Analytical Galaxy Profiles for Photometric and Lensing Analysis

This article introduces a family of analytical functions of the form x^{\nu} K_{\nu}(x), where K_{\nu} is the incomplete Bessel function of the third kind. This family of functions can describe the density profile, projected and integrated light profiles and the gravitational potentials of galaxies. For the proper choice of parameters, these functions accurately approximate Sersic functions over a range of indices and are good fits to galaxy light profiles. With an additional parameter corresponding to a galaxy core radius, these functions can fit galaxy like M87 over a factor of 100,000 in radius. Unlike Sersic profiles, these functions have simple analytical 2-dimensional and 3-dimensional Fourier transforms, so they are easily convolved with spatially varying point spread function and are well suited for photometric and lensing analysis. We use these functions to estimate the effects of seeing on lensing measurements and show that high S/N measurements, even when the PSF is larger than the galaxy effective radius, should be able to recover accurate estimates of lensing distortions by weighting light in the outer isophotes that are less effected by seeing

Analysis of Herpes Simplex Virus-Specific T Cells in the Murine Female Genital Tract Following Genital Infection with Herpes Simplex Virus Type 2

AbstractA murine model of genital infection with a thymidine kinase-deficient (tk-) strain of herpes simplex virus type 2 (HSV-2) was utilized to examine the development of the local T cell response in the genital mucosa and draining genital lymph nodes (gLN). HSV-specific cytokine-secreting T cells were detected in the gLN 4 days postintravaginal inoculation but not in the urogenital tract or spleen until 5 days postinoculation, suggesting the cellular immune response originates in the gLN. More CD4+ than CD8+ gLN T cells were detected by flow cytometric analysis following primary vaginal inoculation and the majority of HSV-specific gLN T cells detected by ELISPOT were CD4+ and Th1-like based on secretion of IFNγ and not IL-4 or IL-5. A similar population of HSV-specific memory T cells persisted in the genital tract 2 months following HSV-2 tk- genital inoculation. These data suggest that the urogenital cellular immune response elicited in mice following genital inoculation with HSV-2 tk- is predominantly CD4+ and Th1-like, resembling that observed in humans. The results of this study are important for the rational design of vaccines capable of inducing protective immunity in the genital tract

Responsiveness of the PROMIS and its Concurrent Validity with Other Region- and Condition-specific PROMs in Patients Undergoing Carpal Tunnel Release

Background The Patient-reported Outcome Measurement Information System (PROMIS) continues to be an important universal patient-reported outcomes measure (PROM) in orthopaedic surgery. However, there is concern about the performance of the PROMIS as a general health questionnaire in hand surgery compared with the performance of region- and condition-specific PROMs such as the Michigan Hand Questionnaire (MHQ) and the Boston Carpal Tunnel Questionnaire (BCTQ), respectively. To ensure that PROMIS domains capture patient-reported outcomes to the same degree as region- and condition-specific PROMs do, comparing PROM performance is necessary. Questions/purposes (1) Which PROMs demonstrate high responsiveness among patients undergoing carpal tunnel release (CTR)? (2) Which of the PROMIS domains (Physical Function [PF], Upper Extremity [UE], and Pain Interference [PI]) demonstrate concurrent validity with the HHQ and BCTQ domains? Methods In this prospective study, between November 2014 and October 2016, patients with carpal tunnel syndrome visiting a single surgeon who elected to undergo CTR completed the BCTQ, MHQ, and PROMIS UE, PF, and PI domains at each visit. A total of 101 patients agreed to participate. Of these, 31 patients (31%) did not return for a followup visit at least 6 weeks after CTR and were excluded, leaving a final sample of 70 patients (69%). We compared the PROMIS against region- and condition-specific PROMs in terms of responsiveness and concurrent validity. Responsiveness was determined using Cohen’s d or the effect-size index (ESI). The larger the absolute value of the ESI, the greater the effect size. Using the ESI allows surgeons to better quantify the impact of CTR, with a medium ESI (that is, 0.5) representing a visible clinical change to a careful observer. Concurrent validity was determined using Spearman’s correlation coefficient with correlation strengths categorized as excellent (\u3e 0.7), excellent-good (0.61-0.70), good (0.4-0.6), and poor (\u3c 0.4). Significance was set a priori at p \u3c 0.05. Results Among PROMIS domains, the PI demonstrated the best responsiveness (ESI = 0.74; 95% CI, 0.39-1.08), followed by the UE (ESI = -0.66; 95% CI, -1.00 to -0.31). For the MHQ, the Satisfaction domain had the largest effect size (ESI = -1.48; 95% CI, -1.85 to -1.09), while for the BCTQ, the Symptom Severity domain had the best responsiveness (ESI = 1.54; 95% CI, 1.14-1.91). The PROMIS UE and PI domains demonstrated excellent-good to excellent correlations to the total MHQ and BCTQ–Functional Status scores (preoperative UE to MHQ: ρ = 0.68; PI to MHQ: ρ = 0.74; UE to BCTQ–Functional Status: ρ = 0.74; PI to BCTQ–Functional Status: ρ = 0.67; all p \u3c 0.001), while the PROMIS PF demonstrated poor correlations with the same domains (preoperative PF to MHQ; ρ = 0.33; UE to BCTQ–Functional Status: ρ = 0.39; both p \u3c 0.01). Conclusions The PROMIS UE and PI domains demonstrated slightly worse responsiveness than the MHQ and BCTQ domains that was nonetheless acceptable. The PROMIS PF domain was unresponsive. All three PROMIS domains correlated with the MHQ and BCTQ, but the PROMIS UE and PI domains had notably stronger correlations to the MHQ and BCTQ domains than the PF domain did. We feel that the PROMIS UE and PI can be used to evaluate the clinical outcomes of patients undergoing CTR, while also providing more robust insight into overall health status because they are general PROMs. However, we do not recommend the PROMIS PF for evaluating patients undergoing CTR. Level of Evidence Level II, diagnostic study

