Impingement-free Hip Motion: The ‘Normal' Angle Alpha after Osteochondroplasty

Femoroacetabular impingement is considered a cause of hip osteoarthrosis. In cam impingement, an aspherical head-neck junction is squeezed into the joint and causes acetabular cartilage damage. The anterior offset angle α, observed on a lateral crosstable radiograph, reflects the location where the femoral head becomes aspheric. Previous studies reported a mean angle α of 42° in asymptomatic patients. Currently, it is believed an angle α of 50° to 55° is normal. The aim of this study was to identify that angle α which allows impingement-free motion. In 45 patients who underwent surgical treatment for femoroacetabular impingement, we measured the angle α preoperatively, immediately postoperatively, and 1year postoperatively. All hips underwent femoral correction and, if necessary, acetabular correction. The correction was considered sufficient when, in 90° hip flexion, an internal rotation of 20° to 25° was possible. The angle α was corrected from a preoperative mean of 66° (range, 45°-79°) to 43° (range, 34°-60°) postoperatively. Because the acetabulum is corrected to normal first, the femoral correction is tested against a normal acetabulum. We therefore concluded an angle α of 43° achieved surgically and with impingement-free motion, represents the normal angle α, an angle lower than that currently considered sufficien

Axiomatic relation between thermodynamic and information-theoretic entropies

Thermodynamic entropy, as defined by Clausius, characterizes macroscopic observations of a system based on phenomenological quantities such as temperature and heat. In contrast, information-theoretic entropy, introduced by Shannon, is a measure of uncertainty. In this Letter, we connect these two notions of entropy, using an axiomatic framework for thermodynamics [Lieb, Yngvason, Proc. Roy. Soc.(2013)]. In particular, we obtain a direct relation between the Clausius entropy and the Shannon entropy, or its generalisation to quantum systems, the von Neumann entropy. More generally, we find that entropy measures relevant in non-equilibrium thermodynamics correspond to entropies used in one-shot information theory

Profiling Trait Anxiety: Transcriptome Analysis Reveals Cathepsin B (Ctsb) as a Novel Candidate Gene for Emotionality in Mice

Behavioral endophenotypes are determined by a multitude of counteracting but precisely balanced molecular and physiological mechanisms. In this study, we aim to identify potential novel molecular targets that contribute to the multigenic trait “anxiety”. We used microarrays to investigate the gene expression profiles of different brain regions within the limbic system of mice which were selectively bred for either high (HAB) or low (LAB) anxiety-related behavior, and also show signs of comorbid depression-like behavior

Varicellovirus UL49.5 Proteins Differentially Affect the Function of the Transporter Associated with Antigen Processing, TAP

Cytotoxic T-lymphocytes play an important role in the protection against viral infections, which they detect through the recognition of virus-derived peptides, presented in the context of MHC class I molecules at the surface of the infected cell. The transporter associated with antigen processing (TAP) plays an essential role in MHC class I–restricted antigen presentation, as TAP imports peptides into the ER, where peptide loading of MHC class I molecules takes place. In this study, the UL49.5 proteins of the varicelloviruses bovine herpesvirus 1 (BHV-1), pseudorabies virus (PRV), and equine herpesvirus 1 and 4 (EHV-1 and EHV-4) are characterized as members of a novel class of viral immune evasion proteins. These UL49.5 proteins interfere with MHC class I antigen presentation by blocking the supply of antigenic peptides through inhibition of TAP. BHV-1, PRV, and EHV-1 recombinant viruses lacking UL49.5 no longer interfere with peptide transport. Combined with the observation that the individually expressed UL49.5 proteins block TAP as well, these data indicate that UL49.5 is the viral factor that is both necessary and sufficient to abolish TAP function during productive infection by these viruses. The mechanisms through which the UL49.5 proteins of BHV-1, PRV, EHV-1, and EHV-4 block TAP exhibit surprising diversity. BHV-1 UL49.5 targets TAP for proteasomal degradation, whereas EHV-1 and EHV-4 UL49.5 interfere with the binding of ATP to TAP. In contrast, TAP stability and ATP recruitment are not affected by PRV UL49.5, although it has the capacity to arrest the peptide transporter in a translocation-incompetent state, a property shared with the BHV-1 and EHV-1 UL49.5. Taken together, these results classify the UL49.5 gene products of BHV-1, PRV, EHV-1, and EHV-4 as members of a novel family of viral immune evasion proteins, inhibiting TAP through a variety of mechanisms

Tutorial:Speech assessment for multilingual children who do not speak the same language(s) as the speech-language pathologist

