Excited states in warm and hot dense matter.

Accurate modeling of warm and hot dense matter is challenging in part due to the multitude of excited states that must be considered. Here, we present a variational framework that models these excited states. In this framework an excited state is defined by a set of effective one-electron occupation factors, and the corresponding energy is defined by the effective one-body energy with an exchange and correlation term. The variational framework is applied to an atom-in-plasma model (a generalization of the so-called average atom model). Comparisons with a density functional theory based average atom model generally reveal good agreement in the calculated pressure, but our model also gives access to the excitation energies and charge state distributions.

Normative 3D acetabular orientation measurements by the low-dose EOS imaging system in 102 asymptomatic subjects in standing position: Analyses by side, gender, pelvic incidence and reproducibility.

BACKGROUND: Three-dimensional (3D) acetabular orientation is a fundamental topic in orthopedic surgery. Computed tomography (CT) allows 3D measurement of native acetabular orientation, but with a substantial radiation dose. The EOS imaging system was developed to perform this kind of evaluation, but has not been validated in this indication with specific attention to the acetabulum. We therefore performed a prospective study using EOS to assess: (1) the reproducibility of the 3D acetabulum orientation measures; (2) normative asymptomatic acetabular morphology in standing position, according to side and gender; and (3) the relationship between acetabular anteversion and pelvic incidence. HYPOTHESIS: The low-dose EOS imaging system is a reproducible method for measuring 3D acetabular orientation in standing position. PATIENTS AND METHODS: In a previous prospective study of spine sagittal balance, 165 asymptomatic volunteers were examined on whole-body EOS biplanar X-ray; 102 had appropriate images for pelvic and acetabular analysis, with an equal sex-ratio (53 female, 49 male). These EOS images were reviewed using sterEOS 3D software, allowing automatic measurement of acetabular parameters (anteversion and inclination) and pelvic parameters (pelvic incidence, pelvic tilt and sacral slope) in an anatomical (anterior pelvic plane: APP) and a functional reference plane (patient vertical plane: PVP). RESULTS: Both intra- and inter-observer analysis showed good agreement (ICC>0.90); Bland-Altman plot distributions were good. Acetabular anatomical anteversion and inclination relative to APP (AAAPP and AIAPP, respectively) were significantly greater in women than in men, with no effect of side (right AAA: women 21.3°±3.4° vs. men 16.1°±3.3° (P<0001); right AIAPP: women 55.3°±3.7° vs. men 52.5°±3.0° (P<0001); left AAAPP: women 20.9°±3.5° vs. men 15.6°±4.0° (P<0001); left AIAPP: women 54.6°±3.5° vs. men 52.7°±2.8° (P=0003)). The same differences between men and women were observed when measurements were related to PVP. Pelvic incidence subgroup (<44°; 44-62°; >62°) correlated significantly with functional acetabular orientation in standing position: PVP functional anteversion decreased by 5° relative to APP anteversion with incidence <44°, was equal to APP with incidence 44-62°, and or was greater by 4° relative to APP with incidence >62°. DISCUSSION: The use of a 3D sterEOS software prototype version for 3D reconstruction of the native acetabulum from standard EOS X-ray was shown to be a reliable and reproducible method. This innovative method enabled the reference values of 3D acetabular orientation in standing position to be measured for the first time. The results reinforced the concept of hip-spine relationships, and involved very low radiation dose. LEVEL OF EVIDENCE: IV prospective study without control group.

Reproducibility of low-dose stereography measurements of femoral torsion after IM nailing of femoral shaft fractures and in intact femurs.

INTRODUCTION: Rotational malunion is a complication of intramedullary (IM) nailing for femur fractures. Symptoms can appear with 15° or more of axial deformity. None of the currently available measurement methods have a satisfactory reliability/irradiation ratio. The purpose of this study was to study the reproducibility of measuring femoral torsion with an EOS(®) low-dose stereography (LDX) system. HYPOTHESIS: LDX is a reproducible method for measuring post-traumatic femoral torsion. MATERIAL AND METHODS: The intra- and inter-observer reproducibility was studied in 45 patients who had a femoral fracture treated by IM nailing. Both the injured and contralateral healthy femurs were modelled. Bland-Altman plots were used to analyze the measurements made by three different observers (two orthopedic surgeons and one radiologist). For a given comparison, the interval between the upper limit of agreement (ULA) and lower limit of agreement (LLA) had to be within [-5°; 5°] for the examination to qualify as reproducible. Measurements were made by three observers (A, B, C) on the injured and healthy femur. RESULTS: With the fractured femurs (n=39), the intra-observer [LLA; ULA] interval was [-16.295; 12.977]; it was [-18.475; 16.744] for the A-B pairing, [-13.316; 13.532] for the B-C pairing and [-17.839; 19.355] for the A-C pairing. With the healthy femurs (n=37), the intra-observer [LLA; ULA] interval was [-7.909; 7.88]; it was [-11.924; 11.639] for the A-B pairing, [-12.654; 11.93] for the B-C pairing and [-11; 12.009] for the A-C pairing. DISCUSSION: The [LLA; ULA] intervals were greater than the [-5; +5] interval in all cases. LDX reproducibility is not sufficient for measuring femoral torsion after fracture or in healthy femurs. Observer experience, cohort size and the perfectible image quality are likely sources of bias. Conversely, the use of Bland-Altman plots and the multidisciplinary training of observers are major strengths of this study. Reproducibility will likely improve as the software is developed further and the image acquisition improves.

