Types Ia Research Articles

Investigations of sequencing data and sample type on HLA class Ia typing with different computational tools.

Human leukocyte antigen (HLA) can encode the human major histocompatibility complex (MHC) proteins and play a key role in adaptive and innate immunity. Emerging clinical evidences suggest that the presentation of tumor neoantigens and neoantigen-specific T cell response associated with MHC class I molecules are of key importance to activate the adaptive immune systemin cancer immunotherapy. Therefore, accurate HLA typing is very essential for the clinical application of immunotherapy. In this study, we conducted performance evaluations of 4 widely used HLA typing tools (OptiType, Phlat, Polysolver and seq2hla) for predicting HLA class Ia genes from WES and RNA-seq data of 28 cancer patients. HLA genotyping data using PCR-SBT method was firstly obtained as the golden standard and was subsequently compared with HLA typing data by using NGS techniques. For both WES data and RNA-seq data, OptiType showed the highest accuracy for HLA-Ia typing than the other 3 programs at 2-digit and 4-digit resolution. Additionally, HLA typing accuracy from WES data was higher than from RNA-seq data (99.11% for WES data versus 96.42% for RNA-seq data). The accuracy of HLA-Ia typing by OptiType can reach 100% with the average depth of HLA gene regions >20x. Besides, the accuracy of 2-digit and 4-digit HLA-Ia typing based on control samples was higher than tumor tissues. In conclusion, OptiType by using WES data from control samples with the high average depth (>20x) of HLA gene regions can present a probably superior performance for HLA-Ia typing, enabling its application in cancer immunotherapy.

Establishing reference values for the pubofemoral distance in normal infant medial hips by ultrasound

Measuring the pubofemoral distance (PFD) is important for evaluating the effectiveness of hip reduction in the treatment of developmental dysplasia of the hip (DDH). However, reference PFD values have not been established in normal infants. To investigate variations in PFD values measured in normal infant medial hips stratified by age, laterality, and gender. A total of 240 infants diagnosed with Graf type Ia and/or Graf type Ib hips by ultrasonography were stratified into eight age groups: 0-1 month; 1-2 months; 2-3 months; 3-4 months; 4-5 months; 5-6 months; 6-7 months; and 7-12 months. The bilateral medial hips were scanned with transinguinal ultrasound. The PFD was defined as the distance between the lateral edge of the superior ramus of pubic bone and the medial edge of the femoral head. Inter-observer reproducibility was assessed. Among the 240 infants, there were 371 Graf type Ia hips and 109 Graf type Ib hips. Mean ± SD bilateral PFD values of eight groups were measured separately. There were no significant differences in mean PFD values for left or right hips (t = 0.946, P = 0.345) or mean bilateral PFD values in male and female infants (t = 1.445, P = 0.149). Mean PFD values increased linearly with age (left: r = 0.680, P < 0.0001; right: r = 0.682, P < 0.0001). Inter-observer reproducibility was excellent. This study established reference PFD values from the medial hip in infants aged 0-12 months. PFD values increased with age, but were not significantly influenced by laterality or gender. These data provide detailed information that can support follow-up of infants treated for DDH.

Outcomes of Tension Band Fixation in Olecranon Fractures and Osteotomies With Sutures: A Metal-free Solution

To restore the extensor function of the elbow, tension band wiring is a commonly used technique in managing stable olecranon fractures and osteotomies with excellent results. However, the outcome and patient satisfaction are marred with high rates of hardware-related complications requiring reoperation. To diminish the risk of these complications, we employed sutures for tension band fixation instead of wires in open reduction and internal fixation of Mayo types IA and IIA olecranon fractures and olecranon osteotomies in 15 of our patients. All patients achieved the radiologic union of the fractures and osteotomies by 12 weeks, except for 1 patient who developed fibrous union at the osteotomy site. None of the patients had any functional limitations at discharge and had good to excellent outcomes on the Mayo Elbow Performance Score. There were no complications related to hardware and the need for reoperation. The use of sutures in tension band fixation of olecranon fractures and osteotomies replicates the results of the highly successful technique of tension band wiring while significantly reducing the hardware-related complications.

