Search

The dispersion measure (DM) of fast radio bursts (FRBs) provides a unique way to probe ionised baryons in the intergalactic medium (IGM). Cosmological models with different parameters lead to different DM-redshift ($\mathrm{DM}-z$) relations. Additionally, the over/under-dense regions in the IGM and the circumgalactic medium of intervening galaxies lead to scatter around the mean $\mathrm{DM}-z$ relations. We have used the Evolution and Assembly of GaLaxies and their Environments (EAGLE) simulations to measure the mean $\mathrm{DM}-z$ relation and the scatter around it using over one billion lines-of-sight between redshifts $0, Comment: Submitted to MNRAS. 14 pages, 15 figures, Comments Welcome. Data and model will be released upon being accepted

Cognitive processing therapy (CPT) and prolonged exposure therapy (PE) are effective psychotherapies for post-traumatic stress disorder (PTSD). However, these treatments also have high rates of dropout and non-response. Therefore, patients may need a second course of treatment. We compared outcomes for patients who switched between CPT/PE and those who repeated CPT/PE during a second course of treatment. We collected data from Iraq and Afghanistan war veterans (

Fast Radio Bursts (FRBs) are a promising tool for studying the low-density universe as their dispersion measures (DM) are extremely sensitive probes of electron column density. Active Galactic Nuclei (AGN) inject energy into the intergalactic medium, affecting the DM and its scatter. To determine the effectiveness of FRBs as a probe of AGN feedback, we analysed three different AGN models from the EAGLE simulation series. We measured the mean DM-redshift relation, and the scatter around it, using $2.56 \times 10^8$ sightlines at 131 redshift ($z$) bins between $0 \leq z \leq 3$. While the DM-redshift relation itself is highly robust against different AGN feedback models, significant differences are detected in the scatter around the mean: weaker feedback leads to more scatter. We find $\sim 10^4$ localised FRBs are needed to discriminate between the scatter in standard feedback and stronger, more intermittent feedback models. The number of FRBs required is dependent on the redshift distribution of the detected population. A log-normal redshift distribution at $z=0.5$ requires approximately 50% fewer localised FRBs than a distribution centred at $z=1$. With the Square Kilometre Array expected to detect $>10^3$ FRBs per day, in the future, FRBs will be able to provide constraints on AGN feedback., 5 pages, 4 figures; Submitted to MNRAS Letters. Comments welcome

Aims The use and variety of stemless humeral components in anatomical total shoulder arthroplasty (TSA) have proliferated since their advent in 2004. Early outcomes are reassuring but independent mid-term results are scarce. This independent study reports a consecutive series of 143 Eclipse stemless shoulder prostheses with a minimum five-year (5 to 10) follow-up. Methods Outcomes of 143 procedures undertaken for all indications in 131 patients were reviewed, with subset analysis of those for osteoarthritis (OA) (n = 99). The primary outcome was the Oxford Shoulder Score (OSS) at a minimum of five years. Secondary outcomes were ranges of motion and radiological analysis of humeral radiolucency, rotator cuff failure, and glenoid loosening. Results Mean OSS at mean follow-up of 6.67 years (5.0 to 10.74) was 40.12 (9 to 48), with no statistically significant difference between those implanted for a non-OA indication and those for OA (p = 0.056) or time-dependent deterioration between two years and five years (p = 0.206). Ranges of motion significantly improved compared with preoperative findings and were maintained between two and five years with a mean external rotation of 38° (SD 18.1, 0 to 100) and forward elevation of 152° (SD 29.9, 90 to 180). Of those components with radiographs suitable for analysis (n = 83), 23 (28%) were found to have a least one humeral radiolucent line, which were predominantly incomplete, less than 2 mm, and in a single anatomical zone. No humeral components were loose. A radiolucent line was present around 22 (15%) of glenoid components, and 15 (10%) of components had failed. Rotator cuff failure was found in 21 (15%) components. The mean time to either glenoid or rotator cuff failure was greater than three years following implantation. Survivorship was 96.4% (95% CI 91.6 to 98.5, number at risk 128) at five years, and 94.3% (95% CI 88.2 to 97.3, number at risk 76) at seven years, both of which compare favourably with best results taken from available registries. Conclusion Functional and radiological outcomes of the Eclipse stemless TSA are excellent, with no loose humeral components at minimum five-year follow-up. The presence of radiolucent lines is of interest and requires long-term observation but does not impact on the clinical results. Of the eight revisions required, this was predominantly for glenoid and rotator cuff failure. Cite this article: Bone Joint J 2022;104-B(1):83–90.

