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Although bone morphogenetic proteins (BMPs) initially showed effective induction of ectopic bone growth in muscle, it has since been determined that these proteins, as members of the TGF-β superfamily, play a diverse and critical array of biological roles. These roles include regulating skeletal and bone formation, angiogenesis, and development and homeostasis of multiple organ systems. Disruptions of the members of the TGF-β/BMP superfamily result in severe skeletal and extra-skeletal irregularities, suggesting high therapeutic potential from understanding this family of BMP proteins. Although it was once one of the least characterized BMPs, BMP9 has revealed itself to have the highest osteogenic potential across numerous experiments both in vitro and in vivo, with recent studies suggesting that the exceptional potency of BMP9 may result from unique signaling pathways that differentiate it from other BMPs. The effectiveness of BMP9 in inducing bone formation was recently revealed in promising experiments that demonstrated efficacy in the repair of critical sized cranial defects as well as compatibility with bone-inducing bio-implants, revealing the great translational promise of BMP9. Furthermore, emerging evidence indicates that, besides its osteogenic activity, BMP9 exerts a broad range of biological functions, including stem cell differentiation, angiogenesis, neurogenesis, tumorigenesis, and metabolism. This review aims to summarize our current understanding of BMP9 across biology and the body.

Background Context Lumbar disc herniation affects more than 3 million people in the United States every year, and the rate of operation continually increases, particularly in patients 60 years or older (Taylor et al., 1994; Jordan et al., 2011). Surgical discectomy is a common treatment for lumbar disc herniation (Taylor et al., 1994; Atlas et al., 1996). One concern for this method is the risk of undergoing additional surgeries (Jordan et al., 2011; Osterman et al., 2003; Lebow et al., 2011). There are very limited population-level studies that examine the rate of lumbar fusion after lumbar discectomy. Additionally, there is no study that examines the risk of undergoing lumbar fusion in patients who have undergone lumbar discectomies compared with the risk of lumbar fusion in the general population with no previous lumbar discectomy. Purpose The present study aimed to calculate a more definitive rate of lumbar fusion after a lumbar discectomy procedure using a population-size study of more than 200,000 patients in the Truven Healthcare Analytics Marketscan Research Database who underwent discectomies. Additionally, the study aimed to compare the rate of lumbar fusion in patients who have undergone a lumbar discectomy to the rate of lumbar fusion in patients with no prior lumbar discectomy procedure. Study Design/Setting This is a retrospective cohort study. Patient Sample The patients from both parts of the present study were extracted from the Truven Healthcare Analytics Marketscan Research Database. Ten-year fusion after discectomy rates: 223,291 patients who underwent discectomies from the years 2003 to 2015. Fusion rate comparison: 489,975 patients with a previous lumbar ICD-9 (International Classification of Diseases, Ninth Revision) diagnosis code who have also been enrolled in the database for at least 10 years. Outcome Measures Ten-year fusion after discectomy rates: The proportion of patients who received a lumbar fusion up to 10 years after a lumbar discectomy. Fusion rate comparison: The proportion of patients who received a lumbar fusion after a lumbar discectomy compared with the proportion of patients who received a lumbar fusion with no previous lumbar discectomy. Methods Ten-year fusion after discectomy rates: The patients who had undergone discectomies were filtered in the Marketscan database via Current Procedural Terminology (CPT) codes specific for lumbar discectomy (63030, 63035). Patients who had a lumbar fusion before or concurrently with these indexed lumbar discectomy dates were removed from the index group. The group was then followed up every year up to 10 years after the initial indexed lumbar discectomy dates for reoperation involving a lumbar spinal fusion according to the lumbar fusion CPT codes (22533, 22558, 22612, 22630, 22632, 22633, 22634, 22534, 22585, 22614). Fusion rate comparison: Study population only included patients who had a previous lumbar ICD-9 diagnosis in the Marketscan database (7242, 72210, 72251, 72252, 72273, 72293, 7213, 72142, 72283, 72293, 7243, 72402, 72403, 7244, 7245, 7249). The patients were then separated into two arms: one with patients who had undergone lumbar discectomy after initial lumbar diagnosis and another with patients who had not undergone a lumbar discectomy procedure. Pearson chi-square test was used to assess significance when comparing the proportion of patients who receive lumbar fusion after lumbar discectomy with the proportion of patients who receive lumbar fusion without a prior lumbar discectomy in the general ICD-9 lumbar diagnosis population. Results For the 10-year trend of lumbar fusion rates after lumbar discectomy, the rate of fusion ranged from 1.69% (1-year time frame after discectomy) to 8.50% (10-year time frame after discectomy). When comparing the two cohorts in the second part of the present study, the fusion rates were 12.50% for the discectomy group and 4.19% for the non-discectomy group. The Pearson chi-square test reported a statistically significant difference between the fusion rates of the two groups (p Conclusions Our study is the largest population study that explores the rate of lumbar fusion after an initial lumbar discectomy. To our knowledge, it is the first study that concludes that an initial lumbar discectomy is statistically associated with an increased likelihood of a patient undergoing a lumbar fusion in the future. We observed that patients who had previously undergone a lumbar discectomy were roughly three times more likely to undergo a lumbar fusion procedure than a patient with a lumbar diagnosis, but had not undergone a lumbar discectomy. Although not calculated, it stands to reason the difference would be even greater when comparing the discectomy population with a population without lumbar diagnoses. This finding can be an important supplement for the physician-patient discussion regarding expectations and potential for reoperation.

