MRI hip morphology is abnormal in unilateral DDH and increased lateral limbus thickness is associated with residual DDH at minimum 10-year follow-up.

PURPOSE The purpose of the study was to compare the post-reduction magnetic resonance imaging morphology for hips that developed residual acetabular dysplasia, hips without residual dysplasia, and uninvolved contralateral hips in patients with unilateral developmental dysplasia of the hip undergoing closed or open reduction and had a minimum 10-year follow-up. METHODS Retrospective study of patients with unilateral dysplasia of the hip who underwent open/closed hip reduction followed by post-reduction magnetic resonance imaging. Twenty-eight patients with a mean follow-up of 13 ± 3 years were included. In the treated hips, residual dysplasia was defined as subsequent surgery for residual acetabular dysplasia or for Severin grade > 2 at latest follow-up. On post-reduction, magnetic resonance imaging measurements were performed by two readers and compared between the hips with/without residual dysplasia and the contralateral uninvolved side. Magnetic resonance imaging measurements included acetabular version, coronal/ axial femoroacetabular distance, acetabular depth-width ratio, osseous/cartilaginous acetabular indices, and medial/lateral (limbus) cartilage thickness. RESULTS Fifteen (54%) and 13 (46%) hips were allocated to the "no residual dysplasia" group and to the "residual dysplasia" group, respectively. All eight magnetic resonance imaging parameters differed between hips with residual dysplasia and contralateral uninvolved hips (all p < 0.05). Six of eight parameters differed (all p < 0.05) between hips with and without residual dysplasia. Among these, increased limbus thickness had the largest effect (odds ratio = 12.5; p < 0.001) for increased likelihood of residual dysplasia. CONCLUSIONS We identified acetabular morphology and reduction quality parameters that can be reliably measured on the post-reduction magnetic resonance imaging to facilitate the differentiation between hips that develop with/without residual acetabular dysplasia at 10 years postoperatively. LEVEL OF EVIDENCE level III, prognostic case-control study

Market split and basis reduction: towards a solution of the Cornuejols-Dawande instances

Previously, G. Cornuejols and M. Dawande (1998) proposed a set of 0-1 linear programming instances that proved to be very hard to solve by traditional methods, and in particular by linear programming based branch-and-bound. They offered these market split instances as a challenge to the integer programming community. The market split problem can be formulated as a system of linear diophantine equations in 0-1 variables. We use the algorithm of K. Aardal et al. (1998) based on lattice basis reduction. This algorithm is not restricted to deal with market split instances only but is a general method for solving systems of linear diophantine equations with bounds on the variables. We show computational results from solving both feasibility and optimization versions of the market split instances with up to 7 equations and 60 variables and discuss various branching strategies and their effect on the number of enumerated nodes. To our knowledge, the largest feasibility and optimization instances solved before had 6 equations and 50 variables, and 4 equations and 30 variables, respectively. We also present a probabilistic analysis describing how to compute the probability of generating infeasible market split instances. By generating instances in the way prescribed by Cornuejols and Dawande, one obtains relatively many feasible instances for sizes larger than 5 equations and 40 variable

EXPLORING THE ROLE OF OSPREYS IN EDUCATION

Recent research in childhood education has demonstrated that experiences in nature are important in shaping early environmental consciousness (Hinds and Sparks 2008, Hussar and Horvath 2011, Cheng and Monroe 2012) and ultimately the expression of pro-environmental attitudes and behaviors during adulthood (Wells and Lekies 2006, Chawla and Cushing 2007, Collado et al. 2013). Increasingly, those experiences happen via written and electronic media (e.g., textbooks, computer screens) or in very anthropogenic environments (e.g., in parks and zoos) and less through direct contact with nature, a concept Louv (2005) referred to as ‘‘nature deficit disorder.’’ Even in schools where environmental education is prioritized, the extent of access to outdoor classroom activities or experiential learning opportunities can limit the degree to which children can observe, explore, and directly experience the natural world (Hudson 2001, Louv 2005, Ernst 2009). Interestingly, the same information technologies that might serve to limit contact with nature also have the potential to enhance and encourage interest and concern for the natural world (Blewitt 2011, Pearson et al. 2011). We believe this is an important paradox that warrants much further exploration and evaluation within educational and scientific communities

Metabolic control in a nationally representative diabetic elderly sample in Costa Rica: patients at community health centers vs. patients at other health care settings

<p>Abstract</p> <p>Background</p> <p>Costa Rica, like other developing countries, is experiencing an increasing burden of chronic conditions such as diabetes mellitus (DM), especially among its elderly population. This article has two goals: (1) to assess the level of metabolic control among the diabetic population age ≥ 60 years old in Costa Rica, and (2) to test whether diabetic elderly patients of community health centers differ from patients in other health care settings in terms of the level of metabolic control.</p> <p>Methods</p> <p>Data come from the project CRELES, a nationally representative study of people aged 60 and over in Costa Rica. This article analyzes a subsample of 542 participants in CRELES with self-reported diagnosis of diabetes mellitus. Odds ratios of poor levels of metabolic control at different health care settings are computed using logistic regressions.</p> <p>Results</p> <p>Lack of metabolic control among elderly diabetic population in Costa Rica is described as follows: 37% have glycated hemoglobin ≥ 7%; 78% have systolic blood pressure ≥ 130 mmHg; 66% have diastolic blood pressure ≥ 80 mmHg; 48% have triglycerides ≥ 150 mg/dl; 78% have LDL ≥ 100 mg/dl; 70% have HDL ≤ 40 mg/dl. Elevated levels of triglycerides and LDL were higher in patients of community health centers than in patients of other clinical settings. There were no statistical differences in the other metabolic control indicators across health care settings.</p> <p>Conclusion</p> <p>Levels of metabolic control among elderly population with DM in Costa Rica are not that different from those observed in industrialized countries. Elevated levels of triglycerides and LDL at community health centers may indicate problems of dyslipidemia treatment among diabetic patients; these problems are not observed in other health care settings. The Costa Rican health care system should address this problem, given that community health centers constitute a means of democratizing access to primary health care to underserved and poor areas.</p

Cohabitation : the Pan-America View

In this concluding chapter we reflect on a series of issues of both a methodological and substantive nature encountered in this research project. Firstly, we must realize that the use of individual census records not only opened vast possibilities, but also entails a number of limitations. Secondly, the very large sample sizes allowed for the disaggregation of national trends into far more detailed spatial, ethnic and educational patterns. This, in its turn, allowed us to adopt a "geo-historical" view of the rise of cohabitation for almost the entire American continent, from Alaska to Tierra del Fuego. Furthermore, statistical analyses could be performed at the individual and contextual levels simultaneously. Results show that the effects of social stratification, religion and ethnicity are continuing to be of major importance. This not only holds at the individual level, but at the contextual level as well. Nevertheless, an entirely new wave of change started rolling over the pre-existing patterns from the 1970s onward. These trends are following a firm course, irrespective of the economic ups and downs. The Americas, as opposed to many Asian societies and Africa, are now following in the European footsteps, be it with their own distinct and path-dependent characteristics associated with regionally varying historical antecedents

Ten years of major equestrian injury: are we addressing functional outcomes?

YesFunding provided by the Open Access Authors Fund

Enteric Neurospheres Are Not Specific to Neural Crest Cultures: Implications for Neural Stem Cell Therapies

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited