Improving specialised care for neuromuscular patients reduces the frequency of preventable emergency hospital admissions

Two retrospective audits were undertaken across several hospitals to understand the frequency and preventability of emergency admissions in people with neuromuscular disease (NMD). Following audit 1 (A1), a number of preventable themes emerged on the basis of which recommendations were made to improve quality and co-ordination of care and a network approach was developed to improve awareness and education amongst patients and non-expert professionals. Audit 2 (A2) was undertaken to determine the effect of these measures. The central NHS IT database identified emergency NMD admissions. Case notes were reviewed and audited against pre-agreed criteria. A1 included 576 admissions (395 patients) A2 included 361 admissions (314 patients). Preventable admissions (where an NMD was known) accounted for 63% in A1 and 33% in A2, with more patients followed up at a specialized neuromuscular centre in A2. There were fewer re-admissions in A2 (12%) compared with A1 (25%) and lower mortality (A1: 4.5%, A2: 0.3%). A2 showed a significant rise in patients admitted under the care of neuroscience during the acute admission and fewer preventable ITU admissions. These audits demonstrate a significant impact for both patient care and potential for financial savings following the implementation of recommendations made after A1

First observational evidence of a relation between globular clusters' internal rotation and stellar masses

Several observational studies have shown that many Galactic globular clusters (GCs) are characterised by internal rotation. Theoretical studies of the dynamical evolution of rotating clusters have predicted that, during their long-term evolution, these stellar systems should develop a dependence of the rotational velocity around the cluster's centre on the mass of stars, with the internal rotation increasing for more massive stars. In this paper we present the first observational evidence of the predicted rotation-mass trend. In our investigation, we exploited the $\mathit{Gaia}$ Data Release 3 catalogue of three GCs: NGC 104 (47 Tuc), NGC 5139 ($\omega$ Cen) and NGC 5904 (M 5). We found clear evidence of a cluster rotation-mass relation in 47 Tuc and M 5, while in $\omega$ Cen, the dynamically youngest system among the three clusters studied here, no such trend was detected.Comment: 6 pages, 4 figures, 1 table. Accepted for publication in MNRAS Letter

Photometry and astrometry with JWST -- III. A NIRCam-Gaia DR3 analysis of the open cluster NGC 2506

In the third paper of this series aimed at developing the tools for analysing resolved stellar populations using the cameras on board of the James Webb Space Telescope (JWST), we present a detailed multi-band study of the 2 Gyr Galactic open cluster NGC 2506. We employ public calibration data-sets collected in multiple filters to: (i) derive improved effective Point Spread Functions (ePSFs) for ten NIRCam filters; (ii) extract high-precision photometry and astrometry for stars in the cluster, approaching the main-sequence (MS) lower mass of ~0.1 Msun; and (iii) take advantage of the synergy between JWST and Gaia DR3 to perform a comprehensive analysis of the cluster's global and local properties. We derived a MS binary fraction of ~57.5 %, extending the Gaia limit (~0.8 Msun) to lower masses (~0.4 Msun) with JWST. We conducted a study on the mass functions (MFs) of NGC 2506, mapping the mass segregation with Gaia data, and extending MFs to lower masses with the JWST field. We also combined information on the derived MFs to infer an estimate of the cluster present-day total mass. Lastly, we investigated the presence of white dwarfs (WDs) and identified a strong candidate. However, to firmly establish its cluster membership, as well as that of four other WD candidates and of the majority of faint low-mass MS stars, further JWST equally deep observations will be required. We make publicly available catalogues, atlases, and the improved ePSFs.Comment: 20 pages, 17 figures (5 in low resolution), 4 tables. Accepted for publication in MNRAS on August 5, 2023. PSF models, catalogs and stacked images are publicly available at https://web.oapd.inaf.it/bedin/files/PAPERs_eMATERIALs/JWST/Paper_03

Applicability of the cobb angle measurement in idiopathic scoliosis using scanned imaging

OBJECTIVES: To compare the measurement of the Cobb angle on printed radiographs and on scanned radiographs viewed through the software "PixViewer". METHODS: Preoperative radiographs of 23 patients were evaluated on printed films and through the software "PixViewer". The same evaluator, a spine surgeon, chose the proximal and distal limiting vertebrae of the main curve on printed radiographs, without identification of patients, and measured the Cobb angle based on these parameters. The same parameters and measurements were applied to scanned radiographs. The measurements were compared, as well as the choice of limiting vertebrae. RESULTS: The average variation of the Cobb angle between methods was 1.48 ± 1.73°. The intraclass correlation coefficient (ICC) was 0.99, demonstrating excellent reproducibility. CONCLUSION: The Cobb method can be used to evaluate scoliosis through the "PixViewer" tool with the same reliability as the classic method on printed radiographs

Exercise capacity and pulmonary function of school age children with a history of bronchopulmonary dysplasia: a systematic review

Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease accused by the need of oxygen and / or mechanical ventilation in the neonatal period. The resulting lung injury of BPD may lead to changes in lung function, with flow limitation and increased airway resistance, which may persist throughout childhood and adolescence to adulthood. Objective: conduct a systematic review studies that evaluated lung function and exercise capacity in school-age children with BPD. Method: we performed systematic searches of three electronic databases Scielo, PEDro and MEDLINE Ovid, being selected articles published up to january 2014. That assessed pulmonary function and exercise capacity in school-age children with bronchopulmonary dysplasia. Results: through the search strategies 376 titles related to the topic were found, after analysis of the inclusion criteria, only five were selected to compose the final sample. Conclusion: children with a history of BPD have variable airflow obstruction at school age and can reach lower maximal values of oxygen, minute volume and tidal volume during exercise. Still, there is no influence lung function on exercise capacity in this populationIntrodução: a displasia broncopulmonar (DBP) é uma doença respiratória crônica decorrente da necessidade de oxigênio e/ou ventilação mecânica no período neonatal. A lesão pulmonar decorrente da DBP pode levar a alterações na função pulmonar, com limitação do fluxo e aumento da resistência das vias aéreas, que perduram durante a infância e adolescência. Objetivo: realizar uma revisão sistemática de estudos que avaliaram a função pulmonar e a capacidade de exercício de escolares com DBP. Método: realizadas buscas sistematizadas em três bases de dados eletrônicas SciELO, PEDro e MEDLINE via Ovid, sendo selecionados artigos publicados até janeiro de 2014 que avaliaram tanto a função pulmonar como a capacidade de exercício em escolares com DBP. Resultados: através das estratégias de busca foram encontrados 376 títulos relacionados ao tema. Após análise dos critérios de inclusão, apenas cinco trabalhos foram selecionados para compor amostra final. Conclusões: crianças com história de DBP apresentam variável obstrução ao fluxo aéreo em idade escolar e podem atingir menores valores de consumo máximo de oxigênio, volume minuto e volume corrente durante o exercicio. Ainda assim, a função pulmonar parece não influenciar a capacidade de exercício nesta populaçã

From exercise intolerance to functional improvement: The second wind phenomenon in the identification of McArdle disease

McArdle disease is the most common of the glycogen storage diseases. Onset of symptoms is usually in childhood with muscle pain and restricted exercise capacity. Signs and symptoms are often ignored in children or put down to 'growing pains' and thus diagnosis is often delayed. Misdiagnosis is not uncommon because several other conditions such as muscular dystrophy and muscle channelopathies can manifest with similar symptoms. A simple exercise test performed in the clinic can however help to identify patients by revealing the second wind phenomenon which is pathognomonic of the condition. Here a patient is reported illustrating the value of using a simple 12 minute walk test.RSS is funded by Ciências sem Fronteiras/CAPES Foundation. The authors would like to thank the Association for Glycogen Storage Disease (UK), the EUROMAC Registry funded by the European Union, the Muscular Dystrophy Campaign, the NHS National Specialist Commissioning Group and the Myositis Support Group for funding

Theranostics in Boron neutron capture therapy

Boron neutron capture therapy (BNCT) has the potential to specifically destroy tumor cells without damaging the tissues infiltrated by the tumor. BNCT is a binary treatment method based on the combination of two agents that have no effect when applied individually:10B and thermal neutrons. Exclusively, the combination of both produces an effect, whose extent depends on the amount of10B in the tumor but also on the organs at risk. It is not yet possible to determine the10B concentration in a specific tissue using non-invasive methods. At present, it is only possible to measure the10B concentration in blood and to estimate the boron concentration in tissues based on the assumption that there is a fixed uptake of10B from the blood into tissues. On this imprecise assumption, BNCT can hardly be developed further. A therapeutic approach, combining the boron carrier for therapeutic purposes with an imaging tool, might allow us to determine the10B concentration in a specific tissue using a non-invasive method. This review provides an overview of the current clinical protocols and preclinical experiments and results on how innovative drug development for boron delivery systems can also incorporate concurrent imaging. The last section focuses on the importance of proteomics for further optimization of BNCT, a highly precise and personalized therapeutic approach

Astro-photometric study of M37 with Gaia and wide-field ugi-imaging

We present an astrometric and photometric wide-field study of the Galactic open star cluster M37 (NGC 2099). The studied field was observed with ground-based images covering a region of about four square degrees in the Sloan-like filters ugi. We exploited the Gaia catalogue to calibrate the geometric distortion of the large field mosaics, developing software routines that can be also applied to other wide-field instruments. The data are used to identify the hottest white dwarf (WD) member candidates of M37. Thanks to the Gaia EDR3 exquisite astrometry we identified seven such WD candidates, one of which, besides being a high-probability astrometric member, is the putative central star of a planetary nebula. To our knowledge, this is a unique object in an open cluster, and we have obtained follow-up low-resolution spectra that are used for a qualitative characterisation of this young WD. Finally, we publicly release a three-colour atlas and a catalogue of the sources in the field of view, which represents a complement of existing material.Comment: 13 pages, 4 table, 13 figures. Accepted for publication in MNRAS on 2022, July 6, manuscript ID. MN-22-2264-M