Posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws

Purpose: C1-C2 instability or painful osteoarthritis are recognised indications for posterior atlanto-axial fixation. In the traditional trans-articular C1-C2 screw fixation, up to 20% of patients cannot have safe placement of bilateral screws in the event of a medially located vertebral artery and a straight screw trajectory in the sagittal plane. The more recently developed C1-C2 fixation technique with individual C1 lateral mass screws and converging C2 pars screws can be employed in case of a medially located vertebral artery and has comparable biomechanical strength. This is a prospective observational study to investigate the advantages, the safety, and the drawbacks of posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws. Methods: Twelve consecutive patients with C1-2 instability (n = 11) and painful osteoarthritis (n = 1) underwent a posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws. The average follow-up was 16months and all patients reached the 12-month follow-up. Findings: No hardware failure occurred in any of the patients. Correct screw placement and construct stability was found in all 12 patients (100%) at 6 and 12months after surgery. Mean neck pain on a visual analogue scale (VAS) was 2.1 at 6months and 2.0 at 12months. Only transient complications were observed: one patient presented with progressive intestinal herniation through the iliac crest scar; one suffered from severe pain at the posterior iliac crest for 3 months and three patients complained of annoying pain/dysaesthesia in the C2 dermatome for 3-6months after surgery. Conclusion: This study confirms that posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws is a safe and effective surgical option in the treatment of atlanto-axial instability or painful osteoarthriti

Iterative Segmentation from Limited Training Data: Applications to Congenital Heart Disease

We propose a new iterative segmentation model which can be accurately learned from a small dataset. A common approach is to train a model to directly segment an image, requiring a large collection of manually annotated images to capture the anatomical variability in a cohort. In contrast, we develop a segmentation model that recursively evolves a segmentation in several steps, and implement it as a recurrent neural network. We learn model parameters by optimizing the interme- diate steps of the evolution in addition to the final segmentation. To this end, we train our segmentation propagation model by presenting incom- plete and/or inaccurate input segmentations paired with a recommended next step. Our work aims to alleviate challenges in segmenting heart structures from cardiac MRI for patients with congenital heart disease (CHD), which encompasses a range of morphological deformations and topological changes. We demonstrate the advantages of this approach on a dataset of 20 images from CHD patients, learning a model that accurately segments individual heart chambers and great vessels. Com- pared to direct segmentation, the iterative method yields more accurate segmentation for patients with the most severe CHD malformations.Comment: Presented at the Deep Learning in Medical Image Analysis Workshop, MICCAI 201

High-pressure transport properties of CeRu_2Ge_2

The pressure-induced changes in the temperature-dependent thermopower S(T) and electrical resistivity \rho(T) of CeRu_2Ge_2 are described within the single-site Anderson model. The Ce-ions are treated as impurities and the coherent scattering on different Ce-sites is neglected. Changing the hybridisation \Gamma between the 4f-states and the conduction band accounts for the pressure effect. The transport coefficients are calculated in the non-crossing approximation above the phase boundary line. The theoretical S(T) and \rho(T) curves show many features of the experimental data. The seemingly complicated temperature dependence of S(T) and \rho(T), and their evolution as a function of pressure, is related to the crossovers between various fixed points of the model.Comment: 9 pages, 10 figure

Probing the phase diagram of CeRu_2Ge_2 by thermopower at high pressure

The temperature dependence of the thermoelectric power, S(T), and the electrical resistivity of the magnetically ordered CeRu_2Ge_2 (T_N=8.55 K and T_C=7.40 K) were measured for pressures p < 16 GPa in the temperature range 1.2 K < T < 300 K. Long-range magnetic order is suppressed at a p_c of approximately 6.4 GPa. Pressure drives S(T) through a sequence of temperature dependences, ranging from a behaviour characteristic for magnetically ordered heavy fermion compounds to a typical behaviour of intermediate-valent systems. At intermediate pressures a large positive maximum develops above 10 K in S(T). Its origin is attributed to the Kondo effect and its position is assumed to reflect the Kondo temperature T_K. The pressure dependence of T_K is discussed in a revised and extended (T,p) phase diagram of CeRu_2Ge_2.Comment: 7 pages, 6 figure

