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AIM: Liraglutide treatment is associated with gallbladder-related disorders and has been shown to delay postprandial gallbladder refilling. The gut hormones cholecystokinin (CCK), fibroblast growth factor 19 (FGF19) and glucagon-like peptide 2 (GLP-2), are known to regulate gallbladder motility and may be implicated in gallbladder-related disorders associated with liraglutide treatment.MATERIALS AND METHODS: In a double-blind, 12-week trial, 52 participants [50% male, age 47.6 ± 10.0 years, body mass index 32.6 ± 3.4 kg/m 2 (mean ± standard deviation)] with obesity were randomized 1:1 to once-daily subcutaneous liraglutide (escalated from 0.6 mg to 3.0 mg once-daily) or placebo. During liquid meal tests performed at baseline, after the first dose and following 12 weeks of treatment, we evaluated postprandial gallbladder dynamics and plasma responses of CCK, FGF19 and GLP-2. RESULTS: Liraglutide reduced postprandial FGF19 after the first dose [area under the curve (AUC) 0-240 min 24.8 vs. 48.0 min × ng/ml, treatment ratio (TR) (95% confidence interval) 0.52 (0.39; 0.69)] and following 12 weeks of treatment [AUC 0-240 min 33.7 vs. 48.5 ng/ml × min, TR 0.69 (0.52; 0.93)]. Liraglutide also reduced postprandial GLP-2 responses (AUC 0-240 min 3650 vs. 4894 min × pmol/L, TR 0.75 (0.62; 0.90)] following the first dose as well as after 12 weeks [AUC 0-240 min 3760 vs. 4882 min × pmol/L, TR 0.77 (0.60; 0.99)]. Liraglutide increased postprandial responses of CCK after the first dose [AUC 0-240 min 762 vs. 670 min × pmol/L; TR 1.14 (0.97; 1.33)] and following 12 weeks of treatment [AUC 0-240 min 873 vs. 628 min × pmol/L; TR 1.39 (1.12; 1.73)]. CONCLUSION: Compared with placebo, treatment with liraglutide decreased postprandial FGF19 and GLP-2 concentrations and increased postprandial CCK concentrations, which may explain the delayed postprandial gallbladder refilling observed in individuals with obesity treated with liraglutide.

Aim: In this study, we assessed the importance of local- to landscape-scale effects of land cover and land use on flying insect biomass. Location: Denmark and parts of Germany. Methods: We used rooftop-mounted car nets in a citizen science project (“InsectMobile”) to allow for large-scale geographic sampling of flying insects. Volunteers sampled insects along 278 five-km routes in urban, farmland, grassland, wetland and forest landscapes in the summer of 2018. The bulk insect samples were dried overnight to obtain the sample biomass. We extracted proportional land use variables in buffers between 50 and 1,000 m along the routes and compiled them into land cover categories to examine the effect of each land cover, and specific land use types, on insect biomass. Results: We found a negative association between urban cover and flying insect biomass (1% increase in urban cover = 1% [95% CI: −3.0 to 0.0] decrease in biomass in Denmark, and a 3% [95% CI: −3.0 to 0.0] decrease in Germany) at a landscape scale (1,000-m buffer). In Denmark, we also found positive effects of semi-natural land cover types, that is protected grassland (largest at the landscape scale, 1000 m) and forests (largest at intermediate scales, 250 m). Protected grassland cover had a stronger positive effect on insect biomass than forest cover did. For farmland cover, the positive association with insect biomass was not clearly modified by any variable associated with farmland use intensity. The negative association between insect biomass and urban land cover appeared to be reduced by increased urban green space. Main conclusions: Our results show that land cover has an impact on flying insect biomass with the magnitude of this effect varying across spatial scales. However, the vast expanse of grey space in urbanized areas has a direct negative impact on flying insect biomass across all spatial scales examined.

