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This article discusses the development of a tele-ultrasound program in Chile that aims to connect primary care centers in remote areas with specialist doctors in more complex centers. The program utilizes midwives trained in performing ultrasounds and digital technology to transmit high-quality ultrasound images to the specialist doctors for review and consultation. The study demonstrates the feasibility of this tele-ultrasound model, which allows for real-time advice, informed decision-making, and reduces the need for unnecessary patient transfers. [Extracted from the article]

Cardiovascular (CV) morbidity is the major cause of death in patients with Systemic Lupus Erythematosus (SLE). Previous studies on mannose-binding lectin (MBL) gene polymorphisms in SLE patients suggest that low levels of complement MBL are associated with cardiovascular disease (CVD). However, as large studies on MBL deficiency based on resulting MBL plasma concentrations are lacking, the aim of our study was to analyze the association of MBL concentrations with CVD in SLE patients. Plasma MBL levels SLE patients included in the Swiss SLE Cohort Study were quantified by ELISA. Five different CV organ manifestations were documented. Of 373 included patients (85.5% female) 62 patients had at least one CV manifestation. Patients with MBL deficiency (levels below 500 ng/ml or 1000 ng/ml) had no significantly increased frequency of CVD (19.4% vs. 15.2%, P = 0.3 or 17.7% vs. 15.7%, P = 0.7). After adjustment for traditional CV risk factors, MBL levels and positive antiphospholipid serology (APL+) a significant association of CVD with age, hypertension, disease duration and APL+ was demonstrated. In our study of a large cohort of patients with SLE, we could not confirm previous studies suggesting MBL deficiency to be associated with an increased risk for CVD. [ABSTRACT FROM AUTHOR]

This essay seeks to contribute to the understanding of Nicolini's proposal on the approach to practices, focusing mainly on his book "Practice Theory, Work, and Organization" (2012). To that end, the following question was presented: What is Davide Nicolini's proposal? It should be noted that Nicolini is not interested in proposing a new theory of practice since his proposal provides a plurality of sensitizing concepts belonging to different ontologies, epistemologies and methodologies that have similarities between them forming a "programmatic eclecticism". It is perceived that the author provides the bases and orientations for a theory founded that can be constructed from the practical, from the empirical, thus remaining coherent with the ethos, with the logic of "practice", breaking with the dichotomies of traditional approaches, constituting a flat and relational ontology. In this sense, this work emphasizes Grounded Theory as a methodological possibility to be used in the study of practices. [ABSTRACT FROM AUTHOR]

Pistols, revolvers and blank guns are not only used to discharge cartridges, but also for hits to the victim. In such cases, the blows preferably affect the head and/or the interposed hands protecting the body. The impact is mostly exerted either by the grip of a pistol or the butt of a revolver. In vigorous thrusts inflicted with the muzzle end of the weapon, the edge of the barrel may produce circular punch lesions with central skin flaps roughly corresponding to the bore. As in other kinds of pistol-whipping, the scalp wounds may be associated with fractures of the skull and even with brain contusions. Using the example of a homicide committed by pistol-whipping, the morphological features of blunt injuries from a handgun's muzzle are presented. The characteristic wound pattern found on the victim's head could be reproduced experimentally by forceful blows to the forehead of a slaughtered pig. In the case presented, the dominant hand of the perpetrator showed friction blisters due to prolonged striking with an unhandy tool in the form of a pistol. [ABSTRACT FROM AUTHOR]

Context: A significant opportunity remains to further increase the supply of premium sheepmeat products to Australia's customers, which requires a more rapid rebuilding of the national sheep flock. To help meet this challenge, developing relevant information for sheep producers to assist them to achieve a profitable flock-rebuilding outcome is viewed as highly desirable. Aims: (1) Develop flock-rebuild scenarios that track inventory, cashflow, profit and loss, and the overall balance sheet over a 5-year projection. (2) Model the impact on flock-rebuilding pathways of exposure to variation in supplementary-feed costs, purchase of stock and price received for sale animals and flock structure. (3) Model variation in benefits and costs for a range of production zones, enterprise types and flock-age profiles. Methods: Fourteen flock-rebuilding pathways were assessed for up to nine flock types, using a spreadsheet model that tracked inventory, cashflow, profit and loss, and the overall balance sheet over 5 years. Key results: The top four pathways for profitability and capacity to rapidly rebuild flock numbers include retention of more older ewes, purchasing young ewes, purchasing older ewes (mostly 5–6-year olds) in Merino and Merino-cross flock types only and joining ewe lambs in Maternal and Cleanskin flock types only. These pathways were not sensitive to variation in the cost of supplementary feed, stock prices or flock structure, although joining Merino ewe lambs became one of the top four pathways when feed costs were lower. Conclusions and implications: The well established practices of retaining ewes for longer and purchasing ewes, especially young ewes, have the most potential to both rapidly and profitably rebuild flock numbers. However, joining ewe lambs, particularly in Maternal and Cleanskin flocks, can also profitably contribute to rapid flock rebuilding. While reducing reproductive wastage or increasing reproductive potential were mostly profitable, they could not rapidly rebuild flock numbers. In contrast, accelerated lambing systems can rapidly rebuild flock numbers, but are only marginally profitable. The outlook for Australia's sheepmeat industry is very positive, with a significant opportunity available to further increase the supply of premium sheepmeat products to customers, by more rapidly rebuilding the national flock. This paper presents the findings of a study focussed on providing the confidence and material to sheep producers to choose optimal pathways to rebuild their flocks. At least 6 of the 14 alternatives investigated were deemed suitable for commercial use and not sensitive to variations in supplementary-feed costs, stock-purchasing and -sale prices. [ABSTRACT FROM AUTHOR]

An abstract for the article "Prenatal diagnosis and outcome of fetuses with echogenic lung masses" by F. A. Guerra and others is presented.

