Shelf arthroplasties long-term outcome: Influence of labral tears. A prospective study at a minimal 16 years’ follows up

SummaryIntroductionOsteoarthritis lesions extent and dysplasia severity (negative vertical center edge [CE] angle) are recognized as unfavorable criteria for the survival of shelf arthroplasties performed for correcting hip dysplasia. Labral tears have recently been described on dysplastic hips, indicating beginning osteoarthritis and worsening the risk of instability.HypothesisThe labral tears identified in the course of shelf arthroplasty procedures for correction of hip dysplasia carry a predictive value for the survival of this operation.ObjectivesEvaluate this hypothesis at the intermediate term in a long-term prospective observational study.Patient and methodsEighteen adult patients (18 dysplastic hips) having undergone shelf arthroplasty were included consecutively in a continuous prospective study. At the time the shelf arthroplasty was performed, a hip arthroscopic exam was carried out to search for and resect a labral tear if necessary. Fifteen patients were reviewed with a minimum follow-up of 16 years. Two patients died and one patient was lost to follow-up.ResultsDuring arthroscopic exploration, 10 hips presented labral tears (55.6%). At a mean follow-up of 16.3 years (range, 16–18 years), eight hips underwent hip arthroplasty. Of these hips, only one did not present a labral tear. The seven other hips had a tear of the labrum (p<0.001). The overall survival rate was 41.3%; it was 83.3% for hips with no labral tear and 15.2% for hips with a lesion of the labrum (p=0.048).Discussion and conclusionLabral tears had a negative impact on the outcome of shelf arthroplasty for hip dysplasia. This lesion therefore warrants being sought using appropriate exploration techniques (MRI or CT-arthrography) before shelf arthroplasty surgery. The existence of a preoperative labral tear does not seem to cast doubt on shelf arthroplasty itself. However, it should be identified so as to set objectives and expectations: long-term survival is significantly lower in the presence of a labral tear. It seems preferable to repair this type of lesion with arthroscopic guidance during shelf arthroplasty to prevent a potential source of residual pain, keeping in mind that secondary resection will be more difficult after covering the lesion.Level of evidenceLevel 3 prospective observational prognostic study

Disrupted Maturation of the Microbiota and Metabolome among Extremely Preterm Infants with Postnatal Growth Failure

Growth failure during infancy is a major global problem that has adverse effects on long-term health and neurodevelopment. Preterm infants are disproportionately affected by growth failure and its effects. Herein we found that extremely preterm infants with postnatal growth failure have disrupted maturation of the intestinal microbiota, characterized by persistently low diversity, dominance of pathogenic bacteria within the Enterobacteriaceae family, and a paucity of strictly anaerobic taxa including Veillonella relative to infants with appropriate postnatal growth. Metabolomic profiling of infants with growth failure demonstrated elevated serum acylcarnitines, fatty acids, and other byproducts of lipolysis and fatty acid oxidation. Machine learning algorithms for normal maturation of the microbiota and metabolome among infants with appropriate growth revealed a pattern of delayed maturation of the microbiota and metabolome among infants with growth failure. Collectively, we identified novel microbial and metabolic features of growth failure in preterm infants and potentially modifiable targets for intervention

Implementation and evaluation of a transit dosimetry system for treatment verification

PURPOSE: To evaluate a formalism for transit dosimetry using a phantom study and prospectively evaluate the protocol on a patient population undergoing 3D conformal radiotherapy. METHODS: Amorphous silicon EPIDs were calibrated for dose and used to acquire images of delivered fields. The measured EPID dose map was back-projected using the planning CT images to calculate dose at pre-specified points within the patient using commercially available software, EPIgray (DOSIsoft, France). This software compared computed back-projected dose with treatment planning system dose. A series of tests were performed on solid water phantoms (linearity, field size effects, off-axis effects). 37 patients were enrolled in the prospective study. RESULTS: The EPID dose response was stable and linear with dose. For all tested field sizes the agreement was good between EPID-derived and treatment planning system dose in the central axis, with performance stability up to a measured depth of 18cm (agreement within -0.5% at 10cm depth on the central axis and within -1.4% at 2cm off-axis). 126 transit images were analysed of 37 3D-conformal patients. Patient results demonstrated the potential of EPIgray with 91% of all delivered fields achieved the initial set tolerance level of ΔD of 0±5-cGy or %ΔD of 0±5%. CONCLUSIONS: The in vivo dose verification method was simple to implement, with very few commissioning measurements needed. The system required no extra dose to the patient, and importantly was able to detect patient position errors that impacted on dose delivery in two of cases

Propagation en contexte arrière-arc : premiers résultats de la campagne ProFeTi (Bassin Nord-Fidjien, Pacifique SW)

Au centre du bassin Nord-Fidjien, le segment d'accrétion NS, qui se propage vers le Nord aux dépens du segment N15 depuis au moins 1 Ma, a été échantillonné pendant la campagne ProFeTi du NO Alis. Malgré sa position arrière-arc, aucune contamination géochimique caractéristique d'une subduction n'est perceptible. L'échantillonnage étudié montre que les réservoirs magmatiques de ce segment en propagation évoluent dans une perpétuelle dynamique de recherche d'équilibre thermique et chimique, perturbée par les actions conjuguées suivantes : l'éloignement de la pointe du propagateur par rapport aux zones de réalimentations focalisées sous le centre du segment, des réalimentations successives par des liquides primitifs évoluant avec l'état de maturité du propagateur, et un effet de paroi froide provenant du segment N15, dans lequel la lithosphère de la pointe du segment NS se propage. (Résumé d'auteur

Complete Genome Characterization of Eight Human Parainfluenza Viruses from the Netherlands.

