- Synoptic-Scale Precursors of Extreme U.K. Summer 3-Hourly Rainfall. [Journal Article]
- JGJ Geophys Res Atmos 2019 Apr 27; 124(8):4477-4489
- The synoptic-scale meteorological conditions leading up to the 30 most extreme subdaily summer rain events for two regions of the United Kingdom (northwest and southeast) were examined for the period…
The synoptic-scale meteorological conditions leading up to the 30 most extreme subdaily summer rain events for two regions of the United Kingdom (northwest and southeast) were examined for the period 1979-2013. Using a recently available, quality controlled, national hourly rain gauge data set, we were able to identify extreme 3-hr rainfall accumulations that may be indicative of flash flooding. Composites of the state of the atmosphere leading up to these dates were produced to investigate synoptic-scale processes, thus potentially allowing for them to be identified in coarse resolution reanalyses and in climate models. The results show that the two regions have different dominant synoptic-scale conditions leading to extreme 3-hr rainfall, which is thought to be related to the type of rainfall typically experienced in each region. In particular, positive anomalies in mean sea level pressure and the geopotential height at 200 hPa over the United Kingdom are associated with extreme rainfall in the northwest, where the position of the westerly jet is also important. For the southeast, no clear anomalous synoptic-scale conditions could be identified; however, localized moisture sources and unstable air masses were observed in association with extremes. These results indicate the importance of better understanding of both synoptic-scale and thermodynamic drivers of short-duration extreme rainfall, with potential implications in forecasting and flood warning, as well as for understanding the representation of key processes by regional climate models.
- Variation of the minimally invasive CDCR technique. [Journal Article]
- OOrbit 2019 May 20; :1-5
- CONCLUSIONS: This procedure can be done safely and quickly without general anesthesia, resulting in a satisfactorily lower rate of tube migration and cessation of epiphora rates.
- Radiographic appearance of the distal clavicle in relation to the acromion after acromioclavicular joint reconstruction using a braided polyester mesh. [Journal Article]
- JCJ Clin Orthop Trauma 2019 May-Jun; 10(3):486-491
- ACJ stabilization using a braided polyester mesh has become popular in ACJ injuries. However, concerns have been raised about excessive anterior clavicle displacement. The purpose of this study was t…
ACJ stabilization using a braided polyester mesh has become popular in ACJ injuries. However, concerns have been raised about excessive anterior clavicle displacement. The purpose of this study was to report radiographic position of the distal clavicle in relation to the acromion after ACJ reconstruction using this device immediately postoperative and after 6 months follow-up compared with a healthy control group. Thirty-eight patients with ACJ instability treated with a braided polyester mesh were compared within group (pre-/postoperatively) and between groups (with age/sex matched controls). Biplane radiographic measurements by 2 observers were made preoperatively, immediate postoperatively and at 6 months follow-up. Inter-observer reliability was assessed and clinical outcome scores were recorded. ACJ stabilization significantly reduced vertical displacement immediately postoperatively (13.8 ± 4.2 to 3.5 ± 5.5 mm; p < 0.0001) towards controls (1.7 ± 2.3 mm,p < 0.0873). Slight further superior displacement (4.4 mm) occurred at 6 months follow-up compared to immediately postoperative (p = 0.0029) and 6.2 mm more than mean controls (p < 0.0001). In the axial plane, significant early reduction of posterior displacement was achieved (10.3 ± 8.0 to 1.1 ± 5.1 mm,p = 0.0240) and the clavicle settled back to a more posterior position at 4.5 ± 6.7 mm at 6 months post-surgery (p = 0.3062). At both time points, posterior displacement was comparable with the controls (3.4 ± 3.0 mm,p = 0.4371 postoperative, p = 0.563 at 6 months follow-up). Excessive anterior displacement has been observed in 2 of the 5 available axial radiographs early postoperative and in 4 of 14 available axial radiographs at 6 months. Constant, Oxford Shoulder and Nottingham Clavicle scores significantly improved (25 ± 12 to 43 ± 7:p < 0.0001, 46 ± 27 to 80 ± 19:p = 0.0038, 53 ± 14 to 80 ± 17:p < 0.0001). ACJ stabilization using a braided polyester device in ACJ instability is effective at reducing both superior and posterior clavicle displacement with excellent clinical outcome. Overcorrection in the axial plane seems to occur, however this is of no clinical and radiographic significance. Posterior displacement is significantly reduced towards control values at 6 months follow-up.
