Statistical tests for recessive lethal-carriers.

This paper presents a statistical method for testing whether a male mouse is a recessive lethal-carrier. The analysis is based on a back-cross experiment in which the male mouse is mated with some of his daughters. The numbers of total implantations and intrauterine deaths in each litter are recorded. It is assumed that, conditional on the number of total implantations, the number of intrauterine deaths follows a binomial distribution. Using computer-simulated experimentation it is shown that the proposed statistical method, which is sensitive to the pattern of intrauterine death rates, is more powerful than a test based only on the total number of implant deaths. The proposed test requires relatively simple calculations and can be used for a wide range of values of total implantations and background implant mortality rates. For computer-simulated experiments, there was no practical difference between the empirical error rate and the nominal error rate.     

ELISA for detection of IgM and IgG antibodies to sandfly fever sicilian virus

• •An enzyme-linked immunosorbent assay (ELISA) was developed to detect specific human immunoglobulin G and M antibodies to sandfly fever Sicilian (SFS) virus. Acute and early convalescent serum pairs with ⩾ 7 days between the 2 specimens were available from 20 patients and all showed significant optical density (OD) increase and significant titre rise (⩾ 4-fold) by IgG ELISA. However, negative or borderline-positive sera were found as late as 11 days after onset of symptoms when tested by IgG ELISA.
• •Specific IgM antibodies were detected during the first week of symptoms, and maximum OD values were obtained during the first 4 weeks after onset of disease. The IgM OD values declined over the following 3–9 months. All sera collected later than 14 months post-onset were negative by IgM ELISA.
• •The combination of early antibody response and the need to test only one serum specimen gives IgM ELISA an advantage over IgG ELISA in patient diagnosis.
• •The IgG ELISA was also evaluated as a seroepidemiological tool and compared to a plaque reduction neutralization test (PRNT) using sera from a normal Cypriot population. Of 183 sera tested, 34 (19%) were positive in plaque reduction neutralization tests (PRNT) and 113 (62%) by IgG ELISA. A number of PRNT-negative sera were strongly positive by IgG ELISA and also by indirect immunofluorescence test, which may suggest the presence of a virus related to SFS in Cyprus which has not yet been isolated.

     

Outpatient treatment with the wearable cardioverter defibrillator: clinical experience in two Dutch centres

Introduction

The latest European Society of Cardiology Guidelines recommend consideration of a wearable cardioverter-defibrillator (WCD) for patients with a poor left ventricular ejection fraction (LVEF) who are at risk of sudden arrhythmic death but are not eligible for an implantable defibrillator. For these patients a WCD can be an alternative to long-term hospitalisation.

Purpose

To evaluate the use of WCD therapy in these patient groups in two Dutch centres.

Methods

All consecutive patients treated with the WCD between 2009 and 2016 were included from two centres in the Netherlands. Data on events and compliance were collected retrospectively through home monitoring systems and adjudicated by the investigators.

Results

A total of 79 patients were treated with a WCD. Common indications were newly diagnosed cardiomyopathy without optimal medical treatment in 46 patients (58.2%) and bridge to implantable cardioverter-defibrillator (ICD) implant in 33 patients (41.8%). Bridge to implant indications consisted of contraindications for immediate implantation such as infections (e.?g. previous device-related infections) and radiotherapy. Compliance was over 97% per day (median 23.3?h, 22.6–23.7), during a median of 79 days (50.0–109.8.0). Two patients (2.6%) received an appropriate shock (annual rate 13.6%), there was 1 (1.3%) inappropriate shock (annual rate 6.7%). In 24 patients (52.2%) without optimal medical treatment, the LVEF was sufficiently improved and ICD implant was avoided. Eight (10.1%) patients did not receive an ICD. In 45 patients an ICD was implanted (57.0%).

Conclusion

WCD therapy provides a safe and effective treatment in outpatient setting for patients at high risk for sudden cardiac death and reduces the number of ICDs implanted.

