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This study aims to explore the prevalence of Iatrogenic retroposition of the lips sequel (IRLS) after bicuspid extraction, associated dentofacial characteristics and the effectiveness of surgical treatment.and methods: Patients with bicuspid extraction as part of an orthodontic treatment plan were retrospectively included. IRLS was identified by clinical evaluation and cephalometric Legan and Burstone analysis. Association of demographic and cephalometric variables were assessed. The effectiveness of combined orthodontic-orthognathic correction of the retroposition of the lips was evaluated.Out of 144 patients with extracted bicuspids, eight Class I patients, nine Class II patients and five Class III patients were seeking treatment because their lips had retruded as a consequence of compensating orthodontic treatment. Lower jaw bicuspid extraction and a decreased vertical facial height in Class II patients correlated significantly more with IRLS development. Postoperative cephalometric analysis of orthodontic-orthognathic treated patients reported improvement in lip projection and naso-labial angle. Only two Class I patients reported postoperative normalization of the lip position according to Legan and Burstone.The consequence of bicuspid extractions on soft tissue profile differs according to skeletal jaw relation. The impact of orthognathic surgery on IRLS is beneficial, although insufficient to completely correct the facial profile when judged on cephalometric standards.

Examination of newspaper ads and store records of available products combined with data generated from the archaeological record provide insight into how individuals and communities kept pace with national and global trends in medicine and advertising. Decades of archaeological investigation in Springfield, Illinois, by Fever River Research have yielded a rich data set that provides diverse insights into the community. The goal of this case study is to apply a commodity access model to the Springfield, Illinois, data to examine the accuracy of modern researchers’ ideas about the impact of market access on consumer choice. The combination of archaeological artifacts and archival data forms a compelling picture of a community that took advantage of unprecedented access to medicine and commodities during the rise of America's Gilded Age. In contrast to the original results of the commodity model, the results of this analysis indicate that the expansion of trade networks and interaction spheres may not have been the critical factor in consumer choice. Instead, social structures on a local level—between neighborhoods, competing stores, and the consumer—become more important in areas with diverse product access.

The need for secondary orthognathic surgery (OS) after a high condylectomy (HC) in patients with active unilateral condylar hyperplasia was assessed in 25 patients, reviewing patient characteristics and treatment planning. At 6-12 months after HC, 13 patients (52%) required secondary OS. The amount of mandibular dental midline shift before the HC (P=0.037), and a dental crossbite that was present before the HC (P=0.017) were significantly associated with the need for secondary OS. Overall, the mandibular dental midline coincided with the facial midline in eight patients (32%) at 2 weeks after HC. In 16% of the patients, no additional OS was needed despite this being the initial treatment plan. Additionally, the initially planned type of secondary OS was modified in six other patients. Early HC in skeletally immature patients provided very good results, both aesthetic and functional, with only two of them needing supplementary OS at 6-12 months after HC. The HC remains a valuable treatment in patients with active unilateral condylar hyperplasia, as it can eliminate the need for secondary OS and is very well tolerated by most patients. ispartof: INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY vol:51 issue:2 pages:206-213 ispartof: location:Denmark status: published

This study was undertaken to evaluate the infection rate following orthognathic surgery and to identify possible risk factors. A retrospective study was conducted. Patients undergoing orthognathic surgery from August 1, 2017 to July 31, 2018 were included. The outcome variable was surgical site infection (SSI). All data were analysed with respect to demographics and procedure specifications. A total of 137 patients (mean age 28.5±12.69 years) were included in this study, of whom 20 (14.6%) developed a SSI. The only risk factor identified was the type of surgery: those undergoing mandibular osteotomies (in bilateral sagittal split osteotomy (BSSO) or bimaxillary osteotomies) were far more likely to develop infections. Third molar teeth were removed during orthognathic surgery in 28.5% of the procedures, and a genioplasty was performed in 10.9%. Removal of osteosynthesis material because of infectious reasons was necessary in 10.2% of patients, with a strong association to previous SSI. In conclusion, this study showed an infection rate of 14.6% with no link to any demographic risk factor. Neither the simultaneous removal of third molar teeth nor genioplasty was found to be a risk factor for SSI. For literature comparison purposes, there is a clear need for the international guidelines defining SSI to be used.