Introduction: The pathology of a mucoid degeneration of the anterior cruciate ligament (MDACL) has been mentioned in several publications but due to its rare incidence it is not a well-known pathology. Partial or complete resection of the ACL is the option of choice after failed non-surgical treatment. However, the success rate of both surgical techniques and the subsequent risk of an ACL instability is not known. The purpose of this study was to compare the clinical and radiological outcome between partial resection and complete resection of the ACL in patients with MDACL. Materials and methods: Patients with MDACL verified by MRI and persistent knee pain were treated by partial (Group I) or complete resection (Group II) of the ACL and were included in a controlled clinical trial after unsuccessful conservative treatment for at least 6 months. Demographic, clinical and radiological data including the thickness of ACL, ACL/intercondylar ratio, patient's age at the time of surgery, the presenting symptoms, range of motion and ligament stability assessed by the ACL ligament score (Lachman test) were collected. In addition, Tegner activity score and Lysholm score were evaluated preoperatively and at final follow-up after a minimum of 12 months. Results: At final follow-up with a mean of 16.8 ± 8.8 months (range 12–41; Group I: 18.3 ± 9.7 vs. Group II: 15.3 ± 8.0; ns), all patients were pain free. Postoperatively, positive Lachman tests were noted in all patients (100%) in Group II (n = 5 patients with grade II and n = 5 patients with grade III). In Group I, 8 patients (80%) showed a negative Lachman test (grade I) and 2 patients (20%) a slightly elongated Lachman test with a firm stop (grade II). The mean knee flexion at follow-up examination was 132° ± 7° (range 120°–140°; Group I: 129° ± 9° vs. Group II: 135° ± 4°; ns). In pairwise comparison, flexion angle increased significantly in both groups (Group I: p = 0.0124 and Group II: p < 0.001). Pairwise comparison of thickness of the ACL and ACL/intercondylar ratio prior to and post-surgery in Group I showed non-significant differences. Conclusion: Both arthroscopic debridement and complete resection of the ACL lead to improvement of clinical and radiological findings in isolated MDACL. However, complete resection of the ACL will result in higher instability. Therefore, partial resection might be the better treatment option, especially in young patients with MDACL. [ABSTRACT FROM AUTHOR]

Suicide by self-poisoning is rather common around the world. This paper presents an exceptional complex suicide in which nicotine was applied in the form of self-made patches soaked with an extraction from fine-cut tobacco. In addition, the 51-year-old suicide victim took a lethal dose of diphenhydramine. Toxicological analysis also revealed the presence of tetrazepam in subtherapeutic concentrations. The scene of death suggested an autoerotic accident at first, as the body was tied with tapes, cables and handcuffs. As a result of the entire investigations, the fatality had to be classified as a suicidal intoxication by nicotine and diphenhydramine. [ABSTRACT FROM AUTHOR]

Accurateinterfacial tension data for fluid systems such as hydrocarbonsand water is essential to many applications such as reservoir oiland gas recovery predictions. Conventional interfacial tension measurementtechniques typically use optical images to analyze droplet shapesbut require that the continuous-phase fluid be optically transparentand that the fluids are not refractive index matched. Magnetic resonanceimages obtain contrast between fluids using other mechanisms suchas magnetic relaxation weighting, so systems that are impossible tomeasure with optical methods may be analyzed. In this article, wepresent high-field (9.4 T) MRI images of various droplets analyzedwith axisymmetric drop shape analysis. The resultant interfacial tensiondata show good agreement with literature data. The method is subsequentlydemonstrated using both opaque continuous phases and refractive-index-matchedfluids. We conclude with a brief consideration of the potential toextrapolate the methodology to lower magnetic fields (0.3 T), featuringmore accessible hardware; although droplet imaging is possible, resolutionand stability do not currently permit accurate interfacial tensionmeasurements. [ABSTRACT FROM AUTHOR]

