Clinical Stability of Slipped Capital Femoral Epiphysis does not Correlate with Intraoperative Stability

Background: The most important objective of clinical classifications of slipped capital femoral epiphysis (SCFE) is to identify hips associated with a high risk of avascular necrosis (AVN) — so-called unstable or acute slips; however, closed surgery makes confirmation of physeal stability difficult. Performing the capital realignment procedure in SCFE treatment we observed that clinical estimation of physeal stability did not always correlate with intraoperative findings at open surgery. This motivated us to perform a systematic comparison of the clinical classification systems with the intraoperative observations. Questions/purposes: We asked: (1) Is the classification of an acute versus chronic slip based on the duration of symptoms sensitive and specific in detecting intraoperative disrupted physes in patients with SCFE? (2) Is the stable/unstable classification system based on clinical symptoms sensitive and specific in detecting intraoperative disrupted physes in patients with SCFE? Methods: We retrospectively reviewed 82 patients with SCFE treated by open surgery between 1996 and 2009. We classified the clinical stability of all hips using the classifications based on onset of symptoms and on function. We classified intraoperative stability as intact or disrupted. We determined the sensitivity and specificity of two classification systems to determine intraoperative stability. Results: Complete physeal disruption at open surgery was seen in 28 of the 82 hips (34%). With classification as acute, acute-on-chronic, and chronic, the sensitivity for disrupted physes was 82% and the specificity was 44%. With the classification of Loder et al., the values were 39% and 76%, respectively. Conclusion: Current clinical classification systems are limited in accurately diagnosing the physeal stability in SCFE. Level of Evidence: Level III, retrospective diagnostic study. See Guidelines for Authors for a complete description of levels of evidenc

Full Paper Total re¯ection X-ray¯uorescence analysis of laser-deposited solid sample material

Laser ablation (LA) was applied as a sampling technique for the analysis of solids by total re¯ection X-raȳ uorescence (TXRF). The sample material ablated by a pulsed Nd : YAG laser was collected directly on a quartz glass or Plexiglas1 disc commonly used as a sample carrier for TXRF. The analytical capabilities of the combined method were investigated using an improved arrangement of solid sample and TXRF carrier. The technique was applied to the analysis of metallic samples, i.e. Fe±Cr binaries and high-alloy steel, and non-metallic samples, i.e. Al±Ti ceramics, native mineral rocks and gallstones. The nanogram amounts of material deposited on the carrier were always suf®cient for TXRF analysis. Quanti®cation was performed by addition of an internal standard. Absolute detection limits for Fe and Cr in binary samples were 50±60 pg, corresponding to a mass fraction of 5±6 mg g 21 assuming a 10 ng deposit. Sampling from preselected spots of mineral rocks made possible the identi®cation of different components in granite by means of their major and minor constituents. The combined method of LA and TXRF can be used for the rapid characterization of solids on the 10 mm scale without laborious steps of sample preparation

The Digital MIQE Guidelines Update: Minimum Information for Publication of Quantitative Digital PCR Experiments for 2020

Digital PCR (dPCR) has developed considerably since the publication of the Minimum Information for Publication of Digital PCR Experiments (dMIQE) guidelines in 2013, with advances in instrumentation, software, applications, and our understanding of its technological potential. Yet these developments also have associated challenges; data analysis steps, including threshold setting, can be difficult and preanalytical steps required to purify, concentrate, and modify nucleic acids can lead to measurement error. To assist independent corroboration of conclusions, comprehensive disclosure of all relevant experimental details is required. To support the community and reflect the growing use of dPCR, we present an update to dMIQE, dMIQE2020, including a simplified dMIQE table format to assist researchers in providing key experimental information and understanding of the associated experimental process. Adoption of dMIQE2020 by the scientific community will assist in standardizing experimental protocols, maximize efficient utilization of resources, and further enhance the impact of this powerful technology

Design and Simulated Performance of Calorimetry Systems for the ECCE Detector at the Electron Ion Collider

We describe the design and performance the calorimeter systems used in the ECCE detector design to achieve the overall performance specifications cost-effectively with careful consideration of appropriate technical and schedule risks. The calorimeter systems consist of three electromagnetic calorimeters, covering the combined pseudorapdity range from -3.7 to 3.8 and two hadronic calorimeters. Key calorimeter performances which include energy and position resolutions, reconstruction efficiency, and particle identification will be presented.Comment: 19 pages, 22 figures, 5 table

AI-assisted Optimization of the ECCE Tracking System at the Electron Ion Collider

The Electron-Ion Collider (EIC) is a cutting-edge accelerator facility that will study the nature of the "glue" that binds the building blocks of the visible matter in the universe. The proposed experiment will be realized at Brookhaven National Laboratory in approximately 10 years from now, with detector design and R&D currently ongoing. Notably, EIC is one of the first large-scale facilities to leverage Artificial Intelligence (AI) already starting from the design and R&D phases. The EIC Comprehensive Chromodynamics Experiment (ECCE) is a consortium that proposed a detector design based on a 1.5T solenoid. The EIC detector proposal review concluded that the ECCE design will serve as the reference design for an EIC detector. Herein we describe a comprehensive optimization of the ECCE tracker using AI. The work required a complex parametrization of the simulated detector system. Our approach dealt with an optimization problem in a multidimensional design space driven by multiple objectives that encode the detector performance, while satisfying several mechanical constraints. We describe our strategy and show results obtained for the ECCE tracking system. The AI-assisted design is agnostic to the simulation framework and can be extended to other sub-detectors or to a system of sub-detectors to further optimize the performance of the EIC detector.Comment: 16 pages, 18 figures, 2 appendices, 3 table

