Radiographic changes of the talus in congenital clubfoot after surgical release using the mckay procedure

OBJECTIVE: To analyze the morphologic changes of the talus after surgical treatment of congenital clubfoot using the McKay procedure. METHODS: We retrospectively analyzed lateral standing radiographs of the feet in 14 patients with unilateral clubfoot treated by the McKay procedure. All patients were operated on by the same surgeon, with an average of 6.53 years between surgery and the radiograph. We compared the characteristics of the talus between the operated foot and the contralateral foot. We evaluated the deformity of the domus and the head of the talus (sphericity evaluation), the talar length and height, the presence and percentage of navicular subluxation, changes in the Gissane angle, and the trabecular pattern of the bone. RESULTS: Deformities of the head of the talus were observed in 92.8% of the patients; of the domus in 92.8%; and of the trabecular pattern in 100%. The ratio between the talar lengths of the operated foot and the contralateral foot ranged from 0.61 to 0.88 (Mean 0.79, SD = 0.09), while the height ratio ranged from 0.57 to 0.98 (Mean 0.82, SD = 0.12). The Gissane angle was increased in all of the operated feet, which also showed some degree of navicular subluxation, ranging from 6.43 to 59.75% (Mean 26.34%, SD = 16.66%). CONCLUSIONS: Abnormal talar findings were observed in 100% of the feet treated using the McKay procedure. The establishment of radiographic parameters to describe and quantify these deformities was feasible through simple and easy techniques.OBJETIVO: Analisar as alterações morfológicas do tálus após o tratamento cirúrgico do pé torto congênito pela técnica de McKay. MÉTODOS: Foram analisadas, retrospectivamente, radiografias em perfil com carga dos pés de 14 pacientes com pé torto congênito unilateral submetidos ao tratamento pela técnica de McKay por dupla incisão. Todos os pacientes foram operados pelo mesmo cirurgião, com média de 6,53 anos entre a cirurgia e a radiografia. Comparamos as características do tálus dos pés operados com os parâmetros radiográficos dos pés contralaterais. Avaliamos a presença de deformidade do dômus e da cabeça do tálus (avaliação da esfericidade), a altura e o comprimento do tálus, a presença e grau de subluxação do navicular, a alteração do ângulo de Gissane e o padrão do trabeculado ósseo. RESULTADOS: Alterações da cabeça do tálus ocorreram em 92,8% dos casos; do dômus, em 92,8%; e do trabeculado, em 100%. A relação entre o comprimento do tálus do pé operado sobre o contralateral variou de 0,61 a 0,88 (média de 0,79; DP = 0,09), e da altura de 0,57 a 0,98 (média de 0,82; DP = 0,12). O ângulo de Gissane aumentou em todos os pés operados, e todos apresentaram subluxação do navicular, com índice variando de 6,43 a 59,75% (média de 26,34%; DP = 16,66%). CONCLUSÕES: Alterações talares ocorreram em 100% dos pés tratados pela técnica de McKay. Estabelecer parâmetros radiográficos para descrever e quantificar essas deformidades mostrou-se viável através de técnicas simples e de fácil execução.Universidade Federal de São Paulo (UNIFESP) Departamento de Ortopedia e Traumatologia Ortopedia PediátricaUniversidade Federal de São Paulo (UNIFESP) Departamento de Ortopedia e TraumatologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Diagnóstico por ImagemUNIFESP, Depto. de Ortopedia e Traumatologia Ortopedia PediátricaUNIFESP, Depto. de Ortopedia e TraumatologiaUNIFESP, Depto. de Diagnóstico por ImagemSciEL