Orthognathic surgery involving the mandible can lead to remodelling of the temporomandibular joint (TMJ). Cone beam computed tomography (CBCT) provides an easily accessible three-dimensional (3D) approach to study this entity. A systematic review of the literature was performed with the aim of identifying condylar remodelling analysis protocols using CBCT-derived 3D models. The search yielded 10 eligible studies. The systematic review identified three pillars of a condylar remodelling analysis protocol that were retrievable from each of the included studies: (1) registration, (2) segmentation, and (3) analysis. The studies lacked consensus on how these pillars should be transferred to their respective protocol. Through critical assessment, criteria for a universal condylar remodelling analysis are suggested: (1) performance of a regional voxel-based registration of baseline and postoperative CBCT scans using an anatomical region not prone to postoperative changes, (2) application of a (semi-)automated 3D segmentation algorithm, (3) performance of a combination of both volumetric and surface-based 3D condylar analysis, and (4) extensive validation of each step of the protocol. The homogenization of condylar remodelling analysis protocols and their incorporation into virtual planning software suites raises the potential for the inclusion of larger numbers of patients in future prospective studies in order to gain evidence-based data. ispartof: INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY vol:49 issue:2 pages:207-217 ispartof: location:Denmark status: published

BACKGROUND Poor treatment adherence in patients with chronic obstructive pulmonary disease (COPD) or asthma is a global public health concern with severe consequences in terms of patient health and societal costs. A potentially promising tool for addressing poor compliance is eHealth. OBJECTIVE This review investigates the effects of eHealth interventions on medication adherence in patients with COPD or asthma. METHODS A systematic literature search was conducted in the databases of Cochrane Library, PsycINFO, PubMed, and Embase for studies with publication dates between January 1, 2000, and October 29, 2020. We selected randomized controlled trials targeting adult patients with COPD or asthma, which evaluated the effectiveness of an eHealth intervention on medication adherence. The risk of bias in the included studies was examined using the Cochrane Collaboration’s risk of bias tool. The results were narratively reviewed. RESULTS In total, six studies focusing on COPD and seven focusing on asthma were analyzed. Interventions were mostly internet-based or telephone-based, and could entail telemonitoring of symptoms and medication adherence, education, counseling, consultations, and self-support modules. Control groups mostly comprised usual care conditions, whereas a small number of studies used a face-to-face intervention or waiting list as the control condition. For COPD, the majority of eHealth interventions were investigated as an add-on to usual care (5/6 studies), whereas for asthma the majority of interventions were investigated as a standalone intervention (5/7 studies). Regarding eHealth interventions targeting medication adherence for COPD, two studies reported nonsignificant effects, one study found a significant effect in comparison to usual care, and three reported mixed results. Of the seven studies that investigated eHealth interventions targeting medication adherence in asthma, three studies found significant effects, two reported nonsignificant effects, and two reported mixed effects. CONCLUSIONS The mixed results on the effectiveness of eHealth interventions in improving treatment adherence for asthma and COPD are presumably related to the type, context, and intensity of the interventions, as well as to differences in the operationalization and measurement of adherence outcomes. Much remains to be learned about the potential of eHealth to optimize treatment adherence in COPD and asthma.