     

Type of Practice of Physicians in California,Report of the Bureau of Research and Planning

The total number of non-federal^* physicians in California rose from 23,065 in mid-1959 to 26,271 in January, 1962, an 11.3 per cent increase. The proportion of physicians in private active practice remained almost constant during this period.A significant rise, both in number and proportionally, took place in the full-time specialty category, offset by losses in the general practice-part-time specialty group. While specialists increased by over 30 per cent, general practitioners, who made up 31.7 per cent of all non-federal physicians in 1959, were only 24.7 per cent of the total in early 1962.     

Host and Viral Genetic Correlates of Clinical Definitions of HIV-1 Disease Progression

Background

Various patterns of HIV-1 disease progression are described in clinical practice and in research. There is a need to assess the specificity of commonly used definitions of long term non-progressor (LTNP) elite controllers (LTNP-EC), viremic controllers (LTNP-VC), and viremic non controllers (LTNP-NC), as well as of chronic progressors (P) and rapid progressors (RP).

Methodology and Principal Findings

We re-evaluated the HIV-1 clinical definitions, summarized in

Visualisation of coronary venous anatomy by computed tomography angiography prior to cardiac resynchronisation therapy implantation

Background

The purpose of this study was to illustrate the additive value of computed tomography angiography (CTA) for visualisation of the coronary venous anatomy prior to cardiac resynchronisation therapy (CRT) implantation.

Methods

Eighteen patients planned for CRT implantation were prospectively included. A specific CTA protocol designed for visualisation of the coronary veins was carried out on a third-generation dual-source CT platform. Coronary veins were semi-automatically segmented to construct a 3D model. CTA-derived coronary venous anatomy was compared with intra-procedural fluoroscopic angiography (FA) in right and left anterior oblique views.

Results

Coronary venous CTA was successfully performed in all 18 patients. CRT implantation and FA were performed in 15 patients. A total of 62 veins were visualised; the number of veins per patient was 3.8 (range: 2–5). Eighty-five per cent (53/62) of the veins were visualised on both CTA and FA, while 10% (6/62) were visualised on CTA only, and 5% (3/62) on FA only. Twenty-two veins were present on the lateral or inferolateral wall; of these, 95% (21/22) were visualised by CTA. A left-sided implantation was performed in 13 patients, while a right-sided implantation was performed in the remaining 2 patients because of a persistent left-sided superior vena cava with no left innominate vein on CTA.

Conclusion

Imaging of the coronary veins by CTA using a designated protocol is technically feasible and facilitates the CRT implantation approach, potentially improving the outcome.

     

Intra-articular implantation of autologous bone marrow–derived mesenchymal stromal cells to treat knee osteoarthritis: a randomized,triple-blind,placebo-controlled phase 1/2 clinical trial

Background

The intra-articular implantation of mesenchymal stromal cells (MSCs) as a treatment for knee osteoarthritis (OA) is an emerging new therapy. In this study, patients with knee OA received intra-articular implantations of autologous bone marrow–derived MSCs. We sought to assess the safety and efficacy of this implantation.

Numerical simulation on the effects of drug eluting stents at different Reynolds numbers on hemodynamic and drug concentration distribution

Background

The changes of hemodynamics and drug concentration distribution caused by the implantation of drug eluting stents (DESs) in curved vessels have significant effects on In-Stent Restenosis.

Methods

A 3D virtual stent with 90°curvature was modelled and the distribution of wall shear stress (WSS) and drug concentration in this model were numerically studied at Reynolds numbers of 200, 400, 600, 800.

Results

The results showed that (1) the intensity of secondary flow at the 45° cross-section was stronger than that at the 90° cross-section; (2) As the Reynolds number increases, the WSS decreases. When the Reynolds number reaches 600, the low-WSS region only accounts for 3% of the total area. (3) The effects of Reynolds number on drug concentration in the vascular wall decreases in proportionally and then the blood velocity increased 4 times, the drug concentration in the vascular wall decreased by about 30%. (4) The size of the high drug concentration region is inversely proportional to the Reynolds number. As the blood velocity increases, the drug concentration in the DES decreases, especially at the outer bend.

