Evaluation of arthroscopy and macroscopic scoring

INTRODUCTION: Arthroscopy is a minimally invasive technique for retrieving synovial biopsies in rheumatology during the past 20 years. Vital for its use is continual evaluation of its safety and efficacy. Important for sampling is the fact of intraarticular variation for synovial markers. For microscopic measurements scoring systems have been developed and validated, but for macroscopic evaluations there is a need for further comprehensive description and validation of equivalent scoring systems. METHODS: We studied the complication rate and yield of arthroscopies performed at our clinic between 1998 and 2005. We also created and evaluated a macroscopic score set of instructions for synovitis. RESULTS: Of 408 procedures, we had two major and one minor complication; two haemarthrosis and one wound infection, respectively. Pain was most often not a problem, but 12 procedures had to be prematurely ended due to pain. Yield of biopsies adequate for histology were 83% over all, 94% for knee joints and 34% for smaller joints. Video printer photographs of synovium taken during arthroscopy were jointly and individually reviewed by seven raters in several settings, and intra and inter rater variation was calculated. A macroscopic synovial scoring system for arthroscopy was created (Macro-score), based upon hypertrophy, vascularity and global synovitis. These written instructions were evaluated by five control-raters, and when evaluated individual parameters were without greater intra or inter rater variability, indicating that the score is reliable and easy to use. CONCLUSIONS: In our hands rheumatologic arthroscopy is a safe method with very few complications. For knee joints it is a reliable method to retrieve representative tissue in clinical longitudinal studies. We also created an easy to use macroscopic score, that needs to be validated against other methodologies. We hope it will be of value in further developing international standards in this area

Coding of procedures documented by general practitioners in Swedish primary care-an explorative study using two procedure coding systems

<p>Abstract</p> <p>Background</p> <p>Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVÅ) and SNOMED CT.</p> <p>Methods</p> <p>Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed.</p> <p>Results</p> <p>417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions.</p> <p>Conclusions</p> <p>Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED CT.</p> <p>Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care.</p

More Bucks for the Bang: New Space Solutions, Impact Tourism and one Unique Science & Engineering Opportunity at T-6 Months and Counting

For now, the Planetary Defense Conference Exercise 2021's incoming fictitious(!) asteroid, 2021 PDC, seems headed for impact on October 20th, 2021, exactly 6 months after its discovery. Today (April 26th, 2021), the impact probability is 5%, in a steep rise from 1 in 2500 upon discovery six days ago. We all know how these things end. Or do we? Unless somebody kicked off another headline-grabbing media scare or wants to keep civil defense very idle very soon, chances are that it will hit (note: this is an exercise!). Taking stock, it is barely 6 months to impact, a steadily rising likelihood that it will actually happen, and a huge uncertainty of possible impact energies: First estimates range from 1.2 MtTNT to 13 GtTNT, and this is not even the worst-worst case: a 700 m diameter massive NiFe asteroid (covered by a thin veneer of Ryugu-black rubble to match size and brightness) would come in at 70 GtTNT. In down to Earth terms, this could be all between smashing fireworks over some remote area of the globe and a 7.5 km crater downtown somewhere. Considering the deliberate and sedate ways of development of interplanetary missions it seems we can only stand and stare until we know well enough where to tell people to pack up all that can be moved at all and save themselves. But then, it could just as well be a smaller bright rock. The best estimate is 120 m diameter from optical observation alone, by 13% standard albedo. NASA's upcoming DART mission to binary asteroid (65803) Didymos is designed to hit such a small target, its moonlet Dimorphos. The Deep Impact mission's impactor in 2005 successfully guided itself to the brightest spot on comet 9P/Tempel 1, a relatively small feature on the 6 km nucleus. And 'space' has changed: By the end of this decade, one satellite communication network plans to have launched over 11000 satellites at a pace of 60 per launch every other week. This level of series production is comparable in numbers to the most prolific commercial airliners. Launch vehicle production has not simply increased correspondingly - they can be reused, although in a trade for performance. Optical and radio astronomy as well as planetary radar have made great strides in the past decade, and so has the design and production capability for everyday 'high-tech' products. 60 years ago, spaceflight was invented from scratch within two years, and there are recent examples of fastpaced space projects as well as a drive towards 'responsive space'. It seems it is not quite yet time to abandon all hope. We present what could be done and what is too close to call once thinking is shoved out of the box by a clear and present danger, to show where a little more preparedness or routine would come in handy - or become decisive. And if we fail, let's stand and stare safely and well instrumented anywhere on Earth together in the greatest adventure of science