ECCE Sensitivity Studies for Single Hadron Transverse Single Spin Asymmetry Measurements

We performed feasibility studies for various single transverse spin measurements that are related to the Sivers effect, transversity and the tensor charge, and the Collins fragmentation function. The processes studied include semi-inclusive deep inelastic scattering (SIDIS) where single hadrons (pions and kaons) were detected in addition to the scattered DIS lepton. The data were obtained in {\sc pythia}6 and {\sc geant}4 simulated e+p collisions at 18 GeV on 275 GeV, 18 on 100, 10 on 100, and 5 on 41 that use the ECCE detector configuration. Typical DIS kinematics were selected, most notably $Q^2 > 1$ GeV$^2$, and cover the $x$ range from $10^{-4}$ to $1$. The single spin asymmetries were extracted as a function of $x$ and $Q^2$, as well as the semi-inclusive variables $z$, and $P_T$. They are obtained in azimuthal moments in combinations of the azimuthal angles of the hadron transverse momentum and transverse spin of the nucleon relative to the lepton scattering plane. The initially unpolarized MonteCarlo was re-weighted in the true kinematic variables, hadron types and parton flavors based on global fits of fixed target SIDIS experiments and $e^+e^-$ annihilation data. The expected statistical precision of such measurements is extrapolated to 10 fb$^{-1}$ and potential systematic uncertainties are approximated given the deviations between true and reconstructed yields. The impact on the knowledge of the Sivers functions, transversity and tensor charges, and the Collins function has then been evaluated in the same phenomenological extractions as in the Yellow Report. The impact is found to be comparable to that obtained with the parameterized Yellow Report detector and shows that the ECCE detector configuration can fulfill the physics goals on these quantities.Comment: 22 pages, 22 figures, to be submitted to joint ECCE proposal NIM-A volum

ECCE unpolarized TMD measurements

We performed feasibility studies for various measurements that are related to unpolarized TMD distribution and fragmentation functions. The processes studied include semi-inclusive Deep inelastic scattering (SIDIS) where single hadrons (pions and kaons) were detected in addition to the scattered DIS lepton. The single hadron cross sections and multiplicities were extracted as a function of the DIS variables $x$ and $Q^2$, as well as the semi-inclusive variables $z$, which corresponds to the momentum fraction the detected hadron carries relative to the struck parton and $P_T$, which corresponds to the transverse momentum of the detected hadron relative to the virtual photon. The expected statistical precision of such measurements is extrapolated to accumulated luminosities of 10 fb$^{-1}$ and potential systematic uncertainties are approximated given the deviations between true and reconstructed yields.Comment: 12 pages, 9 figures, to be submitted in joint ECCE proposal NIM-A volum

Open Heavy Flavor Studies for the ECCE Detector at the Electron Ion Collider

The ECCE detector has been recommended as the selected reference detector for the future Electron-Ion Collider (EIC). A series of simulation studies have been carried out to validate the physics feasibility of the ECCE detector. In this paper, detailed studies of heavy flavor hadron and jet reconstruction and physics projections with the ECCE detector performance and different magnet options will be presented. The ECCE detector has enabled precise EIC heavy flavor hadron and jet measurements with a broad kinematic coverage. These proposed heavy flavor measurements will help systematically study the hadronization process in vacuum and nuclear medium especially in the underexplored kinematic region.Comment: Open heavy flavor studies with the EIC reference detector design by the ECCE consortium. 11 pages, 11 figures, to be submitted to the Nuclear Instruments and Methods

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis

Publisher Copyright: © 2022, The Author(s).Background: Genetic variants within nearly 1000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery. Results: To expand our understanding of the underlying biological pathways and mechanisms controlling blood lipid levels, we leverage a large multi-ancestry meta-analysis (N = 1,654,960) of blood lipids to prioritize putative causal genes for 2286 lipid associations using six gene prediction approaches. Using phenome-wide association (PheWAS) scans, we identify relationships of genetically predicted lipid levels to other diseases and conditions. We confirm known pleiotropic associations with cardiovascular phenotypes and determine novel associations, notably with cholelithiasis risk. We perform sex-stratified GWAS meta-analysis of lipid levels and show that 3–5% of autosomal lipid-associated loci demonstrate sex-biased effects. Finally, we report 21 novel lipid loci identified on the X chromosome. Many of the sex-biased autosomal and X chromosome lipid loci show pleiotropic associations with sex hormones, emphasizing the role of hormone regulation in lipid metabolism. Conclusions: Taken together, our findings provide insights into the biological mechanisms through which associated variants lead to altered lipid levels and potentially cardiovascular disease risk.Peer reviewe