Automatic craniomaxillofacial (CMF) three dimensional (3D) dense phenotyping promises quantification of the complete CMF shape compared to the limiting use of sparse landmarks in classical phenotyping. This study assesses the accuracy and reliability of this new approach on the human mandible. Classic and automatic phenotyping techniques were applied on 30 unaltered and 20 operated human mandibles. Seven observers indicated 26 anatomical landmarks on each mandible three times. All mandibles were subjected to three rounds of automatic phenotyping using Meshmonk. The toolbox performed non-rigid surface registration of a template mandibular mesh consisting of 17,415 quasi landmarks on each target mandible and the quasi landmarks corresponding to the 26 anatomical locations of interest were identified. Repeated-measures reliability was assessed using root mean square (RMS) distances of repeated landmark indications to their centroid. Automatic phenotyping showed very low RMS distances confirming excellent repeated-measures reliability. The average Euclidean distance between manual and corresponding automatic landmarks was 1.40 mm for the unaltered and 1.76 mm for the operated sample. Centroid sizes from the automatic and manual shape configurations were highly similar with intraclass correlation coefficients (ICC) of > 0.99. Reproducibility coefficients for centroid size were 0.90 indicating again high similarity between shapes quantified by classic or automatic phenotyping. Combined, these findings established high accuracy and repeated-measures reliability of the automatic approach. 3D dense CMF phenotyping of the human mandible using the Meshmonk toolbox introduces a novel improvement in quantifying CMF shape. Automatic craniomaxillofacial (CMF) three dimensional (3D) dense phenotyping promises quantification of the complete CMF shape compared to the limiting use of sparse landmarks in classical phenotyping. This study assesses the accuracy and reliability of this new approach on the human mandible. Classic and automatic phenotyping techniques were applied on 30 unaltered and 20 operated human mandibles. Seven observers indicated 26 anatomical landmarks on each mandible three times. All mandibles were subjected to three rounds of automatic phenotyping using Meshmonk. The toolbox performed non-rigid surface registration of a template mandibular mesh consisting of 17,415 quasi landmarks on each target mandible and the quasi landmarks corresponding to the 26 anatomical locations of interest were identified. Repeated-measures reliability was assessed using root mean square (RMS) distances of repeated landmark indications to their centroid. Automatic phenotyping showed very low RMS distances confirming excellent repeated-measures reliability. The average Euclidean distance between manual and corresponding automatic landmarks was 1.40 mm for the unaltered and 1.76 mm for the operated sample. Centroid sizes from the automatic and manual shape configurations were highly similar with intraclass correlation coefficients (ICC) of > 0.99. Reproducibility coefficients for centroid size were 0.90 indicating again high similarity between shapes quantified by classic or automatic phenotyping. Combined, these findings established high accuracy and repeated-measures reliability of the automatic approach. 3D dense CMF phenotyping of the human mandible using the Meshmonk toolbox introduces a novel improvement in quantifying CMF shape. ispartof: Scientific Reports vol:11 issue:1 ispartof: location:England status: published

Context. Excess microwave emission, commonly known as anomalous microwave emission (AME), is now routinely detected in the Milky Way. Although its link with the rotation of interstellar (carbonaceous) nano-grains seems to be relatively well established at cloud scales, large-scale observations show a lack of correlation between the different tracers of nano-carbons and AME, which has led the community to question the viability of this link. Aims. Using ancillary data and spinning dust models for nano-carbons and nano-silicates, we explore the extent to which the AME that come out of the Galactic Plane might originate with one or another carrier. Methods. In contrast to previous large-scale studies, our method is not built on comparing the correlations of the different dust tracers with each other, but rather on comparing the poor correlations predicted by the models with observed correlations. This is based on estimates that are as realistic as possible of the gas ionisation state and grain charge as a function of the local radiation field and gas density. Results. First, nano-carbon dust can explain all the observations for medium properties, in agreement with the latest findings about the separation of cold and warm neutral medium in the diffuse interstellar medium. The dispersion in the observations can be accounted for with little variations in the dust size distribution, abundance, or electric dipole moment. Second, regardless of the properties and abundance of the nano-silicate dust we considered, spinning nano-silicates are excluded as the sole source of the AME. Third, the best agreement with the observations is obtained when the emission of spinning nano-carbons alone is taken into account. However, a marginal participation of nano-silicates in AME production cannot be excluded as long as their abundance does not exceed $Y_{\rm Si} \sim 1\%$., Comment: accepted for publication by A&A

Aim: To show how an unsuccessful retrieval attempt of a broken root tip of an upper molar could lead to dislocation into the maxillary sinus and and end up at the ostium of the maxillary sinus, necessitating a FESS procedure for retrieval. Summary: An upper right first molar was removed with forcesp extraction. The extraction was complicated with a root fracture. Manipulating the residual root tip resulted in root tip dislocation into the maxillary sinus. It was decided to leave the roottip at the bottom of the sinus, but in the following months the root tip migrated and got stuck into the ostium of the maxillary sinus. There, it was retrieved using functional endoscopic sinus surgery (FESS). Key Learning Points: 1. Manipulating a residual root tip after forceps extraction of an upper molar significantly increases the risk of root tip dislocation into the maxillary sinus. 2. Broken roottips of upper molar roots protruding into the maxillary sinus need not to be removed when it concerns healthy vital pulps. 3. Retrieval attempts of broken roottips can lead to dislocation of the roottip into the maxillary sinus if the roots were protruding into the maxillary sinus or if an insufficient bony barrier is separating the maxillary sinus from the alveolar socket. 4. Cone beam ct is the radiological exam of preference to locate a dislocated roottip in the upper jaw. 5. A roottip stuck a the ostium of the maxillary sinus is best removed with a FESS-procedure.

