Preoperative Imaging for Perforator Flaps in Reconstructive Surgery

Background: Although preoperative imaging of perforator vasculature in planning microvascular reconstruction is commonplace, there has not been any clear demonstration of the evidence for this practice, or data comparing the many available modalities in an evidence-based approach. This article aims to provide an objective, evidence-based review of the literature on this subject.\ud \ud Methods: The evidence supporting the use of various modalities of imaging was investigated by performing focused searches of the PubMed and Medline databases. The articles were ranked according to the criteria set out in March 2009 Oxford Centre for Evidence-Based Medicine definitions. Endpoints comprised objective outcome data supporting the use of imaging, including flap loss, unplanned returns to theater, operative time reduction, and surgeon-reported stress.\ud \ud Results: The objective high level of evidence for any form of preoperative perforator imaging is low with only small number of comparative studies or case series investigating computed tomographic angiography (CTA), magnetic resonance angiography, handheld Doppler, color duplex, and classic angiography. Of all modalities, there is a growing body of level 2b evidence supporting the use of CTA.\ud \ud Conclusion: While further multicenter trials testing hard outcomes are needed to conclusively validate preoperative imaging in reconstructive surgery, sufficient evidence exists to demonstrate that preoperative imaging can statistically improve outcomes, and that CTA is the current gold standard for perforator mapping

Extracting particle freeze-out phase-space densities and entropies from sources imaged in heavy-ion reactions

The space-averaged phase-space density and entropy per particle are both fundamental observables which can be extracted from the two-particle correlation functions measured in heavy-ion collisions. Two techniques have been proposed to extract the densities from correlation data: either by using the radius parameters from Gaussian fits to meson correlations or by using source imaging, which may be applied to any like pair correlation. We show that the imaging and Gaussian fits give the same result in the case of meson interferometry. We discuss the concept of an equivalent instantaneous source on which both techniques rely. We also discuss the phase-space occupancy and entropy per particle. Finally, we propose an improved formula for the phase-space occupancy that has a more controlled dependence on the uncertainty of the experimentally measured source functions.Comment: 14 pages, final version, to appear PRC. Fixed typos, added refs. for last section, added discussions of imaging and d/p ratio

The Ursinus Weekly, June 5, 1961

198 diplomas sum up 4 Ursinus years: Prizes bestowed on outstanding Ursinus students • Sandberg \u2761 valedictorian; Graduates summa cum laude • Four honorary degrees awarded this morning: Robert N. Hilkert delivers address to Ursinus\u27 198 senior graduates • Roadside billboard inspiration for Hilkert\u27s speech • Cash prize given four cited for teaching merit • Barbara Pine wins scholarship; Her blindness no obstacle • Biology instructor leaves to tie up loose ends • Amigo to retire; Students\u27 friend for eleven years • Dr. Paisley\u27s death saddens commencement; Board President served Ursinus for 51 years • Newspaperman elected new trustee board head • September may bring 280 freshmen; U.C. Admissions Department reports • New Weekly ad manager wins Wayne Brown prize • Editorial: Sharpened incisors; Good luck • Ursinus in the past • Art of understanding • Seniors submit post-graduation plans; Many teach, work for further degrees • Lacrosse players undefeated again; Trample Drexel • Snell softballers post 3-2 log; Ask more games • Intramural corner • Wait\u27ll next year when nine starters return to diamond • Lynne Crosley lacrosse all-American first team • Netmen competent despite 3-5 log; Famous is MVP • Sport page outlet for creativity, magazine writes • Track team tallies 5-5 \u2761 record; Wise made captain • Morgan finally defeated; Moran wins in AAU run • Mrs. Shryock to retire; Mrs. Bugelholl plans move • Ursinus professor to attend nuclear session • Organizations list late election results • Ursinus College gets $92,000 in Lehigh estate • Late track news: Morgan runs 4:04.2 in Boardwalk Mile • Dr. Creager reported doing well; Needs rest • Ursinus awarded$12,000 F. J. Clamer memorial fundhttps://digitalcommons.ursinus.edu/weekly/1344/thumbnail.jp

