Renale osteodystrofie : pathofysiologie en behandeling met 1α-hydroxy-derivaten van vitamine D

Renale osteodystrofie omvat de botafwijkingen die ontstaan ten gevolge van veranderingen in de Ca- en P-stofwisse!ing, die optreden bij patiënten met een chronische nierinsufficiëntie. Met de chronische nierziekten zijn bedoeld g!omerulaire/parenchymateuze aandoeningen en niet specifieke tubu!aire defecten zoals bij renale tubulaire acidose en het Fanconi-syndroom. Het is onwaarschijnlijk dat de aetiologie van de g!omerulaire/parenchymateuze nierafwijkingen in het algemeen van invloed is op het soort botafwijkingen, dat onstaat. Wel worden niet altijd dezelfde afwijkingen in dezelfde mate bij alle patiënten met vergelijkbaar nierfunctieverlies gevonden. In wisselende mate worden tekenen van hyperparathyreoidie, osteomalacie en osteosclerose in het histologisch beeld aangetroffe

Quantifying the Differences between 3D Virtual Planning and Attained Postoperative Reduction on CT for Patients with Tibial Plateau Fractures; a Clinical Feasibility Study

Background: Three-Dimensional Virtual Planning (3DVP) has been proven to be effective for limiting intra-articular screw penetration and improving the quality of reduction for numerous fractures. However, the value of 3DVP for patients with tibial plateau fractures has yet to be determined. Purposes: The research question of this study is: Can Computed Tomography Micromotion Analysis (CTMA) provide a reliable quantification of the difference between 3DVP and the postoperative reduction on CT for tibial plateau fractures? Methods: Nine consecutive adult patients who received surgical treatment for a tibial plateau fracture and received pre- and postoperative CT scans were included from a level I trauma center in the Netherlands. The preoperative CT scans of the patients were uploaded in a 3DVP software. In this software, fracture fragments were reduced and the reduction was saved as a 3D file (STL). The quality of the reduction from the 3DVP software was compared with the postoperative results using CT Micromotion Analysis (CTMA). In this analysis, the translation of the largest intra-articular fragment was calculated by aligning the postoperative CT with the 3DVP. Coordinates and measurement points were defined in the X, Y, and Z axes. The combined values of X and Y were used to define the intra-articular gap. The Z-axis was defined as the line from cranial to caudal and was used to define intra-articular step-off. Results: The intra-articular step-off was 2.4 mm (Range 0.5–4.6). Moreover, the mean translation of the X-axis and Y-axis, which was defined as the intra-articular gap, was 4.2 mm (Range 0.6–10.7). Conclusions: 3DVP provides excellent insight into the fracture and its fragments. Utilizing the largest intra-articular fragment, it is feasible to quantify the difference between 3DVP and a postoperative CT using CTMA. A prospective study to further analyze the use of 3DVP in terms of intra-articular reduction and surgical and patient-related outcomes has been started by our team.</p

Prevalence of Rotational Malalignment after Infrapatellar Versus Suprapatellar Intramedullary Nailing of Tibial Shaft Fractures

Background: Up to 30% of patients with a tibial shaft fracture sustain iatrogenic rotational malalignment (RM) after infrapatellar (IP) nailing. Although IP nailing remains the management of choice for most patients, suprapatellar (SP) nailing has been gaining popularity. It is currently unknown whether SP nailing can provide superior outcomes with regard to tibial RM. The aim of this study was to compare the differences in the prevalence of RM following IP versus SP nailing.Methods: This retrospective study included 253 patients with a unilateral, closed tibial shaft fracture treated with either an IP or SP approach between January 2009 and April 2023 in a Level-I trauma center. All patients underwent a postoperative, protocolized, bilateral computed tomography (CT) scan for RM assessment.Results: RM was observed in 30% and 33% of patients treated with IP and SP nailing, respectively. These results indicate no significant difference (p = 0.639) in the prevalence of RM between approaches. Furthermore, there were no significant differences in the distribution (p = 0.553) and direction of RM (p = 0.771) between the 2 approaches. With the IP and SP approaches, nailing of left-sided tibial shaft fractures resulted in predominantly internal RM (85% and 73%, respectively), while nailing of right-sided tibial shaft fractures resulted in predominantly external RM (90% and 80%, respectively). The intraobserver reliability for the CT measurements was 0.95.Conclusions: The prevalence of RM was not influenced by the entry point of tibial nailing (i.e., IP versus SP). Hence, the choice of surgical approach should rely on factors other than the risk of RM.Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.</p

