Saline and hydrocarbon-bearing fluids detected in shallow aquifers of southern New Brunswick, Canada: Natural occurrence, or deep migration along faults and industrial wellbores?

Unconventional hydrocarbon production has sparked public concerns for several years, especially regarding potential potable groundwater contamination by hydrocarbons, brines, and various chemicals related to hydraulic fracturing operations. One possible contamination mechanism is upward migration of deep-seated contaminants over large vertical distances, through preferential pathways such as leaky well casings or permeable geological faults. In New Brunswick (Canada), thermogenic hydrocarbons and brackish water were previously reported in shallow water wells, some of them located close to unconventional gas wells or to major faults, but the exact origin of these fluids remained uncertain. The objective of this paper is to determine whether the presence of these fluids is the result of migration from the deep (>1 km) hydrocarbon bearing units (via natural or anthropogenic migration pathways), or whether they rather originate within the shallow aquifer (<100 m) or from intermediate zone. Tracking fluid origin was achieved by fingerprinting compositional and isotopic values of three indicators: 1) water isotopic signature (including tritium (3H), radiocarbon (14CDIC), δ18OH2O, δ2HH2O), 2) salinity (including Na, Ca, K, SO4, Cl, Br, 87Sr/86Sr), and 3) hydrocarbons (compositional data and δ13CCH4). These various analyses were conducted, when relevant, on samples of different matrices composing the hydrogeological system, namely shallow groundwater (12-90 m depth), shallow bedrock gas (8-131 m), and intermediate zone evaporitic rocks (173-332 m); they were compared with previously published values for deep basin brines and gases (1940-3168 m) from the hydrocarbon bearing Carboniferous Albert Formation. This unique suite of indicators, analytes and matrices allowed drawing the conclusion that thermogenic gas and high salinities present in the sampled wells were naturally occurring and originating from shallow and intermediate-zone bedrock units. Results obtained through this approach did not provide any evidence that hydrocarbon wells in this area have acted as preferential migration pathways for deep-seated fluids towards shallow aquifers.

NaPi2b expression in a large surgical Non-Small Cell Lung Cancer (NSCLC) cohort.

BACKGROUND: NaPi2b is a multi-transmembrane sodium-dependent phosphate transporter expressed at normal levels in several organs, including lung. High expression levels have been reported in various tumors including breast, thyroid, ovarian and non-small cell lung cancer. To date evaluation of NaPi2b expression has mostly been restricted to smaller lung cancer cohorts. METHODS: Analyses were performed on archival formalin fixed paraffin embedded primary tumor specimens from patients who had undergone curative intent resection at an Australian tertiary hospital. Tissue microarrays were constructed and stained with the chimeric anti-NaPi2b antibody, MERS67. Semi-quantitative H-scores (range 0 - 300) were calculated for each core tissue sample (H-score = % tumor cells staining for NaPi2b multiplied by staining intensity). An overall average H-score was reported for each specimen, with a cut-off score of 50 considered positive. RESULTS: Of 438 cases, high NaPi2b expression was observed in 151 (34.5%) overall, high expression in 137 of 208 (65.9%) adenocarcinoma cases, and 5 of 179 (2.8%) squamous cases (P < .0001). High NaPi2b expression was associated with female sex, EGFR or KRAS mutation, and TTF1 positivity (adenocarcinoma cases only). High NaPi2b expression was associated with improved overall survival (median 54 vs. 35 months, P = .029). CONCLUSION: High NaPi2b expression was noted in a significant subset of adenocarcinoma cases, and in particular amongst those who were TTF1+, or exhibited EGFR or KRAS mutations. This agrees with earlier reports and highlights the significance that NaPi2b may have a role as a possible target for delivery of cytotoxic agents via antibody-drug conjugate models for some patients with lung adenocarcinoma.

Sexual quality of life after the treatment of gynecologic cancer: what women want.