HPV is well known as a potential cause of cervical cancer. Less well known is its link to temporal subfertility that is caused by binding of infectious virions to the spermatozoa’s head which induces sperm-DNA damage and causes a reduction in clinical pregnancy rates in women receiving HPV positive semen. This impact on the global fertility burden remains greatly underestimated and underexplored. This risk of reduced fertility due to infectious HPV in sperm is especially important when donor sperm insemination is considered, since testing for the presence of HPV virions before use seems warranted. We tested 514 donor sperm samples from 3 different sperm banks for 18 different HPV types. Overall 3.9% (20/514) of tested donor sperm was positive for HPV, with different prevalence among the 3 different sperm banks (3.6% bank A, 3.1% bank B and 16.7% bank C). Also the HPV virion per spermatozoon ratio in donor samples was similar across the different sperm banks (95% CI 0,01 to 1,07 HPV virions/spermatozoon). When HPV positive donor sperm was used, no clinical pregnancies resulted, whereas when HPV negative donor sperm was used the clinical pregnancy rate was 14.6%. From both a cost/benefit and a safety point of view we recommend that donor sperm should always be tested for HPV before using it for insemination.

Chronic pain or discomfort after hernia surgery is nowadays a more challenging concern than recurrence. This study aimed to evaluate the long-term impact of local anaesthetic repair (LA) on pain, discomfort, paraesthesia and functional outcome after Lichtenstein hernia repair as compared to locoregional (LRA) and general anaesthesia (GA).patients with primary or recurrent inguinal hernia underwent Lichtenstein repair with a polypropylene mesh. All patients with a follow-up of at least three years were sent a detailed questionnaire and offered an outpatient visit. Kaplan-Meier estimates and Cox proportional hazard regressions were used to analyse the relationship between time to event variables and explanatory variables including anaesthesia type.Between 1994 and 2006, in two cohorts, 330 patients answered the questionnaire: 100 under GA, 35 under LRA, and 195 under LA. This represented a response rate of 95, 94, and 98% respectively. Compared to GA and LRA, LA resulted in less long term pain, discomfort and paraesthesia. Moreover, resumption of social and professional activities was faster after LA. Recurrence rates were 1, 0, and 0.5% respectively.After Lichtenstein inguinal hernia repair, LA results in beneficial effects beyond the immediate postoperative period.

© 2018 The Authors Respiratory complications after orthognathic surgery are rare but may be life-threatening. Upper airway impairment, atelectasis, pneumonia, pneumomediastinum, and pneumothorax have been reported. This article reports on a 19-year-old woman suffering from atelectasis, pneumomediastinum and a bilateral pneumothorax after bimaxillary surgery. Possible aetiologies for this cascade of complications are volutrauma and/or air dissecting down the cervical fascial planes. The bilateral pneumothorax is preferably treated with the placement of thoracic drains because of the high early success rates. Orthognathic surgeons should be aware of this potentially life-threatening complication. ispartof: Oral and Maxillofacial Surgery Cases vol:5 issue:1 status: published

In the interstellar medium (ISM), PAHs are abundant and also carry most of the dust surface. They are thus privileged sites for surface reactions such as the formation of H2 . In regions penetrated by UV photons, PAHs loose electrons by the photoelectric effect and efficiently heat the gas. In more shielded regions, PAH recombine and may carry an important fraction of the cloud electronic charge which plays an important role in the gas dynamics and chemistry. We review here processes involving PAHs which control key aspects of the physics of the ISM. We also discuss the corresponding observational constraints. Most of these processes involve a detailed knowledge of the charge of PAHs and we therefore review current models in this area. We argue that more laboratory measurements of the rate of electronic capture on large PAH cations are needed.

Deze survey wil zicht krijgen op de opvattingen van ziekenhuisartsen en verpleegkundigen over de preventie, diagnose en behandeling van delirium. Vragenlijsten werden verspreid aan 2256 verpleegkundigen en 982 artsen werkzaam binnen de Universitaire Ziekenhuizen van Leuven (UZ Leuven). De respons bedroeg 26% met een totaal van 819 bruikbare vragenlijsten (600 verpleegkundigen; 219 artsen). 72% van alle respondenten oordeelde dat delirium geen tot een minimaal probleem was op hun afdeling. Toch vond meer dan de helft van de medewerkers op de afdeling palliatieve zorg (87%, n=15), traumatologie (67%, n=18), cardio-thoracale chirurgie (58%, n=20), intensieve zorg (55%, n=120) en geriatrie (55%, n=42) het een ernstig probleem. Delirium werd beschouwd als een ondergediagnosticeerd (85%), te voorkomen syndroom (75%). Risicopatienten werden echter zelden (34%) tot nooit (52%) gescreend op delirium. Gebeurde dit toch (48%), dan gebruikte slechts 4% een specifiek gevalideerd meetinstrument.