Growth and nutrition in children with Ataxia telangiectasia

Background: Ataxia telangiectasia (A-T) is a rare multisystem disease with high early mortality from lung disease and cancer. Nutritional failure adversely impacts outcomes in many respiratory diseases. Several factors influence nutrition in children with A-T. We hypothesised that children with A-T have progressive growth failure and that early gastrostomy tube feeding (percutaneous endoscopic gastrostomy, or PEG) is a favourable management option with good nutritional outcomes. Methods: Data were collected prospectively on weight, height and body mass index (BMI) at the national paediatric A-T clinic. Adequacy and safety of oral intake was assessed. Nutritional advice was given at each multidisciplinary review. Results: 101 children (51 girls) had 222 measurements (32 once, 32 twice, 24 thrice) between 2009 and 2016. Median (range) age was 9.3 (1.5 to 18.4) years. Mean (sd) weight, height and BMI Z-scores were respectively -1.03(1.57), -1.17 (1.18) and -0.36 (1.43). 35/101 children had weight Z-scores below -2 on at least one occasion. Weight, height and BMI Z-scores declined over time. Decline was most obvious after 8 years of age. 14/101 (13.9%) children had a PEG, with longitudinal data available for 12. In a nested case control study, there was a trend for improvement in weight in those with a PEG (p = 0.06). Conclusions: A-T patients decline in growth over time. There is an urgent need for new strategies, including an understanding of why growth falters. We suggest early proactive consideration of PEG from age 8 years onwards in order to prevent progressive growth failure

The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe

The preponderance of matter over antimatter in the early Universe, the dynamics of the supernova bursts that produced the heavy elements necessary for life and whether protons eventually decay --- these mysteries at the forefront of particle physics and astrophysics are key to understanding the early evolution of our Universe, its current state and its eventual fate. The Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed plan for a world-class experiment dedicated to addressing these questions. LBNE is conceived around three central components: (1) a new, high-intensity neutrino source generated from a megawatt-class proton accelerator at Fermi National Accelerator Laboratory, (2) a near neutrino detector just downstream of the source, and (3) a massive liquid argon time-projection chamber deployed as a far detector deep underground at the Sanford Underground Research Facility. This facility, located at the site of the former Homestake Mine in Lead, South Dakota, is approximately 1,300 km from the neutrino source at Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino charge-parity symmetry violation and mass ordering effects. This ambitious yet cost-effective design incorporates scalability and flexibility and can accommodate a variety of upgrades and contributions. With its exceptional combination of experimental configuration, technical capabilities, and potential for transformative discoveries, LBNE promises to be a vital facility for the field of particle physics worldwide, providing physicists from around the globe with opportunities to collaborate in a twenty to thirty year program of exciting science. In this document we provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess.Comment: Major update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figure

Age-Related Attenuation of Dominant Hand Superiority

The decline of motor performance of the human hand-arm system with age is well-documented. While dominant hand performance is superior to that of the non-dominant hand in young individuals, little is known of possible age-related changes in hand dominance. We investigated age-related alterations of hand dominance in 20 to 90 year old subjects. All subjects were unambiguously right-handed according to the Edinburgh Handedness Inventory. In Experiment 1, motor performance for aiming, postural tremor, precision of arm-hand movement, speed of arm-hand movement, and wrist-finger speed tasks were tested. In Experiment 2, accelerometer-sensors were used to obtain objective records of hand use in everyday activities

Hydromechanical modelling of shaft sealing for CO2 storage

The geological sequestration of CO2 in abandoned coal mines is a promising option to mitigate climate changes while providing sustainable use of the underground cavities. In order to certify the efficiency of the storage, it is essential to understand the behaviour of the shaft sealing system. The paper presents a numerical analysis of CO2 transfer mechanisms through a mine shaft and its sealing system. Different mechanisms for CO2 leakage are considered, namely multiphase flow through the different materials and flow along the interfaces between the lining and the host rock. The study focuses on the abandoned coal mine of Anderlues, Belgium, which was used for seasonal storage of natural gas. A two-dimensional hydromechanical modelling of the storage site is performed and CO2 injection into the coal mine is simulated. Model predictions for a period of 500 years are presented and discussed with attention. The role and influence of the interface between the host rock and the concrete lining are examined. In addition the impact of some uncertain model parameters on the overall performance of the sealing system is analysed through a sensitivity analysis

Toward Improving Ambient Volta Potential Measurements with SKPFM for Corrosion Studies