Conclusions

It is beneficial for the patient to decrease vigorous activities and keep calm at the beginning of the stent implantation, because a substantial amount of the drug is released in the first two months of stent implantation, thus a calm status is conducive to drug release and absorption; Subsequently, appropriate exercise which increases the blood velocity is helpful in decreasing regions of low-WSS.

     

Comparing pandemic to seasonal influenza mortality: moderate impact overall but high mortality in young children

Background

We assessed the severity of the 2009 influenza pandemic by comparing pandemic mortality to seasonal influenza mortality. However, reported pandemic deaths were laboratory-confirmed – and thus an underestimation – whereas seasonal influenza mortality is often more inclusively estimated. For a valid comparison, our study used the same statistical methodology and data types to estimate pandemic and seasonal influenza mortality.

Methods and Findings

We used data on all-cause mortality (1999–2010, 100% coverage, 16.5 million Dutch population) and influenza-like-illness (ILI) incidence (0.8% coverage). Data was aggregated by week and age category. Using generalized estimating equation regression models, we attributed mortality to influenza by associating mortality with ILI-incidence, while adjusting for annual shifts in association. We also adjusted for respiratory syncytial virus, hot/cold weather, other seasonal factors and autocorrelation. For the 2009 pandemic season, we estimated 612 (range 266–958) influenza-attributed deaths; for seasonal influenza 1,956 (range 0–3,990). 15,845 years-of-life-lost were estimated for the pandemic; for an average seasonal epidemic 17,908. For 0–4 yrs of age the number of influenza-attributed deaths during the pandemic were higher than in any seasonal epidemic; 77 deaths (range 61–93) compared to 16 deaths (range 0–45). The ≥75 yrs of age showed a far below average number of deaths. Using pneumonia/influenza and respiratory/cardiovascular instead of all-cause deaths consistently resulted in relatively low total pandemic mortality, combined with high impact in the youngest age category.

Conclusion

The pandemic had an overall moderate impact on mortality compared to 10 preceding seasonal epidemics, with higher mortality in young children and low mortality in the elderly. This resulted in a total number of pandemic deaths far below the average for seasonal influenza, and a total number of years-of-life-lost somewhat below average. Comparing pandemic and seasonal influenza mortality as in our study will help assessing the worldwide impact of the 2009 pandemic.     

Significant variability in surgeons’ preferred correction maneuvers and instrumentation strategies when planning adolescent idiopathic scoliosis surgery

Background

Increased implant number is thought to provide better control on the scoliotic spine, but there is limited scientific evidence of improved deformity correction and surgical outcomes with high-density constructs. The objective is to assess key anchor points used by experienced spinal deformity surgeons and to evaluate the effect of implant density pattern on correction techniques.

Methods

Seventeen experienced spine surgeons reviewed five Lenke 1 adolescent idiopathic scoliosis cases and provided their preferred posterior correction technique (implant pattern, correction maneuvers, and implants used for their execution) and an alternative technique with the minimal implant density they felt would be acceptable (170 surgical plans total). Additionally, for each case, they selected acceptable screw patterns for surgery from seven published implant configurations. Variability in the surgeons’ plans was assessed, including instrumentation and correction strategies.

Results

The preferred correction plan involved an average of 1.65 implants/vertebra, with 88% of the available anchor points at the apex ±?1 vertebra used for the execution of correction maneuvers and only 43% of possible anchor points used proximal and distal to the apical area. The minimal density that surgeons found acceptable was 1.24 implants/vertebra. The minimal density plan involved more in situ rod contouring (53 vs. 41%), fewer vertebral derotation maneuvers (82 vs. 96%), and fewer implants used for compression/distraction maneuvers (1.18 and 1.42 respectively) (p?<?0.05). Implant placement at alternate levels or dropout of convex implants above and below the apical area was most frequently considered acceptable (>?70% agreement).