In elongating spermatids, human sperm chromatin undergoes a complex compaction in which the transition proteins are extensively replaced by the protamine proteins. Several human studies demonstrate that expression of the protamine proteins is altered in some men with male infertility. For this study, we screened the PRM1 (protamine 1) gene for mutations in a large cohort of 281 men seeking infertility treatment. We identified the c.102G>T transversion that results in an p.Arg34Ser amino acid change in two men. One of these patients presented with oligozoospermia associated with increased sperm DNA fragmentation. The second individual was normospermic but together with his partner sought treatment for idiopathic couple infertility. We also identified a novel missense mutation (c.119G>A, p.Cys40Tyr) in a man with oligoasthenozoospermia. These mutations were not observed in control populations. Interestingly, we also detected variants both 5' and 3' to the PRM1 open-reading frame specifically in infertile individuals. Four individuals with unexplained severe oligozoospermia were heterozygote for a c.-107G>C change that is located at -15 bp from the transcription initiation site of the gene. This mutation may influence PRM1 expression. In addition, a c.*51G>C variant was detected in the 3'UTR of PRM1 specifically in a man with severe oligoasthenozoospermia.

International audience; We present ISO-SWS observations of five pure rotational lines of H2 along a line of sight through the Galaxy which avoids regions of massive star formation. It samples 30 mag of gas, half of it (i.e. 15 mag) being diffuse gas running from the solar neighbourhood to the molecular ring, up to the far side of the Galaxy. The intensities of the S(1) and S(2) lines are too large relative to S(0) to be produced by UV excitation in the known radiation field of the Galaxy. The excitation of these transitions has to tap a more powerful source of energy. We investigate the possibility that it takes place in a large number of magneto-hydrodynamic (MHD) shocks or coherent small-scale vortices, two processes responsible for the intermittent dissipation of MHD turbulence. These dissipation bursts locally and temporarily heat the diffuse gas to temperatures (Tk ˜ 103 K) well above that of the ambient diffuse gas. We compute the spectroscopic signatures of these processes in the H2 lines. Not only are the computed relative line intensities in good agreement with the observations, but the few percent of warm gas involved is consistent with other independent determinations. We find that the fraction of warm H2 in the diffuse gas (i.e. H2 molecules in Ju ≥ 3 levels) on that line of sight, N(H2*)/Av ≈ 4 × 1017 cm-2 mag-1, is the same as that found from far UV spectroscopy in the direction of nearby stars. It is also the same as that estimated in the solar neighbourhood to reproduce the large observed abundances of molecules like CH+. These results suggest that the existence, within the cold neutral medium (CNM), of a few percent of warm gas, for which UV photons cannot be the sole heating source, is ubiquitous and presumably traces the intermittent dissipation of MHD turbulence in the cold diffuse gas.

We present the scientific case for a high resolution spectro-imager in the mid-IR that would be dedicated to the mapping of H 2 emission in its four lowest rotational transitions, at 28.2, 17.0, 12.3 and 9.7 micron with a spectral resolution ~10 4 sufficient to provide kinematical distances in galaxies. The proposed instrument on a 2 m-class telescope will be most sensitive to H 2 line emission simultaneously extended and structured at small scale , in gas at temperatures higher than 80 K. Colder H 2 , which may contribute most of the baryonic dark matter in galaxies, will be traced by the emission of glitters of warm H 2 heated, throughout the medium, by the dissipation of omnipresent turbulence. The main scientific objectives are to (i) directly measure the mass and temperature distribution of the warm H 2 , far from star forming regions, in particular in low metallicity environments where the traditional tracers of H 2 (CO, dust emission) fail, (ii) trace the dissipation of turbulence in the perspective of building a global view of the star formation process in galaxies and (iii) trace baryonic dark matter in the form of cold H 2 in a large sample of galaxies along the Hubble sequence.