We report the complete genome sequences of eight human parainfluenza viruses (HPIV) belonging to Human respirovirus 1 (HPIV-1), Human respirovirus 3 (HPIV-3), Human rubulavirus 2 (HPIV-2), and Human rubulavirus 4 (HPIV-4). The genome sequences were generated using random-primed next-generation sequencing and represent the first HPIV full-genome sequences from the Netherlands

Unconfined Specimens

ABSTRACT: Effective diffusion coefficients, D*, of chloride and zinc diffusing in saturated, unconfined specimens of a compacted sandclay mixture are measured for three specimen lengths, L (2.91, 5.83, and 11.60 cm) and three test durations (7, 14, and 21 days). For a specimen length of 2.91 cm, both the chloride and zinc D* values tend to decrease with increasing test duration, possibly due to the measurement of concentration-dependent D* values. For a 14-day test duration, no consistent trend in D* with specimen length is observed, but the overall effect of specimen length on D* is minor relative to the range of measured D* values. A 21-day test duration provides the best correlation between the D* values based on reservoir concentrations, DiScs, and the D* values based on soil concentrations, D~oil, for chloride for a given test regardless of the specimen length. The effect of test duration on the correlation between D~cs and D~oit for zinc is minor based on the relatively narrow range of measured zinc D* values. The observed effects of specimen length on the correlation between D~¢s and D~oil for a given test are consistent with the more uniform final porosity distributions in the shorter specimens and the contrasting effects of the non-linear distributions in porosity and dry density that become less significant as the specimen length increases. KEYWORDS: adsorption, attapulgite clay, batch equilibrium, chloride diffusion, contaminant transport, diffusion testing, Freundlich isotherm, sand-clay mixture, swelling, zinc diffusion Over the past -30 years, diffusion testing has been performed in several different disciplines (e.g., soil science, geology, oceanography, geotechnical engineering) for several different purposes, including diffusion of nutrients to plant roots (Olsen and Kemper 1968), characterization of pore water in geologic deposits Several different types of diffusion testing procedures can be used, test durations have ranged from a few hours to several months, and the specimen volumes have ranged from as small as 10 cm 3 to more than 944 cm 3 (Shacketford 1991). Practical limitations to some, if not all, of the different test methods undoubtedly exist, and variability in test duration and specimen size may have an effect on determination of the measured diffusion coefficients. As a result, an evaluation of the factors potentially affecting the measurement of effective diffusion coefficients is needed. Such an evaluation is particularly of interest to geotechnical engineers associated with the design and evaluation of waste containment barriers because of the increasing importance placed on contaminant transport, in general, and diffusive transport, in particular, in such applications. The primary objective of this study is to evaluate the potential influence of test duration and specimen length on the diffusion of chloride and zinc in compacted, unconfined specimens of a sandclay mixture. The evaluation is based on the single reservoir, decreasing source concentration method that has been used extensively in the measurement of effective diffusion coefficients associated with waste disposal applications Materials and Methods Soil The soil used in this study is a mixture of 75% sand and 25% attapulgite clay (dry weight basis). Physical and chemical properties of the sand and attapulgite clay are provided i

Prolonged duration of early antibiotic therapy in extremely premature infants.

BackgroundProlonged early antibiotics in extremely premature infants may have negative effects. We aimed to assess prevalence and outcomes of provision of prolonged early antibiotics to extremely premature infants in the absence of culture-confirmed infection or NEC.MethodsCohort study of infants from 13 centers born without a major birth defect from 2008-2014 who were 401-1000 grams birth weight, 22-28 weeks gestation, and survived ≥5 days without culture-confirmed infection, NEC, or spontaneous intestinal perforation. We determined the proportion of infants who received prolonged early antibiotics, defined as ≥5 days of antibiotic therapy started at ≤72 h of age, by center and over time. Associations between prolonged early antibiotics and adverse outcomes were assessed using multivariable logistic regression.ResultsA total of 5730 infants were included. The proportion of infants receiving prolonged early antibiotics varied from 30-69% among centers and declined from 49% in 2008 to 35% in 2014. Prolonged early antibiotics was not significantly associated with death (adjusted odds ratio 1.17 [95% CI: 0.99-1.40], p = 0.07) and was not associated with NEC.ConclusionsThe proportion of extremely premature infants receiving prolonged early antibiotics decreased, but significant center variation persists. Prolonged early antibiotics were not significantly associated with increased odds of death or NEC

How Oxygen Availability Affects the Antimicrobial Efficacy of Host Defense Peptides: Lessons Learned from Studying the Copper-Binding Peptides Piscidins 1 and 3

The development of new therapeutic options against Clostridioides difficile (C. difficile) infection is a critical public health concern, as the causative bacterium is highly resistant to multiple classes of antibiotics. Antimicrobial host-defense peptides (HDPs) are highly effective at simultaneously modulating the immune system function and directly killing bacteria through membrane disruption and oxidative damage. The copper-binding HDPs piscidin 1 and piscidin 3 have previously shown potent antimicrobial activity against a number of Gram-negative and Gram-positive bacterial species but have never been investigated in an anaerobic environment. Synergy between piscidins and metal ions increases bacterial killing aerobically. Here, we performed growth inhibition and time-kill assays against C. difficile showing that both piscidins suppress proliferation of C. difficile by killing bacterial cells. Microscopy experiments show that the peptides accumulate at sites of membrane curvature. We find that both piscidins are effective against epidemic C. difficile strains that are highly resistant to other stresses. Notably, copper does not enhance piscidin activity against C. difficile. Thus, while antimicrobial activity of piscidin peptides is conserved in aerobic and anaerobic settings, the peptide–copper interaction depends on environmental oxygen to achieve its maximum potency. The development of pharmaceuticals from HDPs such as piscidin will necessitate consideration of oxygen levels in the targeted tissue