Differential Expression Hallmarks of Interneurons in Different Types of Focal Cortical Dysplasia.

Focal cortical dysplasia (FCD) is the main cause of medically intractable pediatric epilepsy. Previous studies have suggested that alteration of cortical interneurons and abnormal cytoarchitecture have been linked to initiation and development for seizure. However, whether each individual subpopulation of cortical interneurons is linked to distinct FCD subtypes remains largely unknown. Here, we retrospectively analyzed both control samples and epileptic specimens pathologically diagnosed with FCD types Ia, IIa, or IIb. We quantified three major interneuron (IN) subpopulations, including parvalbumin (PV)-, somatostatin (Sst)-, and vasoactive intestinal peptide (Vip)-positive INs across all the subgroups. Additionally, we calculated the ratio of the subpopulations of INs to the major INs (mINs) by defining the total number of the PV-, Sst-, and Vip-INs as mINs. Compared with the control, the density of the PV-INs in FCD type IIb was significantly lower, and the ratio of PV/mINs was lower in the superficial part of the cortex of the FCD type Ia and IIb groups. Interestingly, we found a significant increase in the ratio of Vip/mINs only in FCD type IIb. Overall, these results suggest that in addition to a reduction in PV-INs, the increase in Vip/mINs may be related to the initiation of epilepsy in FCD type IIb. Furthermore, the increase in Vip/mINs in FCD type IIb may, from the IN development perspective, indicate that FCD type IIb forms during earlier stages of pregnancy than FCD type Ia.

Metal abundances in the MACER simulations of the hot interstellar medium

AbstractHot plasma is the dominant phase of the interstellar medium of early‐type galaxies. It can originate from stellar mass losses, residual gas from the formation epoch, and accretion from outside the galaxies. Its evolution is linked to the dynamical structure of the host galaxy, to the supernova and active galactic nuclei (AGN) feedback, and to (late‐epoch) star formation in a way that has yet to be fully understood. Important clues about the origin and evolution of the hot gas come from the abundances of heavy metals that have been studied with increasing detail through XMM‐Newton and Chandra. We present recent high‐resolution hydrodynamical simulations of the hot gas evolution that include the above processes, where several chemical species, originating in asymptotic giant branch stars and supernovae of types Ia and II, have also been considered. The high resolution, of few parsecs in the central galactic region, allows us to track the metal enrichment, transportation, and dilution throughout the galaxy. The comparison of model results with observed abundances demonstrates good agreement for the region enriched by the AGN wind but also shows discrepancies for the diffuse hot gas; the latter indicates the need for a revision of standard assumptions and/or the importance of neglected effects due to the dust and/or residual uncertainties in deriving abundances from the X‐ray spectra.

Ecografía doppler en el seguimiento de la reparación endovascular del aneurisma de aorta abdominal

Una endofuga se define como la persistencia de flujo sanguíneo en el saco aneurismático. Su incidencia es aproximadamente del 25% y aunque la mayoría cursan de forma “benigna”, en otros casos pueden provocar la presurización del aneurisma, aumentando su tamaño e incrementando el riesgo de ruptura. El objetivo de este estudio fue analizar la validez diagnóstica de la ecografía doppler con respecto a la tomografía computarizada en la detección de endofugas y crecimiento del saco aneurismático, así como analizamos características morfológicas y hemodinámicas en el seguimiento de endofugas con ecografía doppler. Se realizó un estudio descriptivo, retrospectivo en que se incluyeron 142 pacientes, intervenidos mediante reparación endovascular entre 2014 y 2019 a los que se realizó el seguimiento postoperatorio según el protocolo del servicio de Angiología y Cirugía Vascular del Hospital La Fe: angioTAC y ecografía doppler, en nuestro Laboratorio de Diagnóstico Vascular de forma periódica (al mes postoperatorio y después anualmente). Durante el periodo de seguimiento se detectaron un total de 34 endofugas (incidencia del 23.9%) la mayoría correspondiendo al tipo II (65% de las mismas). Los tipos IA, IB y III se asociaron a crecimiento del saco (0,84 cm de crecimiento medio). En un caso se produjo la rotura del aneurisma. Comparando con el estándar oro del TC, obtuvimos que con la ecografía doppler, una sensibilidad del 66%, una especificidad del 95%, un valor predictivo positivo del 92% y un valor predictivo negativo del 95%. El seguimiento con ecografía doppler de pacientes intervenidos mediante EVAR es útil y eficaz en la detección de endofugas, siendo una prueba no invasiva que evita la exposición radiológica y la nefrotoxicidad. Sin embargo dada la sensibilidad debe complementarse con TC en los caso de endofuga persistente y crecimiento del saco aneurismático detectado mediante ecografía doppler.

The use of intraoperative ultrasound in patients with focal cortical dysplasia: preliminary observations

Introduction . The cessation of epileptic seizures after surgical treatment of focal epilepsy is the main objective of the surgeon. When a neurosurgeon operates focal cortical dysplasia (FCD), he/she faces difficulties with the radical removal of pathological tissue, which looks similar to healthy one. Using the neuronavigation system may not be helpful because of errors caused by displacement of brain tissues after opening the dura mater and resection of pathological foci. Intraoperative MRI examination requires significant financial expenses. One alternative is the intraoperative ultrasound (US) test, which allows one to visualize areas of pathological tissue in real time. The aim of this study is to assess the feasibility of using intraoperative US test. Materials and methods . We conducted a retrospective analysis of 20 cases of pharmacoresistant epilepsy that involved US examination during surgical operation for epilepsy caused by focal cortical dysplasia. In the preoperative period, all patients underwent EEG video monitoring in which at least three seizures were detected. In addition, three patients underwent invasive EEG video monitoring as well as preoperative and postoperative brain MRI. Based on histological verification, the distribution of patients was as follows: Ia type – 1 case (5%); Ib type – 4 cases (20%); Ic type –3 cases (15%); IIa type –3 cases (15%); IIb type – 8 cases (40%); IIIa type – 1 case (5%). Postoperative follow-up continued for 14±10 months (min – 2 months, max – 31 months). Results . Twenty (100%) patients underwent intraoperative US examination where signs of an altered cortex were found in locations similar to those revealed with preoperative MRI scans. Based on the US images, radical resection of pathological tissues was performed in these patients. In 15 (75%) patients, the seizures stopped (Engel class I). According to the US data, FCD had the following characteristics: hyperechogenicity as compared to the brain parenchyma; uneven, fuzzy, irregularly shaped contours; lack of a clear border between the white and gray matter. Conclusion . Intraoperative ultrasound is a safe, inexpensive and effective method for intraoperative imaging of FCD. The authors declare the absence of conflict of interest with respect to this publication. All authors contributed equally to this article.

Qualifying mass failures on loess gully sidewalls using laboratory experimentation

The morphology of the failure scar has been a long-debated issue concerning the Loess Plateau of China, and the lack of normative data has hampered vital research in this area. In this study, a series of laboratory experiments were conducted to observe failure geometries and volumes under rainfall simulations. The following six failure-scar types occurred: The sequence of the types described here may be same to that of the following text, namely Tf, Cd, Cu, Ia, Ps, and Co. The number of failure masses in the experiment for scar types Tf, Cd, Cu, Ia, Ps, and Co amounted to 45, 26, 23, 3, 2, and 1% of the total, and the corresponding volumes were 58, 16, 20, 2, 3, and 1% of the total, respectively. This implies that Tf, Cd, and Cu were the three major types of failure scars during the process of gravity erosion on a steep loess slope, and the scar Tf was the most significant. The sensitivity coefficient – the degree of variation in the target value caused by a change in a crucial factor when other conditions remain unchanged – of the slope gradient and rainfall intensity for the total volume of the Tf scar were 4.5 and 3.7, respectively. In other words, a relatively dangerous failure scar (Tf) might appear if the slope became steeper, or if the rainfall became more intensive. In addition, the sensitivity coefficients of the rainfall duration for the total volume of the Cu scar was significant, being 12.4. This shows that a long-duration storm could easily induce a large-volume failure with a Cu scar. The experimental results obtained here provide a morphogenic insight into the gravity-erosion control on a loess gully sidewall.