Background and aim MUTYH-associated polyposis (MAP) is an autosomal recessive inherited disorder characterised by the development of polyposis in the upper and lower gastrointestinal tract and a high risk of colorectal cancer (CRC). We evaluated the natural history of the disease and the outcome of colorectal surveillance and management. Methods A large Western European dataset of biallelic MUTYH mutation carriers comprising 254 patients was used. Detailed information was collected on polyp and cancer development in the colorectum, and the outcome of surveillance and surgery. Survival methods were used to calculate the risk of CRC development. Results The mean follow-up was 9.8 years. Colorectal polyposis was diagnosed at a mean age of 44.8 years (range: 12e77 years). Most patients had <100 colorectal adenomas at diagnosis. CRC was diagnosed in 147 (58%) of the 254 patients (mean age at diagnosis: 48.5, range: 21e77 years). The cumulative lifetime risk of CRC was 63% at age 60 years. There was no correlation between the number of adenomas and the presence of CRC. The cumulative risk of CRC in patients presenting with polyps was 9% after 5 years of follow-up. Patients presenting with CRC had 11% risk of developing a metachronous CRC at 5 years after surgery. Thirty-seven per cent of patients with MAP with CRC who underwent partial colonic resection needed secondary surgery shortly afterwards. Conclusions The high risk of developing CRC under surveillance in patients with MAP may suggest an accelerated carcinogenesis. Surveillance of these patients should therefore include colonoscopy at short intervals, for example, at 1e2-year intervals starting from the age of 18 to 20 years. If surgery for CRC is warranted, a (sub)total colectomy is recommended. [ABSTRACT FROM AUTHOR]

We present the setup and test of a transportable clock laser at 698 nm for a strontium lattice clock. A master-slave diode laser system is stabilized to a rigidly mounted optical reference cavity. The setup was transported by truck over 400 km from Braunschweig to Düsseldorf, where the cavity-stabilized laser was compared to a stationary clock laser for the interrogation of ytterbium (578 nm). Only minor realignments were necessary after the transport. The lasers were compared using a Ti:Sapphire frequency comb as a transfer oscillator. The generated virtual beat showed a combined linewidth below 1 Hz (at 1156 nm). The transport back to Braunschweig did not degrade the laser performance, as was shown by interrogating the strontium clock transition. [ABSTRACT FROM AUTHOR]

Abstract: Parts of the population are permanently exposed to low levels of Hg° and Hg(II) from dental amalgam. It was the aim (1) to investigate the internal exposure to amalgam-related mercury from the kinetics of inorganic Hg in plasma and erythrocytes after amalgam removal, and (2) to estimate the amalgam-related absorbed dose. Dietary coexposure was monitored by determination of blood organic-Hg. Postremoval steady-state Hg concentrations were measured for 18 months. Eighty-two patients had been randomized into three groups: (A) removal of the fillings; (B) removal and non-specific detoxification, and (C) a health promotion program without removal. After amalgam removal, inorganic Hg dropped rapidly in plasma and red cells, stabilizing at 27% of preremoval levels after 60 days. Concentrations of organic Hg in plasma remained unchanged, indicating no change in dietary uptake of organic Hg. The concentration of organic Hg in red cells of group A was in the early postremoval phase lower and in the late postremoval phase higher than the preremoval control (p<0.01 for low-high difference). A protracted increase in organic Hg was also found in red cells of group B after 60 days. Thus, the effect of removal on organic Hg levels in the combined group A+B was compared with the values of group C in a linear mixed effects (LME) model which showed a significant increase with time in group A+B (p=0.028). In all groups, time profiles of urinary concentration and excretion of total-Hg were very similar to those of inorganic-Hg levels in plasma. From extrapolations of blood and urine data it was estimated that the amalgam-related inhalation and ingestion of Hg species were within the limits proposed by WHO, ATSDR and EPA. The integrated daily Hg dose absorbed from amalgam was estimated up to 3μg for an average number of fillings and at 7.4 for a high amalgam load. Conclusions: This is the first study on adult amalgam patients which continuously monitored the postremoval decline of inorganic Hg and the coexposure from dietary organic Hg in a randomized-controlled-trial design. The integrated daily dose of 7.4μg absorbed from a high amalgam load is well below the tolerable dose of 30μg (WHO, 1990). The unexpected postremoval increase in erythrocyte organic Hg, which is associated with the depletion of cellular inorganic Hg, might result from binding of organic Hg to cellular sites previously occupied by inorganic Hg. [Copyright &y& Elsevier]

The aim of the study was to report the relation- ship between cadence and power developed by professional cyclists during high mountain as- cents of the Tour de France. From the 10 cyclists (30±4 years, 178±8 cm, 69±6 kg) involved in the study, 108 ascents were recorded and analyzed using a mobile power measurement device (SRM Training Systems, Julich, Germany). Based on topographic characteristics, the ascents were categorized into 1st and Hors Category (HC) climbs. During the ascents of the 1st Category climbs, power output averaged 312 ± 43 W (4.5 ± 0.6 W/kg) with a mean cadence of 73±6 rpm and a mean duration of 37:41±16:16 min. Power output averaged 294 ± 36 W (4.3 ± 0.6 W/ kg) at a mean cadence of 70 ± 6 rpm during 57:40±10:32 min on HC climbs. The maximal mean power for long durations (1800s) showed a mean power output of 327 W and 346 W for the 1st and HC climbs, respectively. The evaluation of the cadence-power output and the distance per pedaling cycle-power output relationship shows that high power outputs are mainly yielded by higher pedaling cadences and higher gears. [ABSTRACT FROM AUTHOR]