This paper implements and demonstrates visual route mapping and localisation upon a Pixel Processor Array (PPA). The PPA sensor comprises of an array of Processing Elements (PEs), each of which can capture and process visual information directly. This provides significant parallel processing power allowing novel ways in which information can be processed on-sensor. Our method predicts the correct node within a topological map generated from an image sequence by measuring image similarities, spatial coherence, and exploiting the parallel nature of the PPA. Our implementation runs at +300Hz on large public datasets with +2K locations requiring 2.5W at 500 GOPS/W. We compare vs traditionally implemented methods demonstrating better F-1 performance even on simulation. As far as we are aware, we present the first on-sensor mapping and localisation system running entirely on-sensor.

Evolución de la variabilidad genética pra peso a edad comercial en una población seleccionada de camarón blanco del Pacífico [Penaeus (Litopenaeus)vannamei].

OBJECTIVE Hip-spine syndrome has been well studied since it was first described by Offierski and MacNab in 1983. Today, strong evidence links symptoms of hip and spine pathology to postsurgical outcomes. Recent studies have reported increased rates of hip dislocation in patients previously treated with total hip arthroplasty (THA) who had undergone lumbar fusion procedures. However, the effect of this link on native hip-joint degeneration remains an area of ongoing research. The purpose of this study was to characterize the relationship between use of lumbar fusion procedures and acceleration of hip pathology by analyzing the rate of future THA in patients with preexisting hip osteoarthritis. METHODS This population-level, retrospective cohort study was conducted by using the PearlDiver research program. The initial patient cohort was defined by the presence of diagnosis codes for hip osteoarthritis. Patients were categorized according to use of lumbar fusion after diagnosis of hip pathology. Survival curves with respect to THA were generated by comparison of the no lumbar fusion cohort with the lumbar fusion cohort. To assess the impact of fusion construct length, the lumbar fusion cohort was then stratified according to the number of levels treated (1–2, 3–7, or ≥ 8 levels). Hazard ratios (HRs) were then calculated for the risk factors of number of levels treated, patient age, and sex. RESULTS A total of 2,275,683 patients matched the authors’ inclusion criteria. Log-rank analysis showed no significant difference in the rates of THA over time between the no lumbar fusion cohort (2,239,946 patients) and lumbar fusion cohort (35,737 patients; p = 0.40). When patients were stratified according to number of levels treated, again no differences in the incidence rates of THA over the study period were determined (p = 0.30). Patients aged 70–74 years (HR 0.871, p < 0.001), 75–79 years (HR 0.733, p < 0.001), 80–84 years (HR 0.557, p < 0.001), and ≥ 85 years (HR = 0.275, p < 0.001) were less likely to undergo THA relative to the reference group (patients aged 65–69 years). CONCLUSIONS Although lumbar fusion was initially hypothesized to have a significant effect on rate of THA, lumbar fusion was not associated with increased need for future THA in patients with preexisting hip osteoarthritis. Additionally, there was no relationship between fusion construct length and rate of THA. Although lumbar fusion reportedly increases the risk of hip dislocation in patients with prior THA, these data suggest that lumbar fusion may not clinically accelerate native hip degeneration.