Bile acids in plasma are elevated after bariatric surgery and may contribute to metabolic improvements, but underlying changes in bile flow are poorly understood. We assessed bilio-enteric flow of bile and plasma bile concentrations in individuals with Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery compared with matched non-surgical controls (CON). Fifteen RYGB, 10 SG and 15 CON underwent 99Tc-mebrofenin cholescintigraphy combined with intake of a high-fat 111In-DTPA-labelled meal and frequent blood sampling. A 75Se-HCAT test was used to assess bile acid retention. After RYGB, gallbladder filling was decreased (p = 0.045 versus CON), basal flow of bile into the small intestine increased (p = 0.005), bile acid retention augmented (p = 0.021) and basal bile acid plasma concentrations elevated (p = 0.009). During the meal, foods passed unimpeded through the gastric pouch resulting in almost instant postprandial mixing of bile and foods, but the postprandial rise in plasma bile acids was brief and associated with decreased overall release of fibroblast growth factor-19 (FGF-19) compared with CON (p = 0.033). After SG, bile flow and retention were largely unaltered (p > 0.05 versus CON), but gastric emptying was accelerated (p

AIMS: To evaluate the effect of curcumin treatment on hepatic fat content in obese individuals.MATERIALS AND METHODS: In a double-blind, parallel-group trial, 37 obese, non-diabetic individuals were randomised to placebo or curcumin treatment for six weeks. Curcumin was dosed as lecithin-formulated tablet; 200 mg twice daily. Primary endpoint was hepatic fat content as assessed by magnetic resonance spectroscopy (MRS). Other endpoints included anthropometric measurements, hepatic biomarkers including FibroScan® measurements, metabolic parameters, inflammation markers, appetite measures and ad libitum food intake.RESULTS: Baseline characteristics (mean ± SD): age 46 ±14 years; hepatic fat content 12.2 ± 8.8 percent points; body mass index 38.8 ±6.1 kg/m 2 ; waist circumference 125.8 ± 12.3 cm. After six weeks treatment with curcumin, hepatic fat content was changed by -0.86 percent points (95% CI -3.65;1.94) compared to 0.71 percent points (95% CI -2.08;3.51) with placebo, thus resulting in a non-significant estimated treatment difference of -1.57 percent points (95% CI -5.36; 2.22, P = 0.412). Compared to placebo, curcumin treatment caused small reductions in fasting plasma glucose (estimated treatment difference (ETD) -0.24 mmol/L (95% CI -0.45; -0.03)), triglycerides (ETD (percentage change) -20.22% (95% CI -33.21; -6.03)), and gamma glutamyltransferase (ETD (percentage change) -15.70 (95% CI -23.32; -7.32)), but except for gamma glutamyltransferase, none of these differences remained statistically significant after adjusting for multiple testing. Treatment was well tolerated. CONCLUSIONS: Compared to placebo, curcumin treatment for six weeks had no significant effect on MRS-assessed hepatic fat content in obese individuals with primarily mild steatosis. Curcumin was well tolerated. This article is protected by copyright. All rights reserved.

Fatty acid amide hydrolase (FAAH) degrades 2 major classes of bioactive fatty acid amides, the N-acylethanolamines (NAEs) and N-acyl taurines (NATs), in central and peripheral tissues. A functional polymorphism in the human FAAH gene is linked to obesity and mice lacking FAAH show altered metabolic states, but whether these phenotypes are caused by elevations in NAEs or NATs is unknown. To overcome the problem of concurrent elevation of NAEs and NATs caused by genetic or pharmacological disruption of FAAH in vivo, we developed an engineered mouse model harboring a single-amino acid substitution in FAAH (S268D) that selectively disrupts NAT, but not NAE, hydrolytic activity. The FAAH-S268D mice accordingly show substantial elevations in NATs without alterations in NAE content, a unique metabolic profile that correlates with heightened insulin sensitivity and GLP-1 secretion. We also show that N-oleoyl taurine (C18:1 NAT), the most abundant NAT in human plasma, decreases food intake, improves glucose tolerance, and stimulates GPR119-dependent GLP-1 and glucagon secretion in mice. Together, these data suggest that NATs act as a class of lipid messengers that improve postprandial glucose regulation and may have potential as investigational metabolites to modify metabolic disease.

Monitoring insects across space and time is challenging, due to their vast taxonomic and functional diversity. This study demonstrates how nets mounted on rooftops of cars (car nets) and DNA metabarcoding can be applied to sample flying insect richness and diversity across large spatial scales within a limited time period. During June 2018, 365 car net samples were collected by 151 volunteers during two daily time intervals on 218 routes in Denmark. Insect bulk samples were processed with a DNA metabarcoding protocol to estimate taxonomic composition, and the results were compared to known flying insect richness and occurrence data. Insect and hoverfly richness and diversity were assessed across biogeographic regions and dominant land cover types. We detected 15 out of 19 flying insect orders present in Denmark, with high proportions of especially Diptera compared to Danish estimates, and lower insect richness and diversity in urbanized areas. We detected 319 species not known for Denmark and 174 species assessed in the Danish Red List. Our results indicate that the methodology can assess the flying insect fauna at large spatial scales to a wide extent, but may be, like other methods, biased towards certain insect orders.

BACKGROUND In the early phase of the pandemic, some guidelines recommended the use of corticosteroids for critically ill patients with COVID-19, whereas others recommended against the use despite lack of firm evidence of either benefit or harm. In the COVID STEROID trial, we aimed to assess the effects of low-dose hydrocortisone on patient-centred outcomes in adults with COVID-19 and severe hypoxia. METHODS In this multicentre, parallel-group, placebo-controlled, blinded, centrally randomised, stratified clinical trial, we randomly assigned adults with confirmed COVID-19 and severe hypoxia (use of mechanical ventilation or supplementary oxygen with a flow of at least 10��L/min) to either hydrocortisone (200��mg/d) vs a matching placebo for 7��days or until hospital discharge. The primary outcome was the number of days alive without life support at day 28 after randomisation. RESULTS The trial was terminated early when 30 out of 1000 participants had been enrolled because of external evidence indicating benefit from corticosteroids in severe COVID-19. At day 28, the median number of days alive without life support in the hydrocortisone vs placebo group were 7 vs 10 (adjusted mean difference: -1.1��days, 95% CI -9.5 to 7.3, P��=��.79); mortality was 6/16 vs 2/14; and the number of serious adverse reactions 1/16 vs 0/14. CONCLUSIONS In this trial of adults with COVID-19 and severe hypoxia, we were unable to provide precise estimates of the benefits and harms of hydrocortisone as compared with placebo as only 3% of the planned sample size were enrolled. TRIAL REGISTRATION ClinicalTrials.gov: NCT04348305. European Union Drug Regulation Authorities Clinical Trials (EudraCT) Database: 2020-001395-15.

Omega-3 fatty acids from fish oil reduce triglyceride levels in mammals, yet the mechanisms underlying this effect have not been fully clarified, despite the clinical use of omega-3 ethyl esters to treat severe hypertriglyceridemia and reduce cardiovascular disease risk in humans. Here, we identified in bile a class of hypotriglyceridemic omega-3 fatty acid–derived N-acyl taurines (NATs) that, after dietary omega-3 fatty acid supplementation, increased to concentrations similar to those of steroidal bile acids. The biliary docosahexaenoic acid–containing (DHA-containing) NAT C22:6 NAT was increased in human and mouse plasma after dietary omega-3 fatty acid supplementation and potently inhibited intestinal triacylglycerol hydrolysis and lipid absorption. Supporting this observation, genetic elevation of endogenous NAT levels in mice impaired lipid absorption, whereas selective augmentation of C22:6 NAT levels protected against hypertriglyceridemia and fatty liver. When administered pharmacologically, C22:6 NAT accumulated in bile and reduced high-fat diet–induced, but not sucrose-induced, hepatic lipid accumulation in mice, suggesting that C22:6 NAT is a negative feedback mediator that limits excess intestinal lipid absorption. Thus, biliary omega-3 NATs may contribute to the hypotriglyceridemic mechanism of action of fish oil and could influence the design of more potent omega-3 fatty acid–based therapeutics.

Insect diversity and abundance are increasingly reported as being under pressure. However, monitoring insects across space and time is challenging, due to their vast taxonomic and functional diversity. This study demonstrates how nets mounted on rooftops of cars (car nets) and DNA metabarcoding can be applied to sample flying insect diversity across a large spatial scale within a limited time period.During June 2018, 365 car net samples were collected by 151 volunteers during two daily time intervals on 218 routes in Denmark. Insect bulk samples were processed with a DNA metabarcoding protocol to estimate taxonomic composition, and the results were compared to known flying insect diversity and occurrence data.We detected 15 out of 19 flying insect orders present in Denmark. Diptera. Psocoptera and Thysanoptera were overrepresented, while Hymenoptera, Coleoptera, Lepidoptera, Trichoptera, Odonata, Neuroptera and Plecoptera were underrepresented, compared to Danish estimates. We detected 319 species not known for Denmark. Our results indicate that this method can assess the flying insect fauna to a wide extent, but may be, like other methods, biased towards certain insect orders. Furthermore, car net sampling and DNA metabarcoding can update species records for Denmark while preserving specimens for natural history collections.

This document is a collection of laboratory protocols for the citizen science and DNA metabarcoding research project 'InsectMobile' at the Natural History Museum of Denmark/University of Copenhagen 2017-2021. The protocol(s) cover all methodological steps from sample pre-processing to library build for next-generation-sequencing on a HiSeq 4000 150 bp PE platform. Samples are collected with car rooftop-mounted insect nets by citizen scientists in the month of June 2018-2020 and the detachable end of the net containing flying insects is shipped to the laboratories at the Natural History Museum of Denmark/GLOBE Institute in containers containing 96% ethanol. The insects are then size sorted, the large size fraction is identified by morphology and counted, and the sample dry-weight is obtained after which the bulk samples are processed with a DNA metabarcoding protocol. Morphological identification of the insects is not covered by this protocol.

Recent studies report declines in biomass, abundance and diversity of terrestrial insect groups. While anthropogenic land use is one likely contributor to this decline, studies assessing land cover as a driver of insect dynamics are rare and mostly restricted in spatial scale and types of land cover. In this study, we used rooftop-mounted car nets in a citizen science project (‘InsectMobile’) to allow for large-scale geographic sampling of flying insects across Denmark and parts of Germany. Citizen scientists sampled insects along 278 10 km routes in urban, farmland and semi-natural (grassland, wetland and forest) landscapes in the summer of 2018. We assessed the importance of local to landscape-scale effects and land use intensity by relating insect biomass to land cover in buffers of 50, 250, 500 and 1000 m along the routes. We found a negative association of urban cover and a positive association of farmland on insect biomass at a landscape-scale (1000 m buffer) in both countries. In Denmark, we also found positive effects of all semi-natural land covers, i.e. grassland (largest at the landscape-scale, 1000 m), forests (largest at intermediate scales, 250 m), and wetlands (largest at the local-scale, 50 m). The negative association of insect biomass with urban land cover and positive association with farmland were not clearly modified by any variable associated with land use intensity. Our results show that land cover has an impact on flying insect biomass with the magnitude of this effect varying across spatial scales. Since we consistently found negative effects of urban land cover, our findings highlight the need for the conservation of semi-natural areas, such as wetlands, grasslands and forests, in Europe.

Farnesoid X receptor (FXR) and Takeda G-protein coupled receptor 5 (TGR5) are the two known bile acid (BA) sensitive receptors and are expressed in the intestine and liver as well as in extra-enterohepatic tissues. The physiological effects of extra-enterohepatic FXR/TRG5 remain unclear. Further, the extent BAs escape liver reabsorption and how they interact with extra-enterohepatic FXR/TGR5 is understudied. We investigated if hepatic BA reuptake differed between BAs agonistic for FXR and TGR5 compared to non-agonists in the rat. Blood was collected from the portal vein and inferior caval vein from anesthetized rats before and 5, 20, 30, and 40 min post stimulation with sulfated cholecystokinin-8. Plasma concentrations of 20 different BAs were assessed by liquid chromatography coupled to mass spectrometry. Total portal vein BA AUC was 3&ndash, 4 times greater than in the vena cava inferior (2.7 &plusmn, 0.6 vs. 0.7 &plusmn, 0.2 mM x min, p &lt, 0.01, n = 8) with total unconjugated BAs being 2&ndash, 3-fold higher than total conjugated BAs (AUC 8&ndash, 10 higher p &lt, 0.05 for both). However, in both cases, absolute ratios varied greatly among different BAs. The average hepatic reuptake of BAs agonistic for FXR/TGR5 was similar to non-agonists. However, as the sum of non-agonist BAs in vena portae was 2&ndash, 3-fold higher than the sum agonist (p &lt, 0.05), the peripheral BA pool was composed mostly of non-agonist BAs. We conclude that hepatic BA reuptake varies substantially by type and does not favor FXR/TGR5 BAs agonists.

Laboratory workers are potentially exposed to a wide range of chemical hazards while performing experimental research. Moreover, unique combinations of chemicals can generate hazards that the indiv...

The need for liquid fuels from inexpensive and abundant biomass sources continues to increase in light of the growing environmental and strategic consequences of relying on depletable petroleum. Fructose, a monomeric sugar derived from biomass, can be dehydrated to 5-hydroxymethylfurfural (HMF), an intermediate to furans that are high-energy-content compounds miscible with petroleum. To be economically competitive, production of HMF from fructose must achieve high selectivities and yields, but the design of catalysts that achieve high-yield HMF production is made difficult by the lack of understanding of the mechanistic aspects of fructose conversion to HMF. Various studies examining fructose conversion to HMF by homogeneous acids have proposed that different factors control selectivity, including the acid type, fructose tautomer distribution, and solvent type. A high-throughput system was utilized to develop detailed insights into mechanisms and factors controlling HMF selectivity from fructose dehydrati...

The design and successful performance of citizen science-based monitoring require an understanding of the motivation and the needs of participants. Herem we use a questionnaire to assess intrinsic and extrinsic motivations and investigate in links between project support service and motivations in 181 participants taking part in three insect-focused citizen science projects in Denmark, Germany and Israel. Across all three countries, main intrinsic motivation for participating in the projects were “to have fun” and to “do something (good) for nature”. Equally important across all countries were extrinsic motivations such as “contribute to science” and “contribute to nature conservation”. Interestingly, differences in the projects (country or program-type) were more strongly related to respondent's motivation than demographic variables such as age and gender. Linking project support services to participants' intrinsic and extrinsic motivations revealed that the intrinsic motivation of “feeling a part of the community” as well as the extrinsic motivation “learning” and the service to provide “training on insect identification” were positively related. Interestingly, the support service of “monetary incentives” was negatively related with the motivation to “conserve species generally” and “conserve insects specifically”. We conclude, that early identification of the citizen scientists' motivation and the assessment of how motivations may change over time are important to foster successful and sustainable citizen science monitoring programs. International networks of (potentially similar) biodiversity monitoring schemes should consider differences in cultural background and citizen scientist's requirements, and accordingly tailor the projects designs to activate, train, and support participants according to their needs.

Bile acids in plasma are elevated after bariatric surgery and may contribute to metabolic improvements, but underlying changes in bile flow are poorly understood. We assessed bilio-enteric flow of bile and plasma bile concentrations in individuals with Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery compared with matched non-surgical controls (CON).Fifteen RYGB, 10 SG and 15 CON underwentAfter RYGB, gallbladder filling was decreased (p = 0.045 versus CON), basal flow of bile into the small intestine increased (p = 0.005), bile acid retention augmented (p = 0.021) and basal bile acid plasma concentrations elevated (p = 0.009). During the meal, foods passed unimpeded through the gastric pouch resulting in almost instant postprandial mixing of bile and foods, but the postprandial rise in plasma bile acids was brief and associated with decreased overall release of fibroblast growth factor-19 (FGF-19) compared with CON (p = 0.033). After SG, bile flow and retention were largely unaltered (p 0.05 versus CON), but gastric emptying was accelerated (p 0.001) causing earlier mixture of bile and foods also in this group. Neither basal nor postprandial bile acid concentrations differed between SG and CON.Bilio-enteric bile flow is markedly altered after RYGB resulting in changes in plasma concentrations of bile acids and FGF-19, whereas bile flow and plasma concentrations are largely unaltered after SG.