Fahrov sindrom - neurološka manifestacija endokrinološkog oboljenja

Syndrome Fahr is described as calcification of the basal ganglia and is a rare inherited or sporadic neurological disease with a prevalence of 1:1000000 (1). For the first time described in 1930 in the works of Dr. Karl Theodor Fahr, it is characterized by calcium deposition in areas of the brain to control movement: basal gamma, thalamus, cerebral cortex, cerebellum, dentate nucleus, subcortical white matter and hippocampus (2). The diagnostic criteria were revised and modified by Moskowitz et al. in 1971., Ellie et al. in 1989. and Manyam in 2005. and include: bilateral calcifications of the basal ganglia confirmed by neuroradiological visualization, progressive neurological dysfunction and neuropsychiatric manifestations, absence of biochemical and somatic entities of mitochondrial disease, absence of infectious, traumatic, or toxic etiology, and autosomal dominant inheritance (2,3,4). Etiologically, endocrine diseases, and especially parathyroid gland dysfunction, are closely related to Farr's syndrome, including idiopathic hypoparathyroidism, secondary hypoparathyroidism, pseudohypoparathyroidism, pseudo-pseudohypoparathyroidism, and hyperparathyroidism. Pseudo and pseudo-pseudohypoparathyroidism are defined by a phenotypic spectrum induced by a mutation in RNA. They manifest on average at the age of 8 to 10, with clinical manifestations very similar to hypoparathyroidism, except for a slightly more pronounced intellectual declension. The term pseudohypoparathyroidism (PHP) for subtypes PHP type IA and PHP type 1C includes diseases that share the biochemical characteristics of hypoparathyroidism (hypocalcemia and hyperphosphatemia), and which are the consequences of resistance of target tissues to the action of parathyroid hormone. In some cases, resistance to TSH, gonadotropins, GHRH and calcitonin, which have receptors bound to the Gs Alpha subunit, is detected. Patients with type 1A and type 1C PHP show diverse phenotypic expression combined by the term Albright hereditary osteodystrophy (AHO), which includes premature closure of bone and short bone growth zones, low growth, ectopic calcifications. More specifically, based on the dissemination of ectopic calcifications, patients were classified into three categories: pseudohypoparathyroidism, progressive bone heteroplasia, and osteoma cutis. Our patient was diagnosed as pseudohypoparathyroidism at an early age based on the phenotype characteristics of AHO and the biochemical findings of hypocalcemia. Substitution therapy with vitamin D and calcium was introduced, and after pronounced changes in behavior, feelings of being followed and extreme anxiety, he was hospitalized in the Clinic for Neurology and in the Clinic for Endocrinology, Clinical Center of Serbia. Neurofunctional studies have shown progressive decline in intellectual function, neuroradiologically were detected zones of calcification of the basal ganglia and frontal subcortical white matter, as well as hypothyroidism as a consequence of TSH resistance. High concentrations of calcitonin were detected, also as a consequence of resistance of target tissues to calcitonin.

