Correlation of Clinical Examination, MRI and Arthroscopy Findings in Menisco-Cruciate Injuries of the Knee: A Prospective Diagnostic Study

Background: The aim of this study was to examine the correlation of the clinical examination, MRI and arthroscopic findings in cruciate ligaments and meniscal injuries of knee and to evaluate the accuracy of clinical examination and MRI with the gold standard arthroscopy. Methods: A prospective diagnostic double-blind study was conducted on 104 consecutive patients admitted to the outdoor/casualty with trauma to the knee complaining of knee pain/locking/ instability, from August 2012 to June 2014. All the patients were subjected to clinical examination, MRI scanning and diagnostic arthroscopy. Variables like sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical examination and MRI against arthroscopy were evaluated. Results: The sensitivity, specificity and accuracy of clinical examination for anterior cruciate ligament tears were 94.7%, 71.4% and 88.5% and for MRI were 94.7%, 78.6% and 90.4%, respectively; for posterior cruciate ligament tears 100%, 100% and 100% for clinical examination and for MRI 80%, 97.9% and 96.2%, respectively. These values for medial meniscus tears were 76.5%, 68.6% and 71.2% for clinical examination and 88.2%, 62.8% and 71.2% respectively for MRI. For lateral meniscus tears, 40%, 94.6% and 78.8% for clinical examination and 46.7%, 89.2% and 76.9% respectively for MRI. Conclusions: A skillfully performed clinical examination establishes a diagnosis on which an arthroscopic procedure can be planned, reserving MRI scans for patients where the clinical examination fails to establish a diagnosis or cannot be performed. Decision to use MRI should be based on the criteria that it would confirm, expand the diagnosis or change diagnosis in such a way that alters the proposed treatment

High- and mid-latitude quasi-2-day waves observed simultaneouslyby four meteor radars during summer 2000

International audienceResults from the analysis of MLT wind measurements at Dixon (73.5°N, 80°E), Esrange (68°N, 21°E), Castle Eaton (UK) (53°N, 2°W), and Obninsk (55°N, 37°E) during summer 2000 are presented in this paper. Using S-transform or wavelet analysis, quasi-two-day waves (QTDWs) are shown to appear simultaneously at high- and mid-latitudes and reveal themselves as several bursts of wave activity. At first this activity is preceded by a 51?53h wave with S=3 observed mainly at mid-latitudes. After a short recess (or quiet time interval for about 10 days near day 205), we observe a regular sequence of three bursts, the strongest of them corresponding to a QTDW with a period of 47?48h and S=4 at mid-altitudes. We hypothesize that these three bursts may be the result of constructive and destructive interference between several spectral components: a 47?48h component with S=4; a 60-h component with S=3; and a 80-h component with S=2. The magnitudes of the lower (higher) zonal wave-number components increase (decrease) with increasing latitude. The S-transform or wavelet analysis indicates when these spectral components create the wave activity bursts and gives a range of zonal wave numbers for observed bursts from about 4 to about 2 for mid- and high-latitudes. The main spectral component at Dixon and Esrange latitudes is the 60-h oscillation with S=3. The zonal wave numbers and frequencies of the observed spectral components hint at the possible occurrence of the nonlinear interaction between the primary QTDWs and other planetary waves. Using a simple 3-D nonlinear numerical model, we attempt to simulate some of the observed features and to explain them as a consequence of the nonlinear interaction between the primary 47?48h and the 9?10day waves, and the resulting linear superposition of primary and secondary waves. In addition to the QTDW bursts, we also infer forcing of the 4-day wave with S=2 and the 6?7day wave with S=1, possibly arising from nonlinear decoupling of the 60-h wave with S=3. The starting mechanism for this decoupling is the Rossby wave instability (e.g. Baines, 1976). This result is consistent with the day-to-day wind variability during the observed QTDW events. An interesting feature of the final stage of the observed QTDW activity in summer 2000 is the occurrence of strong 4?5 day waves with S=3. Key words. Meteorology and atmospheric dynamics (middle atmosphere dynamics; waves and tides; general or miscellaneous