Measurement artefacts lead to false positives in the study of birdsong in noise

Numerous studies over the past decade have reported correlations between elevated levels of anthropogenic noise and a rise in the minimum frequency of acoustic signals of animals living in noisy habitats. This pattern appears to be occurring globally, and higher pitched signals have been hypothesized to be adaptive changes that reduce masking by low‐frequency traffic noise. However, the sound analysis methods most often used in these studies are prone to measurement errors that can result in false positives. In addition, the commonly used method of measuring frequencies visually from spectrograms might also lead to observer‐expectancy biases that could exacerbate measurement errors. We conducted an experiment to (i) quantify the size and type of errors that result from ‘eye‐balling’ frequency measurements with cursors placed manually on spectrograms of signals recorded in noise and no‐noise conditions, and (ii) to test whether observer expectations lead to significant errors in frequency measurements. We asked 54 volunteers, blind to the true intention of our study, to visually measure the minimum frequency of a variety of natural and synthesized bird sounds, recorded either in noise, or no‐noise conditions. Test subjects were either informed or uninformed about the hypothesized results of the measurements. Our results demonstrate that inappropriate methodology in acoustic analysis can yield false positives with effect sizes as large, or even larger, than those reported in published studies. In addition to these measurement artefacts, psychological observer biases also led to false positives – when observers expected signals to have higher minimum frequencies in noise, they measured significantly higher minimum frequencies than uninformed observers, who had not been primed with any expectation. The use of improper analysis methods in bioacoustics can lead to the publication of spurious results. We discuss alternative methods that yield unbiased frequency measures and we caution that it is imperative for researchers to familiarize themselves both with the functions and limitations of their sound analysis programmes. In addition, observer‐expectancy biases are a potential source of error not only in the field of bioacoustics, but in any situation where measurements can be influenced by human subjectivity

Central-West Siberian-breeding Bar-tailed Godwits (<i>Limosa lapponica</i>) segregate in two morphologically distinct flyway populations

Long-distance migratory species often include multiple breeding populations, with distinct migration routes, wintering areas and annual-cycle timing. Detailed knowledge on population structure and migratory connectivity provides the basis for studies on the evolution of migration strategies and for species conservation. Currently, five subspecies of Bar-tailed Godwits Limosa lapponica have been described. However, with two apparently separate breeding and wintering areas, the taxonomic status of the subspecies L. l. taymyrensis remains unclear. Here we compare taymyrensis Bar-tailed Godwits wintering in the Middle East and West Africa, respectively, with respect to migration behaviour, breeding area, morphology and population genetic differentation in mitochondrial DNA. By tracking 52 individuals from wintering and staging areas over multiple years, we show that Bar-tailed Godwits wintering in the Middle East bred on the northern West-Siberian Plain (n = 19), while birds from West Africa bred further east, mostly on the Taimyr Peninsula (n = 12). The two groups differed significantly in body size and shape, and also in the timing of both northward and southward migrations. However, they were not genetically differentiated, indicating that the phenotypic (i.e. geographical, morphological and phenological) differences arose either very recently or without current reproductive isolation. We conclude that the taymyrensis taxon consists of two distinct populations with mostly non-overlapping flyways, which warrant treatment as separate taxonomic units. We propose to distinguish a more narrowly defined taymyrensis subspecies (i.e. the Bar-tailed Godwits wintering in West Africa and breeding on Taimyr), from a new subspecies (i.e. the birds wintering in the Middle East and breeding on the northern West-Siberian Plain)

Nutrient extraction and exportation by common bean cultivars under different fertilization levels: I - macronutrients

The use of cultivars with a higher yield potential and the adoption of new technology have achieved high grain yields in common bean, which probably changed the demand for nutrients in this crop. However, there is almost no information about the periods of the cycle in which nutrients are most demanded at which quantities by the main cultivars. The objective of this study was to evaluate the macronutrient extraction and exportation by the common bean cultivars Pérola and IAC Alvorada, under different levels of NPK fertilization, on a dystroferric Red Nitosol, in Botucatu, São Paulo State, Brazil. The experiment was arranged in a randomized complete block (split plot) design with four replications. The plots consisted of six treatments based on a 2 x 3 factorial model, represented by two cultivars and three NPK levels (PD0 - 'Pérola' without fertilization, PD1 - 'Pérola' with 50 % of recommended fertilization, PD2 - 'Pérola' with 100 % of recommended fertilization, AD0 - 'IAC Alvorada' without fertilization, AD1 - 'IAC Alvorada' with 50 % of recommended fertilization, and AD2 - 'IAC Alvorada' with 100 % of recommended fertilization) and subplots sampled seven times during the cycle. At higher levels of NPK fertilization, the grain yield and macronutrient extraction and exportation of both cultivars were higher, but without statistical differences. Macronutrient absorption was higher in the treatments with 100 % of recommended NPK fertilization (average amounts per hectare: 140 kg N, 16.5 kg P, 120 kg K, 69 kg Ca, 17.9 kg Mg, and 16.3 kg S). Regardless of the treatment, the demand for N, P, K, Ca, and Mg was highest from 45 to 55 days after emergence (DAE), i.e., in the R7 stage (pod formation), while the highest S absorption rates were concentrated between 55 and 65 DAE. More than 70 % of P, between 58 and 69 % of N, 40 and 52 % of S, 40 and 48 % of K, and 35 and 45 % of Mg absorbed during the cycle was exported with grains, whereas less than 15 % of Ca was exported.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Department of Crop Science College of Agricultural Sciences São Paulo State University - FCA/UNESP, P.O. Box 37, CEP 18610-307 Botucatu SPFCA/UNESPDepartment of Crop Science College of Agricultural Sciences São Paulo State University - FCA/UNESP, P.O. Box 37, CEP 18610-307 Botucatu SPFCA/UNESPFAPESP: 10/18602-