BACKGROUND. Exercise has profound pleiotropic health benefits, yet the underlying mechanisms remain incompletely understood. Endocrine FGF21, bile acids (BAs), and BA-induced FGF19 have emerged as metabolic signaling molecules. Here, we investigated if dissimilar modes of exercise, resistance exercise (RE) and endurance exercise (EE), regulate plasma BAs, FGF19, and FGF21 in humans. METHODS. Ten healthy, moderately trained males were enrolled in a randomized crossover study of 1 hour of bicycling at 70% of VO2peak (EE) and 1 hour of high-volume RE. Hormones and metabolites were measured in venous blood and sampled before and after exercise and at 15, 30, 60, 90, 120, and 180 minutes after exercise. RESULTS. We observed exercise mode–specific changes in plasma concentrations of FGF19 and FGF21. Whereas FGF19 decreased following RE (P < 0.001), FGF21 increased in response to EE (P < 0.001). Total plasma BAs decreased exclusively following RE (P < 0.05), but the composition of BAs changed in response to both types of exercise. Notably, circulating levels of the potent TGR5 receptor agonist, lithocholic acid, increased with both types of exercise (P < 0.001). CONCLUSION. This study reveals divergent effects of EE and RE on circulating concentrations of the BA species, FGF19, and FGF21. We identify temporal relationships between decreased BA and FGF19 following RE and a sharp disparity in FGF21 concentrations, with EE eliciting a clear increase parallel to that of glucagon. FUNDING. The Novo Nordisk Foundation (NNF17OC0026114) and the Lundbeck Foundation (R238-2016-2859).

Ionic self-assembly (ISA) is a proven method that exploits non-covalent interactions to generate supramolecular materials. Here, we have expanded the scope of this approach fabricating thin films with nanoscopic order maintained over centimeters. Cationic layers of benzalkonium surfactants form a lamellar template. The template is able to host layers of negatively charged polyaromatic functional units, here demonstrated with β-naphthol-derived azo-dyes. We show that a variety of these functional building blocks can be incorporated in the lamellar template through ISA. Sixteen different materials were produced, characterized, and processed into thin films, with lamellar order perpendicular to the substrate. Thus, a design concept is demonstrated in which diverse functional motifs can be isolated and ordered in a 2D lattice between layers of alkyl chains in bulk and in thin films, in which the molecular order is maintained and aligned to the substrate.