PURPOSE: While the incidence of sexual dysfunction after treatment for gynecologic malignancies is well documented, few studies describe how patients want healthcare providers to address these concerns. The objective of this study was to evaluate changes in sexual function and describe patient preferences regarding healthcare provider roles in addressing and treating sexual dysfunction in gynecologic cancer survivors. METHODS: Patients undergoing gynecologic cancer treatment from 2013 to 2014 at a single University-based Gynecologic Cancer clinic were surveyed using a modified Changes in Sexual Function Questionnaire (CSFQ), along with questions relating to healthcare provider interactions and preferences. RESULTS: Among 277 eligible patients approached to participate, 85 (30.7%) completed the survey. The mean age was 52.2 ± 12.3 years; most were non-Hispanic White (78.8%), partnered (73.2%), had endometrial or ovarian cancer (30.6% and 44.7%, respectively), and were in surveillance (57.3%). Most women (64.7%) reported much or great sexual enjoyment 1 year prior to cancer treatment which decreased to 27.4% currently; 33.3% report only rare sexual activity. There were no statistically significant differences in mean total CSFQ scores by treatment modality. A minority wanted healthcare providers to initiate sexual health discussions (25.3%); the remaining reported not wanting sexual health addressed or preferred raising the issue themselves. The most commonly cited barrier to communication was the feeling that there are more important issues to discuss with their oncology providers (46.2%). CONCLUSIONS: While gynecologic cancer patients report changes in sexual function following cancer therapy, many believe there are other issues more paramount to be addressed. Further studies are warranted to develop better strategies for addressing sexual health in women receiving treatment for gynecologic cancers.

HER2 exon 20 insertions in non-small-cell lung cancer are sensitive to the irreversible pan-HER receptor tyrosine kinase inhibitor pyrotinib.

BACKGROUND: Effective targeted therapy for non-small-cell lung cancer (NSCLC) patients with human epidermal growth factor receptor 2 (HER2) mutations remains an unmet need. This study investigated the antitumor effect of an irreversible pan-HER receptor tyrosine kinase inhibitor, pyrotinib. PATIENTS AND METHODS: Using patient-derived organoids and xenografts established from an HER2-A775_G776YVMA-inserted advanced lung adenocarcinoma patient sample, we investigated the antitumor activity of pyrotinib. Preliminary safety and efficacy of pyrotinib in 15 HER2-mutant NSCLC patients in a phase II clinical trial are also presented. RESULTS: Pyrotinib showed significant growth inhibition of organoids relative to afatinib in vitro (P = 0.0038). In the PDX model, pyrotinib showed a superior antitumor effect than afatinib (P = 0.0471) and T-DM1 (P = 0.0138). Mice treated with pyrotinib displayed significant tumor burden reduction (mean tumor volume, -52.2%). In contrast, afatinib (25.4%) and T-DM1 (10.9%) showed no obvious reduction. Moreover, pyrotinib showed a robust ability to inhibit pHER2, pERK and pAkt. In the phase II cohort of 15 patients with HER2-mutant NSCLC, pyrotinib 400 mg resulted in a objective response rate of 53.3% and a median progression-free survival of 6.4 months. CONCLUSION: Pyrotinib showed activity against NSCLC with HER2 exon 20 mutations in both patient-derived organoids and a PDX model. In the clinical trial, pyrotinib showed promising efficacy. CLINICAL TRIAL REGISTRATION: NCT02535507.

Occupational exposure to endocrine disruptors and lymphoma risk in a multi-centric European study.

BACKGROUND: Incidence rates of lymphoma are usually higher in men than in women, and oestrogens may protect against lymphoma. METHODS: We evaluated occupational exposure to endocrine disrupting chemicals (EDCs) among 2457 controls and 2178 incident lymphoma cases and subtypes from the European Epilymph study. RESULTS: Over 30 years of exposure to EDCs compared to no exposure was associated with a 24% increased risk of mature B-cell neoplasms (P-trend=0.02). Associations were observed among men, but not women. CONCLUSIONS: Prolonged occupational exposure to endocrine disruptors seems to be moderately associated with some lymphoma subtypes.

Oral fructose absorption in obese children with non-alcoholic fatty liver disease.