Rapid classification of group B Streptococcus serotypes based on matrix-assisted laser desorption ionization-time of flight mass spectrometry and machine learning techniques

BackgroundGroup B streptococcus (GBS) is an important pathogen that is responsible for invasive infections, including sepsis and meningitis. GBS serotyping is an essential means for the investigation of possible infection outbreaks and can identify possible sources of infection. Although it is possible to determine GBS serotypes by either immuno-serotyping or geno-serotyping, both traditional methods are time-consuming and labor-intensive. In recent years, the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been reported as an effective tool for the determination of GBS serotypes in a more rapid and accurate manner. Thus, this work aims to investigate GBS serotypes by incorporating machine learning techniques with MALDI-TOF MS to carry out the identification.ResultsIn this study, a total of 787 GBS isolates, obtained from three research and teaching hospitals, were analyzed by MALDI-TOF MS, and the serotype of the GBS was determined by a geno-serotyping experiment. The peaks of mass-to-charge ratios were regarded as the attributes to characterize the various serotypes of GBS. Machine learning algorithms, such as support vector machine (SVM) and random forest (RF), were then used to construct predictive models for the five different serotypes (Types Ia, Ib, III, V, and VI). After optimization of feature selection and model generation based on training datasets, the accuracies of the selected models attained 54.9–87.1% for various serotypes based on independent testing data. Specifically, for the major serotypes, namely type III and type VI, the accuracies were 73.9 and 70.4%, respectively.ConclusionThe proposed models have been adopted to implement a web-based tool (GBSTyper), which is now freely accessible at http://csb.cse.yzu.edu.tw/GBSTyper/, for providing efficient and effective detection of GBS serotypes based on a MALDI-TOF MS spectrum. Overall, this work has demonstrated that the combination of MALDI-TOF MS and machine intelligence could provide a practical means of clinical pathogen testing.

Downregulation of activin-signaling gene expression in passaged normal human dermal fibroblasts.

Activins are members of the transforming growth factor-β (TGF-β) superfamily and play important roles in proliferation, differentiation, and apoptosis of various target cells. We investigated changes of activin, activin receptor (ActR), and Smad-signaling gene expression with increasing passage number in normal human dermal fibroblasts. The expression of mRNA and protein was measured by reverse transcription-quantitative polymerase chain reaction and immunoblot analysis from passage numbers 5 to 15. Activin A and follistatin transcript levels increased with increasing passage number. ActR types IA, IB, IIA and IIB mRNA levels decreased at high passage number. The levels of Smad2, 3 and 4 protein decreased with increasing passage number, which also attenuated phosphorylation of Smad2 and 3 protein expression. Smad7 was enhanced with increasing passage number. These results suggest that expression of activin-signaling in aging normal human dermal fibroblasts increases activin A and follistatin, whereas ActR-Smad signaling is decreased.

Assessment of Night-Time Lighting for Global Terrestrial Protected and Wilderness Areas

Protected areas (PAs) play an important role in biodiversity conservation and ecosystem integrity. However, human development has threatened and affected the function and effectiveness of PAs. The Defense Meteorological Satellite Program/Operational Linescan System (DMSP/OLS) night-time stable light (NTL) data have proven to be an effective indicator of the intensity and change of human-induced urban development over a long time span and at a larger spatial scale. We used the NTL data from 1992 to 2013 to characterize the human-induced urban development and studied the spatial and temporal variation of the NTL of global terrestrial PAs. We selected seven types of PAs defined by the International Union for Conversation of Nature (IUCN), including strict nature reserve (Ia), wilderness area (Ib), national park (II), natural monument or feature (III), habitat/species management area (IV), protected landscape/seascape (V), and protected area with sustainable use of natural resources (VI). We evaluated the NTL digital number (DN) in PAs and their surrounding buffer zones, i.e., 0–1 km, 1–5 km, 5–10 km, 10–25 km, 25–50 km, and 50–100 km. The results revealed the level, growth rate, trend, and distribution pattern of NTL in PAs. Within PAs, areas of types V and Ib had the highest and lowest NTL levels, respectively. In the surrounding 1–100 km buffer zones, type V PAs also had the highest NTL level, but type VI PAs had the lowest NTL level. The NTL level in the areas surrounding PAs was higher than that within PAs. Types Ia and III PAs showed the highest and lowest NTL growth rate from 1992 to 2013, respectively, both inside and outside of PAs. The NTL distributions surrounding the Ib and VI PAs were different from other types. The areas close to Ib and VI boundaries, i.e., in the 0–25 km buffer zones, showed lower NTL levels, for which the highest NTL level was observed within the 25–100 km buffer zone. However, other types of PAs showed the opposite NTL patterns. The NTL level was lower in the distant buffer zones, and the lowest night light was within the 1–25 km buffer zones. Globally, 6.9% of PAs are being affected by NTL. Conditions of wilderness areas, e.g., high latitude regions, Tibetan Plateau, Amazon, and Caribbean, are the least affected by NTL. The PAs in Europe, Asia, and North America are more affected by NTL than South America, Africa, and Oceania.