(13C)-Methacetin breath test provides evidence of subclinical liver dysfunction linked to fat storage but not lifestyle

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is characterised by the presence of hepatic steatosis in the absence of other causes of secondary hepatic fat accumulation, and is usually associated with visceral, metabolically active obesity. However, the subclinical effects of body and liver fat accumulation on liver function are still unclear. Methods: We used orally administered (13C)-methacetin and breath test to quantify the efficiency of hepatic extraction from portal blood flow and liver microsomal function in 81 participants, in relation to presence/absence of ultrasonographic NAFLD, extent of body fat accumulation, insulin resistance, dietary models, and lifestyle. Results: NAFLD was present in 23% of participants with normal weight, and prevalence increased with body fat and insulin resistance. Fat accumulation, NAFLD, and insulin resistance were associated with decreased hepatic extraction efficiency, and liver microsomal function was impaired in moderate-to-severe NAFLD. Caloric intake, dietary models, and lifestyles had a minor role in promoting functional changes. Conclusions: The interplay between body fat accumulation, insulin resistance, and NAFLD is linked with altered hepatic extraction efficiency from blood flow and deranged microsomal function. Non-invasive diagnosis of subclinical alterations of liver function is relevant for primary and secondary prevention measures. Furthermore, the occurrence of NAFLD in lean individuals and the evidence that caloric intake, dietary models, and lifestyle played a minor role require further studies exploring the role of environmental factors in the natural history of these diseases. Lay summary: Obesity is progressively increasing worldwide and is paralleled by fat accumulation in the liver (non-alcoholic fatty liver disease [NAFLD]), the most common chronic liver disease worldwide. NAFLD can alter liver structure and function, with a variety of consequences ranging from asymptomatic and subclinical alterations to cirrhosis and cancer. (13C)-Methacetin breath test, a non-invasive diagnostic tool, can reveal early subclinical alterations of liver dynamic function in individuals with obesity and in patients with NAFLD

Effective Shielding of NaYF4:Yb3+,Er3+ Upconverting Nanoparticles in Aqueous Environments Using Layer-by-Layer Assembly

Aqueous solutions are the basis for most, biomedical assays, but they quench the upconversion luminescence significantly. Surface modifications of upconverting nanoparticles are vital for shielding the obtained luminescence. Modifications also provide new possibilities for further use by introducing attaching sites for biomolecule conjugation. We demonstrate the use of a layer-by-layer surface modification method combining varying lengths of negatively charged polyelectrolytes with positive neodymium ions in coating the upconverting NaYF4:Yb3+,Er3+ nanoparticles. We confirmed the formation of the bilayers and investigated the surface properties with Fourier transform infrared and reflectance spectroscopy, thermal analysis, and (zeta-potential measurements. The effect of the coating on the upconversion luminescence properties was characterized, and the bilayers with the highest improvement in emission intensity were identified. In addition, studies for the nanoparticle and surface stability were carried out in aqueous environments. It was observed that the bilayers were able to shield the materials' luminescence from quenching also in the presence of phosphate buffer that is currently considered the most disruptive environment for the nanoparticles

Finite Temperature Time-Dependent Effective Theory for the Phase Field in two-dimensional d-wave Neutral Superconductor

We derive finite temperature time-dependent effective actions for the phase of the pairing field, which are appropriate for a 2D electron system with both non-retarded d- and s-wave attraction. As for s-wave pairing the d-wave effective action contains terms with Landau damping, but their structure appears to be different from the s-wave case due to the fact that the Landau damping is determined by the quasiparticle group velocity v_{g}, which for d-wave pairing does not have the same direction as the non-interacting Fermi velocity v_{F}. We show that for d-wave pairing the Landau term has a linear low temperature dependence and in contrast to the s-wave case are important for all finite temperatures. A possible experimental observation of the phase excitations is discussed.Comment: 23 pages, RevTeX4, 10 EPS figures; final version to appear in PR

