Sonographic evaluation of the association between calcific tendinopathy and rotator cuff tear: a case-controlled comparison

Objectives: To compare the incidence of rotator cuff (RC) tears on shoulder ultrasounds of patients with RC calcific tendinopathy (CaT) to that of a control group without CaT. Method: In this retrospective case-control study, 50 shoulder ultrasounds of patients with CaT were compared independently by 2 musculoskeletal radiologists to 50 patients from a control group without CaT to catalog the number and type of RC tears. RC tears in the CaT group were further characterized based on location, into tears in the specific tendon(s) containing calcium versus all tendon tears. Results: RC tears were diagnosed in 38% (19/50) of the control group (16 full-thickness) as compared to 22% (11/50) with CaT (6 full-thickness). The fewer full-thickness tears in the CaT group (12%, 6 of 50) compared to that in the control group (32%, 16 of 50) was statistically significant (P = 0.016, odds ratio 0.29). Only 7 of the 11 tears in the CaT group were in a calcium-containing tendon (3 full-thickness). The fewer calcium-containing tendon tears compared to tears in the control group was also statistically significant (P = 0.006, odds ratio 0.27). Furthermore, the fewer full-thickness calcium-containing tendon tears (6%, 3/50) compared to full-thickness tears in the control group (32%, 16/50) were yet more statistically significant (P = 0.001, odds ratio 0.14). Conclusions: In patients with shoulder pain and CaT, we observed a decreased number of RC tears and especially calcium-containing tendon tears, as compared to similar demographic patients with shoulder pain but without CaT. Key Points • Patients with rotator cuff calcific tendinopathy have few rotator cuff tears, especially full-thickness tears, compared to a control group without calcific tendinopathy. • The tendons containing the calcium hydroxyapatite deposition were the least likely to have a rotator cuff tear. • Future studies could evaluate if calcium hydroxyapatite deposition provides a protective mechanism against rotator cuff tears. • Musculoskeletal ultrasound is more sensitive than MRI in the evaluation of rotator cuff calcific tendinopathy

Elbow Torque May be Predictive of Anatomic Adaptations to the Elbow After a Season of Collegiate Pitching: A Dynamic Ultrasound Study

Purpose: To determine whether elbow torque was associated with anatomic adaptations of the medial elbow following a season of competitive pitching. Methods: Pitchers from 3 collegiate baseball teams were recruited during the preseason for participation. Before the season, pitchers were recorded throwing 5 game-speed fastball pitches from a standard distance off a mound while wearing a wearable sensor baseball compression sleeve that calculates elbow torque, arm speed, arm slot, and arm rotation. Participants subsequently underwent dynamic ultrasound imaging of the medial elbow, including measurements of the ulnar collateral ligament (UCL) and ulnohumeral joint space to assess elbow laxity. Following a full season of competitive pitching, all testing was repeated, and statistical analysis comparing preseason to postseason sonographic findings was performed. Results: Twenty-eight collegiate pitchers underwent preseason sonographic and kinematic testing. Nineteen pitchers were available for postseason testing. The average age (standard deviation) and playing experience was 19.9 (1.2) and 14.7 (1.5) years. Compared with preseason, there were significant increases in postseason UCL thickness (1.92 ± 0.09 vs 1.56 ± 0.09 mm, P \u3c .01) and elbow laxity (1.77 ± 0.23 vs 1.15 ± 0.22 mm, P = .028) after a season of pitching. No significant changes in pitching kinematic measurements were observed between preseason and postseason testing. Preseason pitching kinematic measurements were significantly associated with increased UCL thickness (arm slot: beta estimate -0.03 ± 0.01, P = .011) and reduction in elbow laxity (elbow torque: beta estimate -0.03 ± 0.01, P = .04) after a season of pitching. Pitchers with increased body weight and arm length demonstrated reduced medial elbow torque during pitching (P \u3c .05). Conclusions: After a season of competitive pitching, adaptive changes of the medial elbow were demonstrated on dynamic ultrasound. However, the influence of pitching kinematic measurements on these adaptations are of small magnitude and unknown clinical significance. Although wearable sensor technology may have value in trending individual pitcher kinematics, no discrete threshold appears to predict the development of adaptive changes at the elbow. Level of Evidence: Level II, prospective observational study

Significant variability exists in preoperative planning software measures of glenoid morphology for shoulder arthroplasty

