Reproducibility of different screening classifications in ultrasonography of the newborn hip

<p>Abstract</p> <p>Background</p> <p>Ultrasonography of the hip has gained wide acceptance as a primary method for diagnosis, screening and treatment monitoring of developmental hip dysplasia in infants. The aim of the study was to examine the degree of concordance of two objective classifications of hip morphology and subjective parameters by three investigators with different levels of experience.</p> <p>Methods</p> <p>In 207 consecutive newborns (101 boys; 106 girls) the following parameters were assessed: bony roof angle (α-angle) and cartilage roof angle (β-angle) according to Graf's basic standard method, "femoral head coverage" (FHC) as described by Terjesen, shape of the bony roof and position of the cartilaginous roof. Both hips were measured twice by each investigator with a 7.5 MHz linear transducer (SONOLINE G60S^®ultrasound system, SIEMENS, Erlangen, Germany).</p> <p>Results</p> <p>Mean kappa-coefficients for the subjective parameters shape of the bony roof (0.97) and position of the cartilaginous roof (1.0) demonstrated high intra-observer reproducibility. Best results were achieved for α-angle, followed by β-angle and finally FHC. With respect to limits of agreement, inter-observer reproducibility was calculated less precisely.</p> <p>Conclusions</p> <p>Higher measurement differences were evaluated more in objective scorings. Those variations were observed by every investigator irrespective of level of experience.</p

The relative effects of upwelling and river flow on the phytoplankton diversity patterns in the ria of A Coruña (NW Spain)

Phytoplankton species assemblages in estuaries are connected to those in rivers and marine environments by local hydrodynamics leading to a continuous flow of taxa. This study revealed differential effects of upwelling and river flow on phytoplankton communities observed in 2011 along a salinity gradient from a river reservoir connected to the sea through a ria-marine bay system in A Coruña (NW Spain, 43° 16-21’ N, 8° 16-22’ W). With 130 phytoplankton taxa identified, the assemblages were dominated in general by diatoms, particularly abundant in the bay and in the estuary, but also by chlorophycea and cyanobacteria in the reservoir. Considering the entire seasonal cycle, the local assemblages were mainly characterized by changes in cryptophytes and diatoms, small dinoflagellates and some freshwater chlorophycea. Salinity, nitrate, and organic matter variables, were the main environmental factors related to the changes in the phytoplankton communities through the system, while phosphate and nitrite were also important for local communities in the estuary and the bay, respectively. The corresponding local phytoplankton assemblages showed moderate levels of connectivity. The estuarine community shared a variable number of taxa with the adjacent zones, depending on the relative strength of upwelling (major influence from the bay) and river flow (major influence of the reservoir) but had on average 35% of unique taxa. Consequently, local and zonal diversity patterns varied seasonally and were not simply related to the salinity gradient driven by the river flow.ANILE (CTM2009-08396 and CTM2010-08804-E), FIOME (CTM2011-28792-C02-01-MAR), and MEFIO (CTM2011-28792-C02-02-MAR) of the Plan Nacional de I+D+i (Spain), and RADIALES of the Instituto Español de Oceanografía (IEO, Spain).Versión del editor2,01

Primary DNA damage and genetic polymorphisms for CYP1A1, EPHX and GSTM1 in workers at a graphite electrode manufacturing plant

<p>Abstract</p> <p>Background</p> <p>The results of a cross-sectional study aimed to evaluate whether genetic polymorphisms (biomarkers of susceptibility) for <it>CYP1A1</it>, <it>EPHX </it>and <it>GSTM1 </it>genes that affect polycyclic aromatic hydrocarbons (PAH) activation and detoxification might influence the extent of primary DNA damage (biomarker of biologically effective dose) in PAH exposed workers are presented. PAH-exposure of the study populations was assessed by determining the concentration of 1-hydroxypyrene (1OHP) in urine samples (biomarker of exposure dose).</p> <p>Methods</p> <p>The exposed group consisted of workers (n = 109) at a graphite electrode manufacturing plant, occupationally exposed to PAH. Urinary 1OHP was measured by HPLC. Primary DNA damage was evaluated by the alkaline comet assay in peripheral blood leukocytes. Genetic polymorphisms for <it>CYP1A1</it>, <it>EPHX</it> and <it>GSTM1</it> were determined by PCR or PCR/RFLP analysis.</p> <p>Results</p> <p>1OHP and primary DNA damage were significantly higher in electrode workers compared to reference subjects. Moreover, categorization of subjects as normal or outlier highlighted an increased genotoxic risk OR = 2.59 (CI95% 1.32–5.05) associated to exposure to PAH. Polymorphisms in <it>EPHX</it> exons 3 and 4 was associated to higher urinary concentrations of 1OHP, whereas none of the genotypes analyzed (<it>CYP1A1</it>, <it>EPHX</it>, and <it>GSTM1</it>) had any significant influence on primary DNA damage as evaluated by the comet assay.</p> <p>Conclusion</p> <p>The outcomes of the present study show that molecular epidemiology approaches (i.e. cross-sectional studies of genotoxicity biomarkers) can play a role in identifying common genetic risk factors, also attempting to associate the effects with measured exposure data. Moreover, categorization of subjects as normal or outlier allowed the evaluation of the association between occupational exposure to PAH and DNA damage highlighting an increased genotoxic risk.</p

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment

THREE FIRST-ORDER FINITE VOLUME ELEMENT METHODS FOR STOKES EQUATIONS UNDER MINIMAL REGULARITY ASSUMPTIONS

Three first-order finite volume element methods, namely, conforming, nonconforming, and discontinuous Galerkin schemes for Stokes equations, are analyzed and compared using the medius analysis. The latter analysis is based on a combination of arguments from a priori and a posteriori error analyses under no extra regularity assumptions on the weak solution. Best-approximation results for the energy norms hold in all cases and allow for comparison results up to generic equivalence constants and higher-order data oscillation of the applied volume forces with little modification for different pressure approximations. A priori and a posteriori analyses of discontinuous Galerkin finite volume element methods with SIPG, IIPG, NIPG are included for completeness

Comparison results and unified analysis for first-order finite volume element methods for a Poisson model problem

There exist at least three first-order finite volume element methods with totally different dual meshes and conforming or nonconforming P-1 finite element trial functions and the question arises of whether they are comparable. The fact that the underlying norms are very different does not prevent the proof that the errors are equivalent on any mesh in some norm. This equivalence is independent of the regularity of the exact solution and holds for any coarse or fine mesh with or without local mesh refining, but up to equivalence constants and additional explicit data-oscillation terms of higher order. The equivalence constants depend on the minimal angle of the shape-regular triangulation and the penalization parameter of the discontinuous Galerkin scheme. This also implies quasi-optimality in the sense that the error is bounded by the best approximation of the flux by piecewise constants. An a posteriori error analysis for the discontinuous Galerkin finite volume element scheme is also discussed. The analysis is exemplified for a boundary value model problem for some second-order elliptic partial differential equation in two dimensions