A new procedure for fractures of the medial epicondyle in children: Mitek(®) bone suture anchor.

We present a new bone suture anchor technique for fractures of the medial epicondyle. The hypothesis was that the results would be similar to those with the divergent K-wire fixation. This retrospective study included 40 patients who presented with displaced fractures of the medial epicondyle: one group was treated with a Mitek(®) non-resorbable bone suture anchor (group A: n=21), the other by K-wire fixation (group B: n=19). A medial approach was taken with an anchor placed above the olecranon fossa. The epicondyle was then repositioned by bone suture. After a mean follow-up of 18.6 months, union was obtained in all epicondyles. There was no difference in flexion-extension of the elbow. The rate of hypertrophy of the medial epicondyle was similar in both groups (57%). The bone suture anchor of the medial epicondyle is an effective technique that does not require hardware removal and is an alternative treatment option to divergent K-wire fixation.

Intrauterine bacterial inoculation and level of dietary methionine alter amino acid metabolism in nulliparous yearling ewes.

Using an intrauterine bacterial inoculation method, our objective was to determine the effects of acute sepsis and level of dietary metabolizable Met (MM) on splanchnic metabolism of AA in ewes. Twenty-four nulliparous yearling Rambouillet-cross ewes (initial BW = 65.1 +/- 0.6 kg), surgically fitted with chronic-indwelling catheters in hepatic and portal veins, a mesenteric vein and artery, and the uterine lumen, were assigned to a 2 x 2 factorial arrangement of treatments. Factors were intrauterine bacterial inoculation (noninoculated vs. inoculated) and level of MM [low (2.28 g/d) vs. high (3.91 g/d)]. Beginning 12 h before sampling, inoculated and noninoculated ewes received 10-mL intrauterine infusions of Escherichia coli (9.69 x 10(11) cfu) + Arcanobacterium pyogenes (2.76 x 10(12) cfu) and of sterile saline, respectively. Uterine infection was induced in ewes that received intrauterine bacterial inoculations, but not in ewes infused with sterile saline. Bacterial inoculation resulted in increased hepatic release and plasma concentrations of aromatic AA used for acute-phase protein synthesis, increased hepatic removal and decreased plasma concentrations of AA used for glutathione synthesis, and decreased plasma concentrations of some gluconeogenic and acetogenic AA used for glucose recycling and anaerobic energy production, respectively (P < 0.05). In ewes fed high-MM diets, compared with low-MM diets, a consistent net hepatic uptake of Phe occurred throughout the sampling period, more Asp was released from the portal-drained viscera, and hepatic vein glucose concentrations were greater (P < 0.05). We conclude that Met seemed to be limiting in low-MM ewes, and as such, would continue to be limiting during sepsis. However, additional MM, in excess of the dietary requirement, would not necessarily result in a benefit to ewes experiencing acute sepsis.

Application of ultrasonic backscattering for level measurement and process monitoring of expanded-bed adsorption columns.

Expanded-bed adsorption is a newly commercialized technique for the purification of proteins from cellular debris in downstream processing. An expanded bed presents the possibility of protein recovery in a single step, eliminating the often costly clarification processing steps such as ultrafiltration, centrifugation, and precipitation. A major obstacle to the successful commercialization of this technology is the inability to accurately monitor and control the bed height in these systems. Fluctuations in the feedstock viscosity are common during normal operation and tend to make the operation and control of expanded beds for biological applications complex and difficult. We develop a level measurement technique based upon ultrasonics. It is shown that this technique has great promise for bed-height measurement in expanded-bed adsorption systems. Furthermore, the bed-height measurement can be used in feedback control strategies for bed-height regulation. The proposed ultrasonic sensor is also capable of monitoring for plugging and bubbling in the column.

Relative body weight as a factor in the decision to abort.

PIP: Abortion referral data of 692 pregnant women visiting a large urban planned parenthood clinic were analyzed to determine whether relative weight, as measured by an adiposity index, as well as other variables, were associated with a decision to terminate or not terminate a pregnancy. Relative weight, length of pregnancy, education, age, ethnicity, and marital status were found to be associated with the decision to abort. While most of these variables were previously shown to have been related to the decision to terminate or not terminate a pregnancy, a relationship between relative weight and abortion has not previously been reported. In the analyses of all the women in this study and of a subsample consisting only of those in the early stages of their pregnancies, increased relative weight was associated with a decrease in the likelihood of pregnancy termination. Possible reasons for this relationship and the evolutionary implications are discussed.^ieng