Anatomy and imaging of the equine metacarpophalangeal/metatarsophalangeal joint

The metacarpo-/metatarsophalangeal joint is a high motion joint and is therefore prone to be injured. Lameness attributable to the metacarpo-/metatarsophalangeal joint is a frequent cause of early retirement from athletic activity in horses and should therefore be detected as early as possible. The basis of the examination for lameness remains the clinical examination, including a complete motion examination in which the lameness is unambiguously localized by means of local anesthesia. A combination of radiography and ultrasonography is often sufficient for visualizing the lesions. However, in the absence of clear radiological or ultrasonographical findings, more advanced imaging modalities, such as computed tomography (CT) or magnetic resonance imaging (MRI), are necessary. The choice of technique largely depends on the tissue characteristics of the expected lesion, the cost restraints of the owner, and the willingness to take the risk of general anesthesia

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Impact of the economic recession on the European power sector’s CO2 emissions

This paper investigates the impact of the economic recession on CO2 emissions in the European power sector, during the years 2008 and 2009. Three main determinants of the power sector’s emissions are identified: the demand for electricity, the CO2 price, and fuel prices. A counterfactual scenario has been set up for each of these, i.e., what these parameters would have been if not affected by the recession. A simulation model of the European power sector is then employed, comparing a historical reference simulation (taking the parameters as actually occurred) with the counterfactual scenarios. The lower electricity demand (due to the recession) is shown to have by far the largest impact, accounting for an emission reduction of about 175 Mton. The lower CO2 price (due to the recession) resulted in an increase in emissions by about 30 Mton. The impact of fuel prices is more difficult to retrieve; an indicative reduction of about 17 Mton is obtained, mainly as a consequence of the low gas prices in 2009. The simulated combined impact of the parameters results in an emission reduction of about 150 Mton in the European power sector over the years 2008 and 2009 as a consequence of the recession

Impact of the economic recession on the European power sector's CO2 emissions

This paper investigates the impact of the economic recession on CO2 emissions in the European power sector, during the years 2008 and 2009. Three main determinants of the power sector's emissions are identified: the demand for electricity, the CO2 price, and fuel prices. A counterfactual scenario has been set up for each of these, i.e., what these parameters would have been if not affected by the recession. A simulation model of the European power sector is then employed, comparing a historical reference simulation (taking the parameters as actually occurred) with the counterfactual scenarios. The lower electricity demand (due to the recession) is shown to have by far the largest impact, accounting for an emission reduction of about 175 Mton. The lower CO2 price (due to the recession) resulted in an increase in emissions by about 30 Mton. The impact of fuel prices is more difficult to retrieve; an indicative reduction of about 17 Mton is obtained, mainly as a consequence of the low gas prices in 2009. The simulated combined impact of the parameters results in an emission reduction of about 150 Mton in the European power sector over the years 2008 and 2009 as a consequence of the recession.CO2 emission Economic recession European Union Emission Trading Scheme (EU ETS)

Scapular muscle recruitment patterns: Trapezius muscle latency with and without impingement symptoms

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Mobilité, transports et psychologie : un champ disciplinaire à construire ?

Présentation du dossier sur la psychologie des transports et de la conduite dans le Journal des Psychologue