Charge asymmetry in high-energy μ+μ−\mu^+\mu^- photoproduction in the electric field of a heavy atom

The charge asymmetry in the differential cross section of high-energy $\mu^+\mu^-$ photoproduction in the electric field of a heavy atom is obtained. This asymmetry arises due to the Coulomb corrections to the amplitude of the process (next-to-leading term with respect to the atomic field). The deviation of the nuclear electric field from the Coulomb field at small distances is crucially important for the charge asymmetry. Though the Coulomb corrections to the total cross section are negligibly small, the charge asymmetry is measurable for selected final states of $\mu^+$ and $\mu^-$. We further discuss the feasibility for experimental observation of this effect.Comment: 6 pages, 3 figure

Red flags presented in current low back pain guidelines: a review.

OBJECTIVE: The purpose of this study was to identify and descriptively compare the red flags endorsed in guidelines for the detection of serious pathology in patients presenting with low back pain to primary care. METHOD: We searched databases, the World Wide Web and contacted experts aiming to find the multidisciplinary clinical guideline in low back pain in primary care, and selected the most recent one per country. We extracted data on the number and type of red flags for identifying patients with higher likelihood of serious pathology. Furthermore, we extracted data on whether or not accuracy data (sensitivity/specificity, predictive values, etc.) were presented to support the endorsement of specific red flags. RESULTS: We found 21 discrete guidelines all published between 2000 and 2015. One guideline could not be retrieved and after selecting one guideline per country we included 16 guidelines in our analysis from 15 different countries and one for Europe as a whole. All guidelines focused on the management of patients with low back pain in a primary care or multidisciplinary care setting. Five guidelines presented red flags in general, i.e., not related to any specific disease. Overall, we found 46 discrete red flags related to the four main categories of serious pathology: malignancy, fracture, cauda equina syndrome and infection. The majority of guidelines presented two red flags for fracture ('major or significant trauma' and 'use of steroids or immunosuppressors') and two for malignancy ('history of cancer' and 'unintentional weight loss'). Most often pain at night or at rest was also considered as a red flag for various underlying pathologies. Eight guidelines based their choice of red flags on consensus or previous guidelines; five did not provide any reference to support the choice of red flags, three guidelines presented a reference in general, and data on diagnostic accuracy was rarely provided. CONCLUSION: A wide variety of red flags was presented in guidelines for low back pain, with a lack of consensus between guidelines for which red flags to endorse. Evidence for the accuracy of recommended red flags was lacking

The expanding phenotype of MELAS caused by the m.3291T \u3e C mutation in the MT-TL1 gene

Crown Copyright © 2016 Published by Elsevier Inc. m.3291T \u3e C mutation in the MT-TL1 gene has been infrequently encountered in association with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), however remains poorly characterized from a clinical perspective. In the following report we describe in detail the phenotypic features, long term follow up (\u3e 7 years) and management in a Caucasian family with MELAS due to the m.3291T \u3e C mutation and review the literature on m.3291T \u3e C mutation. The clinical phenotype in the proposita included overlapping features of MELAS, MERRF (Myoclonic epilepsy and ragged-red fiber syndrome), MNGIE (Mitochondrial neurogastrointestinal encephalopathy), KSS (Kearns-Sayre Syndrome) and CPEO (Chronic progressive external ophthalmoplegia)

Structural phase transitions in the kagome lattice based materials Cs2-xRbxSnCu3F12 (x = 0, 0.5, 1.0, 1.5)

The solid solution Cs2-xRbxSnCu3F12 (x = 0, 0.5, 1.0, 1.5) has been investigated crystallographically between 100 and 300 K using synchrotron X-ray powder diffraction and, in the case of x = 0, neutron powder diffraction.Comment: 14 pages, 9 figure

Novel, bilateral, two-bellied muscles span the extensor forearm, thenar eminence to insert on the proximal phalanx of the thumb: clinical and embryological significance

Muscle and tendon variations in the forearm, wrist and hand are commonly reported in the anatomical and surgical literature. They are frequently the source of inflammatory conditions such as de Quervain’s tenosynovitis or carpal tunnel syndrome. During academic dissection, a cadaver presented with bilateral, additional muscles running parallel to the abductor pollicis longus muscles (APL) in the extensor compartment of the forearm. Both additional muscles had two bellies, one proximal and one distal, with an intervening tendon. The proximal bellies were separate and distinct from the adjacent APLs. The tendons traversed the first dorsal compartments with the tendons of the APLs and the extensor pollicis brevis muscles (EPB). The distal bellies lay adjacent to the abductor pollicis brevis (APB) muscles in the thenar compartments, and inserted onto the volar base of the proximal phalanges of the thumbs. Following a thorough search of the literature, we determined that these additional muscles constitute a previously unreported variation. This report details the variation, compares it with other reported variations, presents the related embryology, and reviews the significance of this variation as it relates to inflammatory conditions and surgical procedures