Models of coherent exciton condensation

That excitons in solids might condense into a phase-coherent ground state was proposed about 40 years ago, and has been attracting experimental and theoretical attention ever since. Although experimental confirmation has been hard to come by, the concepts released by this phenomenon have been widely influential. This tutorial review discusses general aspects of the theory of exciton and polariton condensates, focussing on the reasons for coherence in the ground state wavefunction, the BCS to Bose crossover(s) for excitons and for polaritons, and the relationship of the coherent condensates to standard lasers.Comment: 27 pages, 6 figures. Submitted for a special issue of J. Phys. Cond. Matt. associated with the EU network "Photon-mediated phenomena in semiconductor nanostructures

Effective action for Superconductors and BCS-Bose crossover

A standard perturbative expansion around the mean-field solution is used to derive the low-energy effective action for superconductors at T=0. Taking into account the density fluctuations at the outset we get the effective action where the density $\rho$ is the conjugated momentum to the phase $\theta$ of the order parameter. In the hydrodynamic regime, the dynamics of the superconductor is described by a time dependent non-linear Schr\"odinger equation (TDNLS) for the field $\Psi(x)=\sqrt{\rho/2} e^{i\theta}$. The evolution of the density fluctuations in the crossover from weak-coupling (BCS) to strong-coupling (Bose condensation of localized pairs) superconductivity is discussed for the attractive Hubbard model. In the bosonic limit, the TDNLS equation reduces to the the Gross-Pitaevskii equation for the order parameter, as in the standard description of superfluidity. The conditions under which a phase-only action can be derived in the presence of a long-range interaction to describe the physics of the superconductivity of ``bad metals'' are discussed.Comment: 13 pages, accepted for publication on Phys. Rev.

Phase fluctuations, dissipation and superfluid stiffness in d-wave superconductors

We study the effect of dissipation on quantum phase fluctuations in d-wave superconductors. Dissipation, arising from a nonzero low frequency optical conductivity which has been measured in experiments below $T_c$, has two effects: (1) a reduction of zero point phase fluctuations, and (2) a reduction of the temperature at which one crosses over to classical thermal fluctuations. For parameter values relevant to the cuprates, we show that the crossover temperature is still too large for classical phase fluctuations to play a significant role at low temperature. Quasiparticles are thus crucial in determining the linear temperature dependence of the in-plane superfluid stiffness. Thermal phase fluctuations become important at higher temperatures and play a role near $T_c$.Comment: Presentation improved, new references added (10 latex pages, 3 eps figures). submitted to PR

The giant, horizontal and asymptotic branches of galactic globular clusters. I. The catalog, photometric observables and features

A catalog including a set of the most recent Color Magnitude Diagrams (CMDs) is presented for a sample of 61 Galactic Globular Clusters (GGCs). We used this data-base to perform an homogeneous systematic analysis of the evolved sequences (namely, Red Giant Branch (RGB), Horizontal Branch (HB) and Asymptotic Giant Branch (AGB)). Based on this analysis, we present: (1) a new procedure to measure the level of the ZAHB (V_ZAHB) and an homogeneous set of distance moduli obtained adopting the HB as standard candle; (2) an independent estimate for RGB metallicity indicators and new calibrations of these parameters in terms of both spectroscopic ([Fe/H]_CG97) and global metallicity ([M/H], including also the alpha-elements enhancement). The set of equations presented can be used to simultaneously derive a photometric estimate of the metal abundance and the reddening from the morphology and the location of the RGB in the (V,B-V)-CMD. (3) the location of the RGB-Bump (in 47 GGCs) and the AGB-Bump (in 9 GGCs). The dependence of these features on the metallicity is discussed. We find that by using the latest theoretical models and the new metallicity scales the earlier discrepancy between theory and observations (~0.4 mag) completely disappears.Comment: 51 pages, 23 figures, AAS Latex, macro rtrpp4.sty included, accepted by A