Hip kinematics and kinetics in total hip replacement patients stratified by age and functional capacity

To examine functional differences in total hip replacement patients (THR) when stratified either by age or by functional ability as defined by self-selected walking speed. THR patients and a control group underwent three-dimensional motion analysis under self-selected normal and fast walking conditions. Patients were stratified into five age groups for comparison with existing literature. The THR cohort was also stratified into three functional groups determined by their self-selected gait speed (low function 1S.D; normal function within 1S.D). Hip kinematics, ground reaction forces, joint moments and joint powers in all three planes (x-y-z) were analysed. 137 THR and 27 healthy control patients participated. When stratified by age, during normal walking the youngest two age groups walked quicker than the oldest two groups (p<0.0001) but between-group differences were not consistent across age strata. The differences were diminished under the fast walking condition. When stratified by function, under normal walking conditions, the low function and normal function THR groups had a reduced extension angle (mean=1.75°, SD=±7.75, 1.26°±7.42, respectively) compared to the control group (-6.07°±6.43; p<0.0001). The low function group had a reduced sagittal plane hip power (0.75watts/kg±0.24), reduced flexor (0.60Nm/kg±0.85) and extensor moment (0.51Nm/kg±0.17) compared to controls (p<0.0001). These differences persisted under the fast walking condition. There were systematic differences between patients when stratified by function, in both walking conditions. Age related differences were less systematic. Stratifying by biomechanical factors such as gait speed, rather than age, might be more robust for investigating functional differences

Accounting for variability in the detection and use of markers for simple and complex traits

There are many sources of variability in gene–phenotype associations. During the measurement of genotype and phenotype and during selection, researchers must deal with experimental error in trials; gene-gene interaction (epistasis) for sub-traits and observed traits; trait-trait interaction (pleiotropy) and gene- or genotype-by-environment interaction. These effects can be structured in a framework that allows simulation of the entire gene-environment ‘landscape’. Studies of these landscapes have been published by others. Here we aim to explain with simple examples some of the types of insights that can be made. A current challenge for breeders working with simple marker–phenotype associations is to design selection strategies that can rapidly create new combinations of multiple marker-based traits. For a real-world example in wheat, we have used simulation to show how gene enrichment during early generations (selection of homozygotes and heterozygotes with desirable alleles) can greatly reduce resource requirements when combining 9 genes into one genotype through marker-assisted selection. Another wheat example compares phenotypic and QTL-based selection for coleoptile length where the QTL also had a pleiotropic association with plant height. These simulations show the relative negative effects of either low heritability, or less than complete detection of QTL associated with traits. Finally, we revisit a marker-assisted selection (MAS) example whereby a QTL study is undertaken on a population for a complex trait, and then those QTL are used in selection. This process is subject to all sources of error described above. If the trait is complex, then interactions among sub-traits; between sub-traits and the environment; or between the chromosomal locations of controlling genes, create an extremely ‘rugged’ selection landscape that slows breeding progress. In this situation, a detailed understanding of some of these interactions is required if MAS is to be able to exceed the progress of conventional breedin

Guidance for Restarting Inflammatory Bowel Disease Therapy in Patients Who Withheld Immunosuppressant Medications During COVID-19

Patients with inflammatory bowel diseases [IBD] are frequently treated with immunosuppressant medications. During the coronavirus disease 2019 [COVID-19] pandemic, recommendations for IBD management have included that patients should stay on their immunosuppressant medications if they are not infected with the severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], but to temporarily hold these medications if symptomatic with COVID-19 or asymptomatic but have tested positive for SARS-CoV-2. As more IBD patients are infected globally, it is important to also understand how to manage IBD medications during convalescence while an individual with IBD is recovering from COVID-19. In this review, we address the differences between a test-based versus a symptoms-based strategy as related to COVID-19, and offer recommendations on when it is appropriate to consider restarting IBD therapy in patients testing positive for SARS-CoV-2 or with clinical symptoms consistent with COVID-19. In general, we recommend a symptoms-based approach, due to the current lack of confidence in the accuracy of available testing and the clinical significance of prolonged detection of virus via molecular testing