Conclusions

Implant position and number affect surgeons correction maneuvers selection. For low implant density constructs, dropout in the convexity and particularly in the periapical region is accepted by surgeons, with minor influence on planned correction maneuvers. Thus, preoperative implant planning must take into account which anchor points are needed for desired correction maneuvers.

     

Current status of bioassays in genetic toxicology--the dominant lethal assay. A report of the U.S. Environmental Protection Agency Gene-Tox Program

The term dominant lethal may be defined as death of the heterozygote arising through multiple chromosomal breaks. The assay is generally conducted by treating male animals, usually mice or rats, acutely (1 dose), subacutely (5 doses), or over the entire period of spermatogenesis. Animals treated acutely or subacutely are mated at weekly intervals to females for a sufficient number of weeks to cover the period of spermatogenesis. Those treated for the entire spermatogenic cycle are mated for 1 or 2 successive weeks at the termination of treatment. Females usually are killed at 14 days of pregnancy and examined for the number of total implantations in the uterus, the number of implantations classified as early deaths, and, in some cases, the number of corpora lutea. The category of early death is the most significant index of dominant lethality. A total of 249 papers were reviewed and 140 chemicals were evaluated. Of the 140 chemicals, 65 were positive by the criteria used by the Work Group in evaluating each publication. The category of "positive" includes those responses of a borderline nature. 99 chemicals were declared negative. There is considerable overlap of chemicals in both categories, which accounts for the incongruity in the total number of chemicals tested and the number considered positive and negative. A total of 44 animal carcinogens have been tested in the dominant lethal assay, 26 of which were positive and 18 negative for a correlation of 59%. The role of the assay should be that of confirming positive results from lower tier chromosomal aberration-detecting systems (confirming in the sense of indicating the ability of the chemical to penetrate gonadal tissue and to produce cytogenetic damage). The dominant lethal assay should not be used as a risk assessment method.     

Isolation and screening of euryhaline <Emphasis Type="Italic">Tetraselmis</Emphasis> spp. suitable for large-scale outdoor culture in hypersaline media for biofuels

Natural saline lakes in Western Australia were sampled for microalgae species and strains with potential for large-scale outdoor cultivation over a wide range of salinities for biofuels production. Using a rational isolation and screening process, several Tetraselmis strains (Chlorophyta, Chlorodendrales) with a broad range of salinity tolerance were identified and were characterised further for their potential for biofuels production. Specific growth rates increased from 0.8 to 1.2 days^?1 when the medium salinity was decreased from 11 to 3 % (w/v) NaCl (1.88 to 0.51 M NaCl) in batch cultivation mode, thereby indicating quick adaptation to large salinity changes. In general, ash-free dry weight (AFDW), total lipid, protein and carbohydrate contents per cell were highest in the early stages of growth. Salinity increases led to an increase in cell AFDW, with the highest mean maximum of 2555?±?659 pg AFDW.cell^?1 at 11 % (w/v) NaCl in the strains Tetraselmis MUR 167 and MUR 219 which had been in culture for many years, as compared to the mean maximum of 981?±?141 pg AFDW.cell^?1 the in newly isolated strains MUR 230, 231, 232 and 233. Similar observations on total lipid, protein and carbohydrate content per cell were made between the two groups of strains. Overall, all strains yielded high biomass and total lipid productivities over a very wide range of salinities without large variation in their gross biochemical composition and growth pattern. Based on AFDW and total lipid productivity data, the order of preference for selecting strains for further investigation for large-scale culture was MUR 231?>?MUR 233?>?MUR 219?>?MUR 230?>?MUR 232?>?MUR 167. The Tetraselmis spp. were also very competitive as shown by the outdoor cultivation of diatom, Halamphora coffeaeformis MUR 158, in parallel with Tetraselmis sp. MUR 167 which resulted in the diatom being outcompeted by the green alga. Our results demonstrate the high commercial potential of euryhaline Tetraselmis spp. for cultivation over a broad range of salinity in outdoor cultures.