Objectives To investigate the clinical utility of additional axillary or Velpeau views in evaluating potential shoulder trauma after a standard radiograph series of anteroposterior, Grashey, and/or trans-scapular views. Design Retrospective study. Setting Level I academic medical center. Patients All patients in a 10-year span who received an initial shoulder radiograph series followed by additional axillary/Velpeau views within 24 hours. Main outcome measurements The clinical utility of the additional axillary/Velpeau views, including the final diagnosis and treatment plan, as ascertained through examination of radiology reports, progress notes, and radiograph images. Results A total of 271 cases were reviewed, with 35 patients being excluded from the final cohort because they received post-treatment radiographs to confirm a successful therapeutic outcome. The additional axillary/Velpeau views did not affect clinical decision making in 230 (97.5%) of the remaining 236 cases. All 6 patients whose care benefitted from the additional views carried the diagnosis of shoulder instability, accounting for 40% of this diagnostic group. The additional views confirmed an equivocal finding in 5 of these 6 cases and changed the diagnosis (demonstrating a posterior dislocation that was not evident on initial radiographs) and treatment plan (leading to a closed glenohumeral reduction procedure) in the other case. Conclusions Additional axillary/Velpeau views of suspected shoulder trauma rarely led to a change in the final treatment plan, except in patients in which a definitive diagnosis of stability or instability could not be made based on initial radiographs. A cost/benefit analysis is required to weigh the cost of additional radiographs with the benefit of capturing infrequent yet serious dislocations (usually posterior). Level of evidence Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Despite intensive media coverage and international regulations, man-made persistent organic pollutants such as dioxins represent a serious environmental and health threat. Their detection by sophisticated chromatography technologies is highly complex, impeding the constant monitoring of food or environmental samples. This limitation has fostered the development of generations of bioassays exploiting the molecular function of the aryl hydrocarbon receptor (AhR), which binds toxic compounds and directly activates the transcription of target genes. Here, we review the rich panel of available AhR-dependent bioassays and propose a novel classification based on the source of AhR, which can either be endogenously produced by cell types or tissues naturally responsive to dioxins, or exogenously introduced into a wide range of cellular contexts. In both cases, in vitro and in vivo strategies have been engineered to monitor the formation of molecular complexes, and the activation of direct downstream targets or reporter genes. We evaluate and compare bioassays based on exogenous and endogenous AhR proteins and discuss their specific challenges, strengths and opportunities for futures applications. Undoubtedly, the dynamic field of AhR-dependent bioassays will keep providing new and original strategies to help protect human health and ecosystems from persistent organic pollutants.

The main purpose of regenerative biology is to improve human health by exploiting cellular and molecular mechanisms favoring tissue repair. In recent years, non-mammalian vertebrates have emerged as powerful model organisms to tackle the problem of tissue regeneration. Here, we analyze the process of bone repair in metamorphosing Xenopus tropicalis tadpoles subjected to traumatic skull injury. Five days after skull perforation, a dense and highly vascularized mesenchymal is apparent over the injury site. Using an in vivo bone staining procedure based on independent pulses of Alizarin red and Calcein green, we show that the deposition of new bone matrix completely closes the wound in 15 days. The absence of cartilage implies that bone repair follows an intramembranous ossification route. Collagen second harmonic imaging reveals that while a well-organized lamellar type of bone is deposited during development, a woven type of bone is produced during the early-phase of the regeneration process. Osteoblasts lying against the regenerating bone robustly express fibrillar collagen 1a1, SPARC and Dlx5. These analyses establish Xenopus tropicalis as a new model system to improve traumatic skull injury recovery.

