The role of digital rectal examination for diagnosis of acute appendicitis: A systematic review and meta-analysis

Background: Digital rectal examination (DRE) has been traditionally recommendedto evaluate acute appendicitis, although several reports indicate its lack of utility for this diagnosis. No metaanalysis has examined DRE for diagnosis of acute appendicitis. Objectives: To assess the role of DRE for diagnosis of acute appendicitis. Data Sources: Cochrane Library, PubMed, and SCOPUS from the earliest available date of indexing through November 23, 2014, with no language restrictions. Study Selection: Clinical studies assessing DRE as an index test for diagnosis of acute appendicitis. Data Extraction and Synthesis: Two independent reviewers extracted study data and assessed the quality, using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Bivariate random-effects models were used for the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) as point estimates with 95% confidence intervals (CI). Main Outcomes and Measures: The main outcome measure was the diagnostic performance of DRE for diagnosis of acute appendicitis. Results: We identified 19 studies with a total of 7511 patients. The pooled sensitivity and specificity were 0.49 (95% CI 0.42-0.56) and 0.61 (95% CI 0.53-0.67), respectively. The positive and negative likelihood ratios were 1.24 (95% CI 0.97-1.58) and 0.85 (95% CI 0.70-1.02), respectively. The DOR was 1.46 (0.95-2.26). Conclusion and Relevance: Acute appendicitis cannot be ruled in or out through the result of DRE. Reconsideration is needed for the traditional teaching that rectal examination should be performed routinely in all patients with suspected appendicitis

A Humanoid Robot with Anatomy Trains that can Passively Sustain Standing Postures

The 11th International Symposium on Adaptive Motion of Animals and Machines. Kobe University, Japan. 2023-06-06/09. Adaptive Motion of Animals and Machines Organizing Committee.Poster Session P1

Thermal Infrared Imaging Experiments of C-Type Asteroid 162173 Ryugu on Hayabusa2

The thermal infrared imager TIR onboard Hayabusa2 has been developed to investigate thermo-physical properties of C-type, near-Earth asteroid 162173 Ryugu. TIR is one of the remote science instruments on Hayabusa2 designed to understand the nature of a volatile-rich solar system small body, but it also has significant mission objectives to provide information on surface physical properties and conditions for sampling site selection as well as the assessment of safe landing operations. TIR is based on a two-dimensional uncooled micro-bolometer array inherited from the Longwave Infrared Camera LIR on Akatsuki (Fukuhara et al., 2011). TIR takes images of thermal infrared emission in 8 to 12 μm with a field of view of 16×12∘ and a spatial resolution of 0.05∘ per pixel. TIR covers the temperature range from 150 to 460 K, including the well calibrated range from 230 to 420 K. Temperature accuracy is within 2 K or better for summed images, and the relative accuracy or noise equivalent temperature difference (NETD) at each of pixels is 0.4 K or lower for the well-calibrated temperature range. TIR takes a couple of images with shutter open and closed, the corresponding dark frame, and provides a true thermal image by dark frame subtraction. Data processing involves summation of multiple images, image processing including the StarPixel compression (Hihara et al., 2014), and transfer to the data recorder in the spacecraft digital electronics (DE). We report the scientific and mission objectives of TIR, the requirements and constraints for the instrument specifications, the designed instrumentation and the pre-flight and in-flight performances of TIR, as well as its observation plan during the Hayabusa2 mission

Highly porous nature of a primitive asteroid revealed by thermal imaging

Carbonaceous (C-type) asteroids are relics of the early Solar System that have preserved primitive materials since their formation approximately 4.6 billion years ago. They are probably analogues of carbonaceous chondrites and are essential for understanding planetary formation processes. However, their physical properties remain poorly known because carbonaceous chondrite meteoroids tend not to survive entry to Earth’s atmosphere. Here we report on global one-rotation thermographic images of the C-type asteroid 162173 Ryugu, taken by the thermal infrared imager (TIR) onboard the spacecraft Hayabusa2, indicating that the asteroid’s boulders and their surroundings have similar temperatures, with a derived thermal inertia of about 300 J m−2 s−0.5 K−1 (300 tiu). Contrary to predictions that the surface consists of regolith and dense boulders, this low thermal inertia suggests that the boulders are more porous than typical carbonaceous chondrites and that their surroundings are covered with porous fragments more than 10 centimetres in diameter. Close-up thermal images confirm the presence of such porous fragments and the flat diurnal temperature profiles suggest a strong surface roughness effect. We also observed in the close-up thermal images boulders that are colder during the day, with thermal inertia exceeding 600 tiu, corresponding to dense boulders similar to typical carbonaceous chondrites. These results constrain the formation history of Ryugu: the asteroid must be a rubble pile formed from impact fragments of a parent body with microporosity of approximately 30 to 50 per cent that experienced a low degree of consolidation. The dense boulders might have originated from the consolidated innermost region or they may have an exogenic origin. This high-porosity asteroid may link cosmic fluffy dust to dense celestial bodies.Additional co-authors: Tsuneo Matsunaga, Takeshi Imamura, Takehiko Wada, Sunao Hasegawa, Jörn Helbert, Thomas G. Müller, Jens Biele, Matthias Grott, Maximilian Hamm, Marco Delbo, Naru Hirata, Naoyuki Hirata, Yukio Yamamoto, Seiji Sugita, Noriyuki Namiki, Kohei Kitazato, Masahiko Arakawa, Shogo Tachibana, Hitoshi Ikeda, Masateru Ishiguro, Koji Wada, Chikatoshi Honda, Rie Honda, Yoshiaki Ishihara, Koji Matsumoto, Moe Matsuoka, Tatsuhiro Michikami, Akira Miura, Tomokatsu Morota, Hirotomo Noda, Rina Noguchi, Kazunori Ogawa, Kei Shirai, Eri Tatsumi, Hikaru Yabuta, Yasuhiro Yokota, Manabu Yamada, Masanao Abe, Masahiko Hayakawa, Takahiro Iwata, Masanobu Ozaki, Hajime Yano, Satoshi Hosoda, Osamu Mori, Hirotaka Sawada, Takanobu Shimada, Hiroshi Takeuchi, Ryudo Tsukizaki, Atsushi Fujii, Chikako Hirose, Shota Kikuchi, Yuya Mimasu, Naoko Ogawa, Go Ono, Tadateru Takahashi, Yuto Takei, Tomohiro Yamaguchi, Kent Yoshikawa, Fuyuto Terui, Takanao Saiki, Satoru Nakazawa, Makoto Yoshikawa, Seiichiro Watanabe & Yuichi Tsud

