An Increased Iliocapsularis-to-rectus-femoris Ratio Is Suggestive for Instability in Borderline Hips

BACKGROUND The iliocapsularis muscle is an anterior hip structure that appears to function as a stabilizer in normal hips. Previous studies have shown that the iliocapsularis is hypertrophied in developmental dysplasia of the hip (DDH). An easy MR-based measurement of the ratio of the size of the iliocapsularis to that of adjacent anatomical structures such as the rectus femoris muscle might be helpful in everyday clinical use. QUESTIONS/PURPOSES We asked (1) whether the iliocapsularis-to-rectus-femoris ratio for cross-sectional area, thickness, width, and circumference is increased in DDH when compared with hips with acetabular overcoverage or normal hips; and (2) what is the diagnostic performance of these ratios to distinguish dysplastic from pincer hips? METHODS We retrospectively compared the anatomy of the iliocapsularis muscle between two study groups with symptomatic hips with different acetabular coverage and a control group with asymptomatic hips. The study groups were selected from a series of patients seen at the outpatient clinic for DDH or femoroacetabular impingement. The allocation to a study group was based on conventional radiographs: the dysplasia group was defined by a lateral center-edge (LCE) angle of < 25° with a minimal acetabular index of 14° and consisted of 45 patients (45 hips); the pincer group was defined by an LCE angle exceeding 39° and consisted of 37 patients (40 hips). The control group consisted of 30 asymptomatic hips (26 patients) with MRIs performed for nonorthopaedic reasons. The anatomy of the iliocapsularis and rectus femoris muscle was evaluated using MR arthrography of the hip and the following parameters: cross-sectional area, thickness, width, and circumference. The iliocapsularis-to-rectus-femoris ratio of these four anatomical parameters was then compared between the two study groups and the control group. The diagnostic performance of these ratios to distinguish dysplasia from protrusio was evaluated by calculating receiver operating characteristic (ROC) curves and the positive predictive value (PPV) for a ratio > 1. Presence and absence of DDH (ground truth) were determined on plain radiographs using the previously mentioned radiographic parameters. Evaluation of radiographs and MRIs was performed in a blinded fashion. The PPV was chosen because it indicates how likely a hip is dysplastic if the iliocapsularis-to-rectus-femoris ratio was > 1. RESULTS The iliocapsularis-to-rectus-femoris ratio for cross-sectional area, thickness, width, and circumference was increased in hips with radiographic evidence of DDH (ratios ranging from 1.31 to 1.35) compared with pincer (ratios ranging from 0.71 to 0.90; p < 0.001) and compared with the control group, the ratio of cross-sectional area, thickness, width, and circumference was increased (ratios ranging from 1.10 to 1.15; p ranging from 0.002 to 0.039). The area under the ROC curve ranged from 0.781 to 0.852. For a one-to-one iliocapsularis-to-rectus-femoris ratio, the PPV was 89% (95% confidence interval [CI], 73%-96%) for cross-sectional area, 77% (95% CI, 61%-88%) for thickness, 83% (95% CI, 67%-92%) for width, and 82% (95% CI, 67%-91%) for circumference. CONCLUSIONS The iliocapsularis-to-rectus-femoris ratio seems to be a valuable secondary sign of DDH. This parameter can be used as an adjunct for clinical decision-making in hips with borderline hip dysplasia and a concomitant cam-type deformity to identify the predominant pathology. Future studies will need to prove this finding can help clinicians determine whether the borderline dysplasia accounts for the hip symptoms with which the patient presents. LEVEL OF EVIDENCE Level III, prognostic study.

On the Edge of the Primeval Forest. Accounts and reflections of a medical Doctor in French Equatorial Africa

Reading for 4th-year students

A versatile toolkit to produce sensitive FRET biosensors to visualize signaling in time and space

Genetically encoded, ratiometric biosensors based on fluorescence resonance energy transfer (FRET) are powerful tools to study the spatiotemporal dynamics of cell signaling. However, many biosensors lack sensitivity. We present a biosensor library that contains circularly permutated mutants for both the donor and acceptor fluorophores, which alter the orientation of the dipoles and thus better accommodate structural constraints imposed by different signaling molecules while maintaining FRET efficiency. Our strategy improved the brightness and dynamic range of preexisting RhoA and extracellular signal-regulated protein kinase (ERK) biosensors. Using the improved RhoA biosensor, we found micrometer-sized zones of RhoA activity at the tip of F-actin bundles in growth cone filopodia during neurite extension, whereas RhoA was globally activated throughout collapsing growth cones. RhoA was also activated in filopodia and protruding membranes at the leading edge of motile fibroblasts. Using the improved ERK biosensor, we simultaneously measured ERK activation dynamics in multiple cells using low-magnification microscopy and performed in vivo FRET imaging in zebrafish. Thus, we provide a construction toolkit consisting of a vector set, which enables facile generation of sensitive biosensors.

Preference Structure and Random Paths to Stability in Matching Markets

This paper examines how preference correlation and intercorrelation combine to influence the length of a decentralized matching market's path to stability. In simulated experiments, marriage markets with various preference specifications begin at an arbitrary matching of couples and proceed toward stability via the random mechanism proposed by Roth and Vande Vate (1990). The results of these experiments reveal that fundamental preference characteristics are critical in predicting how long the market will take to reach a stable matching. In particular, intercorrelation and correlation are shown to have an exponential impact on the number of blocking pairs that must be randomly satisfied before stability is attained. The magnitude of the impact is dramatically different, however, depending on whether preferences are positively or negatively intercorrelated.