Background This radiological study aims to assess the prevalence of lateral elbow pathology in an asymptomatic population using 3.0T magnetic resonance imaging (MRI). Methods Bilateral elbow MRI was undertaken in 30 asymptomatic volunteers. Exclusion criteria included elbow pain within 3 months, elbow trauma or previous diagnosis of lateral epicondylar tendinopathy. Baseline patient-reported outcome measures were recorded along with age and body mass index (BMI). Two musculoskeletal radiologists independently graded the degree of abnormality at the common extensor tendon. Results Thirty volunteers were categorised according to age; 35–44 ( n = 10), 45–54 ( n = 11), and 55–65 ( n = 9) with a 1:1 male-to-female ratio. Radiological evidence of tendon abnormality was found in 37% of volunteers. The proportion with abnormal findings increased with age; 35–44 (10%), 45–54 (36%), 55–65 (67%) and BMI; 18–24.9 (23%), 25–29.9 (43%), > 30 (67%). Changes were generally ‘mild’ or ‘moderate’, with a single volunteer showing ‘severe’ pathology. Kappa for the radiographic agreement was 0.91 (0.83–0.98). Discussion This study has demonstrated MRI findings suggestive of pathology at the common extensor tendon to be prevalent in an asymptomatic population, increasing with age and BMI. This draws into question the diagnostic and prognostic value of MRI imaging in lateral epicondylar tendinopathy, especially in older patients.

Genome-wide association studies identified numerous loci harbouring single nucleotide polymorphisms (SNPs) associated with various human diseases, although the causal role of many of them remains unknown. In this paper, we postulate that co-location and shared biological function of novel genes with genes known to associate with a specific phenotype make them potential candidates linked to the same phenotype (“guilt-by-proxy”). We propose a novel network-based approach for predicting candidate genes/genomic regions utilising the knowledge of the 3D architecture of the human genome and GWAS data. As a case study we used a well-studied polygenic disorder ‒ schizophrenia ‒ for which we compiled a comprehensive dataset of SNPs. Our approach revealed 634 novel regions covering ~398 Mb of the human genome and harbouring ~9000 genes. Using various network measures and enrichment analysis, we identified subsets of genes and investigated the plausibility of these genes/regions having an association with schizophrenia using literature search and bioinformatics resources. We identified several genes/regions with previously reported associations with schizophrenia, thus providing proof-of-concept, as well as novel candidates with no prior known associations. This approach has the potential to identify novel genes/genomic regions linked to other polygenic disorders and provide means of aggregating genes/SNPs for further investigation.

The Royal Cornwall Hospital virtual clinic service was implemented to follow up hip and knee joint replacement patients in line with national guidelines. In total, 300 patients were followed up via a virtual clinic during the first 11 months, and another 520 patients, who were already undergoing conventional face-to-face follow-up, were recruited to the new service for future follow up after consenting and registering with a web-based system for collecting patient reported outcome measures. There were high levels of patient satisfaction: patients found it effective, quick and easy. However, they missed the personal interaction, which occurs during face-to-face appointments. Only 21% of slots were filled and use of the service varied by surgical teams from 6–54%. Further improvements are planned to fulfil a potential productivity gain that converts two face-to-face appointments into five virtual clinic appointments. Following implementation, our local Clinical Commissioning Group awarded a Commissioning for Quality and Innovation grant of £216 000 to sustain the service beyond its first year.

