Segmental Kinematic Analysis of Planovalgus Feet during Walking in Children with Cerebral Palsy

Pes planovalgus (flatfoot) is a common deformity among children with cerebral palsy. The Milwaukee Foot Model (MFM), a multi-segmental kinematic foot model, which uses radiography to align the underlying bony anatomy with reflective surface markers, was used to evaluate 20 pediatric participants (30 feet) with planovalgus secondary to cerebral palsy prior to surgery. Three-dimensional kinematics of the tibia, hindfoot, forefoot, and hallux segments are reported and compared to an age-matched control set of typically-developing children. Most results were consistent with known characteristics of the deformity and showed decreased plantar flexion of the forefoot relative to hindfoot, increased forefoot abduction, and decreased ranges of motion during push-off in the planovalgus group. Interestingly, while forefoot characteristics were uniformly distributed in a common direction in the transverse plane, there was marked variability of forefoot and hindfoot coronal plane and hindfoot transverse plane positioning. The key finding of these data was the radiographic indexing of the MFM was able to show flat feet in cerebral palsy do not always demonstrate more hindfoot eversion than the typically-developing hindfoot. The coronal plane kinematics of the hindfoot show cases planovalgus feet with the hindfoot in inversion, eversion, and neutral. Along with other metrics, the MFM can be a valuable tool for monitoring kinematic deformity, facilitating clinical decision making, and providing a quantitative analysis of surgical effects on the planovalgus foot

Sagittal Subtalar and Talocrural Joint Assessment During Ambulation With Controlled Ankle Movement (CAM) Boots

Background: The purpose of the current study was to determine sagittal plane talocrural and subtalar kinematic differences between barefoot and controlled ankle movement (CAM) boot walking. This study used fluoroscopic images to determine talar motion relative to tibia and calcaneal motion relative to talus. Methods: Fourteen male subjects (mean age 24.1 ± 3.5 years) screened for normal gait were tested. A fluoroscopy unit was used to collect images at 200 Hz during stance. Sagittal motion of the talocrural and subtalar joints were analyzed barefoot and within short and tall CAM boots. Results: Barefoot talocrural mean maximum plantar and dorsiflexion were 9.2 ± 5.4 degrees and −7.5 ± 7.4 degrees, respectively; short CAM boot mean maximum plantar and dorsiflexion were 3.2 ± 4.0 degrees and −4.8 ± 10.2 degrees, respectively; and tall CAM boot mean maximum plantar and dorsiflexion were −0.2 ± 3.5 degrees and −2.4 ± 5.1 degrees, respectively. Talocrural mean range of motion (ROM) decreased from barefoot (16.7 ± 5.1 degrees) to short CAM boot (8.0 ± 4.9 degrees) to tall CAM boot (2.2 ± 2.5 degrees). Subtalar mean maximum plantarflexion angles were 5.3 ± 5.6 degrees for barefoot walking, 4.1 ± 5.9 degrees for short CAM boot walking, and 3.0 ± 4.7 degrees for tall CAM boot walking. Mean minimum subtalar plantarflexion angles were 0.7 ± 3.2 degrees for barefoot walking, 0.7 ± 2.9 degrees for short CAM boot walking, and 0.1 ± 4.8 degrees for tall CAM boot walking. Subtalar mean ROM decreased from barefoot (4.6 ± 3.9 degrees) to short CAM boot (3.4 ± 3.8 degrees) to tall CAM boot (2.9 ± 2.6 degrees). Conclusion: Tall and short CAM boot intervention was shown to limit both talocrural and subtalar motion in the sagittal plane during ambulation. The greatest reductions were seen with the tall CAM boot, which limited talocrural motion by 86.8% and subtalar motion by 37.0% compared to barefoot. Short CAM boot intervention reduced talocrural motion by 52.1% and subtalar motion by 26.1% compared to barefoot. Clinical Relevance: Both short and tall CAM boots reduced talocrural and subtalar motion during gait. The short CAM boot was more convenient to use, whereas the tall CAM boot more effectively reduced motion. In treatments requiring greater immobilization of the talocrural and subtalar joints, the tall CAM boot should be considered

Fourth-generation SM imprints in B -> K^*l^+l^- decays with polarized K^*

The implication of the fourth-generation quarks in the B -> K^*l^+l^- (l=mu,tau) decays, when K^* meson is longitudinally or transversely polarized, is presented. In this context, the dependence of the branching ratio with polarized K^* and the helicity fractions (f_{L,T}) of K^* meson are studied. It is observed that the polarized branching ratios as well as helicity fractions are sensitive to the NP parameters, especially when the final state leptons are tauons. Hence the measurements of these observables at LHC can serve as a good tool to investigate the indirect searches of new physics beyond the Standard Model.Comment: 13 pages, 10 figures, V2: some of the graphs are modified according to the new data from recent experiments. arXiv admin note: substantial text overlap with arXiv:1107.569

Hydro-NEXRAD-2: Real-time Access To Customized Radar-rainfall For Hydrologic Applications