This paper presents the results of absorptance measurements of the cavity used in the cryogenic radiometer of the National Metrology Center of Mexico (CENAM) as absorptance device. The cavity absorptance was determined for several reference wavelengths in the visible range (VIS) using a He–Ne laser source and a tunable Ar–Kr laser at 476 nm, 488 nm, 520 nm, 568 nm and 676 nm. The absorptance value of 0.999 816 ± 1.9 × 10 −6 ( k = 2) at 632.8 nm obtained, matches with the reference value reported by the manufacturer of the cavity, L-1 Standards and Technology Inc., which is 0.999 823 ± 8.0 × 10 −6 ( k = 2). The variations found in the absorptance values goes from −4.4 × 10 −6 to −5.1 × 10 −7 for the wavelengths listed above.

Objective:Wikipedia is commonly used to acquire information about various medical conditions such as chronic pain. Ideally, better online pain management content could reduce the burden of opioid use disorders. Our goal was to improve the quality of the content available on Wikipedia to make it more accurate and applicable to medical students and the general public while training medical students to practice evidence-based medicine and critically assess their sources of information.Methods:An elective class in Neuroscience, Pain, and Opioids composed of 10 medical students met biweekly to discuss landmark and practice-changing research articles in the fields of acute pain, chronic pain, and opioid management. The professor chose Wikipedia articles relevant to this course. Three independent viewers analyzed the quality of citations, anecdotal medical content, and content value for both patients and medical professionals. As part of their coursework, students then edited the Wikipedia articles.Results:Although some of the Wikipedia pain topic content (6.7% ± 2.0) was anecdotal, financially biased, or inconsistent with Western Medical Practice content, overall articles included primarily high-quality citations (85.6% ± 3.1). On a 0-5 Likert scale, students felt content would be moderately helpful for both medical students/professionals (3.4 ± 0.2) and laypersons (3.5 ± 0.2). Editing and adding citations was feasible, but novel material was often reverted.Conclusion:A significant amount of pain medicine content was relevant and amenable to student editing. Therefore, future use of this tactic could provide a unique opportunity to integrate evidence-based medicine into the medical curriculum and have a direct impact on the widely available medical information. Future refinement in the editorial process may also further improve online information.

The authors undertook this study to describe Latina mothers’ professional help seeking for their young children’s disruptive behaviors. They interviewed 62 Cuban, Puerto Rican, and Dominican first-time help seekers and found four modes of entry: (a) coercion, (b) acceptance of offered referral, (c) responsive and resourceful help seeking subsequent to school reports of behavior problems, and (d) a laborious and convoluted path that was characteristic of 52% of the sample. Schools, maternal and child characteristics, and social network forces played significant roles for all mothers, but the final determinants of service entry varied by the mode of entry followed. Findings suggest that problem labeling is not a necessary precursor to service entry and that direct referrals might effectively shortcut the help-seeking process. Finally, the process that underlies service entry would be described more aptly as a Theory of Affective Action than a Theory of Reasoned Action.

The lek paradox, in which female choice erodes genetic variation in male sexually selected traits, is a fundamental issue in sexual selection. If females gain only genetic benefits from preferentially having their ova fertilized by males with particular traits, what maintains variation in these traits? Under strong directional selection mediated through mate choice, the alleles for beneficial male traits are expected to go to fixation and exhibit little variation. A theoretical solution to the lek paradox is the genic capture hypothesis which states that: costly male traits subject to female choice are condition dependent, that male condition is dependent on genes at many loci and exhibits additive genetic variance, and that positive genetic correlations exist between sexually selected traits and condition. Using a captive population of the zebra finch Taeniopygia guttata, we tested two key predictions from this model: (1) that genetic variance exists in beak color which is a sexually selected trait, but also in condition and immune function, and (2) that positive genetic correlations exist between condition and beak color, and between beak color, condition, and immune function. Genetic parameters were estimated from a large breeding experiment involving 81 sires, 972 offspring, a pedigree of 1526 individuals, using the animal model. We employed the following index of body condition: residuals from a log-log plot of body mass on tarsus length following a standardized and extended period of exercise, in which residual mass is known to reflect fat and protein reserves. Our results were broadly consistent with the genic capture hypothesis because we found (1) additive genetic variation in beak color and immune function and condition, and (2) positive genetic correlations between condition and beak color, and between condition, beak color, and several assays of immune responsiveness. However, both of these results need qualification. In the first case we identified an important general problem in estimating the coefficient of additive genetic variance (CVA) in body condition. In the second case, although most of the genetic correlations were positive as predicted, only some were statistically significant, possibly due to our relatively small sample sizes, because genetic correlations typically have large standard errors and therefore require very large samples to be statistically significant. The statistically significant, positive genetic correlations included those between beak color and immune function (response to tetanus), and between immune function (response to tetanus) and condition, both of which indicate that females gain good genes from mating with males in good condition and/or with a redder beak color. We discuss the implications of our results for devising more rigorous but pragmatic tests of the genic capture hypothesis.