Maternal race and intergenerational preterm birth recurrence

Background Preterm birth is a complex disorder with a heritable genetic component. Studies of primarily White women born preterm show that they have an increased risk of subsequently delivering preterm. This risk of intergenerational preterm birth is poorly defined among Black women. Objective Our objective was to evaluate and compare intergenerational preterm birth risk among non-Hispanic Black and non-Hispanic White mothers. Study Design This was a population-based retrospective cohort study, using the Virginia Intergenerational Linked Birth File. All non-Hispanic Black and non-Hispanic White mothers born in Virginia 1960 through 1996 who delivered their first live-born, nonanomalous, singleton infant ≥20 weeks from 2005 through 2009 were included. We assessed the overall gestational age distribution between non-Hispanic Black and White mothers born term and preterm (<37 weeks) and their infants born term and preterm (<37 weeks) using Cox regression and Kaplan-Meier survivor functions. Mothers were grouped by maternal gestational age at delivery (term, ≥37 completed weeks; late preterm birth, 34-36 weeks; and early preterm birth, <34 weeks). The primary outcomes were: (1) preterm birth among all eligible births; and (2) suspected spontaneous preterm birth among births to women with medical complications (eg, diabetes, hypertension, preeclampsia and thus higher risk for a medically indicated preterm birth). Multivariable logistic regression was used to estimate odds of preterm birth and spontaneous preterm birth by maternal race and maternal gestational age after adjusting for confounders including maternal education, maternal age, smoking, drug/alcohol use, and infant gender. Results Of 173,822 deliveries captured in the intergenerational birth cohort, 71,676 (41.2%) women met inclusion criteria for this study. Of the entire cohort, 30.0% (n = 21,467) were non-Hispanic Black and 70.0% were non-Hispanic White mothers. Compared to non-Hispanic White mothers, non-Hispanic Black mothers were more likely to have been born late preterm (6.8% vs 3.7%) or early preterm (2.8 vs 1.0%), P <.001. Non-Hispanic White mothers who were born (early or late) preterm were not at an increased risk of early or late preterm delivery compared to non-Hispanic White mothers born term. The risk of early preterm birth was most pronounced for Black mothers who were born early preterm (adjusted odds ratio, 3.26; 95% confidence interval, 1.77–6.02) compared to non-Hispanic White mothers. Conclusion We found an intergenerational effect of preterm birth among non-Hispanic Black mothers but not non-Hispanic White mothers. Black mothers born <34 weeks carry the highest risk of delivering their first child very preterm. Future studies should elucidate the underlying pathways leading to this racial disparity

Interaction of two modulational instabilities in a semiconductor resonator

The interaction of two neighboring modulational instabilities in a coherently driven semiconductor cavity is investigated. First, an asymptotic reduction of the general equations is performed in the limit of a nearly vertical input-output characteristic. Next, a normal form is derived in the limit where the two instabilities are close to one other. An infinity of branches of periodic solutions are found to emerge from the unstable portion of the homogeneous branch. These branches have a nontrivial envelope in the bifurcation diagram that can either smoothly join the two instability points or form an isolated branch of solutions

Sequence specificity for uridylylation of the viral peptide linked to the genome (VPg) of enteroviruses

Bio-organic Synthesi

J/Psi Suppression in Heavy Ion Collisions at the CERN SPS

We reexamine the production of J/Psi and other charmonium states for a variety of target-projectile choices at the SPS. For this study we use a newly constructed cascade code LUCIFER II, which yields acceptable descriptions of both hard and soft processes, specifically Drell-Yan and hidden charm production, and soft energy loss and meson production, at the SPS. Glauber calculations of other authors are redone, and compared directly to the cascade results. The modeling of the charmonium states differs from that of earlier workers in its unified treatment of the hidden charm meson spectrum, which is introduced from the outset as a set of coupled states. The result is a description of the NA38 and NA50 data in terms of a conventional hadronic picture. The apparently anomalous suppression found in the most massive Pb+Pb system arises from three sources: destruction in the initial nucleon-nucleon cascade, use of coupled channels to exploit the larger breakup in the less bound Chi and Psi' states, and comover interaction in the final low energy phase.Comment: 36 pages (15 figures

Environment-Induced Decoherence and the Transition From Quantum to Classical

We study dynamics of quantum open systems, paying special attention to those aspects of their evolution which are relevant to the transition from quantum to classical. We begin with a discussion of the conditional dynamics of simple systems. The resulting models are straightforward but suffice to illustrate basic physical ideas behind quantum measurements and decoherence. To discuss decoherence and environment-induced superselection einselection in a more general setting, we sketch perturbative as well as exact derivations of several master equations valid for various systems. Using these equations we study einselection employing the general strategy of the predictability sieve. Assumptions that are usually made in the discussion of decoherence are critically reexamined along with the ``standard lore'' to which they lead. Restoration of quantum-classical correspondence in systems that are classically chaotic is discussed. The dynamical second law -it is shown- can be traced to the same phenomena that allow for the restoration of the correspondence principle in decohering chaotic systems (where it is otherwise lost on a very short time-scale). Quantum error correction is discussed as an example of an anti-decoherence strategy. Implications of decoherence and einselection for the interpretation of quantum theory are briefly pointed out.Comment: 80 pages, 7 figures included, Lectures given by both authors at the 72nd Les Houches Summer School on "Coherent Matter Waves", July-August 199