Congenital dislocation of the hip: Optimal screening strategies in 2014

AbstractA prospective multi-centre nationwide study of patients with congenital dislocation of the hip (CDH) diagnosed after 3 months of age was conducted with support from the French Society for Paediatric Orthopaedics (Société Française d’Orthopédie Pédiatrique [SoFOP]), French Organisation for Outpatient Paediatrics (Association Française de Pédiatrie Ambulatoire [AFPA]), and French-Speaking Society for Paediatric and Pre-Natal Imaging (Société Francophone d’Imagerie Pédiatrique et Prénatale [SFIPP]). The results showed inadequacies in clinical screening for CDH that were patent when assessed quantitatively and probably also present qualitatively. These findings indicate a need for a communication and educational campaign aimed at highlighting good clinical practice guidelines in the field of CDH screening. The usefulness of routine ultrasound screening has not been established. The findings from this study have been used by the authors and French National Health Authority (Haute Autorité de Santé [HAS]) to develop recommendations about CDH screening. There is an urgent need for a prospective randomised multi-centre nationwide study, which should involve primary-care physicians

Sensory profiles and preference analysis in ornamental horticulture: The case of the rosebush

The context of ornamental horticulture is considered in order to extend the techniques of sensory and preference evaluation by taking the rosebush as a plant model. In a preliminary study (Boumaza, Demotes-Mainard, Huché-Thélier, & Guérin, 2009), a sensory evaluation was conducted in order to set up a list of attributes. Subsequently, this list was adapted to assess 10 rosebushes. After the control of the panel performance using a multivariate strategy of analysis, the average scores were used in product mapping. The evaluation of the preferences with regard to these rosebushes was undertaken: 253 subjects were asked to rank the products by decreasing order of liking. Thereafter, the preference data were subjected to an internal preference mapping and a cluster analysis. Six homogeneous segments of consumers were eventually retained. By way of performing an external preference mapping, the average ranks were regressed upon the sensory attributes using principal component regression: the preferences of 67% of the consumers were satisfactorily explained by the attributes

Knee instruments and rating scales designed to measure outcomes

In this article, the knee instruments and rating scales that are designed to measure outcomes are revised. Although the International Knee Documentation Committee Subjective Knee Form can be used as a general knee measure, no instrument is currently universally applicable across the spectrum of knee disorders and patient groups. Clinicians and researchers looking to use a patient-based score for measurement of outcomes must consider the specific patient population in which it has been evaluated. The Western Ontario and McMaster Universities Osteoarthritis Index is recommended for the evaluation of treatment effect in persons with osteoarthritis (OA). This is a generic health status questionnaire that contains 36 items, is widely used, and easy to complete. The Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire evaluates the functional status and quality of life (QoL) of patients with any type of knee injury who are at increased risk of developing OA; i.e., patients with anterior cruciate ligament (ACL) injury, meniscus injury, or chondral injury. So far, the KOOS questionnaire has been validated for several orthopedic procedures such as total knee arthroplasty, ACL reconstruction, and meniscectomy. The utilization of QoL questionnaires is crucial to the adequate assessment of a number of orthopedic procedures of the knee. The questionnaires are generally well accepted by the patients and open up new perspectives in the analysis of prognostic factors for optimal QoL of patients undergoing knee surgery

Therapeutic hypothermia for acute ischaemic stroke. Results of a European multicentre, randomised, phase III clinical trial

Introduction: We assessed whether modest systemic cooling started within 6 hours of symptom onset improves functional outcome at three months in awake patients with acute ischaemic stroke. Patients and methods: In this European randomised open-label clinical trial with blinded outcome assessment, adult patients with acute ischaemic stroke were randomised to cooling to a target body temperature of 34.0–35.0°C, started within 6 h after stroke onset and maintained for 12 or 24 h , versus standard treatment. The primary outcome was the score on the modified Rankin Scale at 91 days, as analysed with ordinal logistic regression. Results: The trial was stopped after inclusion of 98 of the originally intended 1500 patients because of slow recruitment and cessation of funding. Forty-nine patients were randomised to hypothermia versus 49 to standard treatment. Four patients were lost to follow-up. Of patients randomised to hypothermia, 15 (31%) achieved the predefined cooling targets. The primary outcome did not differ between the groups (odds ratio for good outcome, 1.01; 95% confidence interval, 0.48–2.13; p = 0.97). The number of patients with one or more serious adverse events did not differ between groups (relative risk, 1.22; 95% confidence interval, 0.65–1.94; p = 0.52). Discussion: In this trial, cooling to a target of 34.0–35.0°C and maintaining this for 12 or 24 h was not feasible in the majority of patients. The final sample was underpowered to detect clinically relevant differences in outcomes. Conclusion: Before new trials are launched, the feasibility of cooling needs to be improved

Plant responses to red and far-red lights, applications in horticulture

Light drives plant growth and development, so its control is increasingly used as an environment-friendly tool to manage horticultural crops. However, this implies a comprehensive view of the main physiological processes under light control, and bridging knowledge gaps. This review presents the state of the art in i) perception of red (R) and far-red (FR) wavelengths and of the R:FR ratio by plants, ii) phenotypic plant responses, and iii) the molecular mechanisms related to these responses. Changes in red or far red radiation and R:FR ratios are perceived by phytochromes. Phytochrome-mediated regulation is complex and specific to each physiological process. Our review presents the effects of red and far-red lights on germination, aerial architectural development, flowering, photosynthesis and plant nutrition. It also addresses how red and far-red radiations interact with tolerance to drought, pathogens and herbivores. Current knowledge about the mechanisms whereby red, far-red and R:FR regulate these different processes is presented. The specific actors of light signal transduction are better known for germination or flowering than for other processes such as internode elongation or bud outgrowth. The phenotypic response to red, far-red and R:FR can vary among species, but also with growing conditions. The mechanisms underlying these differences in plant responses still need to be unveiled. Current knowledge about plants\u27 response to light is being applied in horticulture to improve crop yield and quality. To that purpose, it is now possible to manipulate light quality thanks to recent technological evolutions such as the development of photo-selective films and light-emitting diodes