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Standardized reporting leads to high-quality data and can reduce administration time. The aim of this study was to (1) get an insight into the variability of what is considered important to report in the surgical report following shoulder instability surgery and (2) determine which elements should be included in the surgical report following shoulder instability surgery according to Dutch surgeons using a Delphi method.

The aim of this study was to identify items that healthcare providers and/or patients consider important to include in a questionnaire for clinical trials and cohort studies in shoulder instability research. This could serve as a basis to develop a core outcome set for shoulder instability research.

AbstractIn this article, I broadly consider the constitutionalisation of the common law of personality from the perspective of the South African transformative constitutionalism paradigm. This interrogation is the result of the Constitutional Court’s judgment in Le Roux v Dey, which provides an ostensible alignment between the common law and the Constitution of the Republic of South Africa, 1996 in respect of the human personality. In this regard, I critique this judgment and show how it creates doctrinal, ideological, substantive and methodological barriers when one considers the common law’s actual constitutionalisation. These critiques follow from my argument that the constitutionalisation of the common law of personality ought to take place in terms of its doctrine, its underpinning ideology and resultant substance and method with reference to the overarching transformative paradigm. I argue that the constitutionalisation of the common law of personality should be revisited in terms of these considerations. At the end of this article, I attempt to demonstrate how these doctrinal, ideological and structural considerations ought to be addressed in mapping the way forward for the actual constitutionalisation of the common law of personality.

Recently, the horizontal and vertical cross wind at 225‐ to 295‐km altitude were derived from linear acceleration measurements of the Gravity field and steady‐state Ocean Circulation Explorer satellite. The vertical component of these wind data is compared to wind data derived from the mass spectrometers of the Atmosphere Explorer C and E and Dynamics Explorer 2 satellites. From a statistical analysis of the 120‐s moving‐window standard deviation of the vertical wind (σ(Vz)), no consistent discrepancy is found between the accelerometer‐derived and the mass spectrometer‐derived data. The validated Gravity field and steady‐state Ocean Circulation Explorer data are then used to investigate the influence of several parameters and indices on the vertical wind activity. To this end, the probability distribution of σ(Vz) is plotted after distributing the data over bins of the parameter under investigation. The vertical wind is found to respond strongly to geomagnetic activity at high latitudes, although the response settles around a maximum standard deviation of 50 m/s at an Auroral Electrojet index of 800. The dependence on magnetic local time changes with magnetic latitude, peaking around 4:30 over the polar cap and around 01:30 and 13:30 in the auroral oval. Seasonal effects only become visible at low to middle latitudes, revealing a peak wind variability in both local summer and winter. The vertical wind is not affected by the solar activity level. Vertical wind standard deviations derived from linear accelerations are consistent with those derived from mass spectrometryGeomagnetic activity and local time are main drivers of vertical wind activity at high latitudes; local time and season at low latitudesThe vertical wind standard deviation levels out at 10–50 m/s (5th and 95th percentiles) for AE index levels above 800

AbstractIn this article, we tackle the legal question of the concurrence of a breach of contract and a delict through the lens of the Constitution of the Republic of South Africa, 1996. We begin by outlining the approach of the judiciary and reiterating the inconsistency between the treatment of traditional subjective interests (in other words physical harm to person and/or property) and purely economic interests (in other words non-physical harm). We then highlight the essential classical liberal premise (as adjusted by 20th-century reliance theory) that appears still to underpin the approach of our courts. Indeed, in the context of pure economic loss, it is said to be challenging to establish an independent delict in terms of the accepted ‘independent delict’ test. In this respect, we identify the delictual element of wrongfulness and in particular, the judiciary’s tendency to treat the risk of indeterminate liability and the anti-circumvention argument mechanically as overriding factors in the application of the boni morestest. We argue that this tendency is inconsistent with the broader constitutional movement away from classical liberalism and toward welfarism where values of human interdependence and solidarity must carry more weight. In more concrete terms, neither of these factors per se can automatically lead to a finding that the defendant did not have a legal duty in delict. At the same time, we maintain that the approach to concurrence in the context of physical harm via the application of the ‘independent delict’ test (as constitutionally informed) fosters a well-reasoned principled approach that enables the weighing up of pertinent policy considerations as required in the post-apartheid era. In the end, therefore, we aver that this (constitutionalised) ‘independent delict’ test ought to apply likewise to physical harm and pure economic loss where there is also a breach of contract. However, since the causing of pure economic loss is prima facielawful (while positive conduct causing physical harm to person or property is prima faciewrongful), an important caveat in relation to pure economic loss is that the element of wrongfulness must be the function of the balancing exercise contemplated by the boni morestest, where the risk of indeterminate liability or the anti-circumvention argument may be relevant factors but cannot, without more, supersede the enquiry.