BACKGROUND: Fructose intake is associated with non-alcoholic fatty liver disease (NAFLD) development. OBJECTIVE: The objective of this study was to measure fructose absorption/metabolism in paediatric NAFLD compared with obese and lean controls. METHODS: Children with histologically proven NAFLD, and obese and lean controls received oral fructose (1 g kg(-1) ideal body weight). Serum glucose, insulin, uric acid, and fructose, urine uric acid, urine fructose, and breath hydrogen levels were measured at baseline and multiple points until 360 min after fructose ingestion. RESULTS: Nine NAFLD (89% Hispanic, mean age 14.3 years, mean body mass index [BMI] 35.3 kg m(-2)), six obese controls (67% Hispanic, mean age 12.7 years, mean BMI 31.0 kg m(-2)) and nine lean controls (44% Hispanic, mean age 14.3 years, mean BMI 19.4 kg m(-2)) were enrolled. Following fructose ingestion, NAFLD vs. lean controls had elevated serum glucose, insulin and uric acid (P < 0.05), higher urine uric acid (P = 0.001), but lower fructose excretion (P = 0.002) and lower breath hydrogen 180-min AUC (P = 0.04). NAFLD vs. obese controls had similar post-fructose serum glucose, insulin, urine uric acid and breath hydrogen, but elevated serum uric acid (P < 0.05) and lower urine fructose excretion (P = 0.02). CONCLUSIONS: Children with NAFLD absorb and metabolize fructose more effectively than lean subjects, associated with an exacerbated metabolic profile following fructose ingestion.

A prospective randomized controlled trial of the natural history of idiopathic scoliosis versus treatment with the SpineCor brace. Sosort Award 2011 winner.

AIM: The purpose of this randomized controlled trial was to evaluate the efficacy of the Dynamic SpineCor brace for early idiopathic scoliosis (15°-30°) compared to the natural evolution of the disease. 68 patients participated in this study (32 treated and 36 controls) with at least 5 years follow-up. METHODS: The inclusion criteria were: 1) high risk of evolution: family history and/or proven progressive; 2) no significant pathological malformation of the spine; 3) initial Cobb angle between 15° and 30°; 4) risser 0, 1 or 2. Assessment of brace efficacy included the percentage of patients who have 5º or less curve progression and the percentage of patients who have 6º or more progression at skeletal maturity. RESULTS: At five-year follow-up a correction was achieved in 50% of treated patient and only in 9.5% of controls, stabilization in 42.3% treated and 47.7% in controls and progression in 26.9% for the treated group and 42.8% for controls. For the control patients we considered as a failure if the Cobb angle worsened by more then 5° from the original angle and the patient then received treatment. CONCLUSION: The results 5 years after the treatment suggested that the SpineCor brace reduced the probability of the progression of early idiopathic scoliosis comparing with its natural history. Moreover, the positive outcome appears to be maintained in the long term.

Incidence and risk factors for inhibitor development in previously untreated severe haemophilia A patients born between 2005 and 2010.

The objective of this study was to evaluate the inhibitor development (ID) in previously untreated patients (PUPs) with severe haemophilia A (FVIII ≤ 0.01 IU mL(-1) ). All Canadian Haemophilia Treatment Centres completed a questionnaire on patients born between September 2005 and August 2010 and followed for up to 7 years. Eligible patients had at least 20 exposure days (ED) or had developed an inhibitor. The odds ratio (OR) and 95% confidence intervals (95% CI) for risk factors to develop an inhibitor were estimated using unconditional logistic regression. A total of 99 haemophilia A PUPs were studied. Thirty-four (34%) developed an inhibitor (24/34 of high titre). Inhibitors developed in 25/63 (40%) patients with a high-risk mutation. ID was most frequent in Aboriginals (86%). Dose intensity (IU kg(-1)  day(-1) X number of ED) at first exposure to factor VIII (FVIII) was associated with a crude OR increase of 1.10 (95% CI: 0.99-1.23) with each increase of 100 dose-intensity units. Haemarthrosis and intracranial bleeding as the indication for first exposure to FVIII concentrate were associated with a crude OR for ID of 7.63 (95% CI: 2.14-27.17) and 5.08 (95% CI: 1.11-23.31) respectively. ID according to FVIII concentrate used was: Advate (®) 18/50 (36%), Kogenate FS(®) or Helixate FS(®) 15/36 (42%), Wilate(®) 0/11 and Xyntha(®) 1/2. In multivariate analysis, Aboriginal ethnicity (OR = 11.69; 95% CI: 1.11-122.86) and haemarthrosis (OR = 4.49; 95% CI: 1.08-18.61) were statistically significant. The cumulative incidence of ID in severe haemophilia A PUPs was 34% and varied according to ethnicity, type of bleeding at first ED, type of FVIII product and dose intensity at first exposure.