Background: Effective treatment of osteochondral lesions in the elbow remains challenging. Arthroscopic débridement and microfracture or retrograde drilling techniques are often insufficient and provide only temporary symptomatic relief. The purpose of this study was to evaluate the treatment of these lesions with osteochondral autografts.Methods: From 1999 to 2002, seven patients with osteochondral lesions of the capitellum humeri (five patients), trochlea (one patient), or radial head (one patient) were treated with cylindrical osteochondral grafts, which were harvested from the non-weight-bearing area of the proximal aspect of the lateral femoral condyle. The patients (three female and four male patients with an average age of seventeen years) were evaluated preoperatively and postoperatively, with an average follow-up of fifty-nine months. The Broberg and Morrey score was chosen for functional evaluation of the elbow (with regard to motion, pain, strength, activities of daily living, and stability), and the American Shoulder and Elbow Surgeons score was used for the analysis of pain. All patients had imaging studies done preoperatively to evaluate the defect and postoperatively to assess the ingrowth and viability of the graft. The ipsilateral knee was examined for donor-site morbidity.Results: The Broberg and Morrey score improved from a mean (and standard deviation) of 76.3 +/- 13.2 preoperatively to 97.6 +/- 2.7 postoperatively, and pain scores were significantly reduced (p < 0.05). The mean elbow extension lag of 4.7 degrees +/- 5.8 degrees was reduced to 0 degrees postoperatively. Compared with the contralateral side, there was a mean preoperative flexion lag of 12.9 degrees +/- 13.8 degrees . At the time of the final follow-up, flexion was free and was equal bilaterally in all patients. None of the plain radiographs made at the time of follow-up showed any degenerative changes or signs of osteoarthritis. The postoperative magnetic resonance imaging scans showed graft viability and a congruent chondral surface in all seven patients. No donor-site morbidity was noted at one year postoperatively.Conclusions: The osteochondral autograft procedure described in the present study provides the opportunity to retain viable hyaline cartilage for the repair of osteochondral lesions in the elbow while restoring joint congruity and function and perhaps reducing the risk of osteoarthritis. These medium-term results suggest that the risks of a two-joint procedure are modest and justifiable. In addition, the described technique provides an option for revision surgery after the failure of other surgical procedures. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the demands of riding a ‘Grand Tour’ by monitoring both heart rate and power output in 15 professional cyclists. SRM power output profiles (SRM Trainingsystem, Jülich, Germany) were collected during 148 mass start stages during the 2005 Tour de France and analyzed to establish average power, heart rate (HR) and cadence produced in different terrain categories (flat [FLT]; semi-mountainous [SMT]; mountainous [MT]). The maximal mean power (MMP) for progressively longer durations was quantified. Average HR was similar between FLT (133±10bpm) and SMT (134±8bpm) but higher during MT (140±3 bpm). Average power output revealed a similar trend (FLT 218±21W [3.1±0.3W/kg], SMT 228±22W [3.3±0.3W/kg], and MT 234±13W [3.3 ± 0.2 W/kg]). Cadence during MT was approximately 6-7 rpm lower (81 ± 15 rpm) compared to FLT or SMT. During MT stages, the MMP for 1800 sec. was highest (394 W vs. 342 W) but the MMP 15 was lower (836W vs. 895 W) compared to FLT. The data document comprehensively the power output demands during the Tour de France. [ABSTRACT FROM AUTHOR]

The objective of this prospective study was to elucidate whether amounts of bicarbonate needed for correction of acidosis and normalization of clinical signs are influenced by bloodd-lactate concentrations in calves with diarrhoea. In 73 calves up to 3 weeks old with acute diarrhoea and base excess values below −10 mmol/l correction of acidosis was carried out within 3.5-h by intravenous administration of an amount of sodium bicarbonate which was calculated using the formula: HCO (mmol) = body mass (kg) × base deficit (mmol/l) × 0.6 (l/kg). Clinical signs, venous base excess, and plasmad-lactate concentrations were monitored immediately following admission, following correction of acidosis at 4 h and 24 h after admission. The base excess and plasmad-lactate concentrations throughout the study were −17.8 ± 4.0, −0.4 ± 0.4, −3.0 ± 5.5 mmol/l (base excess), and 10.0 ± 4.9, 9.8 ± 4.8, 5.4 ± 3.4 mmol/l (d-lactate) for the three times of examination. Metabolic acidosis was not corrected in more than half of the calves ( n = 43) by the calculated amount of bicarbonate, whereas the risk of failure to correct acidosis increases withd-lactate concentrations. The study shows that calves with elevatedd-lactate concentrations do not need additional specific therapy, asd-lactate concentrations regularly fall following correction of acidosis and restitution of body fluid volume, for reasons that remain unclear. However, calves with distinct changes in posture and demeanour need higher doses of bicarbonate than calculated with the factor of 0.6 in the formula mentioned above probably because ofd-hyperlactataemia. [ABSTRACT FROM AUTHOR]