ABSTRACTCurrently, there is no noninvasive test that can reliably diagnose early invasive pulmonary aspergillosis (IA). An electronic nose (eNose) can discriminate various lung diseases through an analysis of exhaled volatile organic compounds. We recently published a proof-of-principle study showing that patients with prolonged chemotherapy-induced neutropenia and IA have a distinct exhaled breath profile (or breathprint) that can be discriminated with an eNose. An eNose is cheap and noninvasive, and it yields results within minutes. We determined whether Aspergillus fumigatuscolonization may also be detected with an eNose in cystic fibrosis (CF) patients. Exhaled breath samples of 27 CF patients were analyzed with a Cyranose 320. Culture of sputum samples defined the A. fumigatuscolonization status. eNose data were classified using canonical discriminant analysis after principal component reduction. Our primary outcome was cross-validated accuracy, defined as the percentage of correctly classified subjects using the leave-one-out method. The Pvalue was calculated by the generation of 100,000 random alternative classifications. Nine of the 27 subjects were colonized by A. fumigatus. In total, 3 subjects were misclassified, resulting in a cross-validated accuracy of the Cyranose detecting IA of 89% (P= 0.004; sensitivity, 78%; specificity, 94%). Receiver operating characteristic (ROC) curve analysis showed an area under the curve (AUC) of 0.89. The results indicate that A. fumigatuscolonization leads to a distinctive breathprint in CF patients. The present proof-of-concept data merit external validation and monitoring studies.

The major histocompatibility complex region has been implicated in explaining some of the variation observed in adaptability and tick susceptibility of cattle. The bovine leukocyte antigen region of 192 cattle representing indigenous, composite and exotic breeds used in commercial beef production in Namibia and South Africa was investigated using four microsatellite markers. Ticks counted under the tail were taken as an indicator of tick susceptibility. Tick scores of all but one population was low (11 to 20 ticks), with only the South African Bonsmara population having an average score of 31 to 40 ticks per animal. The observed variation based on four microsatellite markers ranged from 5.5 alleles in Namibian Afrikaner to 7.7 alleles in South African Nguni and Bonsmara cattle. Unbiased heterozygosity values ranged from 0.66 (Namibian Afrikaner) to 0.76 (South African Bonsmara). Structure analyses grouped the five populations into three indistinct clusters with limited genetic variation between the populations.

The most popular beef breed in South Africa is the Bonsmara, a locally developed composite breed adapted to sub-tropical conditions. The establishment of a genomic reference population is currently ongoing for the application of genomic selection. To date, 583 Bonsmara cattle (388 bulls and 195 cows) have been genotyped with the GeneSeek®Genomic Profiler Bovine HD™ Chip (GGP-HD) 80 K chip, and the population structure of the reference population was studied. The average minor allele frequency for the Bonsmara was 0.280 across 56 248 autosomal single-nucleotide polymorphisms (SNPs), whereas the observed and expected heterozygosity values were 0.361 and 0.365, respectively. After pruning the data set for SNPs in linkage disequilibrium, 19 119 SNPs were retained, averaging 659 SNPs per autosomal chromosome. This generated an average SNP density of 1 SNP per 90 kb. Structure analysis revealed a non-homogenous population with a high level of genetic admixture, which may negatively influence genomic breeding value prediction accuracy. Genotyping of a further 990 Bonsmara cattle are pending, using the GeneSeek®GGP-HD 150 K chip. As more animals will be added to the reference population, the profile of the reference population are expected to change in such a way to ensure improved genomic estimated breeding value accuracies.