Pain Is the Primary Factor Associated With Satisfaction With Symptoms for New Patients Presenting to the Orthopedic Clinic

PURPOSE: The purpose of the current study was to (1) determine the percentage of new orthopedic patients reporting their symptoms to be acceptable at presentation, as measured by the Patient Acceptable Symptom State (PASS) question, and (2) evaluate whether patient-reported outcome measures (PROMs), including Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) or Upper Extremity, Pain Interference (PI), and Depression (D), or sociodemographic factors are associated with acceptable symptoms at presentation. METHODS: Between February 7, 2020, and March 16, 2020, new orthopedic patients who completed PROMs were identified. Patient records were reviewed for those who also completed the PASS question, a yes/no question about whether a patient\u27s current symptom state is satisfactory. Bivariate analysis was conducted to compare patient characteristics, such as area deprivation index (ADI), between those reporting acceptable symptoms and those who did not. Multivariable logistic regression models were used to determine factors associated with acceptable symptoms at presentation. RESULTS: A total of 570 patients were included, with one-fourth (n = 143 [25%]) reporting acceptable symptoms at presentation. In multivariable regression analysis, only pain, as measured by the PROMIS PI, was associated with acceptable symptoms at presentation (non-upper extremity patient regression: PROMIS PI: odds ratio [OR], 0.84; 95% confidence interval [CI], 0.79-0.90, P \u3c .01; upper extremity patient regression: PROMIS PI: OR, 0.91; 95% CI, 0.85-0.98, P \u3c .01). In both multivariable regression analyses, insurance type (private, Medicare, Medicaid, other), visit subspecialty (sports, hand, joints, foot and ankle, spine, other), PROMIS PF, PROMIS D, and national ADI were not associated with acceptable symptoms at presentation (all P \u3e .05). CONCLUSIONS: One-fourth of new orthopedic patients reported their symptoms to be acceptable at presentation. Of those who considered their symptom state unsatisfactory, pain-not functional status, mental health, or sociodemographic factors-was the primary determinant. LEVEL OF EVIDENCE: Level III, diagnostic

When do Patients Achieve PROMIS Milestones Following Anterior Cruciate Ligament Reconstruction?

