7,805 research outputs found
The iBRA (implant breast reconstruction evaluation) study: protocol for a prospective multi-centre cohort study to inform the feasibility, design and conduct of a pragmatic randomised clinical trial comparing new techniques of implant-based breast reconstruction.
BACKGROUND: Implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure in the UK. The introduction of techniques to augment the subpectoral pocket has revolutionised the procedure, but there is a lack of high-quality outcome data to describe the safety or effectiveness of these techniques. Randomised controlled trials (RCTs) are the best way of comparing treatments, but surgical RCTs are challenging. The iBRA (implant breast reconstruction evaluation) study aims to determine the feasibility, design and conduct of a pragmatic RCT to examine the effectiveness of approaches to IBBR. METHODS/DESIGN: The iBRA study is a trainee-led research collaborative project with four phases:Phase 1 - a national practice questionnaire (NPQ) to survey current practicePhase 2 - a multi-centre prospective cohort study of patients undergoing IBBR to evaluate the clinical and patient-reported outcomesPhase 3- an IBBR-RCT acceptability survey and qualitative work to explore patients' and surgeons' views of proposed trial designs and candidate outcomes.Phase 4 - phases 1 to 3 will inform the design and conduct of the future RCT All centres offering IBBR will be encouraged to participate by the breast and plastic surgical professional associations (Association of Breast Surgery and British Association of Plastic Reconstructive and Aesthetic Surgeons). Data collected will inform the feasibility of undertaking an RCT by defining current practice and exploring issues surrounding recruitment, selection of comparator arms, choice of primary outcome, sample size, selection criteria, trial conduct, methods of data collection and feasibility of using the trainee collaborative model to recruit patients and collect data. DISCUSSION: The preliminary work undertaken within the iBRA study will determine the feasibility, design and conduct of a definitive RCT in IBBR. It will work with the trainee collaborative to build capacity by creating an infrastructure of research-active breast and plastic surgeons which will facilitate future high-quality research that will ultimately improve outcomes for all women seeking reconstructive surgery. TRIAL REGISTRATION: ISRCTN37664281
Keep it SMPL: Automatic Estimation of 3D Human Pose and Shape from a Single Image
We describe the first method to automatically estimate the 3D pose of the
human body as well as its 3D shape from a single unconstrained image. We
estimate a full 3D mesh and show that 2D joints alone carry a surprising amount
of information about body shape. The problem is challenging because of the
complexity of the human body, articulation, occlusion, clothing, lighting, and
the inherent ambiguity in inferring 3D from 2D. To solve this, we first use a
recently published CNN-based method, DeepCut, to predict (bottom-up) the 2D
body joint locations. We then fit (top-down) a recently published statistical
body shape model, called SMPL, to the 2D joints. We do so by minimizing an
objective function that penalizes the error between the projected 3D model
joints and detected 2D joints. Because SMPL captures correlations in human
shape across the population, we are able to robustly fit it to very little
data. We further leverage the 3D model to prevent solutions that cause
interpenetration. We evaluate our method, SMPLify, on the Leeds Sports,
HumanEva, and Human3.6M datasets, showing superior pose accuracy with respect
to the state of the art.Comment: To appear in ECCV 201
Silver-Russell Syndrome: A Case Report
A 15-year-old male boy with hemihypertrophy (left side) of the body was admitted in the hospital with the history of repeated attacks of convulsion. The patient was diagnosed as Silver-Russell syndrome on clinical ground. Silver-Russell syndrome (SRS) is a very rare genetic disorder that appears no later than early childhood. This is usually characterized by asymmetry in the size of the two halves or other parts of the body. Silver-Russell Syndrome occurs mostly in isolated cases because of sporadic genetic changes (mutations) for no apparent reason. For lack of facilities we were not able to do genetic study
Holographic Fermi and Non-Fermi Liquids with Transitions in Dilaton Gravity
We study the two-point function for fermionic operators in a class of
strongly coupled systems using the gauge-gravity correspondence. The gravity
description includes a gauge field and a dilaton which determines the gauge
coupling and the potential energy. Extremal black brane solutions in this
system typically have vanishing entropy. By analyzing a charged fermion in
these extremal black brane backgrounds we calculate the two-point function of
the corresponding boundary fermionic operator. We find that in some region of
parameter space it is of Fermi liquid type. Outside this region no well-defined
quasi-particles exist, with the excitations acquiring a non-vanishing width at
zero frequency. At the transition, the two-point function can exhibit non-Fermi
liquid behaviour.Comment: 52 pages, 6 figures. v3: Appendix F added showing numerical
interpolation between the near-horizon region and AdS4. Additional minor
comments also adde
Characterizing the non-linear growth of large-scale structure in the Universe
The local Universe displays a rich hierarchical pattern of galaxy clusters
and superclusters. The early Universe, however, was almost smooth, with only
slight 'ripples' seen in the cosmic microwave background radiation. Models of
the evolution of structure link these observations through the effect of
gravity, because the small initially overdense fluctuations attract additional
mass as the Universe expands. During the early stages, the ripples evolve
independently, like linear waves on the surface of deep water. As the
structures grow in mass, they interact with other in non-linear ways, more like
waves breaking in shallow water. We have recently shown how cosmic structure