Abstract: Background In three-dimensional echocardiography (3DE), individual endocardial trabeculae are not clearly visible necessitating left ventricular (LV) volumes to be measured by tracing the innermost endocardial contour. Ultrasound contrast agents aim to improve endocardial definition, but may delineate the outermost endocardial contour by filling up intertrabecular space. Although measurement reproducibility may benefit, there may be a significant influence on absolute LV volume measurements. Methods Twenty patients with a recent myocardial infarction and good ultrasound image quality underwent 3DE using the TomTec Freehand method before and during continuous intravenous contrast infusion. LV volumes were measured offline using TomTec Echo-Scan software. Results The use of contrast enhancement increased end-diastolic (110±35 vs. 144±53 ml; p<0.01) and end-systolic volume measurements (68±31 vs. 87±45 ml; p<0.01) significantly compared with non-contrast; the ejection fraction remained unchanged (40±13 vs. 41±14%, p=NS). Measurement reproducibility did not improve significantly, however. Conclusion Volumes measured by 3DE are significantly larger when ultrasound contrast is used. Possibly, intertrabecular space comprises a substantial part of the LV cavity. In the presence of an adequate apical acoustic window, ultrasound contrast does not improve LV volume measurement reproducibility. (Neth Heart J 2008;16:47-52.)

ABSTRACTA Luminex suspension array, which had been developed for identification of Cryptococcus neoformansand Cryptococcus gattiiisolates, was tested by genotyping a set of 58 mostly clinical isolates. All genotypes of C. neoformansand C. gattiiwere included. In addition, cerebrospinal fluid (CSF) obtained from patients with cryptococcal meningitis was used to investigate the feasibility of the technique for identification of the infecting strain. The suspension array correctly identified haploid isolates in all cases. Furthermore, hybrid isolates possessing two alleles of the Luminex probe region could be identified as hybrids. In CSF specimens, the genotype of the cryptococcal strains responsible for infection could be identified after optimization of the PCR conditions. However, further optimization of the DNA extraction protocol is needed to enhance the usability of the method in clinical practice.

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is endemic in South East Asia and tropical regions of Northern Australia. Sporadic cases have been described elsewhere. In this article we present a case of acute pulmonary melioidosis with fatal outcome imported from Brazil. The most common pathogen causing severe community-acquired pneumonia in Brazil is Streptococcus pneumoniae. Other possible pathogens include Legionella spp., Mycoplasma pneumonia, Gram-negative rods and viruses. There are few reports of melioidosis in the Americas. This article represents the second known human case of melioidosis from Brazil. Recognition of melioidosis as a possible cause of severe pneumonia, even if a patient has not been travelling in a highly endemic area, is important because of the therapeutic consequences. The epidemiology of melioidosis will be reviewed.

Bisamidinate zirconium dichloride and dimethyl complexes with the sterically demanding amidinate ligands [PhC(NAr)2)]^- (A) and [PhC(NAr)(NAr‘)]^- (B) (Ar = 2,6-ⁱPr2C6H3; Ar‘ = 2,6-Me2C6H3) were prepared. The steric demand of ligand A induces the unusual trans geometry in trans-(A)2ZrCl2, whereas (A)2ZrMe2 and (B)2ZrX2 (X = Cl, Me) adopt the more usual cis-X2 geometry. The dynamic behavior of these complexes in solution was studied by 1D and 2D ¹H NMR spectroscopy. Reaction of (A)2ZrMe2 with H2 leads, after stepwise hydrogenolysis of the Zr−Me bonds, to cyclometalation of the two amidinate ligands. The same product was obtained by thermolysis of the dimethyl complex. The square pyramidal five-coordinate 10 valence electron cationic monomethyl species [(A)2ZrMe]⁺ was generated and structurally characterized. Remarkably, the compound is unreactive toward ethylene, H2, and CO. The sterically slightly less encumbered species [(B)2ZrMe]⁺ does polymerize ethylene, albeit with modest activity.