- Complete Capsular Repair Restores Native Kinematics After Interportal and T-Capsulotomy. [Journal Article]
- AJAm J Sports Med 2019; 47(6):1451-1458
- CONCLUSIONS: Universally, across all conditions, complete capsular repair after interportal or T-capsulotomy restored rotational range of motion and joint translation to values observed in the native joint.
- Wise up: Clarifying the role of metacognition in the Dunning-Kruger effect. [Journal Article]
- JEJ Exp Psychol Gen 2019 Feb 25
- The Dunning-Kruger effect (DKE) is the finding that, across a wide range of tasks, poor performers greatly overestimate their ability, whereas top performers make more accurate self-assessments. The …
The Dunning-Kruger effect (DKE) is the finding that, across a wide range of tasks, poor performers greatly overestimate their ability, whereas top performers make more accurate self-assessments. The original account of the DKE involves the idea that metacognitive insight requires the same skills as task performance, so that unskilled people perform poorly and lack insight. However, global measures of self-assessment are prone to statistical and other biases that could explain the same pattern. We used psychophysical methods to examine metacognitive insight in simple movement and spatial memory tasks: pointing at a dot or recalling its position after a delay. We measured task skill in an initial block, and self-assessment in a second block, in which participants judged after every trial whether they had hit the target or not. Metacognitive calibration and sensitivity were related to task skill, but a path analysis showed that their net contribution to the DKE was weak. The major driver of the DKE was the level of task performance. In a second study, we again measured task skill in an initial block, but titrated task difficulty in the second block so that all participants performed at equivalent levels of success. Metacognitive measures were again related to task skill, but the DKE pattern was eliminated. We present a simple model of these findings, showing that metacognitive differences can contribute to the DKE but are neither necessary nor sufficient for it. This analysis clarifies and quantifies how metacognitive insight and other factors interact to determine this famous effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
- LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance. [Review]
- JHJ Hepatocell Carcinoma 2019; 6:49-69
- The Liver Imaging Reporting and Data System (LI-RADS®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in …
The Liver Imaging Reporting and Data System (LI-RADS®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in individuals at high risk for hepatocellular carcinoma (HCC). LI-RADS is supported and endorsed by the American College of Radiology (ACR). Upon its initial release in 2011, LI-RADS applied only to liver observations identified at CT or MRI. It has since been refined and expanded over multiple updates to now also address ultrasound-based surveillance, contrast-enhanced ultrasound for HCC diagnosis, and CT/MRI for assessing treatment response after locoregional therapy. The LI-RADS 2018 version was integrated into the HCC diagnosis, staging, and management practice guidance of the American Association for the Study of Liver Diseases (AASLD). This article reviews the major LI-RADS updates since its 2011 inception and provides an overview of the currently published LI-RADS algorithms.
- Testicular Volume Changes in Laparoscopic Staged Fowler-Stephens Orchiopexy: Studying the Impact of Testicular Vessel Division. [Journal Article]
- UUrology 2019; 127:113-118
- CONCLUSIONS: Significant testicular volume loss does not occur after testicular vessel division at S1, but expected in approximately 1 quarter of testes after S2. We propose that testicular atrophy after LSFSO is primarily due to defective testicular development and rarely due to vascular compromise during S2.