Novel difunctional oligolactone macromers have been synthesized by ring‐opening oligomerization of various lactones (L‐lactide, glycolide, p‐dioxanone) in the presence of suitable diols (propane‐1,2‐diol, dianhydro‐D‐glucitol) and subsequent endcapping of the formed oligolactones with methacrylate moieties. Based on these macromers, two fabrication procedures were developed to fabricate highly porous scaffolds and the material properties including in vitro biodegradation behaviour of the resulting polymeric scaffolds were investigated. Preliminary in vitro studies on the cytocompatibility of the fabricated scaffolds and on osteoblast cultivation on the optimized polymeric materials demonstrated that the oligolactide based polymer networks possess an excellent biocompatibility and that they are promising candidates as scaffolds in bone tissue engineering. [ABSTRACT FROM AUTHOR]

To determine the cellular targets for glucocorticoid (GC) action, we have generated mice in which a green fluorescent protein-glucocorticoid receptor (GFP-GR) fusion gene is knocked into the endogenous GR locus. We found that GFP-GR function is indistinguishable from endogenous GR on both a cellular and systemic level. Furthermore, the green fluorescence intensity of the GFP-GR protein is proportional to its expression, allowing quantitation of GR expression in single living cells. We initiated our analysis of GR regulation in the thymus. Using multicolor flow cytometry, we found that GR expression is uniform among embryonic thymocyte subpopulations, but gradually "matures" over a three-week period after birth. In the adult, analysis of GFP-GR expression on RAG2[sup -/-] and HY T cell receptor (TCR) transgenic genetic backgrounds, showed that GR is induced to high levels in immature CD25[sup +]CD4[sup -]CD8[sup -] thymocytes and down-regulated by activation of the preTCR during positive but not negative selection. Additionally, relative GR expression is dissociated from GC-induced apoptosis in vivo. These results implicate pre-TCR signaling as a mechanism for GR down-regulation and separate receptor abundance from susceptibility to apoptosis across thymocyte populations. [ABSTRACT FROM AUTHOR]

Then the midwife who performed the ultrasound were connected through the Zoom modality using 3G and 4G networks, to the reference centres. Ultrasound is the main tool in the study of pregnant women. Results This modality allowed us to transmit good quality images, to carry out remote ultrasounds in real time, by a trained midwife, and under the supervision of specialist doctors who delivered opinions from a distance. [Extracted from the article]

In three experiments, the effects of observational, mental and physical practice on the performance of cyclical movement sequences were investigated. Experiment 1 revealed that repeated demonstrations of the criterion motion were sufficient for adequate reproductions of the movement form and that mental or physical practice had only small additional effects. Furthermore, consistency of movement tempo and consistency of relative timing, normally seen as dependent on physical practice, were similar in all experimental conditions at the end of practice. Experiment 2 confirmed this counter-intuitive finding by demonstrating equivalent improvements in the consistency of relative timing after physical and mental practice and after practice in a perceptual discrimination task. In Expt 3, discrimination of a nonspatial version of the criterion motion from similar patterns was also found to enhance consistency, indicating that eye movements were not a crucial factor in the observed effects. The findings suggest that performance, observation and imagery of sequential patterns involve a common process, characterized as event generation, which is either coupled to an articulatory system (in the case of physical practice), synchronized with an external event (in the case of observational practice), or 'runs free' without such articulatory or perceptual coupling in the case of imagery. [ABSTRACT FROM AUTHOR]

The differentiation of intoxication courses is one of the most difficult challenges for forensic pathologists and toxicologists. The case of a 52-year-old female inpatient of a psychiatric clinic with multiple medications who died from doxepin intoxication is reported. Concentrations of doxepin metabolites and isomers, pharmacokinetic modelling and genotyping of the doxepin-metabolizing cytochrome P450 (CYP) enzymes led to the following conclusion: the lethal doxepin concentration of 2100 ng/mL was more likely to have been reached due to drug interactions and genetic peculiarities leading to a reduction of the metabolic capacity and not by an acute (suicidal) overdose. [ABSTRACT FROM AUTHOR]

The differentiation of intoxication courses is one of the most difficult challenges for forensic pathologists and toxicologists. The case of a 52-year-old female inpatient of a psychiatric clinic with multiple medications who died from doxepin intoxication is reported. Concentrations of doxepin metabolites and isomers, pharmacokinetic modelling and genotyping of the doxepin-metabolizing cytochrome P450 (CYP) enzymes led to the following conclusion: the lethal doxepin concentration of 2100 ng/mL was more likely to have been reached due to drug interactions and genetic peculiarities leading to a reduction of the metabolic capacity and not by an acute (suicidal) overdose. [ABSTRACT FROM AUTHOR]

Previous studies on the human mirror neuron system (MNS) indicated its involvement in action observation and in imitation of simple actions. However, until recently it was unclear if the MNS is also activated when participants attempt to imitate actions that are not yet in their behavioral repertoire (i.e., imitation learning). In an initial study, we (Buccino et al., 2004) asked non-guitarists to imitate unfamiliar guitar chords. fMRI indicated that the MNS was indeed activated in this task, and more strongly so compared with action observation without purpose, or observation/ imitation of previously practiced chords. According to our model of imitation learning, the familiar motor elements of a novel observed action are initially represented in the premotor cortex. Prefrontal cortical areas then engage in restructuring these elementary representations into a novel hand configuration. Recently, we have expanded this research toward pure observation-based skill acquisition. Participants who learned a subset of guitar chords by pure observational practice were scanned after 1 and 3 days of practice, respectively, both during observational practice and subsequent physical performance. In this symposium, we present the correlations between neural circuits involved in observational practice and those involved during motor performance and discuss the behavioral and neural differences resulting from observational and physical practice in configural tasks. [ABSTRACT FROM AUTHOR]