The 14-electron alkyl complexes Cp*Hf(C6H10)R (Cp* = η⁵-C5Me5, C6H10 = 2,3-dimethyl-1,3-butadiene, R = CH2SiMe3, 2; CH(SiMe3)2, 3) were synthesized by reaction of Cp*Hf(C6H10)Cl(THF) (1·THF) with the corresponding alkyl-lithium reagents in toluene solvent. Complex 3 consists of a 1:1 mixture of two rotamers with respect to rotation around the Hf−alkyl bond. A crystal structure determination of 3 showed that these two isomers cocrystallize randomly. Warming 3 to 80 °C leads to a rearrangement of the HfCH(SiMe3)2 group to give the complex Cp*Hf(C6H10)(CH2SiMe2CH2SiMe3) (4). It is likely that in this rearrangement the diene ligand acts as a reversible proton acceptor for one of the protons of a SiMe3 group of the alkyl. Reaction of 1·THF with 2 equiv of LiCH(SiMe3)2 in THF leads to deprotonation of one of the alkyl SiMe groups to give Cp*Hf(C6H10)[CH(SiMe3)SiMe2CH2]Li(THF)x (5·THFx, x = 1 or 2), containing a 1-hafna-3-silacyclobutane ring. A crystal structure determination of 5·THF showed that the Li-cation is bridging the methylene of the deprotonated alkyl group and one of the diene methylene groups.

Ultra-shallow diodes have been fabricated by epitaxially growing thin layers of highly doped Si or strained SiGe on silicon substrate wafers and contacting with Al/1%Si. Ideal diode I –V characteristics were achieved for both n+p and p+n junctions as shallow as 20 nm. The formation of silicon precipitates on the contact surface as a result of alloying after metallization was found to be impeded by increasing the Ge content of the epitaxially grown layer. For a concentration of 27%, no precipitates were observed.

The half-sandwich zirconium and hafnium N,N-dimethylaminopropyl complexes Cp*M[(CH2)3NMe2]Cl2 (Cp* = η⁵-C5Me5, M = Zr, 1; Hf, 2) and Cp*M[(CH2)3NMe2]2Cl (M = Zr, 3; Hf, 4) were synthesized by mono- or dialkylation of Cp*MCl3 with the corresponding alkyl-lithium and Grignard reagents. Hydrogenolysis of the monoalkyl species resulted in the formation of the polyhydride complexes Cp*3M3(μ-H)4(μ-Cl)2Cl3 (M = Zr, 5; Hf, 6) and Cp*MCl3. A crystal structure determination of Cp*3Hf3H4Cl5 (6) revealed a fully asymmetric trinuclear structure with three widely differing Hf···Hf distances. Reaction of Cp*3M3H4Cl5 with PMe3 resulted in fragmentation of the cluster and ligand redistribution to give Cp*MCl3(PMe3) and the dimeric hydride complexes Cp*2M2(μ-H)3Cl3(PMe3) (M = Zr, 7; Hf, 8), structurally characterized for M = Zr. The trinuclear polyhydride Cp*3Hf3H4Cl5 reacts with 2,6-xylylisocyanide to give three distinct products, a μ-enediamide complex, [Cp*HfCl2]2[μ-xyNCH&dbd;CHNxy] (11, xy = 2,6-dimethylphenyl), which was structurally characterized, an imido complex, [Cp*Hf(μ-Nxy)Cl]2 (12), and an azaallyl species, Cp*Hf(η³-CH2CHNxy)Cl2 (13). The reactivity of 6 can be interpreted as proceeding through initial cleavage of the trinuclear complex into the fragments “Cp*2Hf2(μ-H)3Cl3” and “Cp*HfHCl2”, followed by the separate reactivity of these fragments.