We combine recent ISO observations of the vibrational ground state lines of H2 towards Photon-Dominated Regions (PDRs) with observations of vibrationally excited states made with ground-based telescopes in order to constrain the formation rate of H2 on grain surfaces under the physical conditions in the layers responsible for H2 emission. We use steady state PDR models in order to examine the sensitivity of different H2 line ratios to the H2 formation rate Rf. We show that the ratio of the 0-0 S(3) to the 1-0 S(1) line increases with Rf but that one requires independent estimates of the radiation field incident upon the PDR and the density in order to infer Rf from the H2 line data. We confirm the earlier result of Habart et al. (2003) that the H2 formation rate in regions of moderate excitation such as Oph W, S140 and IC 63 is a factor of 5 times larger than the standard rate inferred from UV observations of diffuse clouds. On the other hand, towards regions of higher radiation field such as the Orion Bar and NGC 2023, we derive H2 formation rates consistent with the standard value. We find also a correlation between the H2 1-0 S(1) line and PAH emission suggesting that Rf scales with the PAH abundance. With the aim of explaining these results, we consider some empirical models of the H2 formation process. Here we consider both formation on big (a~0.1 microns) and small (a~10 Angstroms) grains by either direct recombination from the gas phase or recombination of physisorbed H atoms with atoms in a chemisorbed site. We conclude that indirect chemisorption is most promising in PDRs. Moreover small grains which dominate the total grain surface and spend most of their time at relatively low temperatures may be the most promising surface for forming H2 in PDRs., A&A in press, 16 pages, 5 figures

This retrospective study of 142 consecutive males operated on, including the learning-curve period, is aimed at evaluating the long-term outcome (>3 years) of Lichtenstein hernia repair. The response rate was 95%. One recurrence (0.7%) and one femoral hernia occurred. Pain persisted more than 2 weeks in 26% of patients, more than 3 months in 8%, and after 3 years in 4%. The corresponding figures for discomfort without need for analgesics are 49, 14, and 11%. Paresthesia persisted over 1 year in 9%. Morbidity due to extensive section of the cremaster muscle and shooting nuisance during ejaculation occurred in four patients. The mean social inactivity period was 3.2 weeks, the time to work resumption 5.4 weeks. The Lichtenstein hernioplasty proved to have a low recurrence rate and immediate morbidity, but the prevalence of chronic pain or discomfort are not to be underestimated.

We present a comparison of the gas and dust properties of the dense interstellar matter in six nearby star-forming regions (d~2 sigma) than the galactic value, derived using the standard extinction curve (R_V = 3.1). This result is consistent with the recent downwards revision of the metallicity of the Sun and stars in the solar vicinity. We find that the rho Oph dense cloud has the same metallicity than the local ISM when assuming that the galactic gas-to-dust ratio remains unchanged. The difference between galactic and local values of the gas-to-dust ratio can thus be attributed entirely to a difference in metallicity., Comment: 21 Pages including 12 figures. Accepted for publication in Astronomy and Astrophysics

International audience; Here we introduce the interstellar dust modelling framework THEMIS (The Heterogeneous dust Evolution Model for Interstellar Solids), which takes a global view of dust and its evolution in response to the local conditions in interstellar media. This approach is built upon a core model that was developed to explain the dust extinction and emission in the diffuse interstellar medium. The model was then further developed to self-consistently include the effects of dust evolution in the transition to denser regions. The THEMIS approach is under continuous development and we are currently extending the framework to explore the implications of dust evolution in HII regions and the photon-dominated regions associated with star formation. We provide links to the THEMIS, DustEM and DustPedia websites where more information about the model, its input data and applications can be found.

Diffuse alveolar hemorrhage (DAH) is a clinical syndrome, which refers to injury to the capillaries, arterioles and venules, leading to red blood cell accumulation in the distal air spaces. It is defined by the clinical triad of hemoptysis, anemia and progressive hypoxemia. Chest radiographs reveal non-specific patchy or diffuse bilateral pulmonary consolidation. Multiple conditions are associated with DAH, of which Wegener’s granulomatosis is the most frequent, and underlying disease determines the prognosis and treatment. This case describes DAH as a result of oral amphetamine abuse in a young patient of which the diagnosis was established by laboratory, clinical and radiologic findings. The patient experienced a rapid recovery without significant sequelae.