A retrospective validation of an imaging protocol for the management of solitary central cartilage tumours of the proximal humerus and around the knee

To validate an imaging protocol for the management of solitary central cartilage tumours (CCTs) of the proximal humerus and around the knee. Over a 10-year period, 387 patients were identified with a CCT in the proximal humerus, distal femur, and proximal tibia, who were referred to a single unit either from primary/secondary care or tertiary care directly to Royal Orthopaedic Hospital, a specialist orthopaedic oncology service. The initial magnetic resonance imaging (MRI) images and any follow-up images were evaluated for length of tumour, presence/absence of endosteal scalloping, or aggressive/malignant features. The cases were categorised into one of seven types according to the Birmingham Atypical Cartilage Tumour Imaging Protocol (BACTIP). The outcome in the cases was assessed to ascertain if application of the protocol would have led to any delay in the diagnosis of malignant transformation to a chondrosarcoma. The incidence of malignancy (chondrosarcoma) increased with ascending BACTIP. There was a 100% benign diagnosis (enchondroma) in types IA and IB, 96% in IIA, and 83% in IIB. Fifty-seven percent of type IIC and 97% type III were diagnosed as malignant. In only one case would the application of the protocol have led to a 5-month delay in the diagnosis of chondrosarcoma. This retrospective study confirms the BACTIP as a useful tool for the general radiologist in the initial assessment of CCT in the proximal humerus and around the knee with the exception of the proximal fibula. In particular, determining which cases need prompt referral to a specialist orthopaedic oncology service for further assessment.

Cytotoxicity of 1-deoxysphingolipid unraveled by genome-wide genetic screens and lipidomics in Saccharomyces cerevisiae.

Hereditary sensory and autonomic neuropathy (HSAN) types IA and IC (IA/C) are caused by elevated levels of an atypical class of lipid named 1-deoxysphingolipid (DoxSL). How elevated levels of DoxSL perturb the physiology of the cell and how the perturbations lead to HSAN IA/C are largely unknown. In this study, we show that C26-1-deoxydihydroceramide (C26-DoxDHCer) is highly toxic to the cell, while C16- and C18-DoxDHCer are less toxic. Genome-wide genetic screens and lipidomics revealed the dynamics of DoxSL accumulation and DoxSL species responsible for the toxicity over the course of DoxSL accumulation. Moreover, we show that disruption of F-actin organization, alteration of mitochondrial shape, and accumulation of hydrophobic bodies by DoxSL are not sufficient to cause complete cellular failure. We found that cell death coincides with collapsed ER membrane, although we cannot rule out other possible causes of cell death. Thus, we have unraveled key principles of DoxSL cytotoxicity that may help to explain the clinical features of HSAN IA/C.