Purpose: The aim of this tutorial is to support speech language pathologists (SLPs) undertaking assessments of multilingual children with suspected speech sound disorders, particularly children who speak languages that are not shared with their SLP. Method: The tutorial was written by the International Expert Panel on Multilingual Children’s Speech, which comprises 46 researchers (SLPs, linguists, phoneticians, and speech scientists) who have worked in 43 countries and used 27 languages in professional practice. Seventeen panel members met for a 1-day workshop to identify key points for inclusion in the tutorial, 26 panel members contributed to writing this tutorial, and 34 members contributed to revising this tutorial online (some members contributed tomore than 1 task). Results: This tutorial draws on international research evidence and professional expertise to provide a comprehensive overview of working with multilingual children with suspected speech sound disorders. This overview addresses referral, case history, assessment, analysis, diagnosis, and goal setting and the SLP’s cultural competence and preparation for working with interpreters and multicultural support workers and dealing with organizational and government barriers to and facilitators of culturally competent practice. Conclusion: The issues raised in this tutorial are applied in a hypothetical case study of an English-speaking SLP’s assessment of a multilingual Cantonese-and English-speaking 4-year-old boy. Resources are listed throughout the tutorial.Australian Research Council: FT0990588United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute on Deafness & Other Communication Disorders (NIDCD

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Outcome Evaluation of Distal Femoral Fractures Following Surgical Management: A Retrospective Cohort Study

Background: Distal femur fractures are challenging in surgical management as the outcome is crucial for restoring the biomechanical stability and longitudinal axis of the leg and function of the knee joint. Methods: A retrospective review of all distal femoral fractures treated in a level I trauma center over a decade was performed. The radiographs were reviewed for fracture entity, osseous healing, implant failure, mechanical axis, and degenerative joint changes. Clinical outcome was reviewed regarding postoperative complications and postoperative range of motion of the knee joint. Results: 130 patients who were managed with screw fixation (n = 35), plating systems (n = 92) or intramedullary nailing systems (n = 3) remained for evaluation. Mean follow up was 26 months. Clinical outcome was significantly better for flexion degrees following screw fixation (p = 0.009). Delayed fracture union (p = 0.002) or non-union (p = 0.006) rates were significantly higher in plate osteosynthesis. Mild pathologic deformity for varus and valgus collapse was found following plate osteosynthesis. Conclusions: Screw fixation shows fewer postoperative complications than plate fixation and is favored for extra and partial intraarticular distal femur fractures. Plating constructs remain the superior fixation method in complex distal femur fractures but are associated with higher rates of non-union and leg axis deviation

Sinnorientierte Führung in selbstorganisierten Systemen

Unternehmensführung durch Kontrolle und Steuerung ist obsolet geworden oder nur noch in ganz wenigen Bereichen hilfreich anwendbar. Viele Führungskräfte befinden sich in dem Dilemma, eine Antwort auf einen zunehmende Freiheitswunsch und die gleichzeitige Verunsicherung durch wegfallende Strukturen in ihren Kontakten mit den Mitarbeitenden zu finden

Current profile of cycling injuries: A retrospective analysis of a trauma centre level 1 in Queensland

Objectives: One out of 50 injury-related presentations to an ED is a transport-related cycling injury. Detailed information about the most frequent mechanism of cycling injuries, sustained injuries and patterns are under-reported. The objective of this research was to examine the pattern of injuries sustained by cyclists at a level 1 trauma centre. Methods: A retrospective review of data of injured cyclists admitted and treated at a level 1 trauma centre between 2011 and 2012 evaluated demographic data, mechanism of injury, injury pattern, economic costs and outcome. Results: Data of 261 patients (mean age of 39years) were reviewed, of which 88% was male patients with an average age of 38 years. Noncollision cycling injuries were reported in 55% of cases followed by collisions with other motor vehicles in 25.6% of cases. The mean injury severity score (ISS) was 9, but an ISS ≥ 12 was documented in 24%. Predominantly upper limb injuries (24.8%) were found, followed by injuries to the head and lower limb (each with 16.8%). Traumatic brain and chest injuries were equally seen in 8%. The overall length of stay was 4 days, and survival rate was 98%. Conclusion: This current data review reveals that non-collision traffic crashes accounted for the majority of injuries in cyclists treated in this facility, and the upper limb has replaced the head as the most injured body part. With a growing number of cyclists, this information contributes to considerations to improve road safety and trauma management

Outcome Evaluation of Distal Femoral Fractures Following Surgical Management: A Retrospective Cohort Study

Background: Distal femur fractures are challenging in surgical management as the outcome is crucial for restoring the biomechanical stability and longitudinal axis of the leg and function of the knee joint. Methods: A retrospective review of all distal femoral fractures treated in a level I trauma center over a decade was performed. The radiographs were reviewed for fracture entity, osseous healing, implant failure, mechanical axis, and degenerative joint changes. Clinical outcome was reviewed regarding postoperative complications and postoperative range of motion of the knee joint. Results: 130 patients who were managed with screw fixation (n = 35), plating systems (n = 92) or intramedullary nailing systems (n = 3) remained for evaluation. Mean follow up was 26 months. Clinical outcome was significantly better for flexion degrees following screw fixation (p = 0.009). Delayed fracture union (p = 0.002) or non-union (p = 0.006) rates were significantly higher in plate osteosynthesis. Mild pathologic deformity for varus and valgus collapse was found following plate osteosynthesis. Conclusions: Screw fixation shows fewer postoperative complications than plate fixation and is favored for extra and partial intraarticular distal femur fractures. Plating constructs remain the superior fixation method in complex distal femur fractures but are associated with higher rates of non-union and leg axis deviation