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Development of a Cooled Radial Flameholder for the F404/RM12 Afterburner: Part III Afterburner Rumble Prediction and Suppression

One-dimensional methods used for solving acoustic instabilities are of doubtful value in the design of afterburner systems. In this paper a three-dimensional method developed and used at Volvo Aero Corporation is described. The method deals with the mean flow and the perturbation flow separately. The perturbation part is based on the linearized Euler equations (time domain) for compressible multi-species flow together with a spectrum trans-formation and Arnoldis method for eigenmode extraction

Development of a Cooled Radial Flameholder for the F404/RM12 Afterburner: Part III Afterburner Rumble Prediction and Suppression

One-dimensional methods used for solving acoustic instabilities are of doubtful value in the design of afterburner systems. In this paper a three-dimensional method developed and used at Volvo Aero Corporation is described. The method deals with the mean flow and the perturbation flow separately. The perturbation part is based on the linearized Euler equations (time domain) for compressible multi-species flow together with a spectrum trans-formation and Arnoldis method for eigenmode extraction

In Situ Formation of Ge Nanoparticles by Annealing of Al-Ge-N Thin Films Followed by HAXPES and XRD

Ge nanoparticles embedded in thin films have attracted a lot of attention due to their promising optical and electronic properties that can be tuned by varying the particle size and choice of matrix material. In this study, Ge nanoparticle formation was investigated for Al-Ge-N based thin films by simultaneous measurements of HAXPES and grazing incidence XRD during in situ annealing in vacuum conditions. As-deposited Al-Ge-N thin films, synthesized by reactive dc magnetron sputtering, consisted of a nanocrystalline (Al1-xGex)Ny solid solution and an amorphous tissue phase of Ge3Ny. Upon annealing to 750 °C, elemental Ge was formed shown by both HAXPES and XRD measurements, and N2 gas was released as measured by a mass spectrometer. Postannealed ex situ analysis by SEM and TEM showed that the elemental Ge phase formed spherical nanoparticles on the surface of the film, with an average size of 210 nm. As the annealing temperature increased further to 850 °C, the Ge particles on the film surface evaporated, while the phase segregation of Ge still could be observed within the film. Thus, these results show the possibility for a controlled synthesis of Ge nanoparticles through annealing of Al-Ge-N thin films to produce materials suitable for use in electronic or optoelectronic devices

Colour and melanophore function in rainbow trout after long term exposure to the new antifoulant medetomidine

Medetomidine is a new antifouling agent, and its effects in non-target aquatic organisms have been investigated. Earlier short-term studies in fish have shown a skin lightening response to medetomidine, but effects after chronic exposure have not been studied. In fish, the dark pigment melanin is contained within specialized cells, melanophores. Medetomidine binds to the melanophore α2-adrenoceptor, which stimulates pigment aggregation resulting in the light appearance. In the present study, rainbow trout (Oncorhynchus mykiss) was long-term exposed to 0.5 and 5.0 nM of medetomidine via water for 54 d. The fish were then photographed for paleness quantification and the images were analyzed using ImageJ analysis software. Additionally, scales were removed and used for in vitro function studies of the melanophores, monitoring the response to melanophore stimulating hormone (MSH) and subsequent medetomidine addition. The number of melanophores was also investigated. As a result of the medetomidine exposure, fish from the 5 nM treatment were significantly paler than control fish and the melanophores from these fishes were also more aggregated. Melanophores from all the treatments were functional, responding to MSH by dispersion and to subsequent medetomidine by aggregation. However, the results indicate a difference in sensitivity among treatments. The number of melanophores in the scales did not change significantly after long term exposure to medetomidine. These results suggest that the observed paleness may be reversible, even after chronic exposure

RESEARCH ARTICLE Open Access

Coding of procedures documented by general practitioners in Swedish primary care-a