There are several source rock units in the Gulf of Suez graben, but the Upper Cretaceous–Miocene sequence has probably produced most of the commercial hydrocarbons in this petroleum province. One hundred and nine shale, marl and marly shale samples collected from five wells in the West Esh El Mellaha Concession and surrounding area were studied by petrographic and organic geochemical methods to determine organic facies, depositional paleoenvironment, and thermal maturity. We also investigated the molecular and stable carbon isotopic compositions of nine oil samples to establish genetic relationships with the source rock samples. Pyrolysis data for samples from the Cenomanian–Santonian Matulla, Paleocene Esna, Eocene Thebes, Oligo-Miocene Nukhul and Lower–Middle Miocene Rudeis formations contain hydrogen-poor terrigenous Type-III to II/III kerogen. However, the Campanian–Maastrichtian Brown Limestone samples contain Type-II and Type-II/III kerogens indicating very good to excellent generation potential. The acyclic isoprenoids and normal alkane distributions and biomarkers in the source rock extracts indicate derivation from bacteria and algae, with varying contributions from land plants, deposited under suboxic to anoxic conditions in normal marine to higher salinity waters. The oil samples have high sulfur content and low to moderately high API gravity, typical of mature oils from pre-rift marine carbonate or calcareous shale lithofacies. Hierarchical cluster analysis (HCA) of 18 source-related biomarker ratios revealed four genetic families of oil samples. The two South Malak-1 oils (Family-4) are substantially different from the Rabeh E−8 and Rabeh E−10 (Family-1), Rabeh-1 and Hurghada-1 (Family-2) and Abu Marwa-1 and Wadi El Sahl-1 (Family-3) oil families, which are more closely related. Principal component analysis (PCA) and HCA based on the 18 ratios for the total data from extracts and oils indicate three groups. The South Malak-1 oils seem to be most closely related to the two Brown Limestone extracts. Group-1 oils appear to represent mixtures with one end member consisting of the South Malak-1 oils and the Brown Limestone source rock, but the other end member is not in the dataset.

The collision between India and Eurasia and the subsequent uplift of the Qinghai–Xizang plateau region of the Eurasian continent during the latest Mesozoic and Cenozoic had a significant environmental impact on the region. Understanding the vegetation of both palaeocontinents prior to the collision is crucial for interpreting the evolution of their floras and climatic changes during this period. The composition of the vegetation and climate of the plateau from the Middle Jurassic until the end of the Oligocene are inferred herein from the composition of 14 palynofloras and compared with other regions of China. The palynofloras are similar to those of eastern and northwestern parts of China but bear their own unique features brought about by differing climatic influences. Overall, a warm–hot, arid–semi-arid climate prevailed over the plateau during most of the period from the Middle Jurassic until the end of the Cretaceous. The climate cooled and humidity increased in the Paleogene, and especially during the Oligocene. The long-term climatic change in the Qinghai–Xizang plateau region of the Eurasian continent during the Middle Jurassic–Paleogene that is indicated by the miospore assemblages is broadly comparable to the isotope-based SST (sea-surface temperature) changes that have been identified. It is apparent that climatic changes on a global scale were primarily responsible for controlling the composition and distribution of the vegetation on the plateau; no monsoon features are detectable in the northwestern interior of China. A maximum estimation of 2890 m surface palaeoelevation is inferred for the central and northern plateau during the Oligocene based on vegetation analysis, which is lower than previous estimations based on oxygen isotope and coexistence analyses. The elevation of the southern part of the study area, i.e. the area south of the Gandise Mountains, was low, close to sea-level.