Scanning Kelvin probe force microscopy (SKPFM) is used in corrosion studies to quantify the relative nobility of different microstructural features present within complex metallic systems and thereby elucidate possible corrosion initiation sites. However, Volta potential differences (VPDs) measured via SKPFM in the literature for metal alloys exhibit large variability, making interpretation and application for corrosion studies difficult. We have developed an improved method for referencing SKPFM VPDs by quantifying the closely related work function of the probe relative to an inert gold standard whose modified work function is calculated via density functional theory (DFT). By measuring and tracking changes in the probe vs. gold VPD, this method compensates for some of the complex effects that cause changes in an individual probe\u27s work function. Furthermore, it provides a path toward direct, quantitative comparison of SKPFM results obtained by different researchers. Application of this method to a Cu-Ag-Ti eutectic braze of a steel sample imaged with multiple SKPFM probes of differing compositions led to enhanced repeatability both within and among probe types, as well as enabled the calculation of modified work function values for each of the microstructural constituents present

How Generation Z College Students Prefer to Learn: A Comparison of U.S. and Brazil Students

The purpose of this study was to engage in a comparative analysis of Generation Z college students in the United States and Brazil regarding characteristics, motivations, interpersonal styles, learning styles, and learning methods. Quantitative data in both countries were collected and analyzed to formulate comparative findings. Themes that emerged include learning that makes a difference, achievement orientation, logic-based learning, intrapersonal and interpersonal learning, applied and hands-on experiences, learning through words, recognition, and lacking vision, inspiration, and creativity. More similarities than differences were found across themes in both populations

The severity of pandemic H1N1 influenza in the United States, from April to July 2009: A Bayesian analysis

Background: Accurate measures of the severity of pandemic (H1N1) 2009 influenza (pH1N1) are needed to assess the likely impact of an anticipated resurgence in the autumn in the Northern Hemisphere. Severity has been difficult to measure because jurisdictions with large numbers of deaths and other severe outcomes have had too many cases to assess the total number with confidence. Also, detection of severe cases may be more likely, resulting in overestimation of the severity of an average case. We sought to estimate the probabilities that symptomatic infection would lead to hospitalization, ICU admission, and death by combining data from multiple sources. Methods and Findings: We used complementary data from two US cities: Milwaukee attempted to identify cases of medically attended infection whether or not they required hospitalization, while New York City focused on the identification of hospitalizations, intensive care admission or mechanical ventilation (hereafter, ICU), and deaths. New York data were used to estimate numerators for ICU and death, and two sources of data - medically attended cases in Milwaukee or self-reported influenza-like illness (ILI) in New York - were used to estimate ratios of symptomatic cases to hospitalizations. Combining these data with estimates of the fraction detected for each level of severity, we estimated the proportion of symptomatic patients who died (symptomatic case-fatality ratio, sCFR), required ICU (sCIR), and required hospitalization (sCHR), overall and by age category. Evidence, prior information, and associated uncertainty were analyzed in a Bayesian evidence synthesis framework. Using medically attended cases and estimates of the proportion of symptomatic cases medically attended, we estimated an sCFR of 0.048% (95% credible interval [CI] 0.026%-0.096%), sCIR of 0.239% (0.134%-0.458%), and sCHR of 1.44% (0.83%-2.64%). Using self-reported ILI, we obtained estimates approximately 7-96lower. sCFR and sCIR appear to be highest in persons aged 18 y and older, and lowest in children aged 5-17 y. sCHR appears to be lowest in persons aged 5-17; our data were too sparse to allow us to determine the group in which it was the highest. Conclusions: These estimates suggest that an autumn-winter pandemic wave of pH1N1 with comparable severity per case could lead to a number of deaths in the range from considerably below that associated with seasonal influenza to slightly higher, but with the greatest impact in children aged 0-4 and adults 18-64. These estimates of impact depend on assumptions about total incidence of infection and would be larger if incidence of symptomatic infection were higher or shifted toward adults, if viral virulence increased, or if suboptimal treatment resulted from stress on the health care system; numbers would decrease if the total proportion of the population symptomatically infected were lower than assumed.published_or_final_versio