Fat storage syndrome in Pacific peoples: a combination of environment and genetics?

Pacific people (especially Micronesian and Polynesian) have some of the highest rates of obesity and diabetes in the world that largely developed since the introduction of western culture and diet. Recent studies suggest that much of the risk relates to the excessive intake of sugar (sucrose) and carbohydrates, leading to a type of fat storage syndrome (metabolic syndrome). Here we discuss some of the environmental. genetic and epigenetic reasons why this group might be especially prone to developing obesity and diabetes compared to other ethnic groups. Indirect evidence suggests that the higher endogenous uric acid levels in the Polynesian-Micronesian population may represent a predisposing factor for the development of obesity and diabetes in the context of Western diets and lifestyles. Pacific people may be an ideal group to study the role of "thrifty genes" in the pathogenesis of the current obesity epidemic.

A retrospective cohort study of cancer incidence among patients treated with radiosynoviorthesis.

Radiosynoviorthesis (RS) is an intra-articular injection of a radioactive colloid for the treatment of synovitis administered most often to patients with rheumatoid arthritis or haemophilia. Although highly cost-effective in comparison with surgical or arthroscopic synovectomy, the risk of cancer associated with this treatment is not well known. We evaluated the incidence of cancer in a group of patients treated with RS. A cohort of 2412 adult patients with a variety of underlying conditions (mainly rheumatoid arthritis) and treated with at least one RS between January 1976 and December 2001, was recruited from two centres in Montréal. Cancer incidence and mortality data for cohort members over that time period were obtained from regulatory agencies using linkage. Background rates for all and specific types of cancer were obtained for the provincial (Québec) and national (Canada) population according to age, gender and calendar period categories. Category-specific rates in the cohort were compared with rates in similar categories from the general population generating standardized incidence ratios (SIR). The effects of specific isotope doses and of number of RS treatments were analysed using a Cox-regression model. No increase in the risk of cancer was observed (SIR 0.96; 95% confidence interval 0.82-1.12). There was no dose-response relationship with the amount of radioisotope administered or number of RS treatments. The study provides some indication for the safety of the procedure but homogenous diagnostic groups of younger patients (such as haemophilic patients) receiving RS will need more evaluation.

Grafting Tomato to Manage Bacterial Wilt Caused by Ralstonia solanacearum in the Southeastern United States.

Bacterial wilt, caused by Ralstonia solanacearum, can result in severe losses to tomato (Solanum lycopersicum) growers in the southeastern United States, and grafting with resistant rootstocks may be an effective strategy for managing this disease. However, R. solanacearum populations maintain considerable diversity, and little information is known regarding the efficacy of commercially available rootstocks to reduce bacterial wilt incidence and subsequent crop loss in the United States. In this study, tomato plants grafted onto 'Dai Honmei' and 'RST-04-105-T' rootstocks had significantly lower area under the disease progress curve (AUDPC) values compared with nongrafted plants (P < 0.05). Across three locations in North Carolina, final bacterial wilt incidence for non- and self-grafted plants was 82 ± 14 to 100%. In contrast, bacterial wilt incidence for the grafted plants was 0 to 65 ± 21%. Final bacterial wilt incidence of plants grafted with Dai Honmei rootstock was 0 and 13 ± 3% at two locations in western North Carolina but 50 ± 3% at a third site in eastern North Carolina. Similarly, grafting onto RST-04-105-T rootstock significantly reduced AUDPC values at two of the three locations (P < 0.05) compared with that of the nongrafted plants, but performed poorly at the third site. Total fruit yields were significantly increased by grafting onto resistant rootstocks at all three sites (P < 0.05). Regression analyses indicated that yield was significantly negatively correlated with bacterial wilt AUDPC values (R2 was 0.4048 to 0.8034), and the use of resistant rootstocks enabled economically viable tomato production in soils naturally infested with R. solanacearum.