Evidence for Sub-Chandrasekhar Type Ia Supernovae from Stellar Abundances in Dwarf Galaxies∗

Abstract There is no consensus on the progenitors of Type Ia supernovae (SNe Ia) despite their importance for cosmology and chemical evolution. We address this question using our previously published catalogs of Mg, Si, Ca, Cr, Fe, Co, and Ni abundances in dwarf galaxy satellites of the Milky Way (MW) to constrain the mass at which the white dwarf (WD) explodes during a typical SN Ia. We fit a simple bi-linear model to the evolution of [X/Fe] with [Fe/H], where X represents each of the elements mentioned above. We use the evolution of [Mg/Fe] coupled with theoretical supernova yields to isolate what fraction of the elements originated in SNe Ia. Then, we infer the [X/Fe] yield of SNe Ia for all of the elements except Mg. We compare these observationally inferred yields to recent theoretical predictions for two classes of Chandrasekhar-mass (M Ch) SN Ia as well as sub-M Ch SNe Ia. Most of the inferred SN Ia yields are consistent with all of the theoretical models, but [Ni/Fe] is consistent only with sub-M Ch models. We conclude that the dominant type of SN Ia in ancient dwarf galaxies is the explosion of a sub-M Ch WD. The MW and dwarf galaxies with extended star formation histories have higher [Ni/Fe] abundances, which could indicate that the dominant class of SN Ia is different for galaxies where star formation lasted for at least several Gyr.

FRW dark energy cosmological model with hybrid expansion law

In this work, we study a cosmological model of spatially homogeneous and isotropic accelerating universe which exhibits a transition from deceleration to acceleration. For this, Friedmann Robertson Walker(FRW) metric is taken and Hybrid expansion law a(t)=tαexp(βt) is proposed and derived. We consider the universe to be filled with two types of fluids barotropic and dark energy which have variable equations of state. The evolution of dark energy, Hubble, and deceleration parameters etc., have been described in the form of tables and figures. We consider 581 data’s of observed values of distance modulus of various SNe Ia type supernovae from union 2.1 compilation to compare our theoretical results with observations and found that model satisfies current observational constraints. We have also calculated the time and redshift at which acceleration in the Universe had commenced.

Clinical spectrum of congenital tibial hemimelia in 35 limbs of 24 patients: A single center observational study from India

PurposeConsidering the paucity of reports on large series of patients with tibial hemimelia, we assessed the clinical spectrum of this rare congenital disorder in patients seen at a single Indian center over 10 years. MethodsRetrospective review of medical records of patients seen at single center in 10 years. ResultsThirty-five cases of TH, mostly Jones types Ia (18) and II (10), were diagnosed in 24 patients (13 had unilateral TH). Associated foot deformities included equinovarus (22), varus foot (10), absence of the medial row of toes (5) and polydactyly (3). Upper limbs anomalies included split-hand deformity (five patients) and radial club hand (two patients). Nine limbs of seven patients were surgically reconstructed. Modified orthosis was provided to seven patients, custom designed prosthesis fitment in six and amputation with prosthesis fitment in one. Patients presenting at adolescence or later were habituated to their deformity for indoor ambulation; families declined amputation. ConclusionReports of more TH cases will provide input to researchers to consider comprehensive rehabilitation for enhancing indoor and community ambulation.

Risk factors for complications and adverse outcomes in polytrauma patients with associated upper extremity injuries