Thermal inertia of asteroid Ryugu using dawn-side thermal images by TIR on Hayabusa2

A thermal inertia map of the C-type Near-Earth asteroid 162173 Ryugu has been derived using the one-rotation global thermal image sets observed from the Home Position at 20 km altitude [1]. This time the thermal images of the night side areas of the surface just before sunrise were taken during observations from the dawn side. The coldest brightness temperature of the surface indicates another information on the thermal inertia of the surface. The thermal inertia is preliminary estimated at 250 [J m-2K-1s-0.5] or lower, which is consistent with other than those derived from the daytime observations [2]

A case of myxoid adrenocortical neoplasm: computed tomography and magnetic resonance imaging characteristics

Myxoid adrenocortical neoplasms are rare; to our knowledge, only 56 cases have been reported in the literature. Therefore, distinguishing benign from malignant cases is challenging. Although the histopathological features of myxoid adrenocortical neoplasia have been amply demonstrated, their imaging characteristics are yet to be reported. We describe here these characteristics for such a neoplasm. Our patient, a 70-year-old male, was found to have a 3-cm left adrenal incidentaloma through a non-enhanced computed tomography. Attenuation measurements were 22 Hounsfield units on precontrast imagery, and percentage enhancement washout was 92%. Magnetic resonance imaging showed no loss of signal intensity in T1-weighted out-of-phase images, but high signal intensity on T2-weighted and diffusion-weighted images. Left adrenalectomy was performed and the pathological diagnosis was confirmed as myxoid adrenocortical neoplasm. The imaging characteristics reported here will be beneficial to the differential diagnosis of myxoid adrenocortical neoplasms based upon image analysis and will help distinguish benign from malignant neoplasms

Urinary dipeptidyl peptidase-4 is a useful marker for tubulitis, and it is released from the tubular cells of kidney transplant recipients

Abstract Background Biomarkers are needed to diagnose kidney rejection in transplant recipients. We evaluated whether dipeptidyl peptidase-4 (DPP-4) could serve as a biomarker of rejection. Methods We determined DPP-4 concentrations and enzymatic activities in serum and urine, as well as DPP-4 expression in 49 kidney biopsy samples from 28 kidney transplant recipients. This study was approved by the ethical standards of the institutional research committee and comply with Helsinki declaration. All patients provided their informed consent. Donors were not from prisoners and were not paid or coerced. Results Serum and urinary DPP-4 activities closely correlated with DPP-4 concentrations, but were suppressed by DPP-4 inhibitors. Urinary DPP-4 concentrations increased with acute T cell-mediated rejection (ATCMR; p = 0.030) and higher Banff t and i scores (p < 0.001), and correlated with urinary protein/creatinine ratios (r = 0.450), and inversely with estimated glomerular filtration rate (r =  − 0.604). The area under the receiver operator characteristics curves for urinary DPP-4 concentrations with either Banff t3 or i3 scores were 0.811 (95% confidence interval: 0.687–0.934). The expression of DPP-4 in renal tubular cells was decreased in patients with ATCMR and higher in those with Banff t, i, ct, ci, ah, and ti scores, but was not associated with interstitial fibrosis/tubular atrophy. Conclusions We speculated that ATCMR leads to DPP-4 release from tubular cells into urine, resulting in a decrease in tubular cell expression. If so, then ATCMR would induce the elevation of urinary DPP-4 and could therefore serve as a biomarker of tubulitis

Optimal integration of kinematic and ball-flight information when perceiving the speed of a moving ball

In order to intercept a moving target such as a baseball with high spatio-temporal accuracy, the perception of the target's movement speed is important for estimating when and where the target will arrive. However, it is unclear what sources of information are used by a batter to estimate ball speed and how those sources of information are integrated to facilitate successful interception. In this study, we examined the degree to which kinematic and ball-flight information are integrated when estimating ball speed in baseball batting. Thirteen university level baseball batters performed a ball-speed evaluation task in a virtual environment where they were required to determine which of two comparison baseball pitches (i.e., a reference and comparison stimuli) they perceived to be faster. The reference and comparison stimuli had the same physical ball speed, but with different pitching movement speeds in the comparison stimuli. The task was performed under slow (125 km/h) and fast (145 km/h) ball-speed conditions. Results revealed that the perceived ball-speed was influenced by the movement speed of the pitcher's motion, with the influence of the pitcher's motion more pronounced in the fast ball-speed condition when ball-flight information was presumably less reliable. Moreover, exploratory analyses suggested that the more skilled batters were increasingly likely to integrate the two sources of information according to their relative reliability when making judgements of ball speed. The results provide important insights into how skilled performers may make judgements of speed and time to contact, and further enhance our understanding of how the ability to make those judgements might improve when developing expertise in hitting