A palynofacies and organic geochemical investigation has been undertaken on 46 core and cuttings samples taken from seven wells drilled in the NC115 Concession, Murzuq Basin, south-west Libya. Most of the samples yielded marine and non-marine palynomorphs in a fair to good state of preservation, which together with palynological data have been used to confirm the age, determine the environment of deposition, and evaluate the petroleum source potential of the Tanezzuft Formation. The palynological assemblage recovered from the basal Hot Shale contains an abundance of acritarchs, chitinozoans and cryptospores, with some taxa, such as Plectochitina sp., Evittia remota, and Tetrahedraletes medinensis, indicating an early–mid Rhuddanian (early Llandovery) age for this unit. The deposits overlying the Hot Shale yielded diverse assemblages of palynomorphs, the occurrence of Angochitina qusaibaensis and Leiofusa banderillae in particular indicating a late Rhuddanian–Telychian (Llandovery) age. Two palynofacies associations have been identified. The Hot Shale palynofacies (PF-A) contains Type-II ≥ I kerogen, which is highly oil-prone and reflects a distal suboxic–anoxic sedimentary environment. The palynofacies of the overlying deposits of the Tanezzuft Formation (PF-B) is dominated by Type-II/III kerogen, which is both oil- and gas-prone, and indicates depositional conditions that range from distal dysoxic–oxic shelf to mud-dominated oxic shelf (distal shelf). Rock-Eval pyrolysis results indicate that the Hot Shale is organically-rich with an average total organic carbon (TOC) content 7.23 wt%, whereas the TOC of the overlying deposits averages 0.62 wt%. The organic matter in the Hot Shale has the capability of generating more liquid hydrocarbons than the rest of the formation, which lies within the early oil-maturity window. A simulated burial history for the NC115 Concession allowed the time and magnitude of hydrocarbon generation from the main Silurian Tanezzuft Formation source rock to be determined. Oil generation from this source rock took place during the Carboniferous/mid-Cretaceous period, whereas the maturation level for gas had not been reached at this stage.

Two palynofacies associations are documented from the Silurian Tanezzuft Formation in the Ghadames Basin. These are characteristic of the basal ‘Hot Shale’ and the overlying deposits, referred to here as the Cold Shale. The former reflects deposition in distal suboxic anoxic conditions and is dominated by highly oil-prone amorphous organic matter (AOM) typical of deposition in generally anoxic, restricted marine basins. Only a few acritarchs, prasinophyte algae and chitinozoans occur in association: virtually no spores or cryptospores were recorded. Thick-walled prasinophytes are most numerous in this part of the Tanezzuft Formation in both the Ghadames and Murzuq basins, suggesting enhanced surface water productivity. Deposition took place after the melting of the Late Ordovician ice sheets, which led to a major marine transgression. The palynofacies recorded from the overlying ‘Cold Shale’ deposits indicate deposition in distal shelf and basin conditions that were also relatively anoxic. They contain more palynomorphs, especially acritarchs, and generally less AOM. The phytoplankton assemblages are dominated by simple and thin-walled prasinophyte algae (leiospheres), suggesting dysoxic–anoxic conditions. Overall the middle and the upper parts of the Tanezzuft Formation are regarded as being deposited in distal dysoxic–anoxic shelf, distal dysoxic–oxic shelf and distal suboxic–anoxic basin respectively. Because chitinozoans are very rare, age determinations of the samples investigated are based mainly on acritarchs. The Hot Shale is dated as early-mid Rhuddanian (early Llandovery) whereas the rest of the formation is considered to late Rhuddanian–Telychian in age. As documented previously from other samples of the Tanezzuft Formation in both the Ghadames and Murzuq basins, the Hot Shale has a very high TOC content and excellent source potential for liquid hydrocarbons, whereas rest of the formation is less rich in organic matter with larger terrestrial and oxidized components and hence reduced potential for sourcing hydrocarbons (both oil and gas).