National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive test (CAT) assessments have become increasingly utilized within sports medicine due to their efficient administration and favorable correlation with traditional patient reported outcome measures (PROMs). One key advantage of CAT forms is the ability to draw from hundreds of item bank questions while utilizing very few questions in order to produce an accurate quantitative health measurement for the patient. The Computer Adaptive Tests (CAT) algorithm assigns questions based on previous answers by the patient. The purpose of this study is to utilize this feature of the PROMIS PF CAT questionnaire to determine at which point during their recovery a patient is able to reach certain milestones and to elucidate the number of days – in increments of 30 (i.e., monthly) – it takes for patients who undergo ACL surgery to answer “with some difficulty” or “without any difficulty” for the five most frequently asked questions in the PROMIS PF CAT questionnaire. Understanding these timepoints will directly aid in clinical counseling and monitoring following surgery and provide an objective, quantitative bases for appropriate activity restriction and progression. All patients who underwent ACLR by one of two sports medicine fellowship-trained orthopedic surgeons between 5/1/17 and 7/29/19 were included in this study. Post-operative PROMIS PF scores were reviewed with respect to individual item, response, and timing of response (with respect to number of days following surgery using 30-day increments). For each PROMIS PF CAT item, the following five answer choices were available: “Without any difficulty”, “With a little difficulty”, “With some difficulty”, “With much difficulty”, and “Unable to do”. A task was considered achievable if the patient answered any answer with “Without any difficulty” or “With a little difficulty”. The percentage of patients in each 30-day group who answered with either of these responses was recorded. Chi-square tests were run between the number of days postoperatively the surveys were administered and patient responses to determine whether or not there were statistically significant differences between groups. A total of 2,822 patient responses (284 patients) were included in the final analysis with an average number of days postoperatively the surveys were administered of 72 and a standard deviation of 192.4. The five most frequently asked questions along with the percent of patients achieving these milestones were found to be: “Does your health now limit you in doing two hours of physical labor?” (n=966), “Does your health now limit you in doing yard work like raking leaves, weeding, or pushing a lawn mower?” (n=647), “Does your health now limit you in hiking a couple of miles (3km) on uneven surfaces, including hills?” (n=459), “Are you able to do chores such as vacuuming or yard work?” (n=442), and “Does your health now limit you in walking more than a mile (1.6km)?” (n=308). The times at which greater than 50% of respondents answered either “Without any difficulty” or “With a little difficulty” are shown in Table 1. All five questions showed statistically significant associations between number of days postoperatively and patient responses (p On average, patients undergoing ACLR achieved milestones measured by the five most commonly asked questions on the PROMIS PF CAT by 2-4 months postoperatively. Patients also showed significant improvements in physical function over the same time span. These findings can be incorporated into post-operative monitoring, and patients who fail to achieve these milestones in the appropriate timepoints may require additional investigation or rehabilitation

Do Patient Sociodemographic Factors Impact the PROMIS Scores Meeting the Patient-Acceptable Symptom State at the Initial Point of Care in Orthopaedic Foot and Ankle Patients?

Background Patient-reported outcome measures such as the Patient-Reported Outcomes Measurement Information System (PROMIS) allow surgeons to evaluate the most important outcomes to patients, including function, pain, and mental well-being. However, PROMIS does not provide surgeons with insight into whether patients are able to successfully cope with their level of physical and/or mental health limitations in day-to-day life; such understanding can be garnered using the Patient-acceptable Symptom State (PASS). It remains unclear whether or not the PASS status for a given patient and his or her health, as evaluated by PROMIS scores, differs based on sociodemographic factors; if it does, that could have important implications regarding interpretation of outcomes and fair delivery of care. Questions/purposes In a tertiary-care foot and ankle practice, (1) Is the PASS associated with sociodemographic factors (age, gender, race, ethnicity, and income)? (2) Do PROMIS Physical Function (PF), Pain Interference (PI), and Depression scores differ based on income level? (3) Do PROMIS PF, PI, and Depression thresholds for the PASS differ based on income level? Methods In this retrospective analysis of longitudinally obtained data, all patients with foot and ankle conditions who had new-patient visits (n = 2860) between February 2015 and December 2017 at a single tertiary academic medical center were asked to complete the PROMIS PF, PI, and Depression survey and answer the following single, validated, yes/no PASS question: “Taking into account all the activity you have during your daily life, your level of pain, and also your functional impairment, do you consider that the current state of your foot and ankle is satisfactory?” Of the 2860 new foot and ankle patient visits, 21 patient visits (0.4%) were removed initially because all four outcome measures were not completed. An additional 225 patient visits (8%) were removed because the patient chart did not contain enough information to accurately geocode them; 15 patients visits (0.5%) were removed because the census block group median income data were not available. Lastly, two patient visits (0.1%) were removed because they were duplicates. This left a total of 2597 of 2860 possible patients (91%) in our study sample who had completed all three PROMIS domains and answered the PASS question. Patient sociodemographic factors such as age, gender, race, and ethnicity were recorded. Using census block groups as part of a geocoding method, the income bracket for each patient was recorded. A chi-square analysis was used to determine whether sociodemographic factors were associated with different PASS rates, two-way ANOVA analyses with pairwise comparisons were used to determine if PROMIS scores differed by income bracket, and a receiver operating characteristic (ROC) curve analysis was performed to determine PASS thresholds for the PROMIS score by income bracket. The minimum clinically important difference (MCID) for PROMIS PF in the literature in foot and ankle patients ranges from about 7.9 to 13.2 using anchor-based approaches and 4.5 to 4.7 using the ½ SD, distribution-based method. The MCID for PROMIS PI in the literature in foot and ankle patients ranges from about 5.5 to 12.4 using anchor-based approaches and about 4.1 to 4.3 using the ½ SD, distribution-based method. Both were considered when evaluating our findings. Such MCID cutoffs for PROMIS Depression are not as well established in the foot and ankle literature. Significance was set a priori at p \u3c 0.05. Results The only sociodemographic factor associated with differences in the proportion of patients achieving PASS was age (15% [312 of 2036] of patients aged 18-64 years versus 11% [60 of 561] of patients aged ≥ 65 years; p = 0.006). PROMIS PF (45 ± 10 for the ≥ USD 100,000 bracket versus 40 ± 10 for the ≤ USD 24,999 bracket, mean difference 5 [95% CI 3 to 7]; p \u3c 0.001), PI (57 ± 8 for ≥ USD 100,000 versus 63 ± 7 for ≤ USD 24,999, mean difference -6 [95% CI -7 to -4]; p \u3c 0.001), and Depression (46 ± 8 for the ≥ USD 100,000 bracket versus 51 ± 11 for ≤ USD 24,999, mean difference -5 [95% CI -7 to -3]; p \u3c 0.001) scores were better for patients in the highest income bracket compared with those in the lowest income bracket. For PROMIS PF, the difference falls within the score change range deemed clinically important when using a ½ SD, distribution-based approach but not when using an anchor-based approach; however, the score difference for PROMIS PI falls within the score change range deemed clinically important for both approaches. The PASS threshold of the PROMIS PF for the highest income bracket was near the mean for the US population (49), while the PASS threshold of the PROMIS PF for the lowest income bracket was more than one SD below the US population mean (39). Similarly, the PASS threshold of the PROMIS PI differed by 6 points when the lowest and highest income brackets were compared. PROMIS Depression was unable to discriminate the PASS. Conclusions Discussions about functional and pain goals may need to be a greater focus of clinic encounters in the elderly population to ensure that patients understand the risks and benefits of given treatment options at their advanced age. Further, when using PASS in clinical encounters to evaluate patient satisfaction and the ability to cope at different symptom and functionality levels, surgeons should consider income status and its relationship to PASS. This knowledge may help surgeons approach patients with a better idea of patient expectations and which level of symptoms and functionality is satisfactory; this information can assist in ensuring that each patient’s health goal is included in shared decision-making discussions. A better understanding of why patients with different income levels are satisfied and able to cope at different symptom and functionality levels is warranted and may best be accomplished using an epidemiologic survey approach. Level of Evidence Level III, diagnostic study