Magnetic resonance imaging plays an important role in the therapeutic follow-up of patients with bone tumors. Follow-up includes monitoring of response to neoadjuvant chemotherapy prior to limb salvage surgery, assessment of local recurrence of tumor, differentiation of suspected recurrence from hematopoietic bone marrow reconversion, inflammation, seroma, or reactive tissue, and detection of therapeutic complications, such as osteonecrosis, infection, and radiation-induced sarcoma. This article reviews the role of magnetic resonance imaging in the therapeutic follow-up of patients with bone tumors.

Context. The evolution of amorphous hydrocarbon materials, a-C(:H), principally resulting from ultraviolet (UV) photon absorption- induced processing, are likely at the heart of the variations in the observed properties of dust in the interstellar medium. Aims. The consequences of the size-dependent and compositional variations in a-C(:H), from aliphatic-rich a-C:H to aromatic-rich a-C, are studied within the context of the interstellar dust extinction and emission. Methods. Newly-derived optical property data for a-C(:H) materials, combined with that for an amorphous forsterite-type silicate with iron nano-particle inclusions, a-SilFe, are used to explore dust evolution in the interstellar medium. Results. We present a new dust model that consists of a power-law distribution of small a-C grains and log-normal distributions of large a-SilFe and a-C(:H) grains. The model, which is firmly anchored by laboratory-data, is shown to quite naturally explain the variations in the infrared (IR) to far-ultraviolet (FUV) extinction, the 217 nm UV bump, the IR absorption and emission bands and the IR-mm dust emission. Conclusions. The major strengths of the new model are its inherent simplicity and built-in capacity to follow dust evolution in interstellar media. We show that mantle accretion in molecular clouds and UV photo-processing in photo-dominated regions are likely the major drivers of dust evolution., 22 pages, 20 figures

We screened a cohort of 5 male and 20 female patients with a Rett spectrum disorder for mutations in the coding region of FOXG1, previously shown to cause the congenital variant of Rett syndrome. Two de novo mutations were identified. The first was a novel missense mutation, p.Ala193Thr (c.577G>A), in a male patient with congenital Rett syndrome, and the second was the p.Glu154GlyfsX301 (c.460dupG) truncating mutation in a female with classical Rett syndrome, a mutation that was previously reported in an independent patient. The overall rate of FOXG1 mutations in our cohort is 8%. Our findings stress the importance of FOXG1 analysis in male patients with Rett syndrome and in female patients when mutations in the MECP2 and CDKL5 genes have been excluded.

Damage to the meniscus is one of the most common causes of pain in the knee joint. Accurate imaging of the meniscus is essential to evaluate the damaged area and to select the most appropriate treatment. Similarly, in the postoperative meniscus, imaging is important for treatment, follow-up and identification of any further injury. A number of factors have to be considered when selecting the most appropriate imaging technique. Currently, magnetic resonance (MR) imaging is the preferred imaging modality for the virgin, operated or transplanted meniscus. MR imaging is a non-invasive but highly sensitive technique for the detection of meniscal lesions. MR arthrography does not improve on the accuracy of MR imaging in the non-operated knee, but the technique is useful for detecting a retear in the sutured meniscus. Computed tomography (CT) arthrography is used less frequently and in situations where MR imaging is contraindicated, e.g. in the presence of orthopaedic hardware. This chapter describes the available imaging techniques for the assessment of the meniscus and reviews the use of MR imaging in both the non-operated and postoperative meniscus.

The Molecular Hydrogen Explorer, H2EX, was proposed in response to the ESA 2015 - 2025 Cosmic Vision Call as a medium class space mission with NASA and CSA participations. The mission, conceived to understand the formation of galaxies, stars and planets from molecular hydrogen, is designed to observe the first rotational lines of the H2 molecule (28.2, 17.0, 12.3 and 9.7 micron) over a wide field, and at high spectral resolution. H2EX can provide an inventory of warm (> 100 K) molecular gas in a broad variety of objects, including nearby young star clusters, galactic molecular clouds, active galactic nuclei, local and distant galaxies. The rich array of molecular, atomic and ionic lines, as well as solid state features available in the 8 to 29 micron spectral range brings additional science dimensions to H2EX. We present the optical and mechanical design of the H2EX payload based on an innovative Imaging Fourier Transform Spectrometer (IFTS) fed by a 1.2m telescope. The 20'x20' field of view is imaged on two 1024x1024 Si:As detectors. The maximum resolution of 0.032 cm^-1 (FWHM) means a velocity resolution of 10 km s^-1 for the 0-0 S(3) line at 9.7 micron. This instrument offers the large field of view necessary to survey extended emission in the Galaxy and local Universe galaxies as well as to perform unbiased extragalactic and circumstellar disks surveys. The high spectral resolution makes H2EX uniquely suited to study the dynamics of H2 in all these environments. The mission plan is made of seven wide-field spectro-imaging legacy programs, from the cosmic web to galactic young star clusters, within a nominal two years mission. The payload has been designed to re-use the Planck platform and passive cooling design., Accepted for publication in Experimental Astronomy special issue on Cosmic Vision Proposals, 19 pages and 9 figures