BackgroundIn terms of upper extremity fractures by patients with multiple injuires, a lot of studies have assessed the functional outcome following trauma to have less favorable outcomes in regards to functional recovery. We tested the hypothesis that differences in clinical outcome occur between shaft and articular injuries of the upper extremity, when patients that sustained neurologic deficits (e.g. brachial plexus lesions) are excluded.MethodsWe involved Patients with isolated or combined upper extremity fracture, ISS > 16 in a level one trauma center. The follow up was at least 10 years after the initial injury. Both clinical examination (range of motion, instability, contractures, peripheral nerve damage) and radiographic analysis were carried out. We evaluated also the development of heterotopic ossifications. To analyse patients were subdivided into 3 different subgroups (articular [IA], shaft [IS], and combined [C]).ResultsA statistically significant difference was found when ROM was compared between Group IS and C (p = 0.012), for contractures between Groups IA and C (p = 0.009) and full muscle elbow forces between Groups IS and C (p = 0.005) and Group IA and IS (p = 0.021). There was a significantly increased incidence in heterotopic ossifications when articular involvement was present. This applied for the isolated (p < 0.02) and the combined group (Group C vs Group IS, p = 0.003).When Brooker type I/II in group IA and Brooker types III/IV were combined, there was a significant difference (p < 0.001). In group IA (n = 1) and in group C (n = 6), HO developed or worsened after revision surgery, all of which were performed for malunion or nonunion.ConclusionsIn this study, patients with isolated shaft fractures of the upper extremity tend to have a more favorable outcome in comparison with combined to isolated articular fractures in terms of range of motion, pain and the ability to use the arm for everyday activities.In the clinical practice of the treatment of polytraumatized patients with upper extremity injuries, we feel that the relevance of these injuries should not be underestimated. They are especially prone to development of heterotopic ossifications, thus requiring prophylactic measures, if necessary. As their incidence increases with the rate of reoperations, we feel that even during initial care, meticulous surgery is required to avoiding the necessity of revision surgeries. Similar to injuries below the knee, upper extremity injuries, should be treated to avoid any functional disability.

Nitrogen and phosphorus fluxes in three soils fertigated with decentralised wastewater treatment effluent to field capacity

Abstract The Decentralised Wastewater Treatment System (DEWATS) provides low cost onsite sanitation to residents living in informal settlements. Wastewater management through agriculture prevents environmental pollution and promotes sustainable agriculture. This study investigated the effects of fertigation with DEWATS effluent to field capacity in three South African soils under a banana crop. The experiment was conducted as a complete randomised design in a greenhouse with two irrigation water treatments (DEWATS effluent vs municipal tap water irrigation + fertiliser) × three soil types (Ia, Cf and Se) and four replicates over 728 days. Data were collected on crop growth, nitrogen (N) and phosphorus (P) uptake and dynamics in the soil. The DEWATS effluent significantly (p &amp;lt; 0.05) increased N and P uptake and soil NH+4-N and extractable P concentrations. Furthermore, DEWATS effluent fertigation significantly (p &amp;lt; 0.05) increased N leaching from the Ia soil and P leaching from the Cf soil. Nitrogen and phosphorus leaching from DEWATS was lower than the tap water irrigation + fertiliser treatment. There was, however, excess N and P accumulation from the DEWATS than the irrigation + fertiliser treatment, which would cause environmental concerns from runoff and leaching losses in the medium to long term.

Tycho's Supernova: The View from Gaia

Abstract SN 1572 (Tycho Brahe’s supernova) clearly belongs to the Ia (thermonuclear) type. It was produced by the explosion of a white dwarf (WD) in a binary system. Its remnant has been the first of this type to be explored in search of a possible surviving companion, the mass donor that brought the WD to the point of explosion. A high peculiar motion with respect to the stars at the same location in the Galaxy, mainly due to the orbital velocity at the time of the explosion, is a basic criterion for the detection of such companions. Radial velocities from the spectra of the stars close to the geometrical center of Tycho’s supernova remnant, plus proper motions of the same stars, obtained by astrometry with the Hubble Space Telescope (HST), have been used so far. In addition, a detailed chemical analysis of the atmospheres of a sample of candidate stars had been made. However, the distances to the stars remained uncertain. Now, the Second Gaia Data Release (DR2) provides unprecedented accurate distances, and new proper motions for the stars can be compared with those obtained from the HST. We consider the Galactic orbits that the candidate stars to the SN companion would have in the future. We do this to explore any kinematic peculiarity. We also locate a representative sample of candidate stars in the Toomre diagram. Using the new data, we re-evaluate the status of the candidates suggested thus far, as well as the larger sample of the stars seen in the central region of the remnant.