Lecithin-cholesterol acyltransferase (LCAT) deficiency without mutations in the coding sequence: a case report and literature review.

Familial lecithin-cholesterol acyltransferase (LCAT) deficiency (FLD) is a rare genetic disease characterized by corneal opacities, normocytic anemia, dyslipidemia, and proteinuria progressing to chronic renal failure. In all FLD cases, a mutation has been found in the coding sequence of the LCAT gene. FLD is clinically distinguished from an acquired form of LCAT deficiency by the presence of corneal opacities. Here we describe a 36-year-old woman presenting with clinical, pathological, and laboratory data compatible with FLD. Her mother and elder sister had corneal opacities. However, genetic analysis revealed there were no mutations in the LCAT coding sequences and no alterations in LCAT mRNA expression. Furthermore, we were unable to find any underlying conditions that may lead to LCAT deficiency. The present case therefore demonstrates that LCAT deficiency may be caused by factors other than mutations in the coding sequence and we suggest that a translational or posttranslational mechanism may be involved.

Horizontal body and trunk center of mass offset and standing balance in scoliotic girls.

In adolescent idiopathic scoliotic girls, postural imbalance is attributed to a sensory rearrangement of the motor system on the representation of the body in space. The objectives of this study were to test if the anteroposterior (AP), mediolateral (ML) and resultant body-head and trunk center of mass (COM) horizontal offsets were similar in able-bodied and scoliotic girls and if these offsets were related to the center of pressure displacements. A total of 21 adolescent idiopathic scoliosis girls and 20 able-bodied girls participated in this study. Their body COM position and that of the head and trunk were estimated according to Damavandi et al. (Med Eng Phys 31:1187-1194, 2009). The COP range and speed in both AP and ML axes were calculated from force plate measurements in quiet standing. The AP offset of the able-bodied group was anterior to the body COM by 11.0 ± 15.9 mm, while that of the scoliotic group was posterior to it by -17.3 ± 11.2 mm. The able-bodied group maintained their head-trunk segment COM more to the right by 14.1 ± 13.1 mm, while that of the scoliotic group was nearly over their body centerline. The scoliotic girls presented higher values for COP range and COP speed than the able-bodied girls. The resultant COM offset was correlated with both the ML COP range and speed only for the scoliotic girls. The small ML COM offset in the scoliotic girls was attributed to a compensatory action of the spinal deformity in the frontal plane resulting in a backward resultant COM offset to regain postural balance concomitant to an increase in the ML neuromuscular demand.

Peanut allergy: is maternal transmission of antigens during pregnancy and breastfeeding a risk factor?

BACKGROUND: Peanut allergy is an important public health problem in western countries. However, the risk factors associated with this allergy remain uncertain. OBJECTIVE: To determine whether the consumption of peanuts during pregnancy and breastfeeding is a risk factor for peanut allergy in infants. METHODS: We enrolled 403 infants in a case-control study. The cases were infants aged 18 months or less with a diagnosis of peanut allergy based on a history of clinical reaction after exposure to peanuts and the presence of peanut-specific immunoglobulin E. Controls were age-matched infants with no known clinical history or signs of atopic disease. The mothers of the children filled out a detailed questionnaire about maternal diet during pregnancy and breastfeeding, the infant's diet, the presence of peanut products in the infant's environment, and family history of atopy. RESULTS: The mean (SD) age of cases was 1.23 (0.03) years. The groups were comparable in terms of the rate and duration of breastfeeding. However, the reported consumption of peanuts during pregnancy and breastfeeding was higher in the case group and associated with an increased risk of peanut allergy in offspring (odds ratio [OR], 4.22 [95% confidence interval [CI], 1.57-11.30 and OR, 2.28 [95% CI, 1.31-3.97] for pregnancy and breastfeeding, respectively). Overall, the infants with peanut allergy did not seem to be more exposed to peanut products in their environment than the controls. CONCLUSION: Early exposure to peanut allergens, whether in utero or through human breast milk, seems to increase the risk of developing peanut allergy.