Pulmonary magnetic-resonance-imaging (MRI) and x-ray computed-tomography have provided strong evidence of spatially and temporally persistent lung structure-function abnormalities in asthmatics. This has generated a shift in their understanding of lung disease and supports the use of imaging biomarkers as intermediate endpoints of asthma severity and control. In particular, pulmonary (1)H MRI can be used to provide quantitative lung structure-function measurements longitudinally and in response to treatment. However, to translate such biomarkers of asthma, robust methods are required to segment the lung from pulmonary (1)H MRI. Therefore, their objective was to develop a pulmonary (1)H MRI segmentation algorithm to provide regional measurements with the precision and speed required to support clinical studies.The authors developed a method to segment the left and right lung from (1)H MRI acquired in 20 asthmatics including five well-controlled and 15 severe poorly controlled participants who provided written informed consent to a study protocol approved by Health Canada. Same-day spirometry and plethysmography measurements of lung function and volume were acquired as well as (1)H MRI using a whole-body radiofrequency coil and fast spoiled gradient-recalled echo sequence at a fixed lung volume (functional residual capacity + 1 l). We incorporated the left-to-right lung volume proportion prior based on the Potts model and derived a volume-proportion preserved Potts model, which was approximated through convex relaxation and further represented by a dual volume-proportion preserved max-flow model. The max-flow model led to a linear problem with convex and linear equality constraints that implicitly encoded the proportion prior. To implement the algorithm, (1)H MRI was resampled into ∼3 × 3 × 3 mm(3) isotropic voxel space. Two observers placed seeds on each lung and on the background of 20 pulmonary (1)H MR images in a randomized dataset, on five occasions, five consecutive days in a row. Segmentation accuracy was evaluated using the Dice-similarity-coefficient (DSC) of the segmented thoracic cavity with comparison to five-rounds of manual segmentation by an expert observer. The authors also evaluated the root-mean-squared-error (RMSE) of the Euclidean distance between lung surfaces, the absolute, and percent volume error. Reproducibility was measured using the coefficient of variation (CoV) and intraclass correlation coefficient (ICC) for two observers who repeated segmentation measurements five-times.For five well-controlled asthmatics, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) was 83% ± 7% and FEV1 was 86 ± 9%pred. For 15 severe, poorly controlled asthmatics, FEV1/FV C = 66% ± 17% and FEV1 = 72 ± 27%pred. The DSC for algorithm and manual segmentation was 91% ± 3%, 92% ± 2% and 91% ± 2% for the left, right, and whole lung, respectively. RMSE was 4.0 ± 1.0 mm for each of the left, right, and whole lung. The absolute (percent) volume errors were 0.1 l (∼6%) for each of right and left lung and ∼0.2 l (∼6%) for whole lung. Intra- and inter-CoV (ICC) were0.5% (0.91%) for DSC and4.5% (0.93%) for RMSE. While segmentation required 10 s including ∼6 s for user interaction, the smallest detectable difference was 0.24 l for algorithm measurements which was similar to manual measurements.This lung segmentation approach provided the necessary and sufficient precision and accuracy required for research and clinical studies.

There are few previous studies on the incidence of shoulder dislocation in the general population. The aim of the study was to report the incidence of acute shoulder dislocations in the capital of Norway (Oslo) in 2009. Patients of all ages living in Oslo, sustaining a dislocation of the glenohumeral joint, were identified using electronic diagnosis registers, patient protocols, radiological registers of the hospitals, and the Norwegian Patient Register (NPR). The overall incidence rate was 56.3 [95% confidence interval (CI) 50.2–62.4] per 100 000 person-years, with rates of 82.2 (95% CI 71.7–92.8) and 30.9 (95% CI 24.5–37.3) in men and women, respectively. The incidence of primary dislocations was 26.2 (95% CI 22.1–30.4). The overall incidence of shoulder dislocations in Oslo was higher than previously reported incidences. The incidence of primary dislocations was also higher than that in previously reported studies for the general population but it was close to the incidence reported in Malmø, Sweden.

In a study of 40 young adults the pelvic inclination measured by a specially constructed inclinometer was found to be the same in the supine and standing positions when related to the horizontal and frontal planes, respectively. Consequently supine CT measurements of the hip are also representative of corresponding standing angles. The variations of the acetabular anteversion and the sector angles on CT of the hips in 5 adult corpses were measured by angulating the gantry in increments of 5° to ±20°. An approximate linear relationship was found for all parameters, the acetabular anteversion varied 0.5° with 1° pelvic rotation, and the sector angles 0.7°. A theoretic mathematical model for the variation of the acetabular anteversion outside the measured range employing a sine curve is introduced.

