules containing a strip and a macro-pixel sensor stacked on top of each other. The SSA provides both full readout of the strip hit information when triggered, and, together with the MPA, correlated clusters called stubs from the two sensors for use by the CMS Level-1 (L1) trigger system. Results from the first prototype module consisting of a sensor and two SSA chips are presented. The prototype module has been characterized at the Fermilab Test Beam Facility using a 120 GeV proton beam

Test beam performance of a CBC3-based mini-module for the Phase-2 CMS Outer Tracker before and after neutron irradiation

The Large Hadron Collider (LHC) at CERN will undergo major upgrades to increase the instantaneous luminosity up to 5–7.5×10$^{34}$ cm$^{-2}$s$^{-1}$. This High Luminosity upgrade of the LHC (HL-LHC) will deliver a total of 3000–4000 fb-1 of proton-proton collisions at a center-of-mass energy of 13–14 TeV. To cope with these challenging environmental conditions, the strip tracker of the CMS experiment will be upgraded using modules with two closely-spaced silicon sensors to provide information to include tracking in the Level-1 trigger selection. This paper describes the performance, in a test beam experiment, of the first prototype module based on the final version of the CMS Binary Chip front-end ASIC before and after the module was irradiated with neutrons. Results demonstrate that the prototype module satisfies the requirements, providing efficient tracking information, after being irradiated with a total fluence comparable to the one expected through the lifetime of the experiment

Combined searches for the production of supersymmetric top quark partners in proton–proton collisions at √s=13Te

A combination of searches for top squark pair production using proton–proton collision data at a center-of-mass energy of 13TeV at the CERN LHC, corresponding to an integrated luminosity of 137fb$^{-1}$ collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on the model, the combined result excludes a top squark mass up to 1325GeV for a massless neutralino, and a neutralino mass up to 700GeV for a top squark mass of 1150GeV. Top squarks with masses from 145 to 295GeV, for neutralino masses from 0 to 100GeV, with a mass difference between the top squark and the neutralino in a window of 30GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420GeV