When an observer watches the action of another individual, not only sensory but also motor structures are activated in the observer's brain, which overlap with those involved in actual performance of the action. Neurons with such dual properties (visual and motor) have been called mirror neurons. In this symposium, held 15 years after the first related publication (DiPellegrino et al., 1992), we investigate the relevance of findings from human brain imaging studies for theories of observation-based skill acquisition. We discuss the following: Do modern imaging techniques provide a window into assessing expertise in athletes (at group and/or individual level)? Is it conceivable to employ brain imaging to optimize observation-based practice procedures? Moreover, given that the human mirror neuron system is likely to be involved in imitation and observational learning, what impact do the neurophysiological findings have for theorizing about action observation and imitation? Speakers will highlight recent advances in this area of study and discuss potential implications for fundamental and applied research in the field of motor behavior. [ABSTRACT FROM AUTHOR]

Pulmonary arteriovenous malformation (PAVM) is a rare finding in a fetus and may lead to cardiac failure and hydrops. Pulmonary trunk (PT) and right pulmonary artery (RPa) were dilated with retrograde perfusion through the ductus arteriosus. Doppler of the PT revealed a velocity of 72 cm/s and high velocity at the fistula (260 cm/s) with low pulsatility. [Extracted from the article]

Objective. Surgical guidewires are commonly used in placing fixation implants to stabilize fractures. Accurate positioning of these instruments is challenged by difficulties in 3D reckoning from 2D fluoroscopy. This work aims to enhance the accuracy and reduce exposure times by providing 3D navigation for guidewire placement from as little as two fluoroscopic images. Approach. Our approach combines machine learning-based segmentation with the geometric model of the imager to determine the 3D poses of guidewires. Instrument tips are encoded as individual keypoints, and the segmentation masks are processed to estimate the trajectory. Correspondence between detections in multiple views is established using the pre-calibrated system geometry, and the corresponding features are backprojected to obtain the 3D pose. Guidewire 3D directions were computed using both an analytical and an optimization-based method. The complete approach was evaluated in cadaveric specimens with respect to potential confounding effects from the imaging geometry and radiographic scene clutter due to other instruments. Main results. The detection network identified the guidewire tips within 2.2 mm and guidewire directions within 1.1°, in 2D detector coordinates. Feature correspondence rejected false detections, particularly in images with other instruments, to achieve 83% precision and 90% recall. Estimating the 3D direction via numerical optimization showed added robustness to guidewires aligned with the gantry rotation plane. Guidewire tips and directions were localized in 3D world coordinates with a median accuracy of 1.8 mm and 2.7°, respectively. Significance. The paper reports a new method for automatic 2D detection and 3D localization of guidewires from pairs of fluoroscopic images. Localized guidewires can be virtually overlaid on the patient's pre-operative 3D scan during the intervention. Accurate pose determination for multiple guidewires from two images offers to reduce radiation dose by minimizing the need for repeated imaging and provides quantitative feedback prior to implant placement. [ABSTRACT FROM AUTHOR]

Introduction: Anterior cruciate ligament (ACL) reconstruction is considered the first line treatment in ACL rupture. However, some patients return to high intensity sport activities and show a normal knee function without ACL reconstruction. Therefore, aim of this study was to evaluate the rate and prognostic factors of spontaneous healing in patients with ACL rupture and the short-term functional outcome. Methods: The rate, prognostic factors and short-term functional results of spontaneous healing in patients with ACL rupture were evaluated in 381 patients. Morphology of ACL rupture and extent of posterior tibial slope (PTS) were classified by MR- and x-ray imaging. In patients with normal knee stability in anesthesia examination and healed ACL during the arthroscopy 6 weeks after trauma ACL reconstruction was canceled. IKDC -, Tegner Activity Score, KT 1000 testing and radiological characteristics were collected 12 months postoperatively in these patients. Results: 14.17% of the patients with ACL rupture showed a spontaneous healing after 6 weeks. Femoral ACL-rupture (p < 0.02) with integrity of ligament stump > 50% (p < 0.001), without bundle separation (p < 0.001) and decreased PTS (p < 0.001) was found significantly more often in patients with a spontaneous healed ACL. The average IKDC score was high at 84,63 in patients with healed ACL at 1 year follow-up, but KT 1000 testing was inferior compared to non-injured side. Conclusion: Spontaneous healing of a ruptured ACL happened in 14% of the patients. Especially in low-demand patients with femoral single bundle lesions without increased posterior tibial slope delayed ACL surgery should be considered to await the possibility for potential spontaneous ACL healing. [ABSTRACT FROM AUTHOR]