Safety and efficacy of filgotinib, lanraplenib and tirabrutinib in Sjogren's syndrome: a randomized, phase 2, double-blind, placebo-controlled study

OBJECTIVE: The aim of this study was to characterize the safety and efficacy of filgotinib, lanraplenib and tirabrutinib in patients with active SS. METHODS: This multicentre, double-blind study randomized patients with active primary or secondary SS [EULAR SS disease activity index (ESSDAI) ≥5) to receive filgotinib 200 mg (Janus kinase-1 inhibitor), lanraplenib 30 mg (spleen tyrosine kinase inhibitor), tirabrutinib 40 mg (Bruton’s tyrosine kinase inhibitor), or placebo. The composite primary end point was the week-12 proportion of patients fulfilling protocol-specified improvement criteria (based on CRP and SS-related symptoms). The EULAR SS patient-reported index (ESSPRI) and the ESSDAI change from baseline (CFB) were secondary end points. Exploratory end points included disease-related biomarkers. Treatment-emergent adverse events (AEs) represented safety outcomes. RESULTS: The mean of the baseline ESSDAI was 10.1, and of ESSPRI was 6.2 in the 150 patients who were treated; 125 completed the 24-week placebo-controlled treatment period. At week 12, 43.3% of the filgotinib group achieved the primary end point (P = 0.17 vs placebo) vs 42.3% (P = 0.16), 34.7% (P = 0.33), and 26.7% of lanraplenib, tirabrutinib, and placebo groups, respectively. Neither secondary end point was met. Biomarker reductions included immunoglobulins classically associated with SS disease activity. Filgotinib ESSDAI CFB appeared more pronounced in subgroups with baseline ESSDAI ≥14 or without DMARDs/CSs. Most AEs were Grade 1 or 2. CONCLUSION: Three drugs with disparate mechanisms were tested, but no significant differences vs placebo in primary or secondary end points were observed. These results may be considered hypothesis-generating, given the drug tolerability, subgroup analysis, and biomarker findings. TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT03100942

High-resolution computed tomography reconstructions of invertebrate burrow systems

The architecture of biogenic structures can be highly influential in determining species contributions to major soil and sediment processes, but detailed 3-D characterisations are rare and descriptors of form and complexity are lacking. Here we provide replicate high-resolution micro-focus computed tomography (μ-CT) data for the complete burrow systems of three co-occurring, but functionally contrasting, sediment-dwelling inter-tidal invertebrates assembled alone, and in combination, in representative model aquaria. These data (≤2,000 raw image slices aquarium−1, isotropic voxel resolution, 81 μm) provide reference models that can be used for the development of novel structural analysis routines that will be of value within the fields of ecology, pedology, geomorphology, palaeobiology, ichnology and mechanical engineering. We also envisage opportunity for those investigating transport networks, vascular systems, plant rooting systems, neuron connectivity patterns, or those developing image analysis or statistics related to pattern or shape recognition. The dataset will allow investigators to develop or test novel methodology and ideas without the need to generate a complete three-dimensional computation of exemplar architecture

A novel accessory muscle in the flexor compartment of anterior forearm inserting into the tenosynovium of the flexor pollicis longus

A common variant of accessory muscles in the anterior forearm is the Gantzer’s muscle (GM). GM arises as a muscle belly from flexor digitorum superficialis (FDS) or ulnar coronoid process to merge distally with the flexor pollicis longus (FPL) muscle. In the present case report, we describe a novel accessory muscle in the flexor compartment of the forearm. The proximal attachment was tendinous and came from three sources: FDS muscle, ulnar coronoid process, and the medial aspect of the proximal radius. The distal tendon of the novel accessory muscle ran parallel to FPL, passed through the carpal tunnel, and entered the palmar aspect of the hand. In the hand, the tendon thinned out and blended with the tenosynovium of the FPL, contributing to the sheath around the FPL tendon. This accessory muscle of the FPL is comparable to the frequently documented Gantzer muscle (GM); however, the present case exhibited fundamental nuances that distinguish it from the previously described iterations of the GM in the following ways: 1) The novel accessory muscle is tendinous from its proximal origin and throughout the upper one-third of the forearm, and one component of its origin arose from the medial aspect of the radius. Gantzer muscles with an origin on the radius have not been previously reported. 2) In the middle one-third, the tendinous proximal attachment transitioned to a muscle belly that passed through the carpal tunnel and entered the hand. 3) In the hand, the novel tendon widened, thinned, and merged with the tenosynovium of the FPL. Accessory muscles are a common finding in the anterior forearm during cadaveric dissection. In patients, they can be the cause of neuropathies due to compression of the anterior interosseous nerve. Awareness of variations is also important for clinicians who examine the forearm and hand, as well as hand and surgeons