Development and Validation of a Spontaneous Smile Assay

IMPORTANCE Smiling can be a voluntary or involuntarymovement. Facial reanimation procedures differ in their ability to restore a spontaneous smile, and an assay designed to evoke and evaluate a spontaneous smile is not available. OBJECTIVE To develop and validate an assay to assess the spontaneous smile of patients with facial paralysis. DESIGN, SETTING, AND PARTICIPANTS Thiswas an exploratory cohort study. A series of short video clips were administered to laypersons via an online survey service from January 1, 2014, to March 31, 2014. Respondents rated how funny each video was on a visual analog scale from 0 to 100. The 4 funniest videos were selected to generate a 11/2-minute spontaneous smile assay. The assay was then administered from July 1, 2014, to December 31, 2014, to 2 different study groups: the first was composed of 100 healthy individuals (control group) and the second was composed of 30 patients with facial paralysis.We analyzed the capability of this assay to provoke at least 1 spontaneous smile and calculated smile excursion in both groups. Statistical analysis was performed using analysis of variance. INTERVENTION Spontaneous smile assay administered to both healthy and diseased groups. MAIN OUTCOMES AND MEASURES Ability of the assay to elicit smiles, as defined by an oral commissure excursion greater than 3 mm, as well as difference in commissure excursion. RESULTS Ninety-five (95.0%) participants in the control group and 29 (96.7%) patients with facial paralysis experienced at least 1 oral commissure excursion that appeared to be a spontaneous smile while viewing the assay. Mean oral commissure excursion with spontaneous smile was 9.08mm(95%CI, 2.77-15.39) in controls, 6.72mm(95%CI, 3.13-10.31) on the healthy side in patients with flaccid facial paralysis (P=.004 vs controls), and 9.64mm(95%CI, 3.52-15.76) on the healthy side in patients with nonflaccid facial paralysis (P=.74). Among patients with flaccid facial paralysis, a statistically significant difference was found between smile excursion of the affected and the unaffected sides (P = .03). There was no statistically significant difference in the measurement between sides for the control group (P = .67). CONCLUSIONS AND RELEVANCE Although humor is a challenging construct to universalize, our assay was able to elicit a smile in almost all individuals in the group with facial paralysis and the control group. The spontaneous smile assay will facilitate future research on the ability of facial reanimation procedures and other interventions to restore a spontaneous smile

Can a total knee arthroplasty be both rotationally unconstrained and anteroposteriorly stabilised? A pulsed fluoroscopic investigation

Objectives: Throughout the 20th Century, it has been postulated that the knee moves on the basis of a four-bar link mechanism composed of the cruciate ligaments, the femur and the tibia. As a consequence, the femur has been thought to roll back with flexion, and total knee arthroplasty (TKA) prostheses have been designed on this basis. Recent work, however, has proposed that at a position of between 0° and 120° the medial femoral condyle does not move anteroposteriorly whereas the lateral femoral condyle tends, but is not obliged, to roll back - a combination of movements which equates to tibial internal/femoral external rotation with flexion. The aim of this paper was to assess if the articular geometry of the GMK Sphere TKA could recreate the natural knee movements in situ/in vivo. Methods: The pattern of knee movement was studied in 15 patients (six male: nine female; one male with bilateral TKAs) with 16 GMK Sphere implants, at a mean age of 66 years (53 to 76) with a mean BMI of 30 kg/m2 (20 to 35). The motions of all 16 knees were observed using pulsed fluoroscopy during a number of weight-bearing and non-weight-bearing static and dynamic activities. Results: During maximally flexed kneeling and lunging activities, the mean tibial internal rotation was 8° (standard deviation (SD) 6). At a mean 112° flexion (SD 16) during lunging, the medial and lateral condyles were a mean of 2 mm (SD 3) and 8 mm (SD 4) posterior to a transverse line passing through the centre of the medial tibial concavity. With a mean flexion of 117° (SD 14) during kneeling, the medial and lateral condyles were a mean of 1 mm (SD 4) anterior and 6 mm (SD 4) posterior to the same line. During dynamic stair and pivoting activities, there was a mean anteroposterior translation of 0 mm to 2 mm of the medial femoral condyle. Backward lateral condylar translation occurred and was linearly related to tibial rotation. Conclusion: The GMK Sphere TKA in our study group shows movements similar in pattern, although reduced in magnitude, to those in recent reports relating to normal knees during several activities. Specifically, little or no translation of the medial femoral condyle was observed during flexion, but there was posterior roll-back of the lateral femoral condyle, equating to tibiofemoral rotation. We conclude that the GMK Sphere is anteroposteriorly stable medially and permits rotation about the medial compartment