During the Cretaceous Period, the Indian Plate separated from Gondwana and drifted northwards, eventually colliding with Eurasia at the end of the period or in the early Cenozoic. This led to major changes in the composition of the flora and fauna of the region. Palynomorph assemblages from Cretaceous deposits in Gamba County, southern Xizang (Tibet), China, are analyzed herein in an attempt to determine how the vegetation of the northern margin of the Indian Plate changed. The Gamba assemblages were initially similar in composition to those from Australia but by the Santonian Stage they were more similar to those of North Africa. Differences from the former are increasingly apparent through the Albian–Cenomanian transition. The rate of evolution of the Gamba flora was about the same as that of the Australian flora prior to the Albian, somewhat slower during this stage, but faster from the Cenomanian onwards, implying that this was, to a large extent, a result of the separation of the Indian Plate from Gondwana and its northward drift during the Cretaceous Period. During the Albian, the Australian block drifted eastwards whereas the Indian Plate remained relatively static. This resulted in few changes in the Gamba palynoflora but many in palynofloras from Australia. However, the northward movement of the Indian Plate in the Late Cretaceous led to pronounced changes, with numerous inceptions of genera and species in the Gamba succession. Of these, many have an African or equatorial distribution and none has connections with Australia, indicating that the climate at this time was similar to that of North Africa and that separation from Australia was complete. The arrival of the Indian Plate in equatorial regions allowed floral exchange between its northern part and North Africa during the Santonian.

Cutibacterium Acnes (C.acnes) has been linked to several shoulder pathologies. An alternative hypothesis suggests it only occurs in the joint secondary to previous instrumentation. Our hypothesis was patients with previous instrumentation would have C.acnes in their joint if it was in skin.Sixty-six patients undergoing arthroscopic shoulder surgery had biopsies taken from the affected joint at the time of surgery, along with control biopsies of subdermal fat. The extended culture results were assessed and correlated to previous intervention.35% tested positive for C.acnes in their joint. 78% were male. 53% had absence of C.acnes in both skin and joint and 29% had presence in both (p = 0.0001). 15% with previous surgery had C.acnes. 53% with previous injection had C.acnes. 25% of patients with virgin joints had C.acnes. There was no statistical difference in the presence of C.acnes in the joint between those with previous instrumentation and without.The significant factors for joint C.acnes were male sex and the presence of the bacteria in the fat. Previous instrumentation was not correlated with C.acnes in the joint. This raises the question of whether the process of biopsy itself may lead to inoculation of the joint.

This systematic review asked which patterns of complications are associated with the three reverse total shoulder arthroplasty (RTSA) prosthetic designs, as classified by Routman et al, in patients undergoing RTSA for the management of cuff tear arthropathy, massive cuff tear, osteoarthritis, and rheumatoid arthritis. The three implant design philosophies investigated were medial glenoid/medial humerus (MGMH), medial glenoid/lateral humerus (MGLH), and lateral glenoid/medial humerus (LGMH).A systematic review of the literature was performed via a search of MEDLINE and Embase. Two reviewers extracted data on complication occurrence and patient-reported outcome measures (PROMs). Meta-analysis was conducted on the reported proportion of complications, weighted by sample size, and PROMs were pooled using the reported standardized mean difference (SMD). Quality of methodology was assessed using Wylde's non-summative four-point system. The study was registered with PROSPERO (CRD42020193041).A total of 42 studies met the inclusion and exclusion criteria. Rates of scapular notching were found to be significantly higher in MGMH implants (52% (95% confidence interval (CI) 40 to 63)) compared with MGLH ((18% (95% CI 6 to 34)) and LGMH (12% (95% CI 3 to 26)). Higher rates of glenoid loosening were seen in MGMH implants (6% (95% CI 3 to 10)) than in MGLH implants (0% (95% CI 0 to 2)). However, strength of evidence for this finding was low. No significant differences were identified in any other complication, and there were no significant differences observed in PROMs between implant philosophies.This systematic review has found significant improvement in PROMS and low complication rates across the implant philosophies studied. Scapular notching was the only complication found definitely to have significantly higher prevalence with the MGMH implant design. Cite this article