Background & Hypothesis: We sought to assess the reliability of 4 different shoulder arthroplasty 3-dimensional preoperative planning programs. Comparison was also made to manual measurements conducted by 2 fellowship-trained musculoskeletal radiologists. We hypothesized that there would be significant variation in measurements of glenoid anatomy affected by glenoid deformity. Methods: A retrospective review of computed tomography (CT) scans of patients undergoing shoulder arthroplasty was undertaken. A total of 76 computed tomographies were analyzed for glenoid version and inclination by 4 templating software systems (VIP, Blueprint, TrueSight, ExactechGPS). Inter-rater reliability was assessed via intra-class correlation coefficient (ICC). For those shoulders with glenohumeral arthritis (58/76), ICC was also calculated when sub-grouping by modified Walch classification. Lin\u27s concordance correlation coefficient was calculated for each system with 2 musculoskeletal-trained radiologists’ measurements. Results: Measurements of glenoid version and inclination differed between at least 2 programs by 5º-10º in 75% and 92% of glenoids respectively, and by \u3e10º in 18% and 45% respectively. ICC was excellent for version but only moderate for inclination. ICC was highest among Walch A glenoids for both version (near excellent) and inclination (good), and lowest among Walch D for version (near poor) and Walch B for inclination (moderate). When measuring version, VIP had the highest concordance with manual measurement; Blueprint had the lowest. For inclination Blueprint had the highest concordance; ExactechGPS had the lowest. Discussion & Conclusion: Despite overall high reliability for measures of glenoid version between 4 frequently utilized shoulder arthroplasty templating softwares, this reliability is significantly affected by glenoid deformity. The programs were overall less reliable when measuring inclination, and a similar trend of decreasing reliability with increasing glenoid deformity emerged that was not statistically significant. Concordance with manual measurement is also variable. Further research is needed to understand how this variability should be accounted for during shoulder arthroplasty preoperative planning. Level of Evidence: Level III; Retrospective Comparative Stud

The Period Changes of the Cepheid RT Aurigae

Observations of the light curve for the 3.7-day Cepheid RT Aur both before and since 1980 indicate that the variable is undergoing an overall period increase, amounting to +0.082 +-0.012 s/yr, rather than a period decrease, as implied by all observations prior to 1980. Superposed on the star's O-C variations is a sinusoidal trend that cannot be attributed to random fluctuations in pulsation period. Rather, it appears to arise from light travel time effects in a binary system. The derived orbital period for the system is P = 26,429 +-89 days (72.36 +-0.24 years). The inferred orbital parameters from the O-C residuals differ from those indicated by existing radial velocity data. The latter imply the most reasonable results, namely a1 sin i = 9.09 (+-1.81) x 10^8 km and a minimum secondary mass of M2 = 1.15 +-0.25 Msun. Continued monitoring of the brightness and radial velocity changes in the Cepheid are necessary to confirm the long-term trend and to provide data for a proper spectroscopic solution to the orbit.Comment: Accepted for publication in PASP (November 2007

Federated Learning on Heterogenous Data using Chest CT

Large data have accelerated advances in AI. While it is well known that population differences from genetics, sex, race, diet, and various environmental factors contribute significantly to disease, AI studies in medicine have largely focused on locoregional patient cohorts with less diverse data sources. Such limitation stems from barriers to large-scale data share in medicine and ethical concerns over data privacy. Federated learning (FL) is one potential pathway for AI development that enables learning across hospitals without data share. In this study, we show the results of various FL strategies on one of the largest and most diverse COVID-19 chest CT datasets: 21 participating hospitals across five continents that comprise >10,000 patients with >1 million images. We present three techniques: Fed Averaging (FedAvg), Incremental Institutional Learning (IIL), and Cyclical Incremental Institutional Learning (CIIL). We also propose an FL strategy that leverages synthetically generated data to overcome class imbalances and data size disparities across centers. We show that FL can achieve comparable performance to Centralized Data Sharing (CDS) while maintaining high performance across sites with small, underrepresented data. We investigate the strengths and weaknesses for all technical approaches on this heterogeneous dataset including the robustness to non-Independent and identically distributed (non-IID) diversity of data. We also describe the sources of data heterogeneity such as age, sex, and site locations in the context of FL and show how even among the correctly labeled populations, disparities can arise due to these biases

Boron isotopes in foraminifera : systematics, biomineralisation, and CO2 reconstruction

Funding: Fellowship from University of St Andrews, $100 (pending) from Richard Zeebe, UK NERC grants NE/N003861/1 and NE/N011716/1.The boron isotope composition of foraminifera provides a powerful tracer for CO2 change over geological time. This proxy is based on the equilibrium of boron and its isotopes in seawater, which is a function of pH. However while the chemical principles underlying this proxy are well understood, its reliability has previously been questioned, due to the difficulty of boron isotope (δ11B) analysis on foraminferal samples and questions regarding calibrations between δ11B and pH. This chapter reviews the current state of the δ11B-pH proxy in foraminfera, including the pioneering studies that established this proxy’s potential, and the recent work that has improved understanding of boron isotope systematics in foraminifera and applied this tracer to the geological record. The theoretical background of the δ11B-pH proxy is introduced, including an accurate formulation of the boron isotope mass balance equations. Sample preparation and analysis procedures are then reviewed, with discussion of sample cleaning, the potential influence of diagenesis, and the strengths and weaknesses of boron purification by column chromatography versus microsublimation, and analysis by NTIMS versus MC-ICPMS. The systematics of boron isotopes in foraminifera are discussed in detail, including results from benthic and planktic taxa, and models of boron incorporation, fractionation, and biomineralisation. Benthic taxa from the deep ocean have δ11B within error of borate ion at seawater pH. This is most easily explained by simple incorporation of borate ion at the pH of seawater. Planktic foraminifera have δ11B close to borate ion, but with minor offsets. These may be driven by physiological influences on the foraminiferal microenvironment; a novel explanation is also suggested for the reduced δ11B-pH sensitivities observed in culture, based on variable calcification rates. Biomineralisation influences on boron isotopes are then explored, addressing the apparently contradictory observations that foraminifera manipulate pH during chamber formation yet their δ11B appears to record the pH of ambient seawater. Potential solutions include the influences of magnesium-removal and carbon concentration, and the possibility that pH elevation is most pronounced during initial chamber formation under favourable environmental conditions. The steps required to reconstruct pH and pCO2 from δ11B are then reviewed, including the influence of seawater chemistry on boron equilibrium, the evolution of seawater δ11B, and the influence of second carbonate system parameters on δ11B-based reconstructions of pCO2. Applications of foraminiferal δ11B to the geological record are highlighted, including studies that trace CO2 storage and release during recent ice ages, and reconstructions of pCO2 over the Cenozoic. Relevant computer codes and data associated with this article are made available online.Publisher PDFPeer reviewe

Deep COVID DeteCT: an international experience on COVID-19 lung detection and prognosis using chest CT

The Coronavirus disease 2019 (COVID-19) presents open questions in how we clinically diagnose and assess disease course. Recently, chest computed tomography (CT) has shown utility for COVID-19 diagnosis. In this study, we developed Deep COVID DeteCT (DCD), a deep learning convolutional neural network (CNN) that uses the entire chest CT volume to automatically predict COVID-19 (COVID+) from non-COVID-19 (COVID�) pneumonia and normal controls. We discuss training strategies and differences in performance across 13 international institutions and 8 countries. The inclusion of non-China sites in training significantly improved classification performance with area under the curve (AUCs) and accuracies above 0.8 on most test sites. Furthermore, using available follow-up scans, we investigate methods to track patient disease course and predict prognosis. © 2021, The Author(s)

Інформаційний довідник

Кінологічне забезпечення діяльності підрозділів Національної поліції України : інформ. довід. / [О. І. Безпалова, А. М. Клочко, О. В. Джафарова та ін.]; МВС України, Харків. нац. ун-т внутр. справ. – Харків: ХНУВС, 2019. – 139 с.В інформаційному довідникові висвітлено основні положення законодавства України, що регулює кінологічне забезпечення діяльності підрозділів Національної поліції України; розкрито теорію та методологію службової кінології, розглянуто організацію та здійснення процесу підготовки кінологів, у тому числі в частині психологічних особливостей діяльності кінологічної служби. Охарактеризовано специфіку організації ветеринарно-санітарного забезпечення кінологічної діяльності, проаналізовано загальні правила дресирування службових собак та методів відбору собак для службової діяльності. Окрему увагу приділено тактиці застосування пошукових собак. Навчальний посібник розраховано на курсантів, слухачів, ад’юнктів, аспірантів, докторантів, викладачів закладів вищої освіти МВС України зі специфічними умовами навчання. Ознайомлення з матеріалами даного інформаційного довідника також буде корисним курсантам та слухачам під час підготовки до атестації здобувача вищої освіти для отримання освітнього ступеню «бакалавр» і «магістр» та для працівників поліції при виконанні своїх обов’язків.The information guide highlights the main provisions of the legislation of Ukraine, which regulates the cynological support of the activities of the National Police of Ukraine; The theory and methodology of official cynology are disclosed, the organization and implementation of the training process for dog handlers, including the psychological characteristics of the activity of the dog service, are considered. The specifics of the organization of veterinary and sanitary support for cynological activities are characterized, the general rules for the training of service dogs and the methods for selecting dogs for service activities are analyzed. Particular attention is paid to the tactics of using search dogs. The manual is designed for cadets, students, adjuncts, graduate students, doctoral students, teachers of higher education institutions of the Ministry of Internal Affairs of Ukraine with specific learning conditions.В информационном справочнике освещены основные положения законодательства Украины, регулирующего кинологическое обеспечение деятельности подразделений Национальной полиции Украины; раскрыто теорию и методологию служебной кинологии, рассмотрена организация и осуществление процесса подготовки кинологов, в том числе в части психологических особенностей деятельности кинологической службы. Охарактеризованы специфику организации ветеринарно-санитарного обеспечения кинологической деятельности, проанализированы общие правила дрессировки служебных собак и методов отбора собак для служебной деятельности. Особое внимание уделено тактике применения поисковых собак. Учебное пособие рассчитано на курсантов, слушателей, адъюнктов, аспирантов, докторантов, преподавателей учреждений высшего образования МВД Украины со специфическими условиями обучения

Solving the Logistical Issues of Rapid MSK MR Scanning

Object or Purpose of Study: State of the art sequences and specialized hardware are beginning to allow for the reduction of the acquisition time of musculoskeletal (MSK) Magnetic Resonance (MR) scans. Shorter acquisition times should allow for more patients to be scanned in a day; however, implementing these rapid scans into the imaging workflow required changing the whole MR scheduling system. We report the challenges and benefits after incorporating rapid scan protocols into our imaging workflows. Methods: Multichannel coils were utilized, enabling the use of parallel imaging techniques to reduce routine total joint scan times to under 10 minutes [1]. MSK MR schedule slot times were reduced from 45 minutes to 30 minutes. The institution’s MR schedule was changed from a basis of 45 minute slots to 30 minute slots. After implementing the new rapid MSK scans and 30 minute slot scheduling system in 2018, we collected the scan volume, scheduling lead time, and technologist feedback for July of 2018. This data was compared to data from July of 2017. Data was obtained from a single scanner to control for extraneous factors such as technologist experience, facility workflow, schedule saturation, and patient compliance. Results: The total number of MR studies performed on the scanner increased from 261 in July of 2017 to 289 in July of 2018. Rapid MSK MR image quality was determined to be adequate for the clinical workflow. The two most prominent issues experienced were scheduling and technologist performance difficulties. 20 minute scheduling slots did not allow sufficient time for patient preparation. However, 30 minute slots were found to be ideal. The MR schedule was reorganized to be based on 30 minute slots from 45 minute slots used previously. 51 studies were reassigned 30 minute slots from 45 minute slots. 30 studies were reassigned 1 hour slots from 45 minutes. 19 studies were reassigned 1 hour slots from 1.5 hour slots. Even though many studies were increased from 45 minutes to 1 hour, we found an overall time savings from studies being reduced to 30 minutes and from 1.5 hours to 1 hour. A surprising benefit of moving to a 30-minute time slot schedule was a decrease in the lead time in scheduling for MR. By having more time slots per day available, MR studies were allowed be scheduled sooner. The mean weekly lead time for July 2017 was 15.4 days and for July 2018 was 9.2 days (p\u3c0.05). Shortened 30 minute time slots place additional burdens on the MR technologists, and highlighted differences in speed and efficiency. With the 30 minute slot workflow, there is much less buffer time for patient preparation tasks such as acquiring screening radiographs. Technologists were required to be more flexible and efficient. These changes resulted in differences in patient experience, with some patients feeling rushed. Significance: Implementing rapid MSK MR scans allowed for our institution to switch from 45-minute time slots to 30 minutes time slots for MR scheduling. As a result, our MR study volume increased and our lead time for scheduling decreased, allowing our patients to obtain their MR studies more quickly.https://scholarlycommons.henryford.com/merf2019qi/1017/thumbnail.jp