N=1 SQCD-like theories with N_f massive flavors from AdS/CFT and beta functions

We study new supergravity solutions related to large-$N_c$ ${\cal N}=1$ supersymmetric gauge field theories with a large number $N_f$ of massive flavors. We use a recently proposed framework based on configurations with $N_c$ color D5 branes and a distribution of $N_f$ flavor D5 branes, governed by a function $N_f S(r)$. Although the system admits many solutions, under plausible physical assumptions the relevant solution is uniquely determined for each value of $x\equiv N_f/N_c$. In the IR region, the solution smoothly approaches the deformed Maldacena-N\'u\~nez solution. In the UV region it approaches a linear dilaton solution. For $x<2$ the gauge coupling $\beta_g$ function computed holographically is negative definite, in the UV approaching the NSVZ $\beta$ function with anomalous dimension $\gamma_0= -1/2$ (approaching $-3/(32\pi^2)(2N_c-N_f)g^3$)), and with $\beta_g \to-\infty$ in the IR. For $x=2$, $\beta_g$ has a UV fixed point at strong coupling, suggesting the existence of an IR fixed point at a lower value of the coupling. We argue that the solutions with $x>2$ describe a "Seiberg dual" picture where $N_f-2N_c$ flips sign.Comment: 18 pages, 10 figure

Holographic Conformal Window - A Bottom Up Approach

We propose a five-dimensional framework for modeling the background geometry associated to ordinary Yang-Mills (YM) as well as to nonsupersymmetric gauge theories possessing an infrared fixed point with fermions in various representations of the underlying gauge group. The model is based on the improved holographic approach, on the string theory side, and on the conjectured all-orders beta function for the gauge theory one. We first analyze the YM gauge theory. We then investigate the effects of adding flavors and show that, in the holographic description of the conformal window, the geometry becomes AdS when approaching the ultraviolet and the infrared regimes. As the number of flavors increases within the conformal window we observe that the geometry becomes more and more of AdS type over the entire energy range.Comment: 20 Pages, 3 Figures. v2: references adde

The Epidemiology of Lead Toxicity in Adults: Measuring Dose and Consideration of Other Methodologic Issues

We review several issues of broad relevance to the interpretation of epidemiologic evidence concerning the toxicity of lead in adults, particularly regarding cognitive function and the cardiovascular system, which are the subjects of two systematic reviews that are also part of this mini-monograph. Chief among the recent developments in methodologic advances has been the refinement of concepts and methods for measuring individual lead dose in terms of appreciating distinctions between recent versus cumulative doses and the use of biological markers to measure these parameters in epidemiologic studies of chronic disease. Attention is focused particularly on bone lead levels measured by K-shell X-ray fluorescence as a relatively new biological marker of cumulative dose that has been used in many recent epidemiologic studies to generate insights into lead’s impact on cognition and risk of hypertension, as well as the alternative method of estimating cumulative dose using available repeated measures of blood lead to calculate an individual’s cumulative blood lead index. We review the relevance and interpretation of these lead biomarkers in the context of the toxico-kinetics of lead. In addition, we also discuss methodologic challenges that arise in studies of occupationally and environmentally exposed subjects and those concerning race/ethnicity and socioeconomic status and other important covariates