Continuing utilisation of specialised health services in extremely preterm infants.

OBJECTIVE: To compare healthcare use from neonatal discharge to 18 months corrected age (CA) of two groups of extremely preterm neonates (23-25 vs 26-28 weeks). DESIGN: Cohort study. PATIENTS: Infants born at < or =28 weeks and admitted in three hospital centres in Quebec, Canada (n=254). MAIN OUTCOME MEASURES: Neurodevelopmental outcomes and healthcare use from neonatal discharge to 18 months CA. RESULTS: Re-hospitalisation rates occurred in 57% of children born at 23-25 weeks and in 49% of those born at 26-28 weeks. In these two age groups, by 18 months, 61% vs 59% were followed in physical or occupational therapy, 29% vs 17% were enrolled in a long-term rehabilitation program, 38% vs 28% used prescribed medication, and 59% vs 33% required medical assistive devices, respectively. Risk of re-hospitalisation was related to bronchopulmonary dysplasia (BPD), severe brain injury, use of home oxygen or an apnoea monitor and older age at neonatal discharge. Multiple births, BPD, severe brain injury, older age at neonatal discharge and single parenthood were associated with risk of using out-patient health services above average (>2 services). CONCLUSION: Extremely preterm children are frequently re-hospitalised during infancy and use a substantial amount of healthcare resources. These results highlight the importance of resource allocation to preterm infants for medical and rehabilitation services after discharge from the neonatal intensive care unit.

Grafting Tomato with Interspecific Rootstock to Manage Diseases Caused by Sclerotium rolfsii and Southern Root-Knot Nematode.

Southern blight (Sclerotium rolfsii) and root-knot nematodes (Meloidogyne spp.) cause severe damage to fresh-market tomato (Solanum lycopersicum) throughout the southeastern United States. Grafting is an emerging technology in U.S. tomato production, and growers require information regarding the resistance characteristics conferred by rootstocks. In this study, southern blight (SB) and root-knot nematodes (RKN) were effectively managed using interspecific hybrid rootstocks. During 2007 and 2008, field trials were carried out at two locations that had soils naturally infested with S. rolfsii. At the end of the growing seasons, the mean SB incidence of nongrafted plants was 27 and 79% at the two sites. SB incidence among plants grafted onto rootstock cultivars Big Power (one location only), Beaufort, and Maxifort ranged from 0 to 5%, and area under the disease progress curve (AUDPC) values were lower than for nongrafted and self-grafted controls (P < 0.01). At one location, soils were naturally infested with RKN, and all three rootstocks reduced RKN AUDPC and RKN soil populations at first harvest (P < 0.01). Big Power was particularly effective at reducing RKN galling and RKN soil populations at final fruit harvest (P < 0.01). Fruit yield was higher when resistant rootstocks were utilized (P < 0.05), and in our study grafting was effective at maintaining crop productivity in soils infested with S. rolfsii and M. incognita.

[Molecular and genetic aspects of idiopathic scoliosis. Blood test for idiopathic scoliosis]. / Molekulare und genetische Aspekte der idiopathischen Skoliose. Bluttest bei idiopathischer Skoliose.

Spinal deformities, and particularly scoliosis, are the most frequent forms of orthopedic deformities in children and adolescents. About 1-6% of the population has scoliosis. This disorder leads to severe spinal deformities and predominantly affects adolescent girls.Although the multifactorial origin of adolescent idiopathic scoliosis (AIS) is broadly recognized, the genetic causes of AIS are still largely unknown. Our previous studies suggested a generalized dysfunction of melatonin transduction (the hormone that is primarily produced in the brain and epiphysis). In the meantime we have demonstrated that such a defect of signal transduction is caused by chemical alterations, which inactivate the function of the inhibitory G protein-coupled melatonin receptors. This discovery has led to the development of the first blood test to detect children without symptoms who are at risk of developing scoliosis. Since a single function (cellular reaction to melatonin) is determined, the unique advantage of this test is that it can be performed without knowledge of mutations in defective genes that could provoke the onset of AIS.