Loving to Straighten Out Development: Sexuality and ‘Ethnodevelopment’ in the World Bank’s Ecuadorian Lending

Gender staff in the World Bank -- the world's largest and most influential development institution -- have a policy problem. Having prioritised efforts to get women into paid employment as the "cure-all" for gender inequality they must deal with the work that women already do -- the unpaid labour of caring, socialisation, and human needs fulfilment. This article explores the most prominent policy solution enacted by the Bank to this tension between paid and unpaid work: the restructuring of normative heterosexuality to encourage a two-partner model of love and labour wherein women work more and men care better. Through a case study of Bank gender lending in Ecuador I argue that staff are trying to (re)forge normative arrangements of intimacy, a policy preference that remains invisible unless sexuality is taken seriously as a category of analysis in development studies. Specifically, I focus on four themes that emerge from the attempt to restructure heteronormativity in the loan: (1) the definition of good gender analysis as requiring complementary sharing and dichotomous sex; (2) the Bank's attempt to inculcate limited rationality in women such that they operate as better workers while retaining altruistic attachments to loved ones; (3) the Bank's attempt to inculcate better loving in men, such that they pick up the slack of caring labour when their (partially) rational wives move into productive work, and; (4) the invocation of a racialised hierarchy resting on the extent to which communities approximate ideals of sharing monogamous partnership. Aside from providing clear evidence that the world's largest development institution is involved in micro-processes of sexuality adjustment alongside macro-processes of economic restructuring, I also critique the Bank's sexualised policy interventions and suggest that they warrant contestation

Integrating transposable elements in the 3D genome

Chromosome organisation is increasingly recognised as an essential component of genome regulation, cell fate and cell health. Within the realm of transposable elements (TEs) however, the spatial information of how genomes are folded is still only rarely integrated in experimental studies or accounted for in modelling. Whilst polymer physics is recognised as an important tool to understand the mechanisms of genome folding, in this commentary we discuss its potential applicability to aspects of TE biology. Based on recent works on the relationship between genome organisation and TE integration, we argue that existing polymer models may be extended to create a predictive framework for the study of TE integration patterns. We suggest that these models may offer orthogonal and generic insights into the integration profiles (or "topography") of TEs across organisms. In addition, we provide simple polymer physics arguments and preliminary molecular dynamics simulations of TEs inserting into heterogeneously flexible polymers. By considering this simple model, we show how polymer folding and local flexibility may generically affect TE integration patterns. The preliminary discussion reported in this commentary is aimed to lay the foundations for a large-scale analysis of TE integration dynamics and topography as a function of the three-dimensional host genome

Atmospheric Peroxyacetyl Nitrate (PAN): A Global Budget and Source Attribution

Peroxyacetyl nitrate (PAN) formed in the atmospheric oxidation of non-methane volatile organic compounds (NMVOCs) is the principal tropospheric reservoir for nitrogen oxide radicals $(NO_x = NO + NO_2)$. PAN enables the transport and release of $NO_x$ to the remote troposphere with major implications for the global distributions of ozone and OH, the main tropospheric oxidants. Simulation of PAN is a challenge for global models because of the dependence of PAN on vertical transport as well as complex and uncertain NMVOC sources and chemistry. Here we use an improved representation of NMVOCs in a global 3-D chemical transport model (GEOS-Chem) and show that it can simulate PAN observations from aircraft campaigns worldwide. The immediate carbonyl precursors for PAN formation include acetaldehyde (44% of the global source), methylglyoxal (30%), acetone (7%), and a suite of other isoprene and terpene oxidation products (19%). A diversity of NMVOC emissions is responsible for PAN formation globally including isoprene (37%) and alkanes (14%). Anthropogenic sources are dominant in the extratropical Northern Hemisphere outside the growing season. Open fires appear to play little role except at high northern latitudes in spring, although results are very sensitive to plume chemistry and plume rise. Lightning $NO_x$ is the dominant contributor to the observed PAN maximum in the free troposphere over the South Atlantic.Engineering and Applied Science