Opinion varies as to the incidence of nerve lesions in anterior dislocation of the shoulder after low-velocity trauma. Most studies are retrospective or do not use EMG. We have investigated the incidence and the clinical consequences of nerve lesions in a prospective study by clinical and electrophysiological examination.Axonal loss was seen in 48% of 77 patients. The axillary nerve was most frequently involved (42%). Although recovery as judged by EMG and muscle strength was almost complete, function of the shoulder was significantly impaired in patients with lesions of the axillary and suprascapular nerves. Unfavourable prognostic factors are increasing age and the presence of a haematoma.It is not necessary to carry out EMG routinely; an adequate programme of physiotherapy is important. In patients with a severe paresis, EMG is essential after three weeks.

Identification of viable myocardium is possible with 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET). More recently, the feasibility of cardiac FDG imaging with single photon emission tomography (SPET) has been reported. In patients with diabetes mellitus, poor image quality is frequently obtained with FDG-PET, due to relative or absolute insulin deficiency and peripheral insulin resistance. To improve image quality of the FDG-PET studies, the hyperinsulinaemic glucose clamp has been proposed. We assessed the image quality of cardiac FDG-SPET studies in 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) and compared the results with those obtained in 10 patients without NIDDM. All FDG studies were performed during hyperinsulinaemic glucose clamping. Image quality was expressed as myocardial to blood pool activity (M/B) ratios. Residual viability was assessed in dysfunctional myocardium. The M/B ratios were comparable between patients with and without NIDDM (2.67 ± 0.8 vs2.50 ± 0.7, N.S.). Residual viability was detected in 51 of the dysfunctional segments of the patients with NIDDM and in 49 of the segments of the patients without NIDDM. In the small subset of patients (n= 10) undergoing revascularization, 19 of 20 (95) segments that had improved wall motion were viable on FDG-SPET. In contrast, 27 of 36 (75) segments that did not improve were necrotic on FDG-SPET. Thus FDG-SPET during hyperinsulinaemic glucose clamping provides adequate image quality in patients with NIDDM compared with patients without NIDDM, and can be used in the detection of viable myocardium.

The enthalpies of solution of tetra-n-butylammonium bromide have been measured in mixtures of formamide (F) with water, N-methylformamide (NMF) with water, N,N-dimethylformamide (DMF) with water, F with NMF, DMF with F, and NMF with DMF at 25°C in the whole mole-fraction range. The enthalpies of solution vs composition profiles show a maximum value in the DMF-H2O and in the DMF-F systems. In the F-NMF and NMF-DMF mixturesn-Bu4NBr displays a nearly ideal behavior, whereas in the other solvent systems the excess enthalpy of solution deviates substantially from zero.

Abstract: The pairwise interaction concept used by Savage and Wood to predict enthalpies of interaction of nonelectrolytes has been applied to several tetraalkylammonium bromides, triethylamine, and some trialkylphosphates in binary aqueous amide mixtures. It is possible to use the same model for electrolytes as well. Values of the functional group interaction parameters for both nonelectrolytes and electrolytes are in reasonable agreement.

Although considerable progress has been made in angioplasty of lower leg arteries, percutaneous treatment of atherosclerotic disease in crural vessels is not considered a routine procedure. When the disease is located only in a short crural segment, percutaneous transluminal angioplasty (PTA) may be successful, but longer segments with crural disease respond less well to PTA. The authors investigated the possibilities of using a 2.2 mm excimer laser catheter, operating at a wavelength of 308 nm, as a stand-alone technique, for angioplasty. Their aim was to establish whether by vaporizing plaque material the excimer laser could be used to create an adequate lumen diameter. They treated 10 patients, 5 for pathology above the knee and 5 below the knee. In this latter group 11 vascular segments underwent laser angioplasty.

In the present study we examined whether mesothelial cells can ingest and digest bacteria. The results showed that all strains were ingested. Ingested staphylococci proliferated abundantly, and only a few were digested. Escherichia coli, however, was digested during the first 8 h, whereafter the mesothelial cells disintegrated and proliferation of bacteria could be observed. The clinical implications of these findings are discussed.