Percutaneous Heel Cord Release for Clubfoot: A Retrospective, Multicentre Cost Analysis

Purpose The Ponseti method of treatment is the standard of care for idiopathic clubfoot. Following serial casting, percutaneous tendo-Achilles tenotomy (TAT) is performed to correct residual equinus. This procedure can be performed in either the outpatient clinic or the operating room. The purpose of this study was to evaluate the expense of this procedure by examining hospital charges in both settings. Methods We retrospectively reviewed charts of 382 idiopathic clubfoot patients with a mean age of 2.4 months (0.6 to 26.6) treated with the Ponseti method at three institutions. Patients were divided into three groups depending on the setting for the TAT procedure: 140 patients in the outpatient clinic (CL), 219 in the operating room with discharge following the procedure (OR) and 23 in the operating room with admission to hospital for observation (OR+). Medical records were reviewed to analyze age, deformity, perioperative complications and specific time spent in each setting. Hospital charges for all three groups were standardized to one institution\u27s charge structure. Results Charges among the three groups undergoing TAT (CL, OR, OR+) were found to be significantly different ($3840.60 versus$7962.30 versus $9110.00, respectively; p ≤ 0.001), and remained significant when separating unilateral and bilateral deformities (p \u3c 0.001). There were nine total perioperative complications (six returns to the ER and three unexpected admissions to the hospital): five (2.3%) in the OR group, four (17.4%) in the OR+ group and none in the CL group. The OR+ group statistically had a higher rate of complications compared with the other two groups (p = 0.006). The total event time of the CL group was significantly shorter compared with the OR and OR+ groups (129.1, 171.7 and 1571.6 minutes respectively; p \u3c 0.001). Conclusion Hospital charges and total event time were significantly less when percutaneous TAT was performed in the outpatient clinic compared with the operating room. In addition, performing the procedure in clinic was associated with the lowest rate of complications. Level of Evidence Therapeutic, Level II

Optical Variability of Narrow-Line Seyfert 1 Galaxies

We present results of a broad-band photometric study of the optical variability of six Narrow-Line Seyfert 1 (NLS1) galaxies observed at 172 epochs. We searched for microvariability on 33 nights. Strong evidence for microvariability was found only for our lowest luminosity object, NGC 4051, on one night. Weaker evidence suggests such variability on a few other nights for two other objects, but the data are not as convincing. Intra-night variability in NLS1s is thus concluded to be rare and of low amplitude. We give illustrations of how variable image quality can produce spurious variability. We find that for well-studied non-NLS1s there is a spread in the amplitude of seasonal variability (i.e., in some years an AGN is more variable than in others). We find that the means of the variability amplitudes of non-NLS1s over several seasons vary from object to object (i.e., some AGNs are, on average, more variable than others). NLS1s also show a spread in seasonal variabilities. The best-studied NLS1, Ark 564, shows a range of amplitudes of variability from season to season that is comparable to the range found in BLS1s, and in one season Ark 564 was as variable as the most variable non-NLS1. The seasonal amplitudes of variability for NLS1s are mostly in the lower half of the range of non-BLS1 seasonal amplitudes, but the absence of a suitable control sample makes a precise comparison difficult. However, on long timescales (weeks to years), NLS1s as a class are not more variable than non-NLS1s. The extreme variability seen in the X-rays was not seen in the optical. This has consequences for the models of AGNs in general as well as NLS1s in particular.Comment: Astrophysical Journal in press (tentatively scheduled for Vol. 608, June 2004 issue);47 pages; 19 figures. Electronic tables not included (contact first author if needed

Reverberation Mapping Measurements of Black Hole Masses in Six Local Seyfert Galaxies