can be characterized by phase correlations associated with these non-linear
interactions, but hitherto there was no way to use that information to reach
quantitative insights into the growth of structures. Here we report a method of
revealing phase information, and quantify how this relates to the formation of
a filaments, sheets and clusters of galaxies by non-linear collapse. We use a
new statistic based on information entropy to separate linear from non-linear
effects and thereby are able to disentangle those aspects of galaxy clustering
that arise from initial conditions (the ripples) from the subsequent dynamical
evolution.Comment: Accepted for publication in Nature. For high-resolution Figure 3,
please see http://www.nottingham.ac.uk/~ppzpc/phases/n0colorphase.html, For
the animations and the idea of this paper please see
http://www.nottingham.ac.uk/~ppzpc/phases/index.htm
Mesoscopic structure and social aspects of human mobility
The individual movements of large numbers of people are important in many
contexts, from urban planning to disease spreading. Datasets that capture human
mobility are now available and many interesting features have been discovered,
including the ultra-slow spatial growth of individual mobility. However, the
detailed substructures and spatiotemporal flows of mobility - the sets and
sequences of visited locations - have not been well studied. We show that
individual mobility is dominated by small groups of frequently visited,
dynamically close locations, forming primary "habitats" capturing typical daily
activity, along with subsidiary habitats representing additional travel. These
habitats do not correspond to typical contexts such as home or work. The
temporal evolution of mobility within habitats, which constitutes most motion,
is universal across habitats and exhibits scaling patterns both distinct from
all previous observations and unpredicted by current models. The delay to enter
subsidiary habitats is a primary factor in the spatiotemporal growth of human
travel. Interestingly, habitats correlate with non-mobility dynamics such as
communication activity, implying that habitats may influence processes such as
information spreading and revealing new connections between human mobility and
social networks.Comment: 7 pages, 5 figures (main text); 11 pages, 9 figures, 1 table
(supporting information
Dual roles for LUBAC signaling in thymic epithelial cell development and survival
Thymic epithelial cells (TECs) form a unique microenvironment that orchestrates T cell differentiation and immunological tolerance. Despite the importance of TECs for adaptive immunity, there is an incomplete understanding of the signalling networks that support their differentiation and survival. We report that the linear ubiquitin chain assembly complex (LUBAC) is essential for medullary TEC (mTEC) differentiation, cortical TEC survival and prevention of premature thymic atrophy. TEC-specific loss of LUBAC proteins, HOIL-1 or HOIP, severely impaired expansion of the thymic medulla and AIRE-expressing cells. Furthermore, HOIL-1-deficiency caused early thymic atrophy due to Caspase-8/MLKL-dependent apoptosis/necroptosis of cortical TECs. By contrast, deficiency in the LUBAC component, SHARPIN, caused relatively mild defects only in mTECs. These distinct roles for LUBAC components in TECs correlate with their function in linear ubiquitination, NFκB activation and cell survival. Thus, our findings reveal dual roles for LUBAC signaling in TEC differentiation and survival
Unique contributions to the scalar bispectrum in `just enough inflation'
A scalar field rolling down a potential with a large initial velocity results
in inflation of a finite duration. Such a scenario suppresses the scalar power
on large scales improving the fit to the cosmological data. We find that the
scenario leads to a hitherto unexplored situation wherein the boundary terms
dominate the contributions to the scalar bispectrum over the bulk terms. We
show that the consistency relation governing the non-Gaussianity parameter
is violated on large scales and that the contributions at the
initial time can substantially enhance the value of .Comment: v1: 5 pages, 4 figure
Treatment response and remission in a double-blind, randomized, head-to-head study of lisdexamfetamine dimesylate and atomoxetine in children and adolescents with attention-deficit hyperactivity disorder
The Author(s) 2014. This article is published with open access at Springerlink.com Objectives A secondary objective of this head-to-head study of lisdexamfetamine dimesylate (LDX) and ato-moxetine (ATX) was to assess treatment response rates in children and adolescents with attention-deficit hyperactiv-ity disorder (ADHD) and an inadequate response to methylphenidate (MPH). The primary efficacy and safety outcomes of the study, SPD489-317 (ClinicalTrials.gov NCT01106430), have been published previously. Methods In this 9-week, double-blind, active-controlled study, patients aged 6–17 years with a previous inadequate response to MPH were randomized (1:1) to dose-optimized LDX (30, 50 or 70 mg/day) or ATX (patients \70 kg: 0.5–1.2 mg/kg/day, not to exceed 1.4 mg/kg/day; patients C70 kg: 40, 80 or 100 mg/day). Treatment response was a secondary efficacy outcome and was predefined as a reduction from baseline in ADHD Rating Scale IV (ADHD-RS-IV) total score of at least 25, 30 or 50 %. Sustained response was predefined as a reduction from baseline in ADHD-RS-IV total score (C25, C30 or C50 %) or a Clinical Global Impressions (CGI)–Improvement (CGI–I) score of 1 or 2 throughout weeks 4–9. CGI– Severity (CGI–S) scores were also assessed, as an indicator of remission. Results A total of 267 patients were enrolled (LDX, n = 133; ATX, n = 134) and 200 completed the study (LDX, n = 99; ATX, n = 101). By week 9, significantly (p \ 0.01) greater proportions of patients receiving LDX than ATX met the response criteria of a reduction from baseline in ADHD-RS-IV total score of at least 25 % (90.5 vs. 76.7 %), 30 % (88.1 vs. 73.7 %) or 50 % (73.0 vs. 50.4 %). Sustained response rates were also signifi-cantly (p \ 0.05) higher among LDX-treated patient
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