Gold Coast diagnostic criteria increase sensitivity in amyotrophic lateral sclerosis

Objective: This study evaluates diagnostic accuracy of the proposed ‘Gold Coast’ (GC) diagnostic criteria for amyotrophic lateral sclerosis (ALS). Methods: Five European centres retrospectively sampled consecutive patients referred for electromyography on suspicion of ALS. Patients were classified according to the GC criteria, the revised El Escorial (rEE) criteria and the Awaji (AW) criteria without and with the ‘Possible’ category (+ Poss). Reference standard was ALS confirmed by disease progression at follow-up. Results: Of 404 eligible patients 272 were diagnosed as ALS, 94 had mimicking disorders, 35 were lost for follow-up, and three had insufficient data. Sensitivity for the GC criteria was 88.2% (95% CI: 83.8-91.8%), which was higher than for previous criteria, of which the AW + Poss criteria reached the highest sensitivity of 77.6% (95% CI: 72.2–82.4%) (p < 0.001). Specificity was high for all criteria. The increase in sensitivity for the GC criteria was mainly due to the inclusion of 28 patients with progressive muscular atrophy (PMA). Conclusions: The simpler GC criteria increase the sensitivity, primarily due to considering PMA as a form of ALS with high specificity preserved. Significance: This validation study supports that GC criteria should be used in clinical practice and may be used for inclusion in trials

A new lumbar fixation device alternative to pedicle-based stabilization for lumbar spine: In vitro cadaver investigation

Context: To evaluate the stability provided by a new bilateral fixation technique using an in vitro investigation for posterior lumbar segmental instrumentation. Design: Experimental cadaver study. In this study, we propose an alternative technique for a posterior lumbar fixation technique called “inferior-oblique transdiscal fixation” (IOTF). Setting: Study performed at Engineering Center for Orthopedic Research Exellence (ECORE) in Toledo University-Ohio. Participants: Six human lumbar cadaveric specimen used in this study. Interventions: In this study, we propose an alternative technique for a posterior lumbar fixation technique called “inferior-oblique transdiscal fixation” (IOTF). As a novel contribution to the classical technique, the entry point of the screw is the supero-lateral point of the intersecting line drawn between the corpus and the pedicle of the upper vertebra. This approach enables the fixation of two adjacent vertebrae using a single screw on each side without utilizing connecting rods. Outcome Measures: Flexion (Flex), extension (Ext), right and left lateral bending (LB & RB), and right and left axial rotation (LR & RR), and the position data were captured at each load step using the Optotrak motion measurement system and compared for IOTF and posterior transpedicular stabilization. Results: The Posterior stabilization system (PSS) and IOTF significantly reduced the ROM of L4-L5 segment compared to intact segment’s ROM. During axial rotation (AR) IOTF fused index segment more than PSS. Besides this, addition of transforaminal lumbar interbody fusion (TLIF) cage improved the stabilization of IOTF system during flexion, extension and lateral bending. Whereas, PSS yielded better fusion results during extension compared to IOTF with and without interbody fusion cages. Conclusions: We hypothesized that the new posterior bilateral system would significantly decrease motion compared to the intact spine. This cadaver study showed that the proposed new posterior fusion technique IOTF fused the index segment in a similar fashion to the classical pedicle screw fusion technique.National Science Foundation (NSF)University of Toledo, Toledo, O

The effect of initial pH and retention time on boron removal by continuous electrocoagulation process

In this study, factors influencing boron removal via the continuous electrocoagulation process were investigated at lab-scale. Different influent pH values (4, 5, 6, 7.45 and 9) and contact times (10, 25, 50 and 100 min) were examined as variable parameters. Plate-type aluminium electrodes with 5 mm distance between them were used. All the experiments were conducted in continuous mode and the current density was kept constant at 5 A throughout the whole experimental period. The initial boron concentration was selected to be 1000 mg L-1. The first set of experiments concerning the influence of the influent pH showed that the highest boron removal (67%) was obtained at pH=6 since it was the optimal pH for boron precipitation through aluminium borate formation. Under the constant current density of the study and with the initial pH adjusted to 6, increasing the duration of the electrocoagulation process from 10 to 100 min resulted in raising the boron removal from 45 to 79% during the second set of experiments. The greater duration of the electrocagulation process enabled higher aluminium dissolution, thus allowing the existence of a higher number of coagulants within the reactor. Moreover, it enhanced boron precipitation because of the longer contact time between the boron ions and the coagulants. After optimizing significant parameters such as the influent pH and the electrocagulation duration, the continuous electrocoagulation process was found to constitute an effective alternative for boron removal

