638 research outputs found
A validation of the Nottingham Clavicle Score: a clavicle, acromioclavicular joint and sternoclavicular jointâspecific patient-reported outcome measure
Background
Patients with acromioclavicular joint (ACJ) and sternoclavicular joint (SCJ) injuries and with clavicle fractures are typically younger and more active than those with other shoulder pathologies. We developed the Nottingham Clavicle Score (NCS) specifically for this group of patients to improve sensitivity for assessing the outcomes of treatment of these conditions compared with the more commonly used Constant Score (CS) and Oxford Shoulder Score (OSS).
Materials and methods
This was a cohort study in which the preoperative and 6-month postoperative NCS evaluations of outcome in 90 patients were compared with the CS, OSS, Imatani Score (IS), and the EQ-5D scores. Reliability was assessed using the Cronbach α. Reproducibility of the NCS was assessed using the test/retest method. Effect sizes were calculated for each score to assess sensitivity to change. Validity was examined by correlations between the NCS and the CS, OSS, IS, and EQ-5D scores obtained preoperatively and postoperatively.
Results
Significant correlations were demonstrated preoperatively with the OSS (Pâ=â.025) and all subcategories of the EQ-5D (Pâ<â.05) and postoperatively with the OSS (Pâ<â.001), CS (Pâ=â.008), IS (Pâ<â.001), and all subcategories of EQ-5D (Pâ<â.02). The NCS had the largest effect size (1.92) of the compared scores. Internal consistency was excellent (Cronbach αâ=â0.87).
Conclusion
The NCS has been proven to be a valid, reliable and sensitive outcome measure that accurately measures the level of function and disability in the ACJ, SCJ and clavicle after traumatic injury and in degenerative disease
Unusual raptor nests around the world
From surveys in many countries, we report using unusual nesting materials (e.g., paper money, rags, metal, antlers, and large bones) and unusual nesting situations. For example, we documented nests of Steppe Eagles [Aquila nipalensis] and Upland Buzzards [Buteo hemilasius] on the ground beside well-traveled roads, Saker Falcon [Falco cherrug] eyries in attics and a cistern, and Osprey [Pandian haliaetus] nests on the masts of boats and on a suspended automobile. Other records include a Golden Eagle [A. chrysaelos] nest 7.0 m in height, believed to be the tallest nest ever described, and, for the same species, we report nesting in rudimentary, nests. Some nest sites are within a Few meters of known predators or competitors. These unusual observations may be important in revealing the plasticity of a species' behavioral repertoire
The Multi-Object, Fiber-Fed Spectrographs for SDSS and the Baryon Oscillation Spectroscopic Survey
We present the design and performance of the multi-object fiber spectrographs
for the Sloan Digital Sky Survey (SDSS) and their upgrade for the Baryon
Oscillation Spectroscopic Survey (BOSS). Originally commissioned in Fall 1999
on the 2.5-m aperture Sloan Telescope at Apache Point Observatory, the
spectrographs produced more than 1.5 million spectra for the SDSS and SDSS-II
surveys, enabling a wide variety of Galactic and extra-galactic science
including the first observation of baryon acoustic oscillations in 2005. The
spectrographs were upgraded in 2009 and are currently in use for BOSS, the
flagship survey of the third-generation SDSS-III project. BOSS will measure
redshifts of 1.35 million massive galaxies to redshift 0.7 and Lyman-alpha
absorption of 160,000 high redshift quasars over 10,000 square degrees of sky,
making percent level measurements of the absolute cosmic distance scale of the
Universe and placing tight constraints on the equation of state of dark energy.
The twin multi-object fiber spectrographs utilize a simple optical layout
with reflective collimators, gratings, all-refractive cameras, and
state-of-the-art CCD detectors to produce hundreds of spectra simultaneously in
two channels over a bandpass covering the near ultraviolet to the near
infrared, with a resolving power R = \lambda/FWHM ~ 2000. Building on proven
heritage, the spectrographs were upgraded for BOSS with volume-phase
holographic gratings and modern CCD detectors, improving the peak throughput by
nearly a factor of two, extending the bandpass to cover 360 < \lambda < 1000
nm, and increasing the number of fibers from 640 to 1000 per exposure. In this
paper we describe the original SDSS spectrograph design and the upgrades
implemented for BOSS, and document the predicted and measured performances.Comment: 43 pages, 42 figures, revised according to referee report and
accepted by AJ. Provides background for the instrument responsible for SDSS
and BOSS spectra. 4th in a series of survey technical papers released in
Summer 2012, including arXiv:1207.7137 (DR9), arXiv:1207.7326 (Spectral
Classification), and arXiv:1208.0022 (BOSS Overview
The PTF Orion Project: a Possible Planet Transiting a T-Tauri Star
We report observations of a possible young transiting planet orbiting a
previously known weak-lined T-Tauri star in the 7-10 Myr old Orion-OB1a/25-Ori
region. The candidate was found as part of the Palomar Transient Factory (PTF)
Orion project. It has a photometric transit period of 0.448413 +- 0.000040
days, and appears in both 2009 and 2010 PTF data. Follow-up low-precision
radial velocity (RV) observations and adaptive optics imaging suggest that the
star is not an eclipsing binary, and that it is unlikely that a background
source is blended with the target and mimicking the observed transit. RV
observations with the Hobby-Eberly and Keck telescopes yield an RV that has the
same period as the photometric event, but is offset in phase from the transit
center by approximately -0.22 periods. The amplitude (half range) of the RV
variations is 2.4 km/s and is comparable with the expected RV amplitude that
stellar spots could induce. The RV curve is likely dominated by stellar spot
modulation and provides an upper limit to the projected companion mass of M_p
sin i_orb < 4.8 +- 1.2 M_Jup; when combined with the orbital inclination, i
orb, of the candidate planet from modeling of the transit light curve, we find
an upper limit on the mass of the planetary candidate of M_p < 5.5 +- 1.4
M_Jup. This limit implies that the planet is orbiting close to, if not inside,
its Roche limiting orbital radius, so that it may be undergoing active mass
loss and evaporation.Comment: Corrected typos, minor clarifications; minor updates/corrections to
affiliations and bibliography. 35 pages, 10 figures, 3 tables. Accepted to
Ap
'To live and die [for] Dixie': Irish civilians and the Confederate States of America
Around 20,000 Irishmen served in the Confederate army in the Civil War. As a result, they left behind, in various Southern towns and cities, large numbers of friends, family, and community leaders. As with native-born Confederates, Irish civilian support was crucial to Irish participation in the Confederate military effort. Also, Irish civilians served in various supporting roles: in factories and hospitals, on railroads and diplomatic missions, and as boosters for the cause. They also, however, suffered in bombardments, sieges, and the blockade. Usually poorer than their native neighbours, they could not afford to become 'refugees' and move away from the centres of conflict. This essay, based on research from manuscript collections, contemporary newspapers, British Consular records, and Federal military records, will examine the role of Irish civilians in the Confederacy, and assess the role this activity had on their integration into Southern communities. It will also look at Irish civilians in the defeat of the Confederacy, particularly when they came under Union occupation. Initial research shows that Irish civilians were not as upset as other whites in the South about Union victory. They welcomed a return to normalcy, and often 'collaborated' with Union authorities. Also, Irish desertion rates in the Confederate army were particularly high, and I will attempt to gauge whether Irish civilians played a role in this. All of the research in this paper will thus be put in the context of the Drew Gilpin Faust/Gary Gallagher debate on the influence of the Confederate homefront on military performance. By studying the Irish civilian experience one can assess how strong the Confederate national experiment was. Was it a nation without a nationalism
An Evolutionarily Conserved Function of Polycomb Silences the MHC Class I Antigen Presentation Pathway and Enables Immune Evasion in Cancer.
Loss of MHC class I (MHC-I) antigen presentation in cancer cells can elicit immunotherapy resistance. A genome-wide CRISPR/Cas9 screen identified an evolutionarily conserved function of polycomb repressive complex 2 (PRC2) that mediates coordinated transcriptional silencing of the MHC-I antigen processing pathway (MHC-I APP), promoting evasion of TÂ cell-mediated immunity. MHC-I APP gene promoters in MHC-I low cancers harbor bivalent activating H3K4me3 and repressive H3K27me3 histone modifications, silencing basal MHC-I expression and restricting cytokine-induced upregulation. Bivalent chromatin at MHC-I APP genes is a normal developmental process active in embryonic stem cells and maintained during neural progenitor differentiation. This physiological MHC-I silencing highlights a conserved mechanism by which cancers arising from these primitive tissues exploit PRC2 activity to enable immune evasion.Cancer Research UK Clinician Scientist Fellowship C53779/A20097 (M.L.B), Leukaemia Foundation Australia Senior Fellowship and Howard Hughes Medical Institute International Research Scholarship 55008729 (M.A.D), Peter and Julie Alston Centenary fellowship (K.D.S.), Wellcome Trust Principal Research Fellowship 101835/Z/13/Z (P.J.L), Peter MacCallum Postgraduate Scholarship (C.E.S), NHMRC Postgraduate Scholarship (K.L.C.), Maddie Riewoldt's Vision 064728 (Y-C.C), Victorian Cancer Agency (E.Y.N.L), CSL Centenary fellowship (S-J.D), National Breast Cancer Foundation Fellowship ECF-17-005 (P.A.B.), Addenbrookeâs Charitable Trust and NIHR Cambridge BRC (M.L.B., P.J.L), NHMRC grant 1085015, 1106444 (M.A.D) and 1128984 (M.A.D, S-J.D)
Impact of Extended-Duration Shifts on Medical Errors, Adverse Events, and Attentional Failures
BACKGROUND: A recent randomized controlled trial in critical-care units revealed that the elimination of extended-duration work shifts (â„24 h) reduces the rates of significant medical errors and polysomnographically recorded attentional failures. This raised the concern that the extended-duration shifts commonly worked by interns may contribute to the risk of medical errors being made, and perhaps to the risk of adverse events more generally. Our current study assessed whether extended-duration shifts worked by interns are associated with significant medical errors, adverse events, and attentional failures in a diverse population of interns across the United States. METHODS AND FINDINGS: We conducted a Web-based survey, across the United States, in which 2,737 residents in their first postgraduate year (interns) completed 17,003 monthly reports. The association between the number of extended-duration shifts worked in the month and the reporting of significant medical errors, preventable adverse events, and attentional failures was assessed using a case-crossover analysis in which each intern acted as his/her own control. Compared to months in which no extended-duration shifts were worked, during months in which between one and four extended-duration shifts and five or more extended-duration shifts were worked, the odds ratios of reporting at least one fatigue-related significant medical error were 3.5 (95% confidence interval [CI], 3.3â3.7) and 7.5 (95% CI, 7.2â7.8), respectively. The respective odds ratios for fatigue-related preventable adverse events, 8.7 (95% CI, 3.4â22) and 7.0 (95% CI, 4.3â11), were also increased. Interns working five or more extended-duration shifts per month reported more attentional failures during lectures, rounds, and clinical activities, including surgery and reported 300% more fatigue-related preventable adverse events resulting in a fatality. CONCLUSIONS: In our survey, extended-duration work shifts were associated with an increased risk of significant medical errors, adverse events, and attentional failures in interns across the United States. These results have important public policy implications for postgraduate medical education
The GALNT9, BNC1 and CCDC8 genes are frequently epigenetically dysregulated in breast tumours that metastasise to the brain.
Tumour metastasis to the brain is a common and deadly development in certain cancers; 18-30Â % of breast tumours metastasise to the brain. The contribution that gene silencing through epigenetic mechanisms plays in these metastatic tumours is not well understood
LSST: from Science Drivers to Reference Design and Anticipated Data Products
(Abridged) We describe here the most ambitious survey currently planned in
the optical, the Large Synoptic Survey Telescope (LSST). A vast array of
science will be enabled by a single wide-deep-fast sky survey, and LSST will
have unique survey capability in the faint time domain. The LSST design is
driven by four main science themes: probing dark energy and dark matter, taking
an inventory of the Solar System, exploring the transient optical sky, and
mapping the Milky Way. LSST will be a wide-field ground-based system sited at
Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m
effective) primary mirror, a 9.6 deg field of view, and a 3.2 Gigapixel
camera. The standard observing sequence will consist of pairs of 15-second
exposures in a given field, with two such visits in each pointing in a given
night. With these repeats, the LSST system is capable of imaging about 10,000
square degrees of sky in a single filter in three nights. The typical 5
point-source depth in a single visit in will be (AB). The
project is in the construction phase and will begin regular survey operations
by 2022. The survey area will be contained within 30,000 deg with
, and will be imaged multiple times in six bands, ,
covering the wavelength range 320--1050 nm. About 90\% of the observing time
will be devoted to a deep-wide-fast survey mode which will uniformly observe a
18,000 deg region about 800 times (summed over all six bands) during the
anticipated 10 years of operations, and yield a coadded map to . The
remaining 10\% of the observing time will be allocated to projects such as a
Very Deep and Fast time domain survey. The goal is to make LSST data products,
including a relational database of about 32 trillion observations of 40 billion
objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures
available from https://www.lsst.org/overvie
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