Reliability of a computer-aided color-coded video-based system for clinical assessment of the foot.

UNLABELLED: There is a need for a user-friendly system that can provide quick and reliable assessment of foot disorders. The study described in this report was undertaken to determine the inter-rater and intra-rater reliability of a computer-aided, color-coded, video-based system developed for the assessment of foot alignment in patients with and without pes cavus deformity. Initially, 15 pedal angles were repetitively measured 7 times on 6 color-coded images of both feet, in 20 healthy adults. From the 7 repetitive measurements, the intra-class correlation was calculated and analysis of variance was used to estimate the minimum number of trials that would be necessary to identify a statistically significant difference in the measurements. To determine intra-rater reliability, 5 examiners evaluated a single set of data taken from 10 subjects. Additionally, data were obtained for 20 subjects with pes cavus deformity. The average intra-class correlation coefficient (ICC) for the anglular measurements for 2 to 7 trials was 0.98 +/- 0.06, while the intra-rater reliability was 0.90 +/- 0.14. No statistically significant differences were observed between right and left foot angles in able-bodied subjects; whereas, in the pes cavus group, 8 different angular measurements were observed to be statistically significantly different. The results of this investigation indicate that a computer-aided, color-coded, video-based system can be used to make reliable measurements of postural alignment in patients with and without pes cavus. LEVEL OF CLINICAL EVIDENCE: 5.

Indoor ultrafine particles and childhood asthma: exploring a potential public health concern.

UNLABELLED: Exposure to airborne particulate matter has a negative effect on respiratory health in both children and adults. The ultrafine fraction of particulate air pollution is of particular interest because of its increased ability to cause oxidative stress and inflammation in the lungs. We reviewed the literature, and to date findings suggest that ultrafine particles (UFPs) may play an important role in triggering asthma symptoms. Furthermore, we believe that indoor UFP exposures may be particularly important because people spend the majority of their time indoors where sources of these contaminants are often present. While several epidemiological studies have examined the respiratory effects of ambient UFP exposures, the relationship between indoor UFP exposures and childhood asthma has yet to be examined in clinical or epidemiological studies. However, the portable instrumentation necessary to conduct such investigations is increasingly available, and we expect that this issue will be addressed in the near future. Therefore, the aim of this article is to provide a general review of UFP toxicity as related to childhood asthma in order to draw attention to a potentially important public health concern. PRACTICAL IMPLICATIONS: A number of indoor sources of ultrafine particles (UFPs) have been identified, but the health effects of indoor UFP exposures remain largely unexplored. The potential respiratory effects of such exposures seem most concerning because these particles are known to cause oxidative stress and inflammation in the lungs. Subsequently, indoor UFP exposures may contribute to the exacerbation of asthma symptoms in susceptible individuals. This paper provides a review of UFP toxicity as related to childhood asthma, and to date evidence suggests that further investigation into the respiratory effects of indoor UFP exposures is warranted.

Biomechanical modeling of anterior spine instrumentation in AIS.

This study is part of a larger project regarding the development of a Spine Surgery Simulator (S3), which has shown good results for posterior instrumentation surgeries. The aim was to develop a biomechanical model for the anterior instrumentation of the scoliotic spine. A biomechanical model using flexible mechanism was developed and surgical manoeuvres (instrumentation, rod installation and compression) were reproduced. Validation of the model was done by comparing the results for the instrumented part of the spine to the post-operative data (analytical Cobb angles in the frontal and sagittal planes, plane of maximum deformity, etc.). To date, surgeries of four patients operated by thoracotomy were reproduced. Preliminary results show that anterior instrumentation of the scoliotic spine can be adequately modelled using pre-operative geometric data and using mechanical properties from literature. Once validated with a larger sample of cases, the anterior instrumentation model could be implemented into S3 and used by orthopaedic surgeons to test various instrumentation strategies in virtual reality before performing the actual surgery.