Crystal Structures of Covalent Complexes of β-Lactam Antibiotics with Escherichia coli Penicillin-Binding Protein 5: Toward an Understanding of Antibiotic Specificity

Penicillin-binding proteins (PBPs) are the molecular target for the widely used β-lactam class of antibiotics, but how these compounds act at the molecular level is not fully understood. We have determined crystal structures of E. coli PBP5 as covalent complexes with imipenem, cloxacillin and cefoxitin. These antibiotics exhibit very different second order rates of acylation for the enzyme. In all three structures, there is excellent electron density for the central portion of the β-lactam, but weak or absent density for the R1 or R2 side chains. Areas of contact between the antibiotics and PBP 5 do not correlate with the rates of acylation. The same is true for conformational changes because although shift of a loop leading to an electrostatic interaction between Arg248 and the β-lactam carboxylate, which occurs completely with cefoxitin, partially with imipenem and is absent with cloxacillin, is consistent with the different rates of acylation, mutagenesis of Arg248 only decreased cefoxitin acylation two fold. Together, these data suggest that structures of post-covalent complexes of PBP 5 are unlikely to be useful vehicles for design of new covalent inhibitors of PBPs. Finally, superimposition of the imipenem-acylated complex with PBP5 in complex with a boronic acid peptidemimetic shows that the position corresponding to the hydrolytic water molecule is occluded by the ring nitrogen of the β-lactam. Since the ring nitrogen occupies a similar position in all three complexes, this supports the hypothesis that deacylation is blocked by the continued presence of the leaving group after opening of the β-lactam ring

The gas distribution in the outer regions of galaxy clusters

We present the analysis of a local (z = 0.04 - 0.2) sample of 31 galaxy clusters with the aim of measuring the density of the X-ray emitting gas in cluster outskirts. We compare our results with numerical simulations to set constraints on the azimuthal symmetry and gas clumping in the outer regions of galaxy clusters. We exploit the large field-of-view and low instrumental background of ROSAT/PSPC to trace the density of the intracluster gas out to the virial radius. We perform a stacking of the density profiles to detect a signal beyond r200 and measure the typical density and scatter in cluster outskirts. We also compute the azimuthal scatter of the profiles with respect to the mean value to look for deviations from spherical symmetry. Finally, we compare our average density and scatter profiles with the results of numerical simulations. As opposed to some recent Suzaku results, and confirming previous evidence from ROSAT and Chandra, we observe a steepening of the density profiles beyond \sim r500. Comparing our density profiles with simulations, we find that non-radiative runs predict too steep density profiles, whereas runs including additional physics and/or treating gas clumping are in better agreement with the observed gas distribution. We report for the first time the high-confidence detection of a systematic difference between cool-core and non-cool core clusters beyond \sim 0.3r200, which we explain by a different distribution of the gas in the two classes. Beyond \sim r500, galaxy clusters deviate significantly from spherical symmetry, with only little differences between relaxed and disturbed systems. We find good agreement between the observed and predicted scatter profiles, but only when the 1% densest clumps are filtered out in the simulations. [Abridged]Comment: The data for the average profiles and individual clusters can be downloaded at: http://www.isdc.unige.ch/~deckert/newsite/The_Planck_ROSAT_project.htm

Measurement of pH. Definition, Standards, and Procedures

The definition of a “primary method of measurement” [1] has permitted a full consideration of the definition of primary standards for pH, determined by a primary method (cell without transference, Harned cell), of the definition of secondary standards by secondary methods, and of the question whether pH, as a conventional quantity, can be incorporated within the internationally accepted system of measurement, the International System of Units (SI, Système International d’Unités). This approach has enabled resolution of the previous compromise IUPAC 1985 Recommendations [2]. Furthermore, incorporation of the uncertainties for the primary method, and for all subsequent measurements, permits the uncertainties for all procedures to be linked to the primary standards by an unbroken chain of comparisons. Thus, a rational choice can be made by the analyst of the appropriate procedure to achieve the target uncertainty of sample pH. Accordingly, this document explains IUPAC recommended definitions, procedures, and terminology relating to pH measurements in dilute aqueous solutions in the temperature range 5–50 °C. Details are given of the primary and secondary methods for measuring pH and the rationale for the assignment of pH values with appropriate uncertainties to selected primary and secondary substances