Summary: We estimated the prevalence of sarcopenia and its impact on disability in older people. Sarcopenia was found to contribute to higher disability scores. However, our study was not able to show any influence of sarcopenia on the rate of functional decline. This directs attention to an accurate diagnosis of sarcopenia as the onset may be influenced, but its rate may not. Introduction: The objectives of this study using data from a population-based cohort were to estimate the prevalence of sarcopenia in older people in Germany and to test the hypothesis that sarcopenia is associated with disability in older adults. Methods: Cross-sectional ( n = 927) and longitudinal analyses ( n = 859) of participants aged ≥65 years at baseline from southern Germany enrolled in the Cooperative Health Research in the Region Augsburg (KORA)-Age study (2009-2012). Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm which includes the presence of both low muscle mass and low muscle function (strength or performance). Disability status was measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI). The presence of disability was defined as HAQ-DI >0. Directed acyclic graphs (DAGs) were constructed to identify potential confounders. The effect of sarcopenia on disability was analyzed using linear mixed effect models with disability values as a continuous outcome. Results: The overall prevalence of sarcopenia was 5.7% (men 4.0%, women 7.5%) and increased with age. The 3-year incidence of disability was 32.7%. After adjustment for potential confounders, presence of sarcopenia was significantly associated with higher disability scores (0.142 [confidence interval 0.029-0.254]). Conclusion: The prevalence of sarcopenia is consistent with estimates from other European studies using this algorithm. Our results suggest that sarcopenia can contribute to higher disability scores in older adults. However, our study was not able to show any influence of sarcopenia on the rate of functional decline using the EWGSOP diagnostic algorithm for sarcopenia. This directs attention to an accurate diagnosis of sarcopenia as the onset may be influenced, but its rate may not. [ABSTRACT FROM AUTHOR]

Purpose. Target localization in pulmonary interventions (e.g. transbronchial biopsy of a lung nodule) is challenged by deformable motion and may benefit from fluoroscopic overlay of the target to provide accurate guidance. We present and evaluate a 3D–2D image registration method for fluoroscopic overlay in the presence of tissue deformation using a multi-resolution/multi-scale (MRMS) framework with an objective function that drives registration primarily by soft-tissue image gradients. Methods. The MRMS method registers 3D cone-beam CT to 2D fluoroscopy without gating of respiratory phase by coarse-to-fine resampling and global-to-local rescaling about target regions-of-interest. A variation of the gradient orientation ( GO) similarity metric (denoted G O ′ ) was developed to downweight bone gradients and drive registration via soft-tissue gradients. Performance was evaluated in terms of projection distance error at isocenter (PDEiso). Phantom studies determined nominal algorithm parameters and capture range. Preclinical studies used a freshly deceased, ventilated porcine specimen to evaluate performance in the presence of real tissue deformation and a broad range of 3D–2D image mismatch. Results. Nominal algorithm parameters were identified that provided robust performance over a broad range of motion (0–20 mm), including an adaptive parameter selection technique to accommodate unknown mismatch in respiratory phase. The G O ′ metric yielded median PDEiso = 1.2 mm, compared to 6.2 mm for conventional GO. Preclinical studies with real lung deformation demonstrated median PDEiso = 1.3 mm with MRMS + G O ′ registration, compared to 2.2 mm with a conventional transform. Runtime was 26 s and can be reduced to 2.5 s given a prior registration within ∼5 mm as initialization. Conclusions. MRMS registration via soft-tissue gradients achieved accurate fluoroscopic overlay in the presence of deformable lung motion. By driving registration via soft-tissue image gradients, the method avoided false local minima presented by bones and was robust to a wide range of motion magnitude. [ABSTRACT FROM AUTHOR]

Recent studies show that participants can engage in motor imagery (MI) and action observation (AO) simultaneously (AO+MI), indicating a capacity for dual action simulation. Here we studied the electrophysiological correlates and behavioural outcomes of two forms of AO+MI, along with pure MI and pure AO control conditions. In synchronised AO+MI, participants imagined performing a rhythmical action in synchrony with an observed distractor action. In contrast in static AO+MI, where the imagery served to conflict with AO, participants imagined holding a static hand posture during AO. Following synchronised AO+MI, rhythmical execution was strongly biased toward the cycle time of the previously observed rhythm ('imitation bias'), whereas a weaker bias was found following pure MI, and particularly for static AO+MI. In line with these findings, event-related desynchronisation (ERD) in primary sensorimotor and parietal regions was more pronounced in synchronised AO+MI compared to both pure AO and pure MI. These ERD amplitudes were, however, highly similar for static and synchronised AO+MI; suggesting that, regardless of co-represented content, both AO+MI states produced stronger motor activations than single action simulation. In contrast, synchronised AO+MI produced significantly stronger ERD in rostral prefrontal cortex compared to the other three conditions. This specific rostral prefrontal involvement most likely reflected additional cognitive processing for aligning dual action simulations. Together these results provide an important empirical validation of different AO+MI states, in that the imitation bias was strongly modulated by the content of the AO+MI instructions, and that synchronised AO+MI produced stronger behavioural and neurophysiological effects compared to pure AO or MI. [ABSTRACT FROM AUTHOR]