87 patients who experienced femoral shaft fracture at the age of two to 14 years were reviewed, on average, seven (three to 12) years after the injury occurred. Three methods of treatment had been used: Bryant skin traction, and skeletal traction using either the Weber table or the Braun frame. Patients two to three years of age at the time of injury had significantly less leg length inequality than those aged four to ten years. The reason was that in the youngest group, where which 16 out of 21 patients had been treated with skin traction, the effect of traction was less efficient and there was therefore a larger overlap of the fragments at fracture healing than in the older group, where all patients had had skeletal traction. Among ten to 14 year olds there was also less leg length inequality than among four to ten year olds. This was because of lack of growth stimulation in the oldest patients after fracture healing. The results indicate that an initial overlap of approximately 10 mm should be aimed at in patients under 11 years of age, whereas overlap should be avoided in older patients. Rotational deformity, defined as side difference in anteversion angle of 15 degrees or more, occurred in seven patients (8%), but none of them had any complaints. We conclude that traction treatment gives good results, with few complications. Over-growth remains a significant problem in children under 11 years of age.

The results of treatment for distal radial fractures of types Older 3 with more than 5 mm shortening and Older 4 were studied in a prospective randomized series of 41 patients with regular follow-up to six months after operation. The patients were treated with closed reduction under anaesthesia and either external fixation ad modum Hoffman or percutanous pinning and a plaster cast for six weeks. Both treatment groups achieved a clinically and radiologically good result without any significant difference. There were no infections, and except for one patient with persistent signs of mild reflex dystrophy we experienced no serious complications. Owing to simplicity and treatment costs we generally prefer treatment by pinning and plaster cast.

100 patients who underwent primary, total hip arthroplasty were consecutively included in this study. Their postoperative sanguineous wound drainage was reinfused, and the purpose of the study was to evaluate if such reinfusion reduced the use of homologous blood. 100 patients who were operated immediately prior to the reinfusion group were used as a historical control group. The mean volume reinfused was 426 milliliters. The mean haemoglobin of the wound drainage was 7.3 g/100 ml. There was no statistically significant reduction in the use of homologous blood. Nor was there any reduction in the number of patients exposed to such blood. Autotransfusion of postoperative sanguineous wound drainage does not seem to be indicated as a routine procedure in primary total hip arthroplasties.

Intoeing is one of the most common reasons for referral of children to orthopaedic evaluation. The most frequent cause is increased femoral anteversion (AV). The AV-angles have traditionally been measured by radiographic methods. In recent years, ultrasonographic techniques for such measurements have been introduced. Relatively liberal indications for surgical correction of increased anteversion by derotational osteotomy have previously been practised in Norway. The indications are now much more restrictive, because several reports have documented spontaneous reduction of the AV-angles during growth. We think operative treatment should be considered if markedly increased AV-angles and serious complaints persist at age 10-12 years.

During the years 1980-89, 13 patients were hospitalized because of bacterial arthritis of the peripheral joints. There were five juvenile patients (under 15 years of age). The remaining eight patients were adults, of whom seven were older than 50 years. The mean delay in establishing the diagnosis was four days (0-10 days). Monarthritis was found in 12 patients, and in one patient two joints were involved. The most commonly affected joints were the shoulder (four cases), knee (four cases), ankle (three cases), hip (two cases) and toe (one case). A predisposing condition was found in five patients, and three cases suffered from reduced mobility of the joint at follow-up. Staphylococcus aureus was the most common etiologic agent.

A new set of angles measured on standard axial CT images of the hip joint is defined. The angles provide information on the support of the femoral head from the anterior and the posterior part of the acetabulum. These angles have been measured in 82 adult hips, and correlated to a set of established parameters commonly measured at conventional roentgenography and on CT images of the hip joint. The defined angles may prove to be valuable in the total appreciation of hip joint function and stability.

From January 1976 until August 1980, femoral fractures in our department were initially stabilized with tibial traction and fixed operatively after 4-7 days. From August 1980 the fractures were treated with immediate operative fixation. In this retrospective study, we compared the incidence of fat embolism syndrome in 106 patients treated with delayed operative fixation to the incidence in 114 patients treated with immediate operative fixation. Eleven patients (10.4%) developed fat embolism syndrome in the group treated with delayed fixation, compared with two patients (1.8%) in the immediate osteosynthesis group (p less than 0.02). We concluded that early operative fixation of femoral fractures seems beneficial for the prevention of fat embolism syndrome.