Solid State Physics

Contains reports on nine research projects

Massive and refined: a sample of large galaxy clusters simulated at high resolution. I:Thermal gas and shock waves properties

We present a sample of 20 massive galaxy clusters with total virial masses in the range of 6 10^14 M_sol<M(vir)< 2 10^15M_sol, re-simulated with a customized version of the 1.5. ENZO code employing Adaptive Mesh Refinement. This technique allowed us to obtain unprecedented high spatial resolution (25kpc/h) up to the distance of 3 virial radii from the clusters center, and makes it possible to focus with the same level of detail on the physical properties of the innermost and of the outermost cluster regions, providing new clues on the role of shock waves and turbulent motions in the ICM, across a wide range of scales. In this paper, a first exploratory study of this data set is presented. We report on the thermal properties of galaxy clusters at z=0. Integrated and morphological properties of gas density, gas temperature, gas entropy and baryon fraction distributions are discussed, and compared with existing outcomes both from the observational and from the numerical literature. Our cluster sample shows an overall good consistency with the results obtained adopting other numerical techniques (e.g. Smoothed Particles Hydrodynamics), yet it provides a more accurate representation of the accretion patterns far outside the cluster cores. We also reconstruct the properties of shock waves within the sample by means of a velocity-based approach, and we study Mach numbers and energy distributions for the various dynamical states in clusters, giving estimates for the injection of Cosmic Rays particles at shocks. The present sample is rather unique in the panorama of cosmological simulations of massive galaxy clusters, due to its dynamical range, statistics of objects and number of time outputs. For this reason, we deploy a public repository of the available data, accessible via web portal at http://data.cineca.it.Comment: 26 pages, 20 figures, New Astronomy accepted. Reference list updated. Higher quality versions of the paper can be found at: http://www.ira.inaf.it/~vazza/papers A public archive of galaxy clusters data is accessible at http://data.cineca.it

Solid State Physics

Contains reports on six research projects

Parameterization Effects in the analysis of AMI Sunyaev-Zel'dovich Observations

Most Sunyaev--Zel'dovich (SZ) and X-ray analyses of galaxy clusters try to constrain the cluster total mass and/or gas mass using parameterised models and assumptions of spherical symmetry and hydrostatic equilibrium. By numerically exploring the probability distributions of the cluster parameters given the simulated interferometric SZ data in the context of Bayesian methods, and assuming a beta-model for the electron number density we investigate the capability of this model and analysis to return the simulated cluster input quantities via three rameterisations. In parameterisation I we assume that the T is an input parameter. We find that parameterisation I can hardly constrain the cluster parameters. We then investigate parameterisations II and III in which fg(r200) replaces temperature as a main variable. In parameterisation II we relate M_T(r200) and T assuming hydrostatic equilibrium. We find that parameterisation II can constrain the cluster physical parameters but the temperature estimate is biased low. In parameterisation III, the virial theorem replaces the hydrostatic equilibrium assumption. We find that parameterisation III results in unbiased estimates of the cluster properties. We generate a second simulated cluster using a generalised NFW (GNFW) pressure profile and analyse it with an entropy based model to take into account the temperature gradient in our analysis and improve the cluster gas density distribution. This model also constrains the cluster physical parameters and the results show a radial decline in the gas temperature as expected. The mean cluster total mass estimates are also within 1 sigma from the simulated cluster true values. However, we find that for at least interferometric SZ analysis in practice at the present time, there is no differences in the AMI visibilities between the two models. This may of course change as the instruments improve.Comment: 19 pages, 13 tables, 24 figure