We present the final results from a high sampling rate, multi-month, spectrophotometric reverberation mapping campaign undertaken to obtain either new or improved Hbeta reverberation lag measurements for several relatively low-luminosity AGNs. We have reliably measured thetime delay between variations in the continuum and Hbeta emission line in six local Seyfert 1 galaxies. These measurements are used to calculate the mass of the supermassive black hole at the center of each of these AGNs. We place our results in context to the most current calibration of the broad-line region (BLR) R-L relationship, where our results remove outliers and reduce the scatter at the low-luminosity end of this relationship. We also present velocity-resolved Hbeta time delay measurements for our complete sample, though the clearest velocity-resolved kinematic signatures have already been published.Comment: 52 pages (AASTeX: 29 pages of text, 8 tables, 7 figures), accepted for publication in the Astrophysical Journa

MHC class I loci of the Bar-Headed goose (Anser indicus)

MHC class I proteins mediate functions in anti-pathogen defense. MHC diversity has already been investigated by many studies in model avian species, but here we chose the bar-headed goose, a worldwide migrant bird, as a non-model avian species. Sequences from exons encoding the peptide-binding region (PBR) of MHC class I molecules were isolated from liver genomic DNA, to investigate variation in these genes. These are the first MHC class I partial sequences of the bar-headed goose to be reported. A preliminary analysis suggests the presence of at least four MHC class I genes, which share great similarity with those of the goose and duck. A phylogenetic analysis of bar-headed goose, goose and duck MHC class I sequences using the NJ method supports the idea that they all cluster within the anseriforms clade

The CD95 Receptor: Apoptosis Revisited

CD95 is the quintessential death receptor and, when it is bound by ligand, cells undergo apoptosis. Recent evidence suggests, however, that CD95 mediates not only apoptosis but also diverse nonapoptotic functions depending on the tissue and the conditions

X-Ray/Ultraviolet Observing Campaign of the Markarian 279 Active Galactic Nucleus Outflow: a close look at the absorbing/emitting gas with Chandra-LETGS

We present a Chandra-LETGS observation of the Seyfert 1 galaxy Mrk 279. This observation was carried out simultaneously with HST-STIS and FUSE, in the context of a multiwavelength study of this source. The Chandra pointings were spread over ten days for a total exposure time of ~360 ks. The spectrum of Mrk279 shows evidence of broad emission features, especially at the wavelength of the OVII triplet. We quantitatively explore the possibility that this emission is produced in the broad line region (BLR). We modeled the broad UV emission lines seen in the FUSE and HST-STIS spectra following the ``locally optimally emitting cloud" approach. We find that the X-ray lines luminosity derived from the best fit BLR model can match the X-ray features, suggesting that the gas producing the UV lines is sufficient to account also for the X-ray emission. The spectrum is absorbed by ionized gas whose total column density is ~5x10^{20} cm^{-2}. The absorption spectrum can be modeled by two distinct gas components (log xi ~ 0.47 and 2.49, respectively) both showing a significant outflow velocity. However, the data allow also the presence of intermediate ionization components. The distribution of the column densities of such extra components as a function of the ionization parameter is not consistent with a continuous, power law-like, absorber, suggesting a complex structure for the gas outflow for Mrk 279 (abridged).Comment: 16 pages, 12 figures. To appear in A&

Safety Profile of Good Manufacturing Practice Manufactured Interferon \u3b3-Primed Mesenchymal Stem/Stromal Cells for Clinical Trials

Mesenchymal stem/stromal cells (MSCs) are widely studied by both academia and industry for a broad array of clinical indications. The collective body of data provides compelling evidence of the clinical safety of MSC therapy. However, generally accepted proof of therapeutic efficacy has not yet been reported. In an effort to generate a more effective therapeutic cell product, investigators are focused on modifying MSC processing protocols to enhance the intrinsic biologic activity. Here, we report a Good Manufacturing Practice-compliant two-step MSC manufacturing protocol to generate MSCs or interferon \u3b3 (IFN\u3b3) primed MSCs which allows freshly expanded cells to be infused in patients on a predetermined schedule. This protocol eliminates the need to infuse cryopreserved, just thawed cells which may reduce the immune modulatory activity. Moreover, using (IFN\u3b3) as a prototypic cytokine, we demonstrate the feasibility of priming the cells with any biologic agent. We then characterized MSCs and IFN\u3b3 primed MSCs prepared with our protocol, by karyotype, in vitro potential for malignant transformation, biodistribution, effect on engraftment of transplanted hematopoietic cells, and in vivo toxicity in immune deficient mice including a complete post-mortem examination. We found no evidence of toxicity attributable to the MSC or IFN\u3b3 primed MSCs. Our data suggest that the clinical risk of infusing MSCs or IFN\u3b3 primed MSCs produced by our two-step protocol is not greater than MSCs currently in practice. While actual proof of safety requires phase I clinical trials, our data support the use of either cell product in new clinical studies