Based on a heterodyne interferometric measurement, an original system to measure the linear thermal expansion coefficient (LTEC) of parallel gauge blocks (GB) has been developed. The automatic instrument measures the displacement of the parallel reference faces of the GB, which is mounted in horizontal way. The dilatometer has to measure the change of temperature and displacement of the GB simultaneously. The measurement displacement is carried out by a laser interferometer using the reference surface of a GB as part of the flat mirror optical interferometer. Termistor sensors in the body of the block measure the temperature. The GB changes its temperature by thermal conduction from electrical heaters. The optical system consists of two plane mirror high stability interferometers and an optical fiber to receive the measurement signal from interferometers. Two laser beams reflect the surface of the GB face in order to provide an optical resolution of λ/4. The total resolution of the commercial interferometric system is λ/128. For the measurement of GB of steel and tungsten carbide, a reproducibility of 0,03 x 10 -6 K -1 has been achieved. The estimated uncertainty in the measurement of LTEC is less than 3 x 10 -7 K -1 for GB of 100 mm. The results for short GBs, the uncertainty analysis and uncertainty budget, the measurement time optimization and the capability to measure objects of different shape of GB are discussed.

Objective: The authors compared self-reported symptoms of posttraumatic stress disorder (PTSD) in a cohort of Cuban children and adolescents with assessments of internalizing and externalizing behaviors by the children’s teachers. Methods: Eighty-seven children and adolescents who had left Cuba by sea in the summer of 1994 and who had been confined to refugee camps for up to eight months before arriving in the United States were evaluated four to six months later. Self-reported symptoms of PTSD were assessed with the Post-Traumatic Stress Disorder Reactive Index, and internalizing and externalizing behaviors were assessed with the Child Behavioral Check List—Teacher Report Form. Results: A majority of the children reported moderate to severe PTSD symptoms. The most common symptom clusters were avoidance (67 percent), regressive behaviors (64 percent), reexperiencing the traumatic events (60 percent), somatic symptoms (52 percent), and hyperarousal (51 percent). Eighty-six percent of the children reported that the refugee experience had severely affected most of their peers. A statistically significant dose-effect relationship was found between the number of stressors and the severity of self-reported PTSD symptoms. There was a modest relationship between withdrawn behavior and children’s feelings that they would die at sea and witnessing violence at the camps. Age and witnessing violence in the camps were moderately associated with PTSD. Teachers’ overall ratings of externalizing and internalizing behaviors did not produce any clinically significant findings. Conclusions: PTSD symptoms among refugee children and adolescents who have been exposed to multiple and prolonged stressors may continue unabated after the stressors are removed. The symptoms are experienced subjectively and may go unnoticed by adults. (Psychiatric Services 53:970–976, 2002)

Non-Hodgkin lymphoma comprises a heterogeneous group of haematological malignancies, classified according to their clinic, anatomic-pathological features and, lately, to their molecular biomarkers. Despite the therapeutic advances, nearly half of the patients will die because of this disease. The new diagnostic tools have been the cornerstone to design recent therapy targets, which must be included in the current treatment guidelines of this sort of neoplasms by means of clinical trials and evidence-based medicine. In the face of poor diagnoses devices in most of the Mexican hospitals, we recommend the present diagnose stratification, and treatment guidelines for non-Hodgkin lymphoma, based on evidence. They include the latest and most innovative therapeutic approaches, as well as specific recommendations for hospitals with limited framework and therapy resources.