Intra- and Extra-articular Features of Temporomandibular Joint Ankylosis in the Cat (Felis catus).

Temporomandibular joint (TMJ) ankylosis is an uncommon clinical entity in human and veterinary medicine. However, the condition is severely debilitating and is life-limiting if not treated. This study sought to characterize the intra- and extra-articular features of naturally occurring TMJ ankylosis in cats. TMJs from client-owned cats (n = 5) that underwent bilateral TMJ gap arthroplasty were examined and compared with TMJs from healthy, age-matched feline cadavers (n = 2) by cone-beam computed tomography (CBCT), micro-computed tomography (μCT) and histologically. Features of bilateral intra- and extra-articular ankylosis compounded by degenerative joint lesions were identified radiographically and histologically in all affected cats. Features of TMJ 'true' ankylosis included variable intracapsular fibro-osseous bridging, degeneration of the disc and the articular surfaces, narrowing of the joint space and flattening of the condylar process of the mandible. Extra-articular features of TMJ ankylosis included periarticular bone formation and fibro-osseous bridging between the mandible, zygomatic arch and coronoid process. In addition, subchondral bone loss or sclerosis, irregular and altered joint contours and irregularly increased density of the medullary bone characterized the degenerative changes of the osseous components of the TMJ. Complex radiological and histological features of both ankylosis and pseudoankylosis were identified that clinically manifested in complete inability to open the mouth

Managing Uncertain Complex Events in Web of Things Applications

A critical issue in the Web of Things (WoT) is the need to process and analyze the interactions of Web-interconnected real-world objects. Complex Event Processing (CEP) is a powerful technology for analyzing streams of information about real-time distributed events, coming from different sources, and for extracting conclusions from them. However, in many situations these events are not free from uncertainty, due to either unreliable data sources and networks, measurement uncertainty, or to the inability to determine whether an event has actually happened or not. This short research paper discusses how CEP systems can incorporate different kinds of uncertainty, both in the events and in the rules. A case study is used to validate the proposal, and we discuss the benefits and limitations of this CEP extension.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Probabilistic analysis and comparison of stress-dependent rock physics models

A rock physics model attempts to account for the nonlinear stress dependence of seismic velocity by relating changes in stress and strain to changes in seismic velocity and anisotropy. Understanding and being able to model this relationship is crucial for any time-lapse geophysical or geohazard modelling scenario. In this study, we take a number of commonly used rock physics models and assess their behaviour and stability when applied to stress versus velocity measurements of a large (dry) core data set of different lithologies. We invert and calibrate each model and present a database of models for over 400 core samples. The results of which provide a useful tool for setting a priori parameter constraints for future model inversions. We observe that some models assume an increase in VP/VS ratio (hence Poisson’s ratio) with stress. A trait not seen for every sample in our data set. We demonstrate that most model parameters are well constrained. However, third-order elasticity models become ill-posed when their equations are simplified for an isotropic rock. We also find that third-order elasticity models are limited by their approximation of an exponential relationship via functions that lack an exponential term. We also argue that all models are difficult to parametrize without the availability of core data. Therefore, we derive simple relationships between model parameters, core porosity and clay content. We observe that these relationship are suitable for estimating seismic velocities of rock but poor when comes to predicting changes related to effective stress. The findings of this study emphasize the need for improvement to models if quantitatively accurate predictions of time-lapse velocity and anisotropy are to be made. Certain models appear to better fit velocity depth log data than velocity–stress core data. Thus, there is evidence to suggest a limitation in core data as a representation of the stress dependence of the subsurface. The differences in the stress dependence of the subsurface compared to that measured under laboratory conditions could potentially be significant. Although potentially difficult to investigate, its importance is of great significance if we wish to accurately interpret the stress dependence of subsurface seismic velocities

Next Generation Sequencing Assay for Detection of Circulating HPV DNA (cHPV-DNA) in Patients Undergoing Radical (Chemo)Radiotherapy in Anal Squamous Cell Carcinoma (ASCC).