The presence of Polycyclic Aromatic Hydrocarbons (PAHs) in the interstellar gas has been proposed recently on the basis of a suggestive resemblance between the set of observed IR emission lines (3.3, 6.2, 7.7, 8.6, 11.3 μm) and the vibrational spectra of these molecules.

To assess the current opinions of physicians and nurses regarding the prevention, diagnosis and management of delirium, survey administration was conducted to 2256 nurses and 982 physicians within the University Hospitals of Leuven (Belgium). Response rate was 26% with 819 respondents (600 nurses; 219 physicians) completing the questionnaire. 72% of the respondents considered delirium as a minor problem or no problem at all. Yet over half of respondents working on a palliative care unit (87%, n=15), traumatological ward (67%, n=18), cardio-thoracic surgery ward (58%, n=20), intensive care unit (55%, n=120) and geriatric ward (55%, n=42) reported it as a serious problem. Delirium was considered as an underdiagnosed (85%) but preventable (75%) syndrome. Yet patients at risk are rarely (34%) or never (52%) screened for delirium. In case of screening (48%), only 4% used a specific validated assessment tool. 97% of all respondents were convinced that delirium requires an active and immediate intervention of nurse and physician. 82% of the physicians preferred haldol to treat delirium, in case of alcohol withdrawal 69% chose tranxene. Physical restraints were considered important in the management of delirium by a greater proportion of nurses (49%) than physicians (28%). The severity of the problem is underestimated. While opinions regarding the treatment were quite correct, prevention and early detection of delirium deserve more attention.

To define an imaging prototype of Ewing's sarcoma (ES).Sixty-four patients with a histopathologically and/or genetically proven diagnosis of ES were analyzed for clinical parameters (age, gender and location), radiographic and CT appearance (distribution, matrix, margins, periosteal reaction, articular extension, cortical reaction and the presence of a pathologic fracture). Size, local extension, signal intensity, degree and pattern of enhancement, and the presence of skip metastases were evaluated on MRI. Distant metastases were recorded on bone scintigraphy and chest CT scan.Patient's age ranged between 7-67 (mean 17.9). Male/female ratio was 2.4/1. Location in the pelvis was most frequent (31%), followed by the femur (20%) and tibia (11%). Most tumors were mixed lytic-sclerotic (75%), and purely lytic in 25%. Plain films and CT scan showed a spiculated periosteal reaction in 50%. A Codman's triangle was seen in 27%. Articular extension was difficult to assess on radiographs. Cortical permeation and destruction is seen in respectively 31 and 42%, whereas cortical thickening is seen in 20%. Pathologic fracture occurred in 7.8%. MRI showed a large mass, with a soft tissue component of more than 50% in 67%. Degree and pattern of enhancement pattern was variable. Signal intensity on T1- and T2-WI was non-specific. Joint involvement was seen in 23%. Isolated involvement of the soft tissue (extraskeletal ES) was seen in 1.5%. Skip metastases at initial presentation were present at initial presentation in 14% and distant metastases in 22%.ES occurs in young patients. On radiographs/CT, 37.5% are located in the axial skeleton and 62.5% in the peripheral skeleton. ES is mostly mixed sclerotic-lytic. A spiculated periosteal reaction is most frequent. The most characteristic finding on MRI is the presence of a large soft tissue mass.

Pelvic inflammatory disease with tuboovarian abscess is rare in postmenopausal women. Clinical and sonographic findings are usually sufficient to recognize pelvic inflammatory disease in premenopausal women, but in the elderly the disease may easily be overlooked, largely by unexpectedness. Computed tomography can be helpful when the clinical and sonographic findings are complex or equivocal. However, when the level of suspicion is low, it can be very difficult to interpret, especially when complicated with peritonitis, as illustrated in the present case report.