Pediatric diabetes consortium T1D New Onset ( NeOn ) study: clinical outcomes during the first year following diagnosis

Objective There have been few prospective, multicenter studies investigating the natural history of type 1 diabetes ( T1D ) from the time of diagnosis. The objective of this report from the Pediatric Diabetes Consortium ( PDC ) T1D New Onset ( NeOn ) study was to assess the natural history and clinical outcomes in children during the first year after diagnosis of T1D . Research design and methods: Clinical measures from the first year following diagnosis were analyzed for 857 participants (mean age 9.1 yr, 51% female, 66% non‐Hispanic White) not participating in an intervention study who had a HbA1c result at 12 months. Results Mean HbA1c ± SD was 102 ± 25 mmol/mol (11.4 ± 2.3%) at diagnosis, 55 ± 12 mmol/mol (7.2 ± 1.1%) at 3 months, 56 ± 15 mmol/mol (7.3 ± 1.3%) at 6 months and 62 ± 16 mmol/mol (7.8 ± 1.5%) at 12 months from diagnosis. A severe hypoglycemic ( SH ) event occurred in 31 (4%) participants (44 events, 5.2 events per 100 person‐years). Diabetic ketoacidosis ( DKA ) not including diagnosis occurred in 10 (1%) participants (13 events, 1.5 events per 100 person‐years). Conclusions After onset of T1D , mean HbA1c reaches its nadir at 3–6 months with a gradual increase through 12 months. SH and DKA are uncommon but still occur during the first year with T1D . Data from large cohorts, such as the PDC T1D NeOn study, provide important insights into the course of T1D during the first year following diagnosis, which will help to inform the development of models to target future interventions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107374/1/pedi12068.pd

Dynamics of the chiral phase transition from AdS/CFT duality

We use Lorentzian signature AdS/CFT duality to study a first order phase transition in strongly coupled gauge theories which is akin to the chiral phase transition in QCD. We discuss the relation between the latent heat and the energy (suitably defined) of the component of a D-brane which lies behind the horizon at the critical temperature. A numerical simulation of a dynamical phase transition in an expanding, cooling Quark-Gluon plasma produced in a relativistic collision is carried out.Comment: 30 pages, 5 figure

Hierarchical HRP-crosslinked silk fibroin/ZnSr-doped TCP nancocomposites towards osteochondral tissue regeneration: Biomechanical performance and in vivo assessment

[Excerpt] Introduction. Recent investigations highlight promising regenerative strategies for osteochondral (OC) tissue treatment, such as hierarchical nanocomposite scaffolds containing ionic dopants.1,2 They allow cell infiltration and ECM formation throughout the engineered cartilage and subchondral tissues. The biomechanical behavior, antibacterial properties, and in vivo performance of hierarchical nanostructures combining enzymatically crosslinked silk fibroin (SF) and ZnSr-doped β-tricalcium phosphate (ZnSrTCP) for OC tissue regeneration is herein assessed. [...]Thanks to the Portuguese Foundation for Science and Technology for M-era-Net/0001/2014 project, and for the distinctions (IF/01285/2015) and (CEECIND/03673/2017)

Clinical outcomes in youth beyond the first year of type 1 diabetes: Results of the Pediatric Diabetes Consortium (PDC) type 1 diabetes new onset (NeOn) study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138914/1/pedi12459.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138914/2/pedi12459_am.pd

Vitamin D status in youth with type 1 and type 2 diabetes enrolled in the Pediatric Diabetes Consortium (PDC) is not worse than in youth without diabetes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134500/1/pedi12340.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134500/2/pedi12340_am.pd

Low-frequency time-domain characterization for fast and reliable evaluation of microwave transistor performance

In this paper, we introduce the use of the low-frequency characterization of electron devices as an accurate and economical way to fast gather consistent data about the electron device performance at microwaves in the evaluation phase of new components, technologies and processes. © 2016 European Microwave Association