Background: Following chemo-radiotherapy (CRT) for human papilloma virus positive (HPV+) anal squamous cell carcinoma (ASCC), detection of residual/recurrent disease is challenging. Patients frequently undergo unnecessary repeated biopsies for abnormal MRI/clinical findings. In a pilot study we assessed the role of circulating HPV-DNA in identifying "true" residual disease. Methods: We prospectively collected plasma samples at baseline (n = 21) and 12 weeks post-CRT (n = 17). Circulating HPV-DNA (cHPV DNA) was measured using a novel next generation sequencing (NGS) assay, panHPV-detect, comprising of two primer pools covering distinct regions of eight high-risk HPV genomes (16, 18, 31, 33, 35, 45, 52, and 58) to detect circulating HPV-DNA (cHPV DNA). cHPV-DNA levels post-CRT were correlated to disease response. Results: In pre-CRT samples, panHPV-detect demonstrated 100% sensitivity and specificity for HPV associated ASCC. PanHPV-detect was able to demonstrate cHPV-DNA in 100% (9/9) patients with T1/T2N0 cancers. cHPV-DNA was detectable 12 weeks post CRT in just 2/17 patients, both of whom relapsed. 1/16 patients who had a clinical complete response (CR) at 3 months post-CRT but relapsed at 9 months and 1/1 patient with a partial response (PR). PanHPV-detect demonstrated 100% sensitivity and specificity in predicting response to CRT. Conclusion: We demonstrate that panHPV-detect, an NSG assay is a highly sensitive and specific test for the identification of cHPV-DNA in plasma at diagnosis. cHPV-DNA post-treatment may predict clinical response to CRT

Beyond persons: extending the personal / subpersonal distinction to non-rational animals and artificial agents

The distinction between personal level explanations and subpersonal ones has been subject to much debate in philosophy. We understand it as one between explanations that focus on an agent’s interaction with its environment, and explanations that focus on the physical or computational enabling conditions of such an interaction. The distinction, understood this way, is necessary for a complete account of any agent, rational or not, biological or artificial. In particular, we review some recent research in Artificial Life that pretends to do completely without the distinction, while using agent-centered concepts all the way. It is argued that the rejection of agent level explanations in favour of mechanistic ones is due to an unmotivated need to choose among representationalism and eliminativism. The dilemma is a false one if the possibility of a radical form of externalism is considered

Perspectives on palliative oxygen for breathlessness: systematic review and meta-synthesis.

Oxygen therapy is frequently prescribed for the palliation of breathlessness, despite lack of evidence for its effectiveness in people who are not hypoxaemic. This study aimed to compare and contrast patients', caregivers' and clinicians' experiences of palliative oxygen use for the relief of chronic breathlessness in people with advanced life-limiting illnesses, and how this shapes prescribing.A systematic review and meta-synthesis of qualitative data was conducted. MEDLINE, CINAHL and PsycINFO were searched for peer-reviewed studies in English (2000-April 2019) reporting perspectives on palliative oxygen use for reducing breathlessness in people with advanced illnesses in any healthcare setting. After data extraction, thematic synthesis used line-by-line coding of raw data (quotes) to generate descriptive and analytical themes.Of 457 articles identified, 22 met the inclusion criteria by reporting perspectives of patients (n=337), caregivers (n=91) or clinicians (n=616). Themes common to these perspectives were: 1) benefits and burdens of palliative oxygen use, 2) knowledge and perceptions of palliative oxygen use beyond the guidelines, and 3) longitudinal trajectories of palliative oxygen use.There are differing perceptions regarding the benefits and burdens of using palliative oxygen. Clinicians should be aware that oxygen use may generate differing goals of therapy for patients and caregivers. These perceptions should be taken into consideration when prescribing oxygen for the symptomatic relief of chronic breathlessness in patients who do not quality for long-term oxygen therapy

Synthesis of trifluoromethylated isoxazoles and their elaboration through inter- and intra-molecular C-H arylation