Determinants of postnatal spleen tissue regeneration and organogenesis

Abstract The spleen is an organ that filters the blood and is responsible for generating blood-borne immune responses. It is also an organ with a remarkable capacity to regenerate. Techniques for splenic auto-transplantation have emerged to take advantage of this characteristic and rebuild spleen tissue in individuals undergoing splenectomy. While this procedure has been performed for decades, the underlying mechanisms controlling spleen regeneration have remained elusive. Insights into secondary lymphoid organogenesis and the roles of stromal organiser cells and lymphotoxin signalling in lymph node development have helped reveal similar requirements for spleen regeneration. These factors are now considered in the regulation of embryonic and postnatal spleen formation, and in the establishment of mature white pulp and marginal zone compartments which are essential for spleen-mediated immunity. A greater understanding of the cellular and molecular mechanisms which control spleen development will assist in the design of more precise and efficient tissue grafting methods for spleen regeneration on demand. Regeneration of organs which harbour functional white pulp tissue will also offer novel opportunities for effective immunotherapy against cancer as well as infectious diseases

What lies beneath: exploring links between asylum policy and hate crime in the UK

This paper explores the link between increasing incidents of hate crime and the asylum policy of successive British governments with its central emphasis on deterrence. The constant problematisation of asylum seekers in the media and political discourse ensures that 'anti-immigrant' prejudice becomes mainstr earned as a common-sense response. The victims are not only the asylum seekers hoping for a better life but democratic society itself with its inherent values of pluralism and tolerance debased and destabilised

A new view of electrochemistry at highly oriented pyrolytic graphite

Major new insights on electrochemical processes at graphite electrodes are reported, following extensive investigations of two of the most studied redox couples, Fe(CN)64–/3– and Ru(NH3)63+/2+. Experiments have been carried out on five different grades of highly oriented pyrolytic graphite (HOPG) that vary in step-edge height and surface coverage. Significantly, the same electrochemical characteristic is observed on all surfaces, independent of surface quality: initial cyclic voltammetry (CV) is close to reversible on freshly cleaved surfaces (>400 measurements for Fe(CN)64–/3– and >100 for Ru(NH3)63+/2+), in marked contrast to previous studies that have found very slow electron transfer (ET) kinetics, with an interpretation that ET only occurs at step edges. Significantly, high spatial resolution electrochemical imaging with scanning electrochemical cell microscopy, on the highest quality mechanically cleaved HOPG, demonstrates definitively that the pristine basal surface supports fast ET, and that ET is not confined to step edges. However, the history of the HOPG surface strongly influences the electrochemical behavior. Thus, Fe(CN)64–/3– shows markedly diminished ET kinetics with either extended exposure of the HOPG surface to the ambient environment or repeated CV measurements. In situ atomic force microscopy (AFM) reveals that the deterioration in apparent ET kinetics is coupled with the deposition of material on the HOPG electrode, while conducting-AFM highlights that, after cleaving, the local surface conductivity of HOPG deteriorates significantly with time. These observations and new insights are not only important for graphite, but have significant implications for electrochemistry at related carbon materials such as graphene and carbon nanotubes

Scaling laws near the conformal window of many-flavor QCD

We derive universal scaling laws for physical observables such as the critical temperature, the chiral condensate, and the pion decay constant as a function of the flavor number near the conformal window of many-flavor QCD in the chiral limit. We argue on general grounds that the associated critical exponents are all interrelated and can be determined from the critical exponent of the running gauge coupling at the Caswell-Banks-Zaks infrared fixed point. We illustrate our findings with the aid of nonperturbative functional Renormalization Group (RG) calculations and low-energy QCD models.Comment: 18 pages, 4 figures, references added and discussion expanded (matches JHEP version

Holography of a Composite Inflaton

We study the time evolution of a brane construction that is holographically dual to a strongly coupled gauge theory that dynamically breaks a global symmetry through the generation of an effective composite Higgs vev. The D3/D7 system with a background magnetic field or non-trivial gauge coupling (dilaton) profile displays the symmetry breaking. We study motion of the D7 brane in the background of the D3 branes. For small field inflation in the field theory the effective Higgs vev rolls from zero to the true vacuum value. We study what phenomenological dilaton profile generates the slow rolling needed, hence learning how the strongly coupled gauge theory's coupling must run. We note that evolution of our configuration in the holographic direction, representing the phyiscs of the strong interactions, can provide additional slowing of the roll time. Inflation seems to be favoured if the coupling changes by only a small amount or very gently. We speculate on how such a scenario could be realized away from N=4 gauge theory, for example, in a walking gauge theory.Comment: 13 pages, 12 figures; v2: Added reference