When skin is subjected to water temperatures gradually rising from moderate to critical ranges for a prolonged period of time, the resulting scalds will initially present as reddening, followed by blistering and at last by full-thickness burns. On changing from second- to third-degree burn, the blisters stop to become enlarged and solidify due to heat-induced coagulation necrosis. Such gradually intensifying tissue damage results in multiple firm skin blisters together with third-degree burn of the affected area. The initially serous blister fluid assumes a jelly-like consistency as the proteins undergo denaturation. Scalds of this special type may occur in persons taking a bath and becoming incapable to act so that the warm water tap remains turned on or a hairdryer continues to work after having been dropped into the bath water. On the basis of two relevant fatalities (suicidal electrocutions in bathtubs by means of hairdryers), the macroscopic and histological appearance of blisters which only secondarily turned into a full-thickness scald is compared with blisters in genuine second-degree scalds. The blister fluid of the latter ones was also investigated as to their protein composition and hemoglobin concentration. [ABSTRACT FROM AUTHOR]

We compared a novel calcium carbonate spacer cement (Copal® spacem) to well-established bone cements. Electron microscopic structure and elution properties of the antibiotics ofloxacin, vancomycin, clindamycin, and gentamicin were examined. A knee wear simulator model for articulating cement spacers was established. Mechanical tests for bending strength, flexural modulus, and compressive and fatigue strength were performed. The electron microscopic analysis showed a microporous structure of the spacer cement, and this promoted a significantly higher and longer antibiotic elution. All spacer cement specimens released the antibiotics for a period of up to 50 days with the exception of the vancomycin loading. The spacer cement showed significantly less wear scars and fulfilled the ISO 5833 requirements. The newly developed spacer cement is a hydrophilic antibiotic carrier with an increased release. Cement without hard radio contrast agents can improve tribological behaviour of spacers, and this may reduce reactive wear particles and abrasive bone defects. [ABSTRACT FROM AUTHOR]

We report on a transportable optical clock, based on laser-cooled strontium atoms trapped in an optical lattice. The experimental apparatus is composed of a compact source of ultra-cold strontium atoms including a compact cooling laser setup and a transportable ultra-stable laser for interrogating the optical clock transition. The whole setup (excluding electronics) fits within a volume of <2 m. The high degree of operation reliability of both systems allowed the spectroscopy of the clock transition to be performed with 10 Hz resolution. We estimate a relative uncertainty of the clock of 7 × 10. [ABSTRACT FROM AUTHOR]

The International Organization for Standardization (ISO) Guide to the expression of Uncertainty in Measurement (GUM) was developed to meet the demand for a standardized way of evaluating and expressing uncertainties. The Davies and Gray (D&G) titrimetry method is routinely used in nuclear safeguards for uranium accountability measurement and a statement of the uncertainty that can reasonably be attributed to the measured assay value is therefore of importance. A mathematical model for an uncertainty evaluation of D&G measurements in compliance with ISO GUM is presented. This is illustrated by a numerical example and the utilization of the uncertainty budget is explored. [ABSTRACT FROM AUTHOR]

Abstract: The Dynamic Analysis (DA) method, for the projection of quantitative elemental images using Proton Induced X-ray Emission (PIXE), has been extended for use with energy-dispersive Synchrotron X-ray Fluorescence (SXRF) data collected with the X-ray microprobe by making use of similarities and synergy with nuclear microscopy. The broad element sensitivity of PIXE is complemented by the selective nature of SXRF, where the beam energy can be tuned to optimize the sensitivity in a portion of the periodic table. PIXE combined with Proton Induced γ-ray Emission (PIGE) in this study provided images of geological samples of 25 elements, including characteristic X-rays up to the energy of the Nd K lines (37keV). Maximum sensitivity was achieved for elements around Z∼33 with detection limits of ∼250ppb (in 5h). SXRF using a 16.1keV photon microbeam provided images of 16 elements, with optimum sensitivity around Z∼35 with detection limits of ∼70 ppb (in 11h), an improvement of ∼2.4 times when corrected for acquisition time. [Copyright &y& Elsevier]

Soft X-ray microscopy has resolved 30 nm structures in biological cells. To protect the cells from radiation damage caused by X-rays, imaging of the samples has to be performed at cryogenic temperatures, which makes it possible to take multiple images of a single cell. Due to the small numerical aperture of zone plates, X-ray objectives have a depth of focus on the order of several microns. By treating the X-ray microscopic images as projections of the sample absorption, computed tomography (CT) can be performed. Since cryogenic biological samples are resistant to radiation damage, it is possible to reconstruct frozen-hydrated cells imaged with a full-field X-ray microscope. This approach is used to obtain three-dimensional information about the location of specific proteins in cells. To localize proteins in cells, immunolabeling with strongly X-ray absorbing nanoparticles was performed. With the new tomography setup developed for the X-ray microscope XM-1 installed at the ALS, we have performed tomography of immunolabeled frozen-hydrated cells to detect protein distributions inside of cells. As a first example, the distribution of the nuclear protein male-specific lethal 1 (MSL-1) in the Drosophila raelanogaster cell was studied. [ABSTRACT FROM AUTHOR]