We report conditions for the preparation of a range of trifluoromethylated isoxazole building blocks through the cycloaddition reaction of trifluoromethyl nitrile oxide. It was found that controlling the rate (and therefore concentration) of the formation of the trifluoromethyl nitrile oxide was Critical for the preferential formation of the desired isoxazole products versus the furoxan dimer. Different conditions were optimised for both aryl- and alkyl-substituted alkynes. In addition, the reactivity at the isoxazole 4-position has been briefly explored for these building blocks. Conditions for intermolecular C–H arylation, lithiation and electrophile quench, and alkoxylation were all identified with brief substrate scoping that signifies useful tolerance to a range of functionalities. Finally, complementary processes for structural diversification through either intramolecular cyclisation or intermolecular cross-coupling were developed

Health Care Resource Utilization and Related Costs of Patients With CKD From the United States: A Report From the DISCOVER CKD Retrospective Cohort

Introduction: It is well established that chronic kidney disease (CKD) results in a significant burden on patients’ health and health care providers. However, detailed estimates of the health care resource utilization (HCRU) of CKD are limited, particularly those which consider severity, comorbidities, and payer type. This study aimed to bridge this evidence gap by reporting contemporary HCRU and costs in patients with CKD across the US health care providers. Methods: Cost and HCRU estimates of CKD and reduced kidney function without CKD (estimated glomerular filtration rate [eGFR]: 60−75 and urine albumin-to-creatinine ratio [UACR]: <30) were derived for US patients included in the DISCOVER CKD cohort study, using linked inpatient and outpatient data from the limited claims-EMR data set (LCED) and TriNetX database. Patients with a history of transplant or undergoing dialysis were not included. HCRU and costs were stratified by CKD severity using UACR and eGFR. Results: Overall health care costs ranged from $26,889 (A1) to$42,139 (A3), and from $28,627 (G2) to$42,902 (G5) per patient per year (PPPY), demonstrating a considerable early disease burden which continued to increase with declining kidney function. The PPPY costs of later stage CKD were particularly notable for patients with concomitant heart failure ($50,191 [A3]) and those covered by commercial payers ($55,735 [A3]). Conclusions: Health care costs and resource use associated with CKD and reduced kidney function pose a substantial burden across health care systems and payers, increasing in line with CKD progression. Early CKD screening, particularly of UACR, paired with proactive disease management may provide both an improvement to patient outcomes and a significant HCRU and cost saving to health care providers

Measurement of inner wall limiter SOL widths in KSTAR tokamak

https://doi.org/10.1016/j.nme.2016.12.001.Scrape-off layer (SOL) widths λq are presented from the KSTAR tokamak using fast reciprocating Langmuir probe assembly (FRLPA) measurements at the outboard mid-plane (OMP) and the infra-Red (IR) thermography at inboard limiter tiles in moderately elongated (κ = 1.45 – 1.55) L-mode inner wall-limited (IWL) plasmas under experimental conditions such as BT = 2.0 T, PNBI = 1.4 – 1.5 MW, line averaged densities 2.5 – 5.1 × 1019 m−3) and plasma current Ip = 0.4 − 0.7 MA. There is clear evidence for a double exponential structure in q||(r) from the FRLPA such that, for example at Ip = 0.6 MA, a narrow feature, λq,near (=3.5 mm) is found close to the LFCS, followed by a broader width, λq,main (=57.0 mm). Double exponential profiles (λq,near = 1.5 – 2.8 mm, λq,main = 17.0 – 35.0 mm) can be also observed in the IR heat flux mapped to the OMP throughout the range of Ip investigated. In addition, analysis of SOL turbulence statistics obtained with the FRLPA shows high relative fluctuation levels and positively skewed distributions in electron temperature and ion particle flux across the SOL, with both properties increasing for longer distance from the LCFS, as often previously observed in the tokamaks. Interestingly, the fluctuation character expressed in terms of spectral distributions remains unchanged in passing from the narrow to the broad SOL heat flux channel