- Confirming the Clinical Safety and Feasibility of a Bundled Methodology to Improve Cardiopulmonary Resuscitation Involving a Head-Up/Torso-Up Chest Compression Technique. [Journal Article]
- CCCrit Care Med 2019; 47(3):449-455
- CONCLUSIONS: The head-up/torso-up cardiopulmonary resuscitation bundle was feasible and associated with an immediate, steady rise in resuscitation rates during implementation followed by a sustained doubling of the number of out-of-hospital cardiac arrest patients being resuscitated. These findings make a compelling case that this bundled technique will improve out-of-hospital cardiac arrest outcomes significantly in other clinical evaluations.
- The role of chromosome segregation and nuclear organisation in human subfertility. [Review]
- BSBiochem Soc Trans 2019 02 28; 47(1):425-432
- Spermatogenesis is central to successful sexual reproduction, producing large numbers of haploid motile male gametes. Throughout this process, a series of equational and reductional chromosome segreg…
Spermatogenesis is central to successful sexual reproduction, producing large numbers of haploid motile male gametes. Throughout this process, a series of equational and reductional chromosome segregation precedes radical repackaging of the haploid genome. Faithful chromosome segregation is thus crucial, as is an ordered spatio-temporal 'dance' of packing a large amount of chromatin into a very small space. Ergo, when the process goes wrong, this is associated with an improper chromosome number, nuclear position and/or chromatin damage in the sperm head. Generally, screening for overall DNA damage is relatively commonplace in clinics, but aneuploidy assessment is less so and nuclear organisation studies form the basis of academic research. Several studies have focussed on the role of chromosome segregation, nuclear organisation and analysis of sperm morphometry in human subfertility observing significant alterations in some cases, especially of the sex chromosomes. Importantly, sperm DNA damage has been associated with infertility and both extrinsic (e.g. lifestyle) and intrinsic (e.g. reactive oxygen species levels) factors, and while some DNA-strand breaks are repaired, unexpected breaks can cause differential chromatin packaging and further breakage. A 'healthy' sperm nucleus (with the right number of chromosomes, nuclear organisation and minimal DNA damage) is thus an essential part of reproduction. The purpose of this review is to summarise state of the art in the fields of sperm aneuploidy assessment, nuclear organisation and DNA damage studies.
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- Inferior Alveolar Nerve Block Injection Pain Using a Computer-Controlled Local Anesthetic Device (CCLAD): A Prospective, Randomized Study. [Journal Article]
- APAnesth Prog 2018; 65(4):231-236
- There is evidence that the Computer-Controlled Local Anesthetic Device (CCLAD) decreases the pain of oral injections. The purpose of this study was to evaluate injection pain of the inferior alveolar…
There is evidence that the Computer-Controlled Local Anesthetic Device (CCLAD) decreases the pain of oral injections. The purpose of this study was to evaluate injection pain of the inferior alveolar nerve block (IANB) using the CCLAD in an upright position versus a supine position. Additionally, we evaluated solution deposition pain with the CCLAD when compared to previous studies using a traditional syringe. One hundred ten asymptomatic subjects were randomly given IANBs using 2% lidocaine with 1:100,000 epinephrine while in an upright sitting position and supine position, at 2 different appointments, spaced at least 2 weeks apart. Each subject rated the pain for needle insertion, needle placement, and solution deposition on a Heft-Parker visual analogue scale. Pain ratings were compared between the upright and supine positions using a repeated-measures analysis of variance with post hoc testing using the Tukey-Kramer procedure. Moderate to severe pain was reported by 10% to 13% of the patients for needle insertion, 74% to 75% for full needle placement, and 8% to 10% for solution deposition. There was no significant difference between groups for phases of the injection. When comparing the injection phases within the groups, the needle placement phase of the injection was statistically more painful than both the needle insertion phase and solution deposition phase (p = .0001). Using the CCLAD, IANB injection pain of the supine and upright positions was not statistically different. Needle placement was the most painful phase of the injection. Solution deposition pain was less with the CCLAD when compared to other studies of the IANB using a traditional syringe.