Dehydration mechanism of a small molecular solid: 5-nitrouracil hydrate

Previous studies of the dehydration of 5-nitrouracil (5NU) have resulted in it being classified as a ‘‘channel hydrate’’ in which dehydration proceeds principally by the exit of the water molecules along channels in the structure. We have re-examined this proposal and found that in fact there are no continuous channels in the 5NU structure that would contribute to such a mechanism. Product water molecules would be immediately trapped in unlinked voids in the crystal structure and would require some additional mechanism to break loose from the crystal. Through a detailed structural analysis of the macro and micro structure of the 5NU as it dehydrates, we have developed a model for the dehydration process based on the observed development of structural defects in the 5NU crystal and the basic crystallography of the material. The model was tested against standard kinetic measurements and found to present a satisfactory account of kinetic observations, thus defining the mechanism. Overall, the study shows the necessity of complementing standard kinetic studies with a parallel macro and micro examination of the dehydrating material when evaluating the mechanisms of dehydration and decomposition processes

Preoperative PROMIS Scores Predict Postoperative PROMIS Score Improvement for Patients Undergoing Hand Surgery

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) can be used alongside preoperative patient characteristics to set postsurgery expectations. This study aimed to analyze whether preoperative scores can predict significant postoperative PROMIS score improvement. Methods: Patients undergoing hand and wrist surgery with initial and greater than 6-month follow-up PROMIS scores were assigned to derivation or validation cohorts, separating trauma and nontrauma conditions. Receiver operating characteristic curves were calculated for the derivation cohort to determine whether preoperative PROMIS scores could predict postoperative PROMIS score improvement utilizing minimal clinically important difference principles. Results: In the nontrauma sample, patients with baseline Physical Function (PF) scores below 31.0 and Pain Interference (PI) and Depression scores above 68.2 and 62.2, respectively, improved their postoperative PROMIS scores with 95%, 96%, and 94% specificity. Patients with baseline PF scores above 52.1 and PI and Depression scores below 49.5 and 39.5, respectively, did not substantially improve their postoperative PROMIS scores with 94%, 93%, and 96% sensitivity. In the trauma sample, patients with baseline PF scores below 34.8 and PI and Depression scores above 69.2 and 62.2, respectively, each improved their postoperative PROMIS scores with 95% specificity. Patients with baseline PF scores above 52.1 and PI and Depression scores below 46.6 and 44.0, respectively, did not substantially improve their postoperative scores with 95%, 94%, and 95% sensitivity. Conclusions: Preoperative PROMIS PF, PI, and Depression scores can predict postoperative PROMIS score improvement for a select group of patients, which may help in setting expectations. Future work can help determine the level of true clinical improvement these findings represent