Análise epidemiológica dos fatores de risco cardíaco em idosos

This study analyzed cardiac risk factors found in older adults, highlighting the increased incidence of cardiovascular diseases with advancing age. A total of 372 elderly individuals were evaluated at Basic Health Units, and divided into sedentary and active groups. Research emphasized the importance of physical activity in reducing cardiovascular risk, using the Framingham Score to identify high cardiovascular risk and to guide interventions. The sociodemographic analysis included age group, ethnicity, marital status, education, income, and family history of diseases. Bayesian inferences were conducted to assess the number of simultaneous changes in variables and calculate the proportion of individuals with potential cardiac risk. The final conclusion of Bayesian inferences indicates that approximately 29.0% of individuals in the sample may bear potential cardiovascular risk due to two or more alterations in the evaluated variables.Este estudio analizó factores de riesgo cardíaco en personas mayores, resaltando el aumento de la incidencia de enfermedades cardiovasculares con el avance de la edad. Se evaluaron 372 adultos mayores en Unidades Básicas de Salud, divididos en grupos sedentarios y activos. La investigación destacó la importancia de la actividad física en la reducción del riesgo cardiovascular, utilizando el Puntaje de Framingham para identificar alto riesgo cardiovascular y dirigir intervenciones. El análisis sociodemográfico incluyó el rango de edad, etnia, estado civil, educación, ingresos y antecedentes familiares de enfermedades. Se realizaron inferencias bayesianas para evaluar el número de cambios simultáneos en las variables y calcular la proporción de individuos potencialmente con riesgos cardíacos (Potenciales Cardiópatas). La conclusión final de las inferencias bayesianas indica que aproximadamente el 29,0% de los individuos en la muestra pueden considerarse potencialmente cardiópatas debido a dos o más cambios en las variables evaluadas.Este estudo analisou fatores de risco cardíaco em idosos, ressaltando o aumento da incidência de doenças cardiovasculares com o avanço da idade. Foram avaliados 372 idosos em Unidades Básicas de Saúde, divididos em grupos sedentários e ativos. A pesquisa destacou a importância da atividade física na redução do risco cardiovascular, utilizando o Escore de Framingham para identificar alto risco cardiovascular e direcionar intervenções. A análise sociodemográfica incluiu faixa etária, etnia, estado civil, educação, renda e histórico familiar de doenças. Inferências Bayesianas foram realizadas para avaliar o número de alterações simultâneas nas variáveis e calcular a proporção de indivíduos potencialmente com riscos cardíacos (Potenciais Cardiopatas). A conclusão final das inferências Bayesianas indica que aproximadamente 29,0% dos indivíduos na amostra podem ser considerados potencialmente cardiopatas devido a duas ou mais alterações nas variáveis avaliadas

Accelerated neuritogenesis and maturation of primary spinal motor neurons in response to nanofibers

Neuritogenesis, neuronal polarity formation, and maturation of axons and dendrites are strongly influenced by both biochemical and topographical extracellular components. The aim of this study was to elucidate the effects of polylactic acid electrospun fiber topography on primary motor neuron development, because regeneration of motor axons is extremely limited in the central nervous system and could potentially benefit from the implementation of a synthetic scaffold to encourage regrowth. In this analysis, we found that both aligned and randomly oriented submicron fibers significantly accelerated the processes of neuritogenesis and polarity formation of individual cultured motor neurons compared to flat polymer films and glass controls, likely due to restricted lamellipodia formation observed on fibers. In contrast, dendritic maturation and soma spreading were inhibited on fiber substrates after 2 days in vitro . This study is the first to examine the effects of electrospun fiber topography on motor neuron neuritogenesis and polarity formation. Aligned nanofibers were shown to affect the directionality and timing of motor neuron development, providing further evidence for the effective use of electrospun scaffolds in neural regeneration applications. © 2010 Wiley Periodicals, Inc. Develop Neurobiol 70: 589–603, 2010Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/77438/1/20792_ftp.pd