Returning Texas Senate Bill 530 back to 1100 Congress Avenue: The need for effective surveillance reporting of student fitness levels to Texas house representatives

Every Texas student is required to complete the FITNESSGRAM fitness assessment under legislation outlined in Senate Bill 530. This study described cardiovascular, body mass index (BMI), and overall fitness levels of students (grades 3–12) in the state of Texas during the 2009–2010 school year, and provides examples of how to effectively present results to Texas House Representatives using three unique health communication strategies. Given the Texas legislature mandates FITNESSGRAM collection yet did not require reporting according to their election district, the data were aggregated to 150 Texas House Representative Districts by sex and grade category to facilitate effective fitness data dissemination. Fitness data were also analyzed with results from the Texas Assessment of Knowledge and Skills (TAKS) to provide insight into potential relationships between fitness and academic achievement. ^ The majority of students in Texas need improvement on at least 1 fitness assessment. In general, female students have superior fitness in elementary and middle school but the fitness edge is erased by high school. Female cardiovascular fitness deteriorates faster from elementary to high school compared to male students. Female BMI deteriorates and male BMI improves from elementary to high school. Cardiovascular fitness and overall fitness decreases from elementary to high school for both male and female students. ^ Student fitness was significantly and strongly independently correlated with academic achievement. Further analysis showed that House Representatives with TAKS scores in the top quartile consistently showed superior fitness. Small significant partial correlations remain between fitness and TAKS assessment after controlling for socioeconomic status. In general, correlations were stronger between female BMI and TAKS assessment compared to male students. Cardiovascular fitness was significantly correlated with TAKS assessment for both genders. This paper supports student fitness as a confounder in the relationship between socioeconomic status and academic achievement. Plus, student fitness has a strong correlation with academic that deserves further exploration. ^ Senate Bill 530 fails to organize and implement a health communication strategy that effectively disseminates the health data collected to stakeholders of interest. The lack of a vital health communication strategy results in an incomplete student health surveillance system. This paper outlines three unique strategies tailored to legislators. It is important to disseminate health information using a variety of methods tailored to your targeted audience. The use of interactive mapping technology presented (GIS) uses new technology that has the potential to effectively reach a large audience.^

Pathway Semantics: An Algebraic Data Driven Algorithm to Generate Hypotheses about Molecular Patterns Underlying Disease Progression

The overarching goal of the Pathway Semantics Algorithm (PSA) is to improve the in silico identification of clinically useful hypotheses about molecular patterns in disease progression. By framing biomedical questions within a variety of matrix representations, PSA has the flexibility to analyze combined quantitative and qualitative data over a wide range of stratifications. The resulting hypothetical answers can then move to in vitro and in vivo verification, research assay optimization, clinical validation, and commercialization. Herein PSA is shown to generate novel hypotheses about the significant biological pathways in two disease domains: shock / trauma and hemophilia A, and validated experimentally in the latter. The PSA matrix algebra approach identified differential molecular patterns in biological networks over time and outcome that would not be easily found through direct assays, literature or database searches. In this dissertation, Chapter 1 provides a broad overview of the background and motivation for the study, followed by Chapter 2 with a literature review of relevant computational methods. Chapters 3 and 4 describe PSA for node and edge analysis respectively, and apply the method to disease progression in shock / trauma. Chapter 5 demonstrates the application of PSA to hemophilia A and the validation with experimental results. The work is summarized in Chapter 6, followed by extensive references and an Appendix with additional material.

Linda Hutcheon, Irony's Edge. The Theory and Politics of Irony. Londres/Nueva York, Routledge, 1994, VII, 248 páginas

Fil: Fernández, Claudia Nélida. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Linda Hutcheon, Irony's Edge. The Theory and Politics of Irony. Londres/Nueva York, Routledge, 1994, VII, 248 páginas

Fil: Fernández, Claudia Nélida. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

A geomorphological seabed classification for the Weddell Sea, Antarctica, with links to ArcGIS project files

Sea floor morphology plays an important role in many scientific disciplines such as ecology, hydrology and sedimentology since geomorphic features can act as physical controls for e.g. species distribution, oceanographically flow-path estimations or sedimentation processes. In this study, we provide a terrain analysis of the Weddell Sea based on the 500 m × 500 m resolution bathymetry data provided by the mapping project IBCSO. Seventeen seabed classes are recognized at the sea floor based on a fine and broad scale Benthic Positioning Index calculation highlighting the diversity of the glacially carved shelf. Beside the morphology, slope, aspect, terrain rugosity and hillshade were calculated. Applying zonal statistics to the geomorphic features identified unambiguously the shelf edge of the Weddell Sea with a width of 45-70 km and a mean depth of about 1200 m ranging from 270 m to 4300 m. A complex morphology of troughs, flat ridges, pinnacles, steep slopes, seamounts, outcrops, and narrow ridges, structures with approx. 5-7 km width, build an approx. 40-70 km long swath along the shelf edge. The study shows where scarps and depressions control the connection between shelf and abyssal and where high and low declination within the scarps e.g. occur. For evaluation purpose, 428 grain size samples were added to the seabed class map. The mean values of mud, sand and gravel of those samples falling into a single seabed class was calculated, respectively, and assigned to a sediment texture class according to a common sediment classification scheme.