The Hydrogen Epoch of Reionization Array Dish I: Beam Pattern Measurements and Science Implications

The Hydrogen Epoch of Reionization Array (HERA) is a radio interferometer aiming to detect the power spectrum of 21 cm fluctuations from neutral hydrogen from the Epoch of Reionization (EOR). Drawing on lessons from the Murchison Widefield Array (MWA) and the Precision Array for Probing the Epoch of Reionization (PAPER), HERA is a hexagonal array of large (14 m diameter) dishes with suspended dipole feeds. Not only does the dish determine overall sensitivity, it affects the observed frequency structure of foregrounds in the interferometer. This is the first of a series of four papers characterizing the frequency and angular response of the dish with simulations and measurements. We focus in this paper on the angular response (i.e., power pattern), which sets the relative weighting between sky regions of high and low delay, and thus, apparent source frequency structure. We measure the angular response at 137 MHz using the ORBCOMM beam mapping system of Neben et al. We measure a collecting area of 93 m^2 in the optimal dish/feed configuration, implying HERA-320 should detect the EOR power spectrum at z~9 with a signal-to-noise ratio of 12.7 using a foreground avoidance approach with a single season of observations, and 74.3 using a foreground subtraction approach. Lastly we study the impact of these beam measurements on the distribution of foregrounds in Fourier space.Comment: 13 pages, 9 figures. Replaced to match accepted ApJ versio

A Revised Broad-Line Region Radius and Black Hole Mass for the Narrow-Line Seyfert 1 NGC 4051

We present the first results from a high sampling rate, multi-month reverberation mapping campaign undertaken primarily at MDM Observatory with supporting observations from telescopes around the world. The primary goal of this campaign was to obtain either new or improved Hbeta reverberation lag measurements for several relatively low luminosity AGNs. We feature results for NGC 4051 here because, until now, this object has been a significant outlier from AGN scaling relationships, e.g., it was previously a ~2-3sigma outlier on the relationship between the broad-line region (BLR) radius and the optical continuum luminosity - the R_BLR-L relationship. Our new measurements of the lag time between variations in the continuum and Hbeta emission line made from spectroscopic monitoring of NGC 4051 lead to a measured BLR radius of R_BLR = 1.87 (+0.54 -0.50) light days and black hole mass of M_BH = 1.73 (+0.55 -0.52) x 10^6 M_sun. This radius is consistent with that expected from the R_BLR-L relationship, based on the present luminosity of NGC 4051 and the most current calibration of the relation by Bentz et al. (2009a). We also present a preliminary look at velocity-resolved Hbeta light curves and time delay measurements, although we are unable to reconstruct an unambiguous velocity-resolved reverberation signal.Comment: 38 pages, 7 figures, accepted for publication in ApJ, changes from v1 reflect suggestions from anonymous refere

Sexual Size Dimorphism and Body Condition in the Australasian Gannet

Funding: The research was financially supported by the Holsworth Wildlife Research Endowment. Acknowledgments We thank the Victorian Marine Science Consortium, Sea All Dolphin Swim, Parks Victoria, and the Point Danger Management Committee for logistical support. We are grateful for the assistance of the many field volunteers involved in the study.Peer reviewedPublisher PD