Hydro-NEXRAD-2 (HNX2) is a prototype system that allows hydrologic users real-time access to NEXRAD radar data in support of a wide range of research. The system processes basic radar data (Level II) and delivers radar-rainfall products based on the user\u27s custom selection of features such as spatial domain, rainfall product space and time resolution, and rainfall estimation algorithms. HNX2 collects real-time, unprocessed data from multiple NEXRAD radars as they become available, processes them through a user-configurable pipeline of data-processing modules, and publishes the processed data-products at regular intervals. Modules in the data-processing pipeline encapsulate algorithms such as non-meteorological echo detection, radar range correction, radar-reflectivity-rain rate (Z-R) conversion, echo advection correction, mosaicking of products from multiple radars, and grid projections and transformations. This paper describes the challenges involved in HNX2\u27s development and implementation, which include real-time error-handling, time-synchronization of data from multiple asynchronous sources, generation of multiple-radar metadata products, and distribution of products to a user base with diverse needs and constraints. HNX2 publishes products through automation and allows multiple users access to published products. Currently, HNX2 is serving near real-time rain-rate maps for Iowa in the USA using data from seven radars covering the state. Hydrologic models operated by The University of Iowa\u27s Iowa Flood Center use these products. © IWA Publishing 2013

Microsurgical testicular sperm extraction for testicular failure: the South African experience and first successful pregnancy

CITATION: Zarrabi, A. D. & Kruger, T. F. 202). Microsurgical testicular sperm extraction for testicular failure : the South African experience and first successful pregnancy. South African Journal of Surgery, 59(2):52-56, doi:10.17159/2078-5151/2021/v59n2a3230.The original publication is available at: http://www.scielo.org.zaBACKGROUND: In men with non-obstructive azoospermia (NOA), biological fatherhood is only possibly by specialised microsurgical sperm retrieval techniques (micro-TESE), only recently introduced to South Africa. This study aimed to analyse the spectrum of causes of NOA and the outcomes of micro-TESE, including live births, following the use of this technique in South Africa METHODS: This was a retrospective review of all micro-TESE cases performed in South Africa by a single surgeon from 2014 to 2018. Data collected prospectively included: patient demographics, preoperative blood results, cause of azoospermia, intraoperative findings and postoperative complications. The primary outcome measured was surgical success of micro-TESE, which was defined as testicular sperm successfully retrieved and cryopreserved. Subsequent live births from assisted reproductive technology (ART) using the cryopreserved sperm were also documented RESULTS: Twenty-six men with NOA underwent micro-TESE between May 2014 and April 2018. Mean preoperative total testosterone level was 12.0 nmol/l (IQR 5.2) and follicle-stimulating hormone level 23.5 IU/l (IQR 15.6). Genetic testing was performed as part of the preoperative work-up in only 10 of the 26 patients. A specific cause of NOA was identified in 9 of the 26 patients and included Klinefelter syndrome (1 patient), Y-chromosome AZFc microdeletion (1 patient), undescended testicles (5 patients) and chemotherapy (2 patients). The average testicular volume was 9.05 ml (IQR 5.6), and the mean duration of surgery 95.8 minutes (IQR 28.0). The overall sperm retrieval rate was 34.6%. A single pregnancy and subsequent live birth were recorded from a total of eight cycles of intracytoplasmic sperm injection (ICSI): four female partners had one ICSI cycle each and two females underwent two cycles each. Frozen and thawed sperm was used in seven of the ICSI cycles and fresh sperm in one cycle CONCLUSION: In this South African series, sperm retrieval rates of micro-TESE for non-obstructive azoospermia were comparable to those reported internationally. Preoperative genetic testing should be increased to optimise the selection of surgical candidatesPublisher's versio

Hypoglycemia After Administration of Somatostatin Analog (SMS 201-995) in Metastatic Carcinoid

SMS 201-995 (Sandoz Pharmaceuticals. East Hanover NJ) is a synthetic peptide analog of native somatostatin that has been used to relieve .symptoms caused by neuroendocrine tumors. Reports have described an insulin suppressive effect of SMS 201-995 that results in elevations of blood glucose. We report a patient with a metastatic small bowel carcinoid and renal failure in whom mild symptomatic hypoglycemia occurred 30 to 60 minutes after SMS 201-995 administration. No increase in insulin or decreases in glucagon. Cortisol, or catecholamines were observed during these hypoglycemic episodes. Elevated levels of growth hormone fell gradually following SMS 201-995 administration and did not temporally correspond to the 30- to 60-minute nadir of blood glucose. However SMS 201-995 levels peaked during this 30- to 60-minute period. As clinical experience with this drug broadens, patients whose glucose control is dependent on counter-regulatory hormones should be monitored for the possibility of hypoglycemia

Some geochemical constraints upon models for the crystallization of the upper critical zone-main zone interval, northwestern Bushveld complex

Ratios between elements Mg, Fe, Co, Cr, Ni, V, and Sc are consistently different in mafic rocks of the upper critical zone, and those above the Bastard unit. Within the 300 m section above the Merensky Reef, 87Sr/86Sr ratios increase from c.0.7063 to c.0.7087, irrespective of rock type. Decoupling of Mg/(Mg + Fe2+) ratios and the Ca contents of plagioclase, and wide variations in the proportions of anorthosite within the Bastard, Merensky, and Merensky Footwall units, are inconsistent with